“Truth decay” increasingly has challenged our society. RAND researchers proposed this caustic word play to describe a dangerous trend impacting public confidence in all forms of scientific expertise.
The pandemic brought a shocking defiance of expertise. Political leaders rejected guidance on simple things like using face masks. Truth decay impacts science, healthcare and political discourse as it erodes our longstanding “trust in and reliance on facts, data and analysis.” Yet there is a context for this. Expertise is undermined by many forces, even those within science. Let us look inward at our own field.
The promotion of quasi-scientific views by behavioral healthcare experts has been common in popular media for decades. They pontificate to inspire and entertain. Some TED talks today are new and improved pop psychology. People from many backgrounds make a good living today from motivational speaking. Some with lofty behavioral health credentials embarrass us.
Scientific expertise often means promoting evidence produced by research. Yet there is a long history of doctors being hired to slant results and hype medications. This collusion between some doctors and drug companies led to reforms which have institutionalized a state of mistrust. Doctors must now attest to having no conflicts of interest in making scientific statements. It is an enduring mark of shame.
Recovery from addiction is possible for many based on the guidance of those with similar lived experience. This strength has become a weakness. Many treatment programs today reflect mainly how their founders got sober. Expertise is undermined when treatment programs are determined more by personal experience than research findings. Examples abound to support an erosion in expertise.
It is worrisome to see expertise knocked off its pedestal, but we should reject an overreaction. We do not need the inflexible, arrogant authority of old. Let us foster a new image of expertise, starting with a recognition that today’s knowledge is often altered by new data. Evidence is usually partial. We can firmly endorse the scientific method while supporting its results within limitations.
The professional side of our field parallels the scientific. We offer a variety of effective clinical solutions, and yet many people are helped only marginally. We have replicated the efficacy of psychotherapy many times over, but it is still a fragile conversation between two people. We will always need to rely on subjective judgment whatever the empirical data reveal.
We should not denigrate any source of knowledge, objective or subjective. At the same time, we should refrain from overestimating any single piece of evidence or clinical technique. Let us promote the facts we uncover through research and yet accept that opinion and theory will always be relevant. We can hold our scientific principles firmly while expecting our data and conclusions to evolve.
The foregoing attitudes are difficult to maintain. Those in the trenches of research or clinical work may occasionally stray since they need single-minded pursuit to excel at their work. The attitude described here is that of a leader, someone who must rise above the field, appreciating its strengths and weaknesses. Our top executives should be well-informed reporters on the complexity of healthcare.
Business leaders should be our frontline troops when politicians try to take scientific discussions in a political direction. They should stand as paragons of the scientifically educated person. Behavioral healthcare executives can also shield us from the damage done by unscrupulous profit-seekers who distort information to help sell inspirational books, new medications or unique services.
Executives can lead a restoration of expertise without being experts. Let us turn to leading scientists in times of crisis. However, healthcare executives should join that speakers panel. They have a unique perspective to counter those who undermine or defy expertise. They cannot be dismissed as detached scholars without knowledge of real-world pressures.
The best response to a willfully ignorant politician promoting destructive policies is an astute business leader speaking credibly about the science and economics of policy proposals. They have science officers and financial officers to support them as they argue for a balanced approach in a complex world. While every leader might not fit this ideal, many are equipped to meet these challenges.
The consequences of truth decay are dire in everything from government to science. Expertise is a valuable commodity to be preserved. The corrosiveness of truth decay warrants a multidimensional response. Why not recruit some smart executives for that team?
Ed Jones, PhD, is senior vice president for the Institute for Health and Productivity Management.