Skepticism seems to be one of those concepts that gets a bad rap not because the actual idea or thought process is a bad one, but due to the misunderstandings and misuse of the word by those claiming to be, and those critical of, skeptics. The concept of skepticism is necessary and important in physical therapy. But first, we have to make sure we understand what skepticism is and what it is not.
Often times, skepticism is mischaracterized as a position of negativity, closed mindedness and cynicism. This mistaken identity is understandable, given that those claiming to be skeptics on social media and elsewhere often default to a negative stance regarding a particular topic or claim. However, in taking a negative stance, one essentially abandons the concept of skepticism. Assuming a negative, or even cynical, stance is more characteristic of what Marcello Truzzi calls a pseudo-skeptical approach.
Actual skepticism is the use of science, logic and reason to test the validity of particular claims. The true skeptic, as defined by Truzzi, “takes an agnostic position, one that says the claim is not proved rather than disproved.” Only after facts are gathered and interpreted does the skeptic assume a particular position. The hallmark of a skeptical approach is that the beginning stance is an agnostic one and the end result is a provisional one. This means that as the evidence changes, so should one’s beliefs and understanding. As David Hume says, “A wise man proportions his belief to the evidence”
In a previous post on survivorship bias, I used the example of cabbage being an effective treatment for lateral elbow pain. A skeptical approach would be to seek proof of cabbage’s effectiveness through assessing available facts and evidence, while remaining neutral as to whether cabbage works or does not work. A pseudo-skeptical approach would be one of disbelief and doubt, a stance assumed prior to analyzing the validity of cabbage’s benefits.
At the moment, there does not seem to be any reasonable evidence to believe cabbage is an effective treatment for lateral elbow pain. Perhaps down the road this will change— new double blind cabbage controlled studies may crop up and demonstrate profound effects. The true skeptic’s position will then follow the evidence. This is one of the greatest values of skepticism and science — “it’s acceptable to change your mind in science if the evidence changes”. And, it is why we need skepticism in physical therapy.
Photo courtesy of flickr user Yi Chen