[perseuswiki]

on the other side:

thelancet: "Offline: What is medicine's 5 sigma?"

http://www.thelancet.com/journals/lancet/article/PIIS0140-67...

"The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness. As one participant put it, “poor methods get results”. The Academy of Medical Sciences, Medical Research Council, and Biotechnology and Biological Sciences Research Council have now put their reputational weight behind an investigation into these questionable research practices. The apparent endemicity of bad research behaviour is alarming. In their quest for telling a compelling story, scientists too often sculpt data to fit their preferred theory of the world. Or they retrofit hypotheses to fit their data. Journal editors deserve their fair share of criticism too. We aid and abet the worst behaviours. Our acquiescence to the impact factor fuels an unhealthy competition to win a place in a select few journals. Our love of “significance” pollutes the literature with many a statistical fairy-tale. We reject important confirmations. Journals are not the only miscreants. Universities are in a perpetual struggle for money and talent, endpoints that foster reductive metrics, such as high-impact publication. National assessment procedures, such as the Research Excellence Framework, incentivise bad practices. And individual scientists, including their most senior leaders, do little to alter a research culture that occasionally veers close to misconduct."

[api]

Also on the other side:

A family member of mine was in the hospital giving birth. She was having a rough time (it later turned out she needed a C-section), and was really in pain. The doctor looked at her, annoyed, and said "you're not very good at this are you?"

That's an extreme example, but it illustrates a major problem with scientific/Western/whatever you want to call it medicine: it considers aesthetics and emotions to be irrelevant frivolities. Visit the inside of a hospital. Most look not terribly unlike prisons. In fact, I've seen prisons that are aesthetically more pleasing.

To the extent that we have data on this -- and assuming it's not untrue -- the data shows that aesthetics and emotions do matter.

Alternative medicine in my experience gets this. The alt-med oriented offices I've seen are beautiful. People are treated like they are sentient beings, not slabs of meat.

[mentalhealth]

That is an extreme and unfortunate example (and there is an entire additional set of issues around bedside manner and how our current training and practice environments select against it). However, establishment medicine is, in general, getting much better at this -- see for example some of the suites in the new Benioff Children's Hospital in SF which have been extensively designed for patient comfort (although lacking in some other areas...).

Patient comfort can be a problem when it's prioritized over treatment, as is often the case in alternative medicine and increasingly so in patient comfort-centered establishment medicine. A good example of this can be found in hospital food -- some medical centers have discovered that patient satisfaction increases dramatically when they're given the food they want/request, even when this food is explicitly counter to nutritional recommendations for their health conditions.

A secondary interesting externality of the recent focus on patient satisfaction is the construction of parking near hospitals. Several studies over the last decade have identified ease of parking as a primary factor in increasing patient satisfaction, so many new facilities are prioritizing this, which only amplifies the already-negative effects healthcare facilities have on their surrounding neighborhoods.

Aesthetics and emotions do matter, and almost all doctors realize this. However, their incentives and the incentives of the facility administrators are rarely aligned towards prioritizing them, and when they are they're often at the expense of the care itself. Alternative medicine is no exception to this phenomenon.

[SilasX]

"Hey, how about we design this place for function, rather than form?"

'... Brilliant!'