"Placebo" memoir piece

From a memoir piece in Guernica written by a doctor who treats chronic pain. He uses the hardware/software analogy. Feels like what's missing here is a discussion about regression to the mean?

 

Which electrical therapy--I'd like the author to come out with it.

 

You can ask the author of this article on Twitter. This tweet goes back to 2019.
https://twitter.com/user/status/1130510888849555457

 

How the hell does a profession that's supposed to be based on science believes in this crap? When it's described honestly it's as delusional as the humors or any of the obsolete stuff ever was.

Turn the argument: "the patient heals anyway" and apply it to literally every pseudoscience out there and it works out the same. Works with healing crystals, astral projection and basically any nonsense one can think of because they are irrelevant factors.

I would actually argue that it isn't the patient who is tricked by the "placebo", rather it's the physician, who somehow trick themselves into believing that, despite doing nothing, they changed something. Whereas anyone with common sense understands that there are other factors involved and when you don't know whether something is causing an effect, one cannot claim any effect.

Honestly we kind of have the exact same in anything having to do with computers. Anyone with computer skills will often be asked by family to help troubleshoot something, who will show us the problem but instead works as intended. Did our presence magically heal the problem? Of course not, it was simply an independent factor that did not happen this time. We often joke about being glad to help but we certainly don't go around actually thinking it. A rigorous investigation would find the cause. There is always one.

The idea of "the body acting in expectation" is some professional grade horse manure. This is basically The Secret. It's actually hard to take people seriously about anything when they go on about this stuff. It reveals serious scientific illiteracy.

And that's the gist of it: obviously it hasn't actually "helped", because whenever this pseudoscience is deployed, the definition of "works" is basically turned into nothing. That's the obvious answer, bias and confounding factors showing the illusion of an effect, which tricks the physician more than the patient, not some magical woo woo. But instead it's turned into an elaborate myth, where there's a perfectly rational and common explanation that applies to everything: unless all factors are controlled for, attributing a cause to an effect is not scientifically valid.

This is really no different than experiment testing the harm of EM waves but they're never turned so the people attribute something independent to a preferred explanation. It's the exact same.

 

When he can show that a study, any study, shows an objective measure being affected & improved by placebo, then he can start talking about people 'getting better'. Placebo's make people think they feel better, they dont actually 'get' better. Like @rvallee says this is just 'the Secret' ie a load of twaddle.

I cite as my evidence fr this the Albuterol trial Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma | NEJM