How does our dependence on expertise and the use of certification to vet that expertise influence the emergence of new practices or the resurgence of more ancient ways of healing?
Estimated reading time: 4 minutes
Reiki, personal experience and professional doubts
As I lay on the massage table, my shoulder being expertly kneaded back into shape, I spoke to my physiotherapist about Reiki. She was reticent. Not because she doubted it could be beneficial, she didn’t, but because of all those who claimed to be experts on the basis of some scanty notions of Reiki. She feared that, bolstered by their conviction of being an expert, they could make all manner of mistakes, some of which might be damaging. I was reminded of my own experience with Reiki. Having taken part in a weekend initiation, I was put off by the unnecessary esoteric nature of the practice. My concern with the whole practice of the ‘laying on of hands’ was to avoid making mistakes out of ignorance. In that, I was disappointed.
Experts: revered or reviled?
Both my physio’s concerns about those who, according to her, unjustly claim expertise and my reticence about using my abilities or trusting my intuition raise wider questions about the impact of expertise and the guarantees in place to ensure its validity. In our society, the opinions of experts are highly valued because they are believed to be founded on trusted knowledge. As such, their conclusions are often used to shore up political and commercial decisions. At the same time, the soundness of their methods and the solidness of their conclusions are increasingly challenged. Those who seek to spread their own distorted version of reality go so far as to openly revile experts.
A narrowing of perspective
Requiring expertise to be certified aims at guaranteeing the reliability of the knowledge and the ability to work with it. It is reassuring to know that the doctor operating on your heart has the credentials and expertise to do so. However, there are a number of disadvantages to a system based on experts. The first is the necessary narrowing of perspective that such specialisation entails. Very often complex situations require a global perspective. An early report of the Club of Rome stressed the need for generalists or globalists in the growing complexity of the world. Nothing could be truer than in the field of healthcare where many interacting factors are at play.
Certification favours formal knowledge over informal experience
Obtaining certification requires a mastery of a pre-determined set of knowledge largely learnt from books and, when practice is involved, in strictly calibrated circumstances. It has very little to do with the rich, informal experience that underlies the practice of the best doctors. This dependence on a fixed body of knowledge reflects an academic bias in the approach to teaching and learning, even when the subject taught is practical and interactional, as in healthcare. It results in a rigidity and inertia in acceptable knowledge and practices against which the validity of expertise is assessed.
Defending the interests of experts
The specialisation that expertise implies naturally morphs into corporatism as experts move to protect the reputation and credibility of their profession and themselves. As a result, alternative perspectives and practices are considered a threat and are excluded or reviled. They do not conform to the body of knowledge and practices recognised by the medical profession. They are not certified and are portrayed as potentially dangerous. But are they a danger to the profession or to people’s health? Note that not all change is rejected. The medical profession is heavily influenced by technology and pharmaceuticals. Innovations in these areas, however dubious their use might be, are much more readily embraced than softer, less intrusive practices like the laying on of hands.
A story of corporate opposition to the innovations of the young
It is this refusal of established medical practitioners to even consider the radically different but successful logic and methods of a group of youngsters to health and healing that plays itself out in the Boy & Girl Saga. Not only does it reflect the scorn of adults in dismissing the discoveries of the young, but also the unnecessary pain and suffering caused by the adherence to a predetermined way of doing things and the failure to consider results and patient satisfaction in the blind defence of a ‘profession’. These adults forget that the medical profession only exists to favour good health.