Truth and plausibility - How should we e...

Welcome to another episode of The Words Matter Podcast.

So it’s been a pretty action packed few weeks on social media; for those of you that have not been following there was a storm in a pericardial tea cup - for my thoughts on the saga visit my Instagram bio where there's an Instagram live video.

It was a rather unique experience, so the researcher in me wants to describe the situation, understand the antecedent conditions and get some purchase on the underlying beliefs and intentions when colleagues make implausible and sometimes bizarre claims and also reflect on our reaction to them and perhaps how we can engineer a more productive response.

As such, I’m going to follow this trail and in addition to this episode there are episodes planned with Carlo Martini (see our previous episodes on expertise and trust here and here) examining the phenomenon of pseudoscience; and also more Outsider episodes where guests relay their own experiences and outcomes of engaging with colleagues who hold such implausible beliefs and make such poorly evidenced claims which can only seem to map to the most distorted view of a biological reality.

So I’m on a bit of a quest for the next few episodes at least to try understand how to approach (small t) truth claims which are used to describe what seems like an objective biological reality but come from seemingly completely different epistemologies and play by a different set of rules than that of biological reality.

How can we talk with colleagues that seem to hold significant differences in foundational aspects of healthcare and what it is to be a health professional such as the nature of evidence, logic, ethics and intellectually honest argumentation?

Just to declare and reflect on my own position; I am not a walking-talking positivist or strident empiricist; far from it - I most certainly do consider and embrace the plurality of truths which comes from the social construction of knowledge…as it relates to the social world; but for me I cannot see how a sense of relativism can extend to the natural world or the biology reality which brutally confronts us every second of our lives- whether we like it or not; literally with every breath we take and every time our left ventricle contracts.

I may be guilty here of epistemological blurring or straddling different paradigms - but clearly as with many of us, my position is evolving and it’s only through more critical self-reflection and more conversations that I might be able to iron out any wrinkles in my position or even change it completely.

So please subscribe to the podcast and consider supporting the show via Patreon; and as always a big thank you to those of you already doing one or both of those things.

So in this episode I’m speaking with Jack Chew and Prof. Dave Newell. Jack is an MSK Physio and broadcaster from the North of England and was the mind behind the phenomenal Physio Matters Podcast which was a huge inspiration for The Words Matter Podcast. He also leads the incredibly successful pan-professional MSK conference Therapy Live; as well as being  the director of MSK Reform. Jack keeps his hand in clinically at Chews Health HQ in South Manchester. And he’s recently been elected as a council member for the Chartered Society of Physiotherapy.

Dave holds positions of Professor of Integrated Musculoskeletal Healthcare and Director of Research at AECC University College also well Visiting Research Fellow at Faculty of Medicine, University of Southampton. He has spent the last 30 years teaching and generating research in chiropractic institutions internationally, holding the position of Research Director in two other chiropractic programs in the UK and Australia.

Dave has published extensively in areas relevant to musculoskeletal conditions in general and the chiropractic profession in particular. His contemporary areas of research interest lie in contextual factors in the therapeutic encounter, therapeutic alliance and the alignment of chiropractic profession with national health systems. Like Jack, Dave is a podcaster and is one of the hosts of icarechirocast, an international podcast discussion with leaders in the chiropractic profession. 

Dave and I spoke way back in August 2020 on episode 15 where we touched on the dogma and ideology which permeates through corners of our respective professions - so take a listen for further context around the topic. Another relevant episode is my recent talk with the philosophers of science Dr Elena Rocca and Dr Saúl Pérez-González about biological mechanisms and how we can judge the plausibility of such mechanistic claims - this was  episode 69 from March this year

So in this episode we speak about:

• The growing phenomenon of calling out the falsehoods make by professional colleagues on social media. We ask if this is effective and whether there's an obligation to do this and with whom does the obligation lie?
• We talk about what constitutes a nonsense claim and the gradations of bizarreness and implausibility.
• We ask what is the most productive way to respond to such seemingly ludicrous claims?
• We talk about to what extent can healthcare professionals hold and perpetuate such beliefs and the ethics and harms in holding or espousing such implausible beliefs.
• We discuss how some practitioners seem to embody and fall in love their such ideas; and the situation where some clinicians are unable or not prepared to separate their ideas from their professional selves and identity; making it almost impossible to 'play the ball and not the person'.

So this was such an enjoyable conversation; and only time will tell as to whether we achieved our mission of at least beginning to make sense of some of the truths and their plausibility in healthcare – I’m grateful to Jack and Dave for sharing their own valuable insights.

Find Jack @JackAChew and Dave @NewellDave on Twitter 

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