Is research all that it is cracked up to be?

For those of you in the UK, it is such a joy to have some summer sunshine!!

I have written some thoughts on my concerns over how research is currently being used. I hope it isn't too heavy! But, the limitations that medical research offers us is not often talked about or understood. I do not know about you, but I am tired of sensational headlines that often misquote research papers and pull a finding out of context. 

I am equally concerned with the current misuse of research in public settings, where 'research' silences the curious mind or is wielded to affirm a clinician's ideology or boost the drug industry profits. Personally, it feels like a bullying tactic, like heavyweight boxers throwing punches on a public stage. We seem to have lost sight of the sick and dying; it has become about ego and the promotion of ideologies or industries.

With this careless and often sensationalised use of research headlines, the public is at risk of becoming disengaged and suspicious of the beautiful world of science. It has already started, with people turning to Netflix documentaries to do their thinking and distrusting our institutions.

We need an honest conversation about the messy nature of research, challenging the idea that research is untouchable and 'king' when making clinical decisions. 

Let me try to explain the limitations of research when considering health.

The science is clear about one thing; the body is not the sum of disparate parts. Instead, we are an integrated system, a myriad of connections that work together for physical, emotional and spiritual health.

This integration is valid for our physical body; for example, your skin complaint could be a manifestation of a gut issue, but it applies to our mental, emotional and spiritual health too. Our physical ailments could result from unresolved emotional trauma, disconnection from life's purpose, social isolation or confusion about our identity.

Furthermore, our emotional problem may result from physical dysfunction such as a nutritional deficiency or gut dysbiosis. The science is stunning, awe-inspiring and compelling. Our body is for us, with an innate ability to heal, repair and prolong life. 

Herein lies the problem. Much of the medical research uses a linear and reductionist approach to health. For research to be valid, it needs to control all the variables and focus on one thing. This approach is excellent when testing a drug but falls far short when considering complex interventions such as nutrition, lifestyle and our connection to nature. Moreover, it cannot accommodate the complexity of our body-mind-spirit life. It does not mean it is not helpful or valid, but we need to interpret and use research while understanding its limitations. As researchers and clinicians, we need to embrace some humility, step back, and understand that we offer a part of the solution, not the solution in its entirety. If we were to offer our advice in such a manner, it might be received as more credible, accessible and acceptable. 

Research should serve us as clinicians in our pursuit of what is best for a patient. However, it is but one tool at hand. Equally, scientific plausibility, clinical acumen and intuition, embracing the healing of the arts, and a patient's beliefs and preferences are resources we should be drawing from as we seek to guide a patient back to health.

The clinician's role is as much an art as a science. This holistic approach is why medicine historically is seen as a vocation. It requires all of our attention.

I see a generation of doctors who know how to categorise disease and implement guidelines, something AI or Google does a lot better than us. Nevertheless, as we discredit or diminish these other essential tools to 'unscientific' or 'soft' skills at the expense of 'hard' science, we can never treat the whole person or be a whole doctor. 

Furthermore, even the hard 'science' part comes with its limitations, as famously said by the father of evidence-based medicine, David Sackett, 

'Half of what you'll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half–so the most important thing to learn is how to learn on your own.'

Let me end with a couple of other considerations:

I am equally disappointed when I hear colleagues use the absence of research as the absence of proof. 

It is a common occurrence to hear a patient say, 'My specialist says that it doesn't matter what I eat; there is no evidence that nutrition can help me.'

I find it mind-blowing that colleagues disregard the basic science of cellular biology, physiology and nutrition when considering supporting health and reversing disease. It is not rocket science; we do not need a study to tell us what we need for the body to function. Likewise, we do not have to wait for the research to advise our patients on the role of adequate vitamins, minerals, fats, proteins, phytonutrients for the cell to function.

I say all this, and we have not even begun to address how widely the interpretation and communication of the same research can vary between equally educated academics. 

So when we read, 'The research says...' we need to hold it lightly and see it as data and not a simple directive. 

And for my fellow clinicians, when we do handle research, we need to keep 'health' as our goal. I am becoming increasingly concerned that the label 'research' is brandished to validate our ideologies held as clinicians. 

I see this in the current vegan movement, for example. As clinicians, our commitment should be to our patient's health, not to prove our ideology. 

The moment we move from health being our end goal, our cognitive bias will taint the interpretation of all that we see, and our egos will want to prove themselves right. Furthermore, as clinicians, we commit to health over our ideology.

This article isnt written to nurture a distrust of research or bring confusion, it is an invitation into the complex nature of healing. 

All that said, lets keep it simple, we are all united on some basic principles that promote health:

Eat a whole food diet

Sleep 8 hours

Keep active

Aggressively eliminate hurry from your life

Furthermore, stay connected to loved ones and nature.