Trying to break out of the echo-chamber…

A brief exercise in navel-gazing regarding engagement and whatnot.


There is obviously a serious side to my protest/spoof application for the job of homeopath to NHS Tayside.

I did not expect the post to get the attention it has got, and I still do not expect it make the bigwigs at NHS Tayside to change their ways and drop the idea of hiring a homeopath at the same time as they sack 500 other employees. That being said, I think that my estimation of the chances of that happening has risen from 0.01% to maybe 0.1% over the last 72 hours.

There has been some criticism of showering the HR department at NHS Tayside with spoof applications, and I can sympathise with this. However, at the last count there have only been 11 (the full list of known participants is available here, at Zeno’s blog) and so whilst I do feel a pang of guilt towards whomever has to plough though them, it’s not as if they have hundreds of extra applications arriving.

In any case, if, by some miracle you are reading this blog, NHS Tayside HR-person, I apologise – although I do hope you had a giggle reading though them. Perhaps if you did, you’d be kind enough to add a comment letting us know?

Inversions.

There has been much introspection within the UK skeptical community recently, following Frank Swain’s talk at Westminster Skeptics. There are numerous blogs covering/discussing this, and Frank has listed them at the bottom of his blogpost. I’d like to touch on a few things mentioned in that talk in respect to the NHS tayside/spoof application situation.

Frank said (and I’m paraphrasing here) that one of the most powerful things that we can do is change someone’s mind, through the power of a rational, well constructed argument. Absolutely true and wonderfully put – but this isn’t what is intended here. I would argue that those who believe that homeopathy works are going to stick to their guns, and I very much doubt that a handful of spoof job applications are going to change that, especially when a well written and argued S&TC evidence check [PDF] failed to do so.

This was never intended to be an engagement exercise either – engagement requires two-way traffic – an exchange of views. I wholly expect that my job application will be very quickly binned when they read my supporting statement.

This was about informing. Spreading the word. Letting people know that, hey, this is going on, and I think it’s pretty shitty.

The use of weapons.

If we’ve learnt anything from Lolcatz and other internet memes, it is that nothing spreads around the internet faster than something that makes you laugh. Sure, small groups with similar interests will share pages that provoke discussion or make you think, but something that raises a smile will be seen by more people, and more quickly. Go and look at your facebook home page now (assuming you have one). If your friends are anything like mine, the majority of the shared links will be to things that are intended to make you laugh.

So, let’s take a quick look at the traffic a few cheap laughs have generated – as a rough guide for how many people we might have made aware of the NHS Tayside situation. David Colquhoun’s and Dean Burnett‘s applications were published on Sunday afternoon – my post at about 11pm the previous evening. I’m taking these three blogs as my yard sticks, and the authors have been kind enough to share their internet traffic figures with me. Apologies to authors who have joined the fray since then.

Since publishing the posts I’ve had roughly 4000 hits, DC has had about 5000, and Dean Burnett about 12000.

Even if we are pessimistic and we assume that everybody who has seen mine and DC’s blog has also seen Dean Burnett’s blog, that’s 12000 people. I have some data on how many people have come to my site via DC’s and Dean’s sites, and the figure is <20%, not 100%. But hey – let’s err on the side of caution and take 12000 as our baseline figure. I am going to guess that the majority of these 12000 people did not know about this story before hand. Even if it’s news to only 10% of them, 1200 more people are aware of the ridiculous situation at NHS Tayside.

As far as I am concerned, for 30 minutes of my time, that’ll do nicely.

I know from my own traffic data that I am getting lots of referrals from places that I don’t usually get referrals, B3ta.com, reddit, BMJblogs, as well as the more skeptically orientated websites like badscience forums and randi.org. One thing that Frank Swain touched on was the fact that skeptics and SiTP is in danger of becoming an echo-chamber – and I share his concerns about this. Referrals and pingbacks from websites not usually associated with skepticism is one measure of how we well we are doing at “breaking out of the echo chamber” – reaching people who we might not normally reach.

Only a well constructed argument is going to change someone’s mind. However, in cases such as this, when perhaps minds do not necessarily need changing, rather they only need pointing at a particular fact or piece of news, I would argue that a quick laugh or a wry smile with a tiny bit of message built in is going to be passed around the internet faster. Sometimes, all that is needed is to shine a light onto those who make questionable decisions, to allow everyone else to see for themselves what is going on, and make up their own minds as to whether it is wrong or right.

I shall finish with a vaguely relevant quote from Nobel Prize winner A.V.Hill that Dr Aust introduced me to:

“Laughter is the best detergent of nonsense”


PS – I realise that everything I have written is entirely internet based and I make no apology for that – the only way I can break out from that would be to get something published in the main stream media. In a case such as this is highly unlikely.

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25 Responses to Trying to break out of the echo-chamber…

  1. xtaldave says:

    Holy Carp! I have just seen through the related posts that NHS Tayside is in need of midwifes –

    http://marlynglenmsp.wordpress.com/2009/12/09/msp-urges-aid-for-nhs-tayside-to-employ-newly-qualified-midwives-2/

    – and yet they persist in employing a homeopath?

  2. David Colquhoun says:

    Not bad uh? I did feel a bit bad about making work with spoof applications, but I doubt they will spend much time on them. It would be a drop in the ocean compared with the money wasted on this absurd job.

    • Don’t be, my wife and I sent a time waster letter to Morrison’s over one pound toy boat we bought for our six month year old daughter. On its maiden voyage it sunk leaving its penguin-captain face-down in the water. An event we pointed out was of ‘Titanic proportions’. On receiving the letter they phoned us up wanting to send some vouchers as it made their day! (Apparently it is now known as the naval disaster in the office and is pinned up on the wall).
      Eleven amusing and well written letters will no-doubt break the tedium if they have a sense of humour.

      • Andy says:

        Today Morrision’s sent us back a tongue-in-check reply with £5 of vouchers for the £1.50 boat. Apparently they have a budget for humour too.

        We can only hope the NHS do too.

  3. […] viral”. Yes, lots of people who read them were already in the “skeptical choir”, but not all. The applicants blog statistics show referrals came from non-skeptical sources. Some people, who were not aware of the waste of NHS funds, will now be […]

  4. Excellent thoughtful post.

    I wish, however, to take issue with your (and Frank Swain’s) faith in the the power of rational, well constructed arguments to change people’s minds. I should argue that – in this kind of context – almost the opposite is true.

    In nutshell, people who believe in things for which there is no evidence or which are logically contradictory have thereby declared themselves to be immune to any well constructed arguments people like ourselves might wish to put to them.

    Rationalists like ourselves might, of course, be mistaken about something or other (we all are from time to time) and persuaded of the error of our ways through well constructed arguments, but beliefs about the world that are not founded on evidence and reason in the first place are not shaken when the absence of evidential and logical underpinnings is pointed out.

    The use a turn of phrase coined by Wittgenstein, we have parted company before we even begin to talk.

    So how do we change the minds of people whose ideas about the world are *incommensurable* with our own (as opposed to people whose ideas are simply different because they or we are mistaken about something)? One way (a favourite throughout history and, sadly, to this day) is to use violence. I tend to think we should try and avoid violence wherever possible.

    Fortunately there are other ways.

    Again using Wittgensteinian terminology, while there is nothing we can *say* to ir-rationalists, we can sometimes *show* them the error of their ways by setting good examples in what we do and, I should argue, by ridiculing what they do.

    I realize that all this sounds confrontational and arrogant, but I have become impatient in my old age with having to pussyfoot my way around the kind of arrant nonsense that is promoted under the ridiculous rubric “alternative medicine”.

    I think my argument supports your conclusion better than your own ;}

  5. Andrew says:

    I guess this might help dissuade the NHS from promoting nonsense — ideally the spoof applications could get passed around the office and raise awareness within the trust — but personally I did it because wasting the time of fools and criminals is fun and makes for good blogposts. I’m also tagging along a woman trying to sell me a magic healing device and a fake psychic. And I take the view that these people have it coming.

    I appreciate that the individual who gets these applications is not responsible for everything NHS Tayside does, but either he’s part of the problem — in which case sod him — or else he’s as exasperated as the rest of us about this nonsense. And if I was in his position, I’d welcome some light relief and moral support. And then I’d put forward only the skeptical applications for interview.

    • xtaldave says:

      Re: The individual that gets to deal with the applications – there is a third possibility – that he/she doesn’t know that this might be an issue. In which case, they might now be moved to do a bit of reading around the subject. They are also perhaps in a better position to change recruitment policy at NHS Tayside.

  6. @jaclong says:

    They also say “Laughter is the best form of medicine.”

    Well, sometimes you’d probably be best to opt for surgery but I can think of some treatments I’d wager it beats.
    Especially when it’s transfused around the internet with 12000 hits – that sounds like quite a high succussion factor, it must start to get pretty potent by then.

    Then this came up on google: http://bit.ly/Ka2a2 seems to be an actual academic study to look into the old wives’ tale.

  7. […] Read the rest of the post on the author's blog… Filed under: Homeopathy, SiTP Leave a comment Comments (0) Trackbacks (0) ( subscribe to comments on this post ) […]

  8. Nancy Malik says:

    Studies in support of Homeopathy published in reputed journals

    British Medical Journal
    http://www.bmj.com/cgi/content/short/302/6772/316 (1991) http://www.bmj.com/cgi/content/full/321/7259/471?view=long&pmid=10948025 (2000) //allergic rhinitis

    Chest http://chestjournal.chestpubs.org/content/127/3/936.full (2005)//COPD

    • xtaldave says:

      Two can play the copy-pasta game Nancy. I just wrote this on another blog you tagged.

      “It is spamming Nancy because you don’t understand the papers or scientific research in general. You cherry pick papers that you assume support your position, and you are seemingly incapable of critically reviewing a paper.

      You clearly don’t understand that papers are not individual, stand alone proofs, but small components of a much larger picture – and it is the picture as a whole we must look at in order to properly understand what is going on.

      Kleijnen et al is nearly 20 years out of date and has been superseded by papers like Shang et al 2005 in the Lancet and Ernsts 2010 Med J Aus paper.
      http://www.ncbi.nlm.nih.gov/pubmed/20402610

      Taylor et al is a has 51 patients split between verum and placebo, and Frass et al has 25 patients in each group – little more than pilot studies and certainly not proof positive that homeopathy has an effect.

      It’s also worth noting that in the Frass paper the two groups may not be entirely compatible.

      More info on Frass study here:
      http://scienceblogs.com/insolence/2007/07/homeopathy_in_thecringeicu_1.php

    • Rocko says:

      Nancy, you are profoundly intellectually dishonest. You copy and post the same few links everywhere a google alert tells you there’s an article on homeopathy. When, yet again, people take time to refute and rebut your claims, or try and engage you in any meaningful debate, you simply move on to other claims or disappear off to conduct another bullshit drive-by elsewhere.

      I assume you have nothing to back up your insistence that “it works!” other than this pitifully small & constantly dusted off arsenal of cherrypicked/outdated/mistated or simply pisspoor twaddle.

      How you haven’t realised that you have no argument by now is what I find interesting. Either you’re a black belt in self-delusion or you’re just a charlatan who actually doesn’t care. Which is it?

  9. […] Three days on, there are at least eleven applications, and the three earliest ones have been read something like 12.000 times. […]

  10. Anonymoosh says:

    +10 Internetz to you Sir, this is what’s known as doinitright.

    Oh and +5 more for attracting a Troll.
    Welcome to internet activism 😉

  11. Richard Dorkins says:

    Really enjoyed reading your post after a friend sent on to me. I thought you might be interested in a tip-off a friend once gave me about homeopathy on the NHS – a friend in the know, as the homeopathic department fell under his budget at the hospital. I have nothing to back this up beyond trusting this guy (and he is a very smart scientist with no faith in homeopathy), but even if he made it up, it stands as an interesting theory in its own right.

    He alleges that it’s commonly known within hospitals which have homeopathic departments that the whole thing is nothing more than snake oil… but then why would a load of smart doctors who have spent their adult lives following scientific theory permit something proven to be nothing more than plain water?

    Well, there is apparently a certain cohort of patients with symptoms that can be broadly explained as “whinging”. Most of these patients will not respond to being told to “sod off, there’s nothing wrong with you”, and worse will keep making their way back into the system one way or another. These “frequent fliers” disproportionately clog up the system and cost hospitals a fortune as they work round doctors and diagnostic departments desperately searching for the cure that all the others have somehow missed.

    However, someone smart figured out that a sizeable majority of these same frequent flyer patients would be completely taken in by a referral to a homeopathic doctor, who would blow smoke up their arse, tell them that all these other idiot doctors are ignoring the magical, mystical wonders of homeopathy and give them a (very cheap) vial of water to drink – complete with no harmful side effects. Bingo, they’re “cured” and stop costing the NHS money. You’ll see in this advertised job description that the audit and patient satisfaction results are superb, which kind of supports this theory.

    Yes, a state-sanctioned placebo / mental health programme, but I can see how it would save the NHS millions (and thus avoid these job cuts). For scientifically trained people (myself included) that is a very bitter (sugar-coated) pill to swallow, but it does reluctantly appeal to the pragmatist inside me. I also know there’s a risk here – they could be genuinely sick and just misdiagnosed as whinging, but suspect that’s unlikely by the time they’re sent for homeopathy and maybe better to at least have them taking placebos under a trained doctor than some back-street psychic.

    I’d love it if anyone had any other experience to backup or refute this anecdote – who knows, maybe even some actual, reliable data?

    P.S. Depending on how those clinical sessions are split between the doctor and the nurse, the salary would be about on par for any normal doctor on the NHS pay scales, they’re not paying more for the homeopathy element of it.

    • xtaldave says:

      Hi,

      What you describe is, IMHO, the only issue where aspects of homeopathy might conceivably have a leg to stand on — basically dispensing placebos to make hypochondriacs go away.

      However, I think Homeopathy is not the right vehicle for prescribing placebos, and I think that prescribing placebos is inherently risky.

      1) The ethical issue with prescribing placebo is that it requires the doctor to deceive the patient — to tell them that homeopathy/placebo works.

      2) I also think that using homeopathy as a vehicle for a state-sanctionned placebo is not a particularly good idea. Homeopathy and homeopaths can not be relied upon to not make grandiose claims, such as being able to cure cancer/AIDS/Malaria (there is no evidence to support any of these claims).

      3) A framework within the NHS for prescribing placebos might work to save the NHS money — but is it almost inevitable that eventually, someone with a genuine complaint will be fobbed off with placebo, and might die due to not receiving the correct treatment or diagnosis… doctors are, after all, only human.


      EDIT – So, No, I haven’t come across any evidence discussing the use of placebo to deal with “frequent fliers”

    • Anonymoosh says:

      If this is true, and I have no evidence it is, it is still dishonest, and no government agency should be seen as promoting something dishonest. The public should be able to trust the NHS.

      • draust says:

        The idea of some doctors using homeopathy as a hand-off for “frequent flyers” rang a bell with me. Years ago I asked one of my GP friends what they thought about homeopathy, which one of the doctors in my friend’s practise was keen on.

        The reply was:

        “Imaginary remedies seem to be quite good for patients with imaginary illnesses”

  12. Omri says:

    “There has been some criticism of showering the HR department at NHS Tayside with spoof applications, and I can sympathise with this. However, at the last count there have only been 11 (the full list of known participants is available here, at Zeno’s blog) and so whilst I do feel a pang of guilt towards whomever has to plough though them, it’s not as if they have hundreds of extra applications arriving.

    In any case, if, by some miracle you are reading this blog, NHS Tayside HR-person, I apologise – although I do hope you had a giggle reading though them. Perhaps if you did, you’d be kind enough to add a comment letting us know?”

    Why apologize? The British civil services are notoriously unresponsive to concerns from the public and expressly punitive towards those who bring up concerns from within the ranks, especially when said concerns come in through the proper channels. Causing trouble is what gets things done.

  13. Nancy Malik says:

    Scientific studies in homeopathy

    European Journal of Paedretics (SpringerLink) http://www.springerlink.com/content/t512515754w83686/fulltext.html (2005) FULL TEXT //ADHD Interdisciplinary Sciences: Life Sciences (SpringerLink)
    http://www.springerlink.com/content/0557v31188m3766x/fulltext.pdf (2009) FULL TEXT // electromagnetic properties of highly-diluted biological samples

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