Quacks Like a Duck
Almost everything about Complementary and Alternative Medicine (CAM) is bunk and its purveyors are at best deluded and at worst quacks and charlatans who would make the snake oil salesmen of olden days blush from shame. Maybe a hundred years ago you could make a case for magic potions and mysterious cures from the East but today we should know better and only don’t because of a combination of scientific illiteracy and an ingrained bias against rational Western thought. What little benefit patients can derive from most of the quackery being sold to them is not worth a fraction of the money spent and the same effects could be achieved without the smoke and mirrors if people paid as much attention to diet, exercise, and all around clean living as they do to looking for an easy fix. Additionally, while I am a firm believer in the principle of caveat emptor (let the buyer beware), CAM verges on criminality when it fleeces the desperate and the hopeless with promises of cures for terminal diseases. Many spend their life’s savings, money that should have gone to the support of the spouse or the family, on worthless therapies.
CAM exists in an alternate universe from real medicine. It wants to be legitimate but manages to avoid the responsibilities and liability of real medical practice. As most CAM treats nebulous symptoms with equally nebulous modalities, there is no measurable standard for efficacy of any of the treatments. Acupuncturists, for example, diagnose perturbations of “qi,” a mystical life force which apart from serving as the basis for Star Wars has no physiological equivalent and cannot be measured in any way except through the magical powers of its purveyors and the faith of its believers. I imagine it would be impossible to sue your acupuncturist for a bad outcome. There are no bad outcomes just as there are no good outcomes. It’s all highly subjective. If you’re not really treating a disease, you can get away with this and probably why EMTALA does not apply to CAM.
What sets complementaty and alternative medicine apart from faith healing and snake handling are the credentials of its believers. Those who speak in toungues and exorcise demons are simple uneducated people who lead intellectually isolated lives. They believe and need no proof other than faith. The adherents of CAM are educated enough to realize that their beliefs are ridiculous and try to give them the imprimateur of scientific legitimacy, often with shoddily constructed studies. Every major legitimate study on CAM, however, has found very little to substantiate it even though the researching institutions bend over backwards and contort their data to make the best possible case for it. CAM is currently the darling of the medical elites and to say, with confidence, that it’s bunk would be to lose your politically correct credentials.
The real medical profession while imperfect like all human endeavors is not so conservative that ineffective or ridiculous therapies are not discarded. This is the whole basis of evidence based medicine. There is no evidence based Complementary and Alternative Medicine. It exists in the absence of and often despite the evidence. When challenged, its practioners will retreat like the sweaty televangelists to anecdotes and testimonials. Either that or they will cite the placebo effect, that last hope and refuge of medical scoundrels and upon which rock they will cling as their last handhold in the rational world.
The placebo effect is vastly over-rated. Imagine the typical double-blinded placebo controlled study. If the patients in the placebo arm have a benefit it is tempting to interpret the results as proof that the mind has strange powers to heal. All it really means, however, is that some patients would have had an outcome with no treatment whatsoever. What placebo control studies really need is a third arm for patients who don’t know they’re being studied and are not given any intervention. Real or not, the even the most ferverent believers of the placebo effect concede that it has a very small role to play in the management of even subjective diseases. It’s a mighty shakey foundation on which to build a medical career.
Homeopathy: Water Has Memory?
According to homeopaths, to cure a desease one has only to isolate the offending agent, say a toxin or a chemical compound, dilute it with enough water so as to have none of the original compound left, and then rely on the retained memory of the compound in the water to have the desired effect. There are some variations but that’s basically it. When pressed, it’s proponents will mumble something incoherent about immunology and suggest that their cures work in a similar manner to vaccines, showing clearly that a little knowledge is a dangerous thing. Vaccines are nothing like exposing yourself to a random molecule of something unwholesome diluted in a bottle. No one who thinks they are should be allowed to graduate medical school and yet you still see the odd Homeopathic Medicine interest group at even academic medical powerhouses.
If you add the usual holistic mumbo-jumbo and exhortations to well-being and spiritual balance to a bottle or two of over-priced tinctures, that’s homepathic medicine and the fact that people can make a living at it makes me weep for the shoddy condition of the public schools.
Advantages: Easy money. No liability. Good street cred with your crunchy friends.
Disadvantages: Somewhat of a niche market and few Homeopathic practitioners can make a living just from homeopathy. Most people with money enough to burn are not that stupid anyways so you’re fighting for a small patient base. The money is in combining homeopathy with other quackery.
Naturopathy
There are two kinds of Naturopaths, the highly educated kind with a quasi-legitimate degree granted by one of a handful of Schools of Naturopathy and the free-lancer with no formal training except perhaps an easy to obtain mail-order degree. There’s not really a dime’s worth of difference between the the two and discerning it is a little like trying to differentiate a pickpocket and a burglar. Both are thieves, you understand, but one works harder at it.
At the heart of Naturopthy is a flawed belief in the healing power of nature. That nature, red in tooth and claw, also includes deadly natural pathogens, horrific genetic mutations, and single-minded predators (both human and otherwise) seems to have escaped consideration. It’s a Bambi-centric weltanschung to say the least and chief among it’s tenets is a reliance on medicinal botanicals which, as they are untainted by the rapacious talons of the Devil (man) are thought to be more effective in restoring some kind of natural order to the body.
Because they’re natural, you see. Nature good. Man bad.
While there is no dobt that many plants have medicinal properties, this doesn’t mean that plants make good medicines. This should be obvious to anybody who has studied even a little pharmacology. You can take some random preparation of weeds for a condition but why not take a cheaper preparation of a chemical compound with better effects and get the benefit of quality control? The next obvious question is why otherwise cynical people who discount many of the claims of the pharmaceutical industry (and I’m one of those cynics, by the way) and view Medical Doctors with dark suspicion are totally credulous when it comes to advice from someone who prescribes them misletoe for their hypertension and are completely trusting of Steve, the nice Sociology major working at the local holistic food store, when he gives medicinal advice about organic dietary supplements.
It is also true that the body has “healing powers.” Of course it does. But again, Naturopathic healing operates on the fringes, just staying on the safe side of subjective complaints and never bringing it’s natural goodness to bear on objectively bad diseases which would require some sort of unequivocal treatment.
Advantages: Easy money for a minimal investment of time. Good hippy street cred. Your marketing has been done for you as most people instinctively think that “natural is better.” Some states view Naturopaths as primary care providers which if you are in primary care should be gravely insulting.
Disadvantages: You probably have to combine your quackery to make a dishonest living. Maybe work as a chiropractor and do a little naturopathy as a side line. Having to compete with those mail-order wankers.
Acupuncture
Traditional Chinese Medicine (of which acupuncture is a prominent part) is so good that everybody lived long, healthy lives in ancient China before they had access to Western medicine.
Ha ha. No, not really. The chinese, like their European couterparts, until very recently had lifespans a fraction of what they are today and were cut down routinely by things that it took Western medicine to finally defeat. So that’s the rub. Acupuncture, as it predates the scientific method, is based on a metaphor of the body and health that has no association with reality. As soon as those wiley Chinese started using antibiotics…bam…diseases started being cured.
The organizing principle of acupuncture is “qi” or a life force which flow in the body through pathways called meridians. As these meridians predate a knowledge of anatomy and physiology, they do not correspond with nerves, blood vessels, or any known physiological process. The existence of qi can’t be proven and some have likened it to the soul, another metaphysical construct that defies objective proof. Fair enough, and as a good son of the Orthodox Church I believe in the soul. I’m just not trying to stick needles into it.
Think of it as Feng Shui (geomancy, another ridiculous asian import) for the body. Some acupuncturists attach bundles of burning herbs to the needles (moxibustion). Others use electrical currents or vibration. Still others don’t use needles at all but pressure points. There are also different schools of acupuncture each with a different map of the body’s meridians. You might go to five different acupuncturists and get five different nebulous diagnosis and five different treatments for the same complaint. It doesn’t matter because you’re not being treated for anything that requires a discrete diagnosis and if you feel subjectively better for a nebulous complaint I guess we can put that in the win column.
On the other hand it’s part and parcel with the medicalization of life so forgive me if I don’t clap my hands and squeal for joy when the intelligentsia gain relief from their imaginary complaints. It’s nice, it’s fun, but it’s not medicine.
Advantages: Money, of course. In the right market you can do well. It also has the air of legitmacy as many major academic institutions, despite underwhelming evidence, walk on eggshells when they should be merrily kicking the ass of acupuncture (and all CAM for that matter).
Disadvantages: Sticking needles into people is more dangerous than other quackery so the needle-trade is a little more regulated than most CAM. There are a bewildering array of licensing and ceritfication options with a confusing mish-mash of abbreviations and credentials.
I was teaching shiatsu in an acupuncture school once so was always getting “recruited” by students who had a clinic opening. Acupuncture never did much, however, maybe it was lack of experience. I went in once for a terrible case of bilateral tennis and golfer’s elbow that had been bothering me for a year. My ortho doc said she was about ready to go in and start scraping around. Next time I went in for needling the pain in my left arm disappeared. The second treatment took care of my left arm and the pain has not returned in over 8 years. Turns out that the “student” was already an accomplished familt trained acupuncturist in Korea and was a student in the USA in order to pass the exams. We can argue that this was placebo but I don’t really care. I have no scars from any surgery to take care of the problem.
And most of us know double-blind studies aren’t worth the journal they are written in.
“And most of us know double-blind studies aren’t worth the journal they are written in.”
Seriously? Yes, I agree, lets just give random chemical compounds to people without testing them.
And what about your right arm, Randall? You said you had bilateral pain, but no mention of it getting better…
“Seriously? Yes, I agree, lets just give random chemical compounds to people without testing them.”
You can do double-blind studies in humans all you want…just be aware of the limitations.
“And what about your right arm, Randall? You said you had bilateral pain, but no mention of it getting better… ”
At the second visit the pain in the right arm was gone.
Sorry, I meant “right arm.” in this statement: “The second treatment took care of my left arm and the pain has not returned in over 8 years.”
Two thoughts.
Some NDs (Naturopathic Doctors) actually order lab workups and such. There’s an ND (who my mom insists on referring to as “Doctor”) downstairs from her business, and she’s got Quest Diagnostics boxes by her office. No idea what she’s testing down there, or the treatments she prescribes, though I am morbidly curious.
She also doesn’t shave her armpits.
Second, many HMOs pay for acupuncture. (Not kidding.) So in that respect, I guess it has a degree of legitimacy. I don’t know jack about it, though. I always did think it strange that one would want to stick needles in oneself.
Well, this was way more controversial than Part I. Here’s hoping for a flood.
Why is it controversial? Quackery is quackery. Randall Sexton, for example, also believes in Shamanism as a legitimate medical therapy which, as much as I like the guy, is totally ridiculous.
“Second, many HMOs pay for acupuncture. (Not kidding.) So in that respect, I guess it has a degree of legitimacy.”
What’s the percentage of ER visits that aren’t really ER worthy? 80%? If an HMO can offer patients a cheaper “primary care” alternative to keep them from going to the ER for a sore elbow, they are saving a ton of money.
You so do not understand the demographic group that use acupuncture. Let’s just say that these are not the kind of people who are clogging the ED.
And, as acupuncture is bunk, it’s academic anyways.
Acupuncture helped my anxiety, actually. Better than getting addicted to a benzo, but not something I’d recommend for a valid medical complaint.
And I totally recommend going to a masseuse for chronic tension headaches. Mmmm….
We were actually forced to sit through a class on CAM as first year med students…and then they had the gall to test us on it. They were trying to sell us especially on accupuncture and its validity by throwing stats at us. They said that 80% of people who undergo accupuncture had a positive outcome versus the relatively constant 30% that respond to placebo treatment.
But then again, for 100% of children who believe in Santa Claus, the Easter Bunny and the Tooth Fairy, they really do exist. Too bad I stopped believing in them a while ago.
“Randall Sexton, for example, also believes in Shamanism as a legitimate medical therapy which, as much as I like the guy, is totally ridiculous.”
But…if you had studied any psychology or medical anthropology you would be unable to make this statement with a straight face.
“Shamanic experiences are quite natural, only our culture has become so removed from them that even our scientific observers do not possess the appropriate concepts or experience to understand them.” – Ian Prattis
“Scientific observers”…well, except for the physicians and scientists I meet in my shaman training.
Randall,
Anything can be natural if there’s nothing there. Don’t give me some nonsense that I’ve closed my mind to shaminism and therefore it won’t work for me. If that mythology held any creditable basis for its claims, my beliefs would be meaningless as the procedures would work regardless of my faith.
By the way, I’ve studied some psychology and I can maintain a straight face while saying that CAM is quackery.
Randall – While I majored in biochemistry and molecular biology in undergrad, I also minored in anthropology with only a few classes and a thesis shy of a second major. Havin studied both psychology and medical anthropology, I’m willing to say, with a straight face, “Shamanism as a legitimate medical therapy… is totally ridiculous.”
Some good stuff here by Half MD: “Don’t give me some nonsense that I’ve closed my mind to shaminism and therefore it won’t work for me. If that mythology held any creditable basis for its claims, my beliefs would be meaningless as the procedures would work regardless of my faith.”
Shamans work in the realm of the imagination where they are masters. Now, you’re probably well versed in the use of imagery in sports performance. Heck, even Panda Bear learned imagery when he was shapeshifting into a Marine. I’ll bet even his physiology changed when his DIs were molding him into a beach storming killing machine. I bet it changed again when he was on board ship dancing with his Navy buddies. Using nothing but your imagination I can make you do things with your own body that you didn’t think possible a few minutes ago.
You don’t have to believe that what I do will work. However, I’ll be in Utah, Texas, Louisiana and Tennessee this summer. If you’re anywhere close, let’s have some fun! The guy teaching me also used to be a “pure-blood” scientist till his world was rocked.
The difference between me and some of you guys is that I’m willing to see if there is something else out there…to “experience”… rather than waiting on a double-blind study published in a peer-reviewed journal.
So how are you with working on a mythic level?
“Shapeshifting?”
Good Lord, Randall, I was a Marine not part of the X-men.
CAM treats the mind, not the body. Having a calm, confident person poke and prod your body and say reassuringly incomprehensible things is inherently comforting. Quackery too serves it’s purpose, and that purpose would be undermined by, ahem, improving the intelligence of the vict… err subjects of that quackery. Think of fortune tellers and tea leaf readers, they’re just scam artists claiming to pass on advice from a higher power, but as long as the subject believes and the purveyors says something positive, that subject is reassured and leaves in a better mental state.
This comes back to my personal view of religion; religion has done a lot of harm in the world but if on no other basis than mass peer pressure it has done far more good. I actually prefer to live in a world where most people are religious because, IMHO, religion controls people who are otherwise incapable of controlling themselves. (Now that was condescending PB, considering I exclude myself from the class, but I don’t aim it at all religious people, only the ‘poor impulse control’ crowd that nonetheless responds to peer pressure)
I think classic quackery is in the same arena. It provide people with a reassuring illusion of control over a process which cannot be controlled. It is in no way a replacement for modern meds or the scientific method, those are the means by which we genuinely extend human lives and our knowledge of the universe. Often, though, either through incomprehension (Ala evolution) or through simple ignorance (Pharmacology and physics) the workings of the modern world, while curing the body as far as possible, do little to treat the mind. This is where CAM steps in.
The comparison I find closest, while unflattering, is to a child. A young child understands little about the world and in the absence of reassurance could rapidly become unstable, or at least mentally unorganized. In the presence of a parent, however (even a parent who is foolish and wrong) that child has the chance to develop and build their own stability, giving them a chance to discover the truth and discard the foolishness that organized their youth.
Yes CAM is a lie. For some of us religion too looks like a lie. That doesn’t mean the lie is more harmful than good, or that it’s without purpose. If you’re defrauding a terminal patient that’s a pretty evil act, but looking at the numbers I’d say it’s a pretty rare act too. Most CAM practitioners are harmless grifters, like carnival barkers, fleecing you of just enough cash to keep them afloat without grinding you so far down they can’t fleece you again next year. As long as they sell you some of their belief and their confidence, that’s enough product to make the transaction look reasonably fair in my book.
I’m hoping the next post is on Chiropractic?
I come the Northwest, where we have quite a few NDs in practice, probably due to a combination of the presence of the country’s biggest naturopathic medical school and the pervasive organic-yoga-sandle-and-incense hippy culture. For the most part, these doctors advertise themselves as “preventative primary care” specialists.
Its my understanding that they serve a generally healthy patient population who, for whatever reason, are gung-ho about optimizing their health through diet, yoga, vitamins, herbs, etc. I think of them more as health counselors.
As long as they are not trying to treat cancer with bat guano and dandelion leaves, I say “no harm-no foul.” If people want to spend their money on this kind of thing, and its generally not hurting them, then why should I care about it?
(PS: I don’t know about other states, but in my state there are pretty strict requirements for getting a license to practice as a naturopath, including 4 years of naturopathic medical school. They are trained to evaluate patients using all the same diagnostic modalities that an MD/DO family physician might use but are expected to refer out when a case requires knowledge or skills beyond their scope of practice.)
I put a chest tube in a dude the other day who had acupuncture done a little too low in his neck and dropped his lung. I guess it took his mind off of his neck pain though.
Chest-u-puncture. I think there’s a meridian in the mid-axillary line at the sixth intercostal space.
(Jerry – awesome story.)
I loved it when one of my patients came in for ‘mineral imbalance’ because the natural chemical reading she had told her that her tin and boron in her blood level was too low. She was also paying alot of money for here personalized mineral replacement therapy.
I had the distinct pleasure of posing a question to a Homeopath who was brought in to lecture a room of residents.
Dr. X: “I will now take any questions you might have.”
Me: “Dr. X, you mentioned that sucessive dilutions of a homeopathic remedy make it stronger and stronger.”
Dr. X: “Yes, that’s right.”
Me: “So presumably you could make an essentially infinitely powerful poison just by diluting certain substances over and over an over. I see potential for real danger, perhaps even weapons of mass destruction here if this knowledge fell into the wrong hands.”
Dr. X: “Well you have to understand that the balance is delicate blah blah blah blah blah.”
What a bunch of horseshit.
My patients often tell me that they would prefer a natural remedy to their illness. No problem, I tell them. The answer is to change your life. Stop working so much, trash your TV, take up exercise, and start eating a healthy diet. Wait Doc, they say, that sounds tough…I’ll take the pill.
While patients may state that they wish natural solutions, above all else their cures must be FAST, EASY, and CHEAP. No fuss, no muss, and NO EFFORT. ‘I know I got myself into this mess doc, but it’s up to you to get me out.’
Many of the quackier fields within CAM combine FEC (fast, easy, cheap) with NATURAL. No wonder patients go for it, it’s the cure that’s got it all.
In my opinion one of the most important questions in modern medicine is ‘Why do patients so often believe their CAM providers over their medical providers?”. It’s a complex question with a number of answers, but I think the most important is that Western society is largely populated by unhappy people who experience their unhappiness as unwellness. As doctors we’ve taken on this (societal) problem (in honesty, probably initially for our own financial gain), but have no good treatment for it. In our unhappy and disconected world of fast cars and big TV’s a sympathetic ear is hard to find, and that is why people like their CAM providers.
A thoughtful and provocative post Panda.
Ramses II wrote: “CAM treats the mind, not the body.” Good God, man…didn’t anyone tell you the mind and body are connected??? Your body is your subconscious mind.
Jerry…”I put a chest tube in a dude the other day who had acupuncture done a little too low in his neck and dropped his lung. I guess it took his mind off of his neck pain though.”
That happens sometimes, but then again how many nicked bowels and arteries do you think I’m aware of from surgeons? So what’s your point (no pun intended)?
And I like this one: “CAM exists in an alternate universe from real medicine.” Speaking for my practice, that is true. Although an ancient practice, it follows the beliefs of modern physics. There was even a physics professor in my last class
For all of the anxious somatoformers who clog up the ER, I am their shaman. The one who knows (that they are FOS). OFten, if I have the time, I use my supernatural psychic healing powers to determine what it is that they are lacking in their lives, and I happily give them some.
Other times, if I am particularly busy with actually sick patients or if they disrespect my awesome powers, I just write them some Motrin and give them the boot.
“…I just write them some Motrin and give them the boot.”
Scapel, be careful with that Motrin. I found myself bleeding out and local paramedic and ER staff trying to get my BP above 70.
For your shamanic reading pleasure:
http://www.emory.edu/EMORY_MAGAZINE/spring2000/shaman.html
Careful with that Motrin, Scapel. Paramedics transported me to a local ER once where a bunch of people were trying to get my BP over 70 after using that stuff.
And for your reading pleasure:http://www.emory.edu/EMORY_MAGAZINE/spring2000/shaman.html
Meaning more inflammatory. I thought there’d be some practicing CAMers who’d get wind of this and fire off angry responses but unfortunately it hasn’t happened.
You know, PB, normally, I agree wholeheartedly with you, but about halfway through the post my eyes gave out, and I passed out. When I awoke, I remembered something about honey’s magical healing properties. Now I know what you were thinking when you wrote this post, but consider this:
http://www.sciencedaily.com/releases/2007/05/070503165159.htm
I am mostly on your side PB, but quackery and pseudomedicine aside, you’d have to be a fool to believe that if it doesn’t come out of a medicine bottle, it can’t do any good. All I’m saying is, the medicine is out there, and we study it, isolate it, formulate it, and put it in cute little bottles for consumption. Willow gave us aspirin, and I’m sure more are out there. Let’s just say that we’ll look once, and then move on to real medicine. Hell, if you have a terminal prognosis, I’m sure you’d be doing a lot of looking too… These are probably the same people that never signed a DNR order because they want to live forever lol…
I’m inclined to agree with Pancho Villa. Out of madness can come some meaning. Our allopathic sect of medicine rejected the Germ Theory for disease for about 20-25 years before it finally realized “Crap, these scientists were right” and “Holy crap, we can beat out the homeopaths if we pull out this Germ Theory card now.” Less than two centuries ago, allopathic doctors were bleeding patients (in a very non-evidenced-based way), sometimes to death. Our history isn’t exactly perfect either.
But, where allopathic medicine shines is through the (unfortunately slow) adoption of evidence-based practices. I personally think it’s pretty useless to talk trash about CAM practices to our patients or to each other; instead, let the evidence speak for itself. If proponents of a particular CAM treatment are unwilling to put their treatments to the test (in a meaningful, well-designed study), then you can tell that they are aware of the inadequacy of their practice. Perhaps I’m overoptimistic from my subjective experiences: the one alternative medicine practitioner (a qi gong practitioner) I’ve known so far was a trained scientist (albeit a physicist) and very active in seeking to have his treatments studied in RCTs, and to determine what proportion of the benefits of his treatments were placebo effects. I personally was and still am skeptical, despite also being a martial artist that practices qi gong for athletic reasons. Nonetheless, he also was the only person who could fix my RSI problems in my wrists, since my doctors at the time had nothing to offer besides pamphlets on how to prevent RSI and were altogether useless. A friend of mine who had the same problem was sketched out by the idea of having some random dude fix his wrists, and he ended up having to skip a year of college and had to have surgery on both of his wrists. I’m no standard bearer for CAM, but I do think that the best way to sort out what is meaningless and what is useful is through proper scientific inquiry.
I’m glad you carry the evidence-based medicine banner. One bothers me most was when a few private practice physicians I’ve met claimed that “evidence-based medicine is just a way for academics to exert control over us (private practice doctors).”
i didn’t read the comments but i can guess you got some angry ones. thanks for having the cojones to write this. i have a friend from med school who is now in ‘alternative medicine’ and he was my physician for about three weeks. he had me on fish oil, 5ht precursors and a variety of other shit. he showed me that old biochemical pathway chart and showed me where all this stuff supposedly worked by le chatlier’s principle. no result. then i found out from a friend who has AODM that he had her on some natural shit and her sugars where never controlled. she is a nurse. when she pointed out that her sugars were remaining high he had asked her to write a paper on how she could improve her attitude towards treatment. needless to say, he is no longer her doctor. he has bought the whole thing and has that MD behind him to impress the easily impressed. keep it up my friend, i love your blog.
I’m an MD. I studied acupuncture in China. I hardly consider what I’m doing as NOT treating disease. I’ve successfully treated facial tics, migraines, low back and leg pain, elbow pain, asthma and a whole lot more “nebulous” entities that western medicine couldn’t even begin to touch. The beauty of my profession is that I know WHEN to turn to western medicine, such as when I had a patient with what I diagnosed to be a torn ligament or another with pneumonia.
I’m not blind to the benefits and limitations of other medical traditions. That’s why I call myself the Eclectic Doctor.
I agree with the Eclectic Doctor. Those of us who have studied more than one system have more than one way of looking at a patient’s problems and can have a greater chance of helping. You do have to realize that each has its strengths and weaknesses, however.
I do think there will be problems at designing studies since we still have problems with “consciousness.”
Absolute, 100-percent, pure-D, grade-A bullshit and tyical of the irrational thinking that provides such a fertile ground for CAM.
“Problems with consciouness” indeed.
And Asthma is a nebulous entity that Western Medicine couldn’t begin to touch? Tell you what, when your kid comes has status asthmaticus let’s just stick a couple of needles in and forget about albuterol. As if. You’ll run to Western medicine at the first sign of trouble for anything at all if it was you or your family.
I can’t speak for the other ‘quackary’ mentioned on the blog but traditional chinese medicine isn’t all bogus…there has been herbal remedies (aka Stuff Found in Nature) which have been shown to work for simple things like pain and inflammation etc.
The problem isn’t that people back in the days were just delusional that eating plants would make their ailments go away, it’s that much of this has not been put to the test in evidence-based medicine, and b/c it’s unregulated in the US, people start making outrageous claims about it, making people think it must all be bogus b/c some charlatans are involved in it.
As someone above mentioned, aspirin came from willow tree, and artemisinin-based drugs are used in combination with other anti-malarial drugs to combat Plasmodium falciparum malaria and to reduce the spread of drug resistance (as recommended by the WHO). Artemisinin is a drug that has been used for malaria in China for the couple of thousand of years, it’s earliest writing of it’s antimalarial properties was found in “The Handbook of Prescriptions for Emergencies†in the 4th century by a Chinese alchemist. However, it wasn’t until 1967 that extracts from the plant was shown to have antimalarial property. But those nutty Chinese herbalists weren’t all charlatans trying to make a buck, some actually saw and recorded on the efficacy of certain medications before the advent of evidence-based medicines.
Also, traditional chinese medicine is a branch of medicine in China, and students take chemistry, biology just like the “modern” medical students but they also learn plant biology as well. At the molecular level, a drug is a drug after all, and TCM is just plant-based medications (in China at least). Also, these same students come to this country and are qualified to work in biology labs as lab techs so they are hardly taking bogus biology classes back in china.
I guess what I’m trying to say is that modern medicine does not have a monopoly on cures and treatments. People had been ‘discovering’ simple remedies for a long time. But we tend to discount these older treatments because those are ‘hit or miss’ treatments. they could be good or they could be bad, there’s no evidence based proof to back the drugs up. And for that reason, I would not do alternative medicine or natural remedies. But that does not mean, as a physician-scientist, I would automatically discount a treatment simply because it had a “natural” or “alternative” label on it. If someone decided to do a study on it and found those remedies to have proven properties against a disease, then I would be open to it. And I believe that some remedies used by our ancestors do have drug properties. I think it would be arrogant of us to assume that we are ‘smarter’ now or that the only good drugs are the ones that are cooked up in a lab. Nature has a lot to offer in this regard and I wouldn’t be surprised that our ancestors knew this too.
“Qi” is a religious concept. I’m all for religion, being a religious fellow myself but, except as religious morality should guide our ethical decisions, religion has no place in medical practice. If I invited my patients to pray with me for divine healing the same people who invoke their mystical principles when convenient would be all over me like a cheap date for invoking mine.
Randall, got any proof to back up any of the horseshit you’re spouting? Or is the proof on some other level of consciousness? I’ll wait while you go get it…
“Rooted in physics?” Really? Repeat after me: quantum mechanics explains the motions of subatomic particles. These principles do not then translate to everything else in the world.
As a med student, I don’t have time to read all the comments, so perhaps someone has already made this point.
You article makes the classic mistake made by those who attempt to “objectively” consider a cultural phenomeneon which they do not understand – without realizing it, you have mixed culture and science.
Rather than actually taking the time to throroughly examine the evidence for and against CAM therapies, you attack alternative medicine based largely on the ideas formed by your own views on nature, disease, and the world. You then invoke science to justify your views, noting that there is a lack of evidence to support CAM therapies. In the scientific method I was trained in, a lack of evidence for or against a theory means nothing except that there is still much work to do.
Condemming unstudied potential treatments with the wide brush you deem fit to employ is not scientific – it clearly demonstrates your cultural bias against treatments you are uncomfortable with. Luckily, the NIH is a bit more forward thinking…
As a former student at one of the “quasi-legitamate” schools of naturopathic medicine and now a student at an osteopathic medical school, you are really writing about things which you know very little about. It might surprise you to learn that our basic science faculty were largely shared with the University of Washington Med School. But then, I would wager there is much that would surprise you…
What about astrology? Some people have devoted their lives to its study. In the ancient days it was a legitimate science and people took it seriously but it’s still bunk.
You are “appealing to authority.” I think it’s fantastic that you take your basic science course at a legitimate university but that doesn’t change the fact that the premise of naturopathy, homeopathy, and most of the rest of CAM is deeply flawed and I don’t have to know the intricacies of them any more than I have to know in which house Virgo currently resides to call “bullshit.”
Clear enough?
Your lumping of naturopathy, homeopathy and “most of the rest of CAM” (whatever that means) into the same boat demonstrates that you need to do a little more homework to speak with any authority on these issues.
It’s convenient to attack what you don’t understand and don’t care to research on the basis of a “flawed premise”, but don’t make the mistake of thinking this represents a scientific, or even balanced perspective.
These questions might get you started towards more info:
Are NDs licensed to use pharmaceutical medications?
Are NDs licensed as primary care providers with full insurance coverage in several states?
Do ND schools recieve NIH grants for research?
Has ND conducted research been published in leading medical journals (ie JAMA)?
Absolute, 100-percent, pure-D, grade-A bullshit and tyical of the irrational thinking that provides such a fertile ground for CAM.
“Problems with consciouness†indeed.”
This is why double-blind studies with humans have limitations…although they are the best we have with our current level of knowledge. If you need me to, I’ll explain it to you.
“And Asthma is a nebulous entity that Western Medicine couldn’t begin to touch? You’ll run to Western medicine at the first sign of trouble for anything at all if it was you or your family.”
For some reason you keep forgetting that I’m not against western medicine. I just have more options than you…and apparently I’m also aware of the psych component of asthma.
“Randall, got any proof to back up any of the horseshit you’re spouting? Or is the proof on some other level of consciousness? I’ll wait while you go get it…”
Yes, I have proof…they are called patients who didn’t get what they wanted from you, lol!
“Rooted in physics?†Really? Repeat after me: quantum mechanics explains the motions of subatomic particles. These principles do not then translate to everything else in the world.”
Have you looked closely at the desk your leaning on? As I mentioned before, I met a physics professor at my last shamanisn class who said she would be giving speeches and writing a book to explain this “stuff” to you. But some other physicists have also…want their names?
Red Beard, naturopaths do not get the same medical training as MDs. http://www.naturowatch.org/ They make that claim; but can’t back it up.
And for those who think they are practicing some kind of “integrative” medicine.
“There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. …” [Philip B. Fontanarosa M.D., George D. Lundberg, M.D., . Alternative medicine meets science. JAMA 280:1618-1619, 1998 ]
While you claim to be selective in use of quackery, I have to wonder what went wrong in your anatomy and physiology classes.
Excellent post.
“Qi†is a religious concept.”
I see you’ve run squarely into a language and cultural block.
Condemming unstudied potential treatments with the wide brush you deem fit to employ is not scientific. Instead, this clearly demonstrates a cultural bias against treatments you are uncomfortable with. Luckily, the NIH is a bit more forward thinking…
It’s convenient to attack what you don’t understand and don’t care to research on the basis of a “flawed premiseâ€, but don’t make the mistake of thinking this represents a scientific, or even balanced perspective.
Dragonwell wrote “Condemming unstudied potential treatments with the wide brush you deem fit to employ is not scientific. Instead, this clearly demonstrates a cultural bias against treatments you are uncomfortable with. Luckily, the NIH is a bit more forward thinking…
It’s convenient to attack what you don’t understand and don’t care to research on the basis of a “flawed premiseâ€, but don’t make the mistake of thinking this represents a scientific, or even balanced perspective.”
CAM is mostly irrational, and, when studied, it fails. If you can’t understand; maybe it’s you: http://www.apa.org/journals/features/psp7761121.pdf
I am amused by what quacks deem to be science.
The fact that the NIH spends 110 million bucks a year researching, among other things, the use of meditation to slow the progression of HIV, should be a cause for deep shame among all educated Americans.
That enough money to equip and fund a Marine Battalion Combat Team for a year, a much better use for the money. Or hell, if you’re one of those “The Air Force should hold Bake Sales to Buy Bombers” kind of people that’s enough to buy a heck of a lot of whatever freebie you want to give to the lazy and the stupid. Instead it goes to subsidize smarmy pseudo-science.
You say that, “Almost everything about Complementary and Alternative Medicine (CAM) is bunk”, which makes me curious, which parts do you believe are not bunk?
Physicians who support integration of so-called CAM into medical school curricula and those who fail to object to it would do well to consider the range of possible outcomes. The following was written by a patient at the clinic where 3 died people after receiving mis-manufactured IV colchicine for treatment of chronic pain.
“Integrated medical team helped many
The tragedy with the Portland Center for Integrative Medicine is that it was so good at bringing us back to life; death was unthinkable.
I ache for each and every one of them for what they have lost, personally and professionally. Of course we grieve for the families and friends of those who died so abruptly.
No one who was not a patient at the center can truly appreciate that healing team of naturopaths, medical doctors and nurses.
We returned there for IVs in one great room of recliners, where we supported each other, learned from each other and watched each other grow healthy again despite multiple sclerosis, heart disease, HIV or heavy metals poisoning. Shingles could be reversed in a day. A woman’s lower leg went from black to pink and rose in an hour.
If an epidemic or pandemic were to hit, they could treat us effectively right away, without antibiotics.
Integrity was so evident and constant. Everyone was genuinely happy and hospitable. Another patient suggested that this was the place to work because no one dies.
Jeanne Owen
North Portland”
Portland Tribune, 2007-05-08.
http://www.portlandtribune.com/opinion/story.php?story_id=117857311299118900
You don’t need advanced training in bioethics to understand why this is problematic.
Well, various “reform” chiropractors who, unlilke their “straight,” “mixer” and other varied kinds of colleagues confine themselves to the treatment of things like back pain certainly can help some patients some of the time. Even a broken clock tells the correct time twice a day you understand.
Now,as to whether somebody needs to go to a sham medical school for four years to learn how to crack backs is not clear. A good masseuse could probably achieve similar results and would be a super-masseuse if he trained for half that time. In fact, my barber when I lived in Japan had some skill at neck-cracking and back-popping (which was a routine thing after a haircut) which was no doubt a valuable skill but he didn’t have a doctoral level degree in it.
Despite carrying 80-pound packs up and down mountains as a vocation, I never developed any back problems so I don’t know the value of a good post-haircut back-cracking except that it did no harm. They don’t crack your back in the states after a haircut and my back felt pretty much the same.Â
I play a Shaman in World of Warcraft. He’s a mean healer, too.
=)
Dragonwell “You say that, “Almost everything about Complementary and Alternative Medicine (CAM) is bunkâ€, which makes me curious, which parts do you believe are not bunk?”
I’ll take that. We can’t really be too specific because these claimants defy rigorous testing. However, there is reason to think that a few of the thousands of claims for herbs are correct.
Dragonwell wrote “Condemming unstudied potential treatments with the wide brush you deem fit to employ is not scientific. Instead, this clearly demonstrates a cultural bias against treatments you are uncomfortable with. Luckily, the NIH is a bit more forward thinking…
It’s convenient to attack what you don’t understand and don’t care to research on the basis of a “flawed premiseâ€, but don’t make the mistake of thinking this represents a scientific, or even balanced perspective.â€
And P. Bear wrote “The fact that the NIH spends 110 million bucks a year researching, among other things, the use of meditation to slow the progression of HIV, should be a cause for deep shame among all educated Americans.”
This is not a case of not understanding or caring to research CAM, or even of being ‘uncomfortable’ with using it. I understand CAM as well as I need to. Others have done fine research on “alternative medical theory” and it has all proven to me that CAM works NO BETTER than placebo in all the areas that matter (ie, morbidity, mortality, disease progression). All CAM does is make patients feel subjectively better, and as this (previously pointed out) is such a nebulous and easily fudged ‘improvement’, in my humble opinion it holds little weight. Getting a massage, having a cute girl smile at me in passing, or winning a b-ball game all make me feel subjectively better, but they will not cure cystic fibrosis. They don’t even alleviate synmptoms! Neither does CAM.
What WORKS is what I will use with patients. Otherwise I am wasting their time and money, as well as damaging what little trust they still have in medicine when whatever snake-oil I’m using doesn’t work.
I don’t even like calling it CAM. Medicine is medicine. Perhaps it should be called what is really is, wishful thinking.
We returned there for IVs in one great room of recliners, where we supported each other, learned from each other and watched each other grow healthy again
Can someone more articulate than me please explain why my woo-warning-bells ring long and loud whenever I hear language like this? Particularly the bit about learning from each other?
despite multiple sclerosis, heart disease, HIV or heavy metals poisoning. Shingles could be reversed in a day. A woman’s lower leg went from black to pink and rose in an hour.
And the objective measures of improvement were? Sorry, but I have to be dubious here. What were the HIV patients’ T counts and viral loads before and after? What AIDS-related illness, if any, did they have and how was its resolution determined? Did ECG, nuclide scans, echo or coronary angiography show objective changes in cardiac function? Was the shingles confirmed by a Tzanck test? What was the aetiology for the heavy metal poisoning, what were the levels before and after, and did any sequelae show improvement?
I’m intrigued by the leg – it appears to represent reversal of critical ischaemia, if not overt gangrene; if so, medical journals would love to get their hands on the case report. Was there a doppler echo done? An angiogram?
This is all the stuff we need to know before we take “CAM” seriously. Otherwise it’s just hand-holding and gentle platitudes while the patient sickens and dies of their disease. But it proves the old medical malpractice legend – “The best communicators never get sued.”
Panda, you’ve done it again: articulated what many of us would love to proclaim in the most articulate manner!
A couple of points to add about the degree of insipid magical thinking expressed by many of these people:
1. Blind hatred of the pharmaceutical industry, citing the cost of drugs as evidence of “evil.” Perhaps they have no idea how much it costs to see ONE PATIENT through an oncology clinical trial, and that the drug company must pay for centralized lab evaluations (often with single samples shipped on dry ice $$$), centralized radiology readings, and often extra CTs or MRIs to ensure the drug isn’t killing people, etc. This doesn’t even address the costs of data management and research and development.
2. The implication that all disease is caused and facilitated by not taking the right suppliments. For example, a friend who’s a true beliver told me that if I would simply ingest some highly purified clay and some stuff that looks like it’s from my spice rack, my rheumatoid arthritis would be cured in 15 MINUTES. Gee, and to think I could’ve prevented years of lost manual dexterity (among other abilities) before the evil drug companies came out with the biologic drugs that saved my life–JUST by raiding my spice rack!
Cardiac angioplasty, anyone?
Sounds like a crock of bullshit – put stents into an artery… oh wait, it was just proved to be.
Medicine is awash with quackery. It’s just who is the better salesman.
…an osteopathic medical school???
What the fk is that? Does it make you a medical student – ie someone who will be awarded an MD/MBBS/MBChB or other legitimate qualification?
And how can you do exams in made up pseudoscience?
Yo’ mamma, first of all the the debate is whether angioplasty improves mortality in all people with ischemic cardiomyopathy. It certainly does improve mortality in people who are suffering from an Acute Myocardial Infarction (AMI) because many with severe obstruction would die if nothing were done, either quickly or soon from complications cardiac tissue death.
The evidence for mortality is less clear for people with angina and no infarction. It certainly improves morbidity. Whether these patients could be just as well medically mangaged is the issue but, and this is the clear distinction between CAM and real medicine, there is a debate and when the final truth of the matter is discovered, the practice of cardiology will be modified accordingly. Already some insurance companies will not pay for a heart cath for a patient with chest pain if it is not indicated, that is, no evidence of MI (normal enzymes, no EKG changes).
If I proved that “qi” was worthless, would you abandon acupuncture? Of course not. To cath or not to cath is a rational decision that we base on empirical evidence. Of course there will be some resistance from interventional caridiologists initially if the indications change but eventually the truth will out. You will never abandon any aspect of CAM because you accept it on faith, as part of your world-view of ego over reality.
As for sounding like a crock, opening an obstructed coronary artery, whether it is the right thing to do or not, make intuitive sense as ischemia from obstructed arteries is the cause of angina and MIs.
“Blind hatred of the pharmaceutical industry, citing the cost of drugs as evidence of “evil.†Perhaps they have no idea how much it costs to see ONE PATIENT through an oncology clinical trial, and that the drug company must pay for centralized lab evaluations (often with single samples shipped on dry ice $$$), centralized radiology readings, and often extra CTs or MRIs to ensure the drug isn’t killing people, etc. This doesn’t even address the costs of data management and research and development.”
True, but maybe they could cut expenses if they get their pusher (drug reps) with all their free gifts off the street. Maybe they could save millions more by not running TV adds trying to persuade people to ask for physician for a certain drug. Maybe they should stop trying to do “secret” benefits for physicians and their families like they did on the island of Oahu by my house…flying in Willie Nelson and other performers for a big shindig that must have cost millions. There was no news of it, but I asked the grounds workers. There’s lots of ways they could cut their expenses.
“make intuitive sense”
Did you really use the word “intuitive sense?”
Blockage in coronary=ischemia=pain+tissue death=opening arteries=reversal of instigating condition.
Intuitive.
Utapu, the Otter God invokes magic river demon=ludicrous.
All doctors are tainted with the miasma created by their totally nasty and incompetent colleagues and their idiotic patients. People just like natural therapies, (HA!), because the people administering them seem calmer and friendlier, is all. Have jade plants in the waiting room.
Check this out.
1993 Yoga class, rural Ohio, rather skeletal student coughing for a month, other student (medical student, me) in class finally says, hey, what’s up with the cough. it’s disturbing my headclearing.
“i went to a person who looked in my blood under a microscope and i have candida from
mercury in the fillings in my teeth…i’ve had a sore throat for like a year..”
Well, have you had a chest x-ray? No.
Several weeks go by, I give her a neck-rub after yoga class and notice, fuck, many many really really huge lymph nodes, must be cancer, something awful…GO TO REGULAR DR NOW PLEASE. Regular DR puts her on amox, after negative strep test. Regular Dr supposedly listened to her lungs, did not order a CXR. I listened to them, velcro crackles…Regular Dr then agrees to put pt on IV Rocephin at home for presumed pneumonia, no CXR yet. It takes the home-health nurses about 10 minutes to figure it out when they get to her house and see 50 bags of sputum-laden tissues…admitted with miliary TB, barely makes it, is now the miracle recovered patient. I’m the 3rd year student who heard the attending Dr on the ward say, “it took a little while to figure it out..”
Yay for medicine in the USA in 1993.
I live in Portland where 3 people just got killed at the center for integrative medicine.
Can someone please write a bestseller book on this subject???? Call it: “the pure cure: why people think alternative medicine is great.”
Or “the myth of alternative medicine and why it lives on.” Heavily emphasize why arrogant
asshole allopaths are losing the business of yoga practitioners for themselves as well as for their more likeable colleagues.
Sorry about the bile. I actually am not a totally unpleasant person, really. I’ve just met too many of them in my profession.
“the pure cure: why people think alternative medicine is great.â€
Why don’t you title it: “The Pure Cure: Why Allopathatic Medicine is the Third Largest Killer.”
Randall, you insult your intelligence. That statisitc is absolute hogwash, and if you and your ilk were not so freaking SUSCEPTIBLE to BS, you would never ever repeat such clap-trap.
Here’s some groundrules: shiatsu is great, medical errors suck, I think we are generally
agreed on that.
What’s not great is the woo-woo, which illustrates that the 10th century is alive and well in America today, and well-meaning folks like you help to perpetuate it.
Tell me how there are people who:
1)fear x-rays/
(ooh, radiation)
2)any medications
(unless herbal, in which case they are happy to take 17 capsules a day and spend 150/month)
3)diagnoses? (let me tell you about a lady across the street from me who starts getting a stiff arm at age 50. Specialist at local medical school tells her: Parkinson’s.
what does she do? Goes to local CAM guru (MD after his name, groan, deserves a bayonetting) who tells her well, not really for sure.
When she starts hardly being able to walk, she spends three months at a clinic in Beijing, where she starts to need a wheelchair. The allopathic people finally take over from the fucking herbalists and she gets put on Parkinson’s meds. Comes back from China a few months ago, hey, she’s walking quite well, thank you. I saw her at the bus-stop recently. The other day she had a vehicle problem and needed to get a kid to choir rehearsal, I loaned her my car and got it back.
Randall, I think shiatsu is great.
Get your head out of its current implantation site.
CAM can be just as dangerous as allopathic medicine, just in a different way, because it
engenders all sorts of support for people’s denial of reality, which, in case you hadn’t realized, is common in people and especailly in ill people.
Tell me how there are people who:
1)fear x-rays/
(ooh, radiation)
Ugh, if it’s not dangerous then why do they put a cap on it?
2)any medications
(unless herbal, in which case they are happy to take 17 capsules a day and spend 150/month)
Wow do you really even have to ask this question? When there are widely prescribed drugs out there that have lethal side-effects, are you really THAT surprised when people seek alternative treatments?
3)diagnoses? (let me tell you about a lady across the street from me who starts getting a stiff arm at age 50. Specialist at local medical school tells her: Parkinson’s.
what does she do? Goes to local CAM guru (MD after his name, groan, deserves a bayonetting) who tells her well, not really for sure.
When she starts hardly being able to walk, she spends three months at a clinic in Beijing, where she starts to need a wheelchair. The allopathic people finally take over from the fucking herbalists and she gets put on Parkinson’s meds. Comes back from China a few months ago, hey, she’s walking quite well, thank you. I saw her at the bus-stop recently. The other day she had a vehicle problem and needed to get a kid to choir rehearsal, I loaned her my car and got it back.
CAM is exactly what it is — complementary. You can’t send someone to the moon with herbs in the same way you can’t cure cancer with a needle. However, that is not to say that treatments that haven’t been put through the necessary studies needed to be labeled as a ‘valid’ modality by Western medicine do not have a therapeutic effect.
Some of the people I see on here need to get off their high horse and open their minds. Just because you spent 10 years in medical training doesn’t mean you are authority on everyone’s health. In fact, that righteous, know-it-all attitude some of you guys have towards CAM is exactly the reason Americans, more so than ever, distrust your services. So do yourselves and future doctors a favor and open up your mind a little.
Tell me something, Muncher. Do you honestly believe that the professionals who have the greatest breadth of experience with the human condition, physicians with clinic and hospital experience spanning the gamut of the organismal ills, with many years of training, should really be compared in the same breath with practitioners of traditional remedies, most of which can’t be found to work?
The lady I knew from yoga class with miliary TB was on grapeseed extract and a low-protein raw diet for a year before she crashed in the hospital, near-death and emaciated. I got to see the last case of non-resistant TB consumption in the US. Guess how long before rifampin and isoniazid and some food worked?
Several weeks later, no cough, no sore throat, no scrofula, she walked out of the hospital with her life in her hands, to go home to her three children.
Alternative medicine and her bias almost killed her.
It makes me very sad that people can’t appreciate the difference, and it makes me angry that everyone thinks CAM is safe, because I can tell you first hand, it is not…..
“Just because you spent ten years in medical training doesn’t mean you are the authority on everyone’s health”
Oh yes it does. So sorry. Now, this is a medical blog so while I appreciate your reading it, I’m sorry if this glimpse into the real world of medicine distresses you and offends your egalitarian sensibilities.
Nice to see that you took your little tirade off of SDF (What on Earth are you talking about?- PB) where I could easily spank you about your lack of knowledge of acupuncture research. Your arguments are once again a smattering of logical fallacies and the typical response of a dogmatic skeptic – ignore the evidence and shift the topic.
When acupuncture first came on the scene, all the skeptics correctly pointed out the lack of research on the efficacy and mechanisms of acupuncture. But once research started to surface, many of the skeptics were converted while an ignorant few stayed in their trenches. But how could they rationally ignore the evidence? By shifting the conversation to the traditional explanation of how acupuncture works: “qi”.
This combination of red herring and strawman is a great way to steer the conversation away from the most relevant topics, i.e., EFFICACY, to one that is easy to pick apart.
It is actually quite pathetic because either you are doing this intentionally, meaning that your goal is not coming to a consensus based on the best available evidence, or you aren’t aware of your inability to focus on the facts.
As for my rational explanation of what “qi” means in the context of TCM, it apparently went in one eye and out the other since the concept of qi being some sort of magical spirit force “resonates” more with you than my explanation. But hey, go ahead and use your erroneous definition of what “qi” is so that you can easily refute it. Par for the course.
And finally, F. Scott Fitzgerald once wrote “the test of a first rate intelligence is the ability to hold two opposed ideas in the mind at the same time and still retain the ability to function”, or as I like to call it, OJ killed his wife AND the cops were racist [Bill Maher 2002]. You consistently give examples of how a CAM provider was unable to effectively treat a patient, which put them on their deathbed obviously, and the patient was resurrected from the gates of hell by conventional medicine.
Apparently you can’t seem to grasp the concept that modalities like acupuncture are used in conjunction with conventional medicine…or you just want to make another strawman.
Hugs and Kisses.
The difference between me and you is that I treat people with real medical problems, many who would die without intervention, and you kind of stick needles in ’em and feed them a line of bullshit.
We just wish we heard about one person with a real diagnosis who was cured by acupuncture.
We just wish that dying cancer patients weren’t talked into one last chance over the border at the experimental clinics of CAM, where they die and leave their hysterically grieving spouses to figure out how to get the bodies home and how to explain what happened to the folks back home…
Yes, we wish there was a common goal forgeable between hospital-trained physicians and CAM practitioners. Thankfully, many CAM people understand their limits and practice accordingly. I think the concern is about those practitioners that share their patient’s worldview: modern medicine is evil.
Those people are dangerous.
[QUOTE]The difference between me and you is that I treat people with real medical problems, many who would die without intervention, and you kind of stick needles in ‘em and feed them a line of bullshit.
[/QUOTE]
First of all, let me say I hope that HTML works or this post will be plain ugly. Secondly, I would like to thank you on proving all of my points, since you did nothing to refute the efficacy or mechanisms of acupuncture and instead chose to say your patients have real diagnoses while mine don’t. Bravo.
This is quite humorous considering the vast majority of my patients suffer from chronic pain. Sure it isn’t as sexy as any of the possible causes of trauma, but there are far more chronic pain patients in the US then there are GSW patients. In addition, your inability to see that there is a world of medicine beyond acute care is fairly sad. But hey, your so important because your patients WOULD DIE IF YOU DIDN’T TREAT THEM! Ours just hopefully benefit from an improved quality of life for a few decades.
Bravo squared.
[QUOTE]We just wish we heard about one person with a real diagnosis who was cured by acupuncture.[/QUOTE]
Me too. Most of the time, we acupuncturists treat chronic conditions and improve quality of life. But cure OA of the knee? Probably not going to happen.
But hey, maybe you could pull a Panda and use some negative anectodal experience about a patient being seen by a completely different class of provider and apply it to all CAM / Integrative Medicine providers. It would be good fun.
Chronic conditions…like fibromyalgia…har har.
I rest my case.
Seriously though, I don’t throw anecdotal evidence around. That’s all the so-called proof for CAM is, anecdotal and no different than that offered by some sweaty faith-healer except that it has the imprimateur of legitimacy based on who supports it, not its merits.
If you look, the evidence for acupuncture is incredibly shoddy. Not to mention that there is a different standard of proof for CAM than real medicine. If I presented the results of a legitimate study which I conducted in as slipshod a manner as the typical research into quackery I would be a laughing stock.
The thing is, I’m skeptical about most things, including a lot of what we do on a routine basis. I do it but I’m not in love with it, you understand. You started with a religious faith in “qi” and now, like the creationists, won’t let it go.
Gosh I miss our rapport…seriously.
Fibromyalgia is a low blow. Every other month a study is published that shows acupuncture works for it followed the next month by a study in which acupuncture fails to show an effect. To be honest, I figure you conventional medicine folks would be pulling for more positive acupuncture research so that you don’t have to deal with the fibromyalgia patients [note: from my own experience, acupuncture is hit or miss with fibromyalgia patients, or as the Bush administration would call it, a “slam dunk”].
To say the research on acupuncture is being held to a different standard implies two things: you are not familiar with the difficulties of acupuncture research and you read too much quackwatch. I would go into detail about the inherent difficulty in performing acupuncture research [how to blind, what is actually a placebo control, blah blah blah] but I’ve already done so ad naseum. Either you realize what I am saying is accurate or you dismiss it because it doesn’t resonate with what you feel in your fifth chakra. Your failing, not mine.
Finally, I am very skeptical as well, which is why your commment about me having a religious faith in “qi” is probably the funnest thing you’ve ever written. I don’t believe that qi is any sort of mystical energy field or aspect of our spirit being. You see, I don’t believe in any spirit, religion, or god. In my book, creationists are tools just like scientologists; Chrisitians that believe in the bible are stroking themselves just as heavily as Muslims that believe they will get 99 virgins when they commit sucide in the name of allah [or is it 100? see teh intro scene to “Postal” for more information].
I’ve explained to you previously what “qi” means in the context of TCM. You have apparently choosen to ignore that explanation in favor of your religiously tainted version, which is…uh…what do they call that again?
Listen, if I have a question about EM, I would probably ask somebody with experience and training…perhaps even the Panda man himself. But acupuncture is out of your knowledge base, and your inability to differentiate between it and crystal-based tantric sexual healing is painful to watch.
Seriously, my entire rebutal just disappeared?
It was marked as spam by “Akismet,” the spam-blocker I use but I have released it and it should appear shortly.
I think if you include too many links or some key words it flags it. I only know about it if I check the spam list which I do not do every day.
Sure, you can stop asthma then and there, but can you actually stop it for extended periods of time? I have.
And yes, I had a cousin with status asthmaticus and treated it with four needles, two near the neck and two in the forearms. Worked instantly.
And Qi is not a religious concept, no more than concepts such as “willpower” and “charisma”. They are concpets that cannot be quantified, but certainly ascertained and effects felt.
“We just wish we heard about one person with a real diagnosis who was cured by acupuncture.”
Okay. I’ve been a migraineur for 10 years. I had ONE acupuncture session in China two years ago. Haven’t had a migraine attack since. Oh, and it’s more than just avoiding the triggers. My migraines were triggered by weather changes.
Now some “real diagnoses” I’ve cured using acupuncture: migraine, asthma, grand mal epilepsy (okay, not really cured, but acupuncture PLUS antiseizure meds were more effective than meds alone), Myofascial pain syndrome…
But yes, there are practitioners out there who see modern medicine as evil. I just with that you, Panda Bear, would take the middle road like I have, recognize that CAM has its uses, just like mainstream medicine does. If you’re so quick to judge CAM like you do, then you are NO BETTER than the CAM practitioner who fails to see the limits of his or her modality.
Bull. I don’t have to take the so-called “middle road” because there is no “middle road.” There’s the super-highway of real medicine and the meandering trail to nowhere known as CAM.
CAM has no uses except in the placebo sense. Since I have no use for placebos I have no use for CAM.
Now, it’s true that I an skeptical about a lot of what we do in the real medical world but this does not translate into the acceptance of primitive superstitions like acupuncture. My skepticism is more of a criticism of the cost versus benefits of a lot of what we do, not the efficacy, pathophysiology, or mechanism. I know, for example, that a levophed drip will raise most patient’s blood pressure. I’m just not sure if improves mortality in an 80-year-old Homo Polymorbidus on whom we typically use it.
See the not-so-subtle difference?
There are lots of specialty career paths in medicine with over 50 career options available, a doctor is assured of finding a suitable career. Some of the options are becoming a surgeon, a general practitioner, a psychiatrist, a medical teacher at medical school, a geneticist, a medical researcher or a public health physician. Although most doctors work within the national service, there are options in other settings, like the Army, or a prison doctor, and many others.
Your close minded, naivete makes me sick. I feel sorry for your future patients.
(Future patients? You do know that I’m a PGY-3 resident and have seen thousands of patients in the last few years? And ain’t none of them got snake oil either. -PB)
There are now palliative care and pain management fellowships for MDs and DOs, I can’t say that I can see a reason for an MD to need to seek out “snake oil” for illnesses causing a pt to experience nebulous discomfort, whether it be pain of unknown (or psychological) cause or inflammation/injury/illness or treatment related pain.
As for the mental side of it, though it’s a wussy justification, it’s a spectacular waste of $$$ to have an MD teach you how to meditate. Now a resident, on the other hand….
Like Panda noted of the history of US residency torture, pain management in western medicine is the grandchild of MDs who were high and addicted, but unlike residencies, pain management has been modernized and analyzed, and continues to be developed. For better or worse, some MDs are better at managing pts with chronic pain than others. Some find the whining annoying, others find it interesting. Whatever. Find someone who likes to listen to you, you should be able to do that within the medical realm.
I like chiropractors and acupuncturists who claim to help people within their realm of expertise, and only within their realm of expertise. If it is a placebo, and it keeps people off narcotics, yippee. On the other hand, a DC performing dx like an MD (say, telling me not to use my inhalers for my asthma, my problem is actually scoliosis), or an acupuncturist trying to sell me juju juice, annoys me, and is unethical and possibly being reckless with my welfare.
It is also interesting to me that there are so few CAM advocates who use the language of science to describe their work, even when speaking to medical students/professionals. Acupuncture, if it is effective, should be explicable in scientific terminology (eg Qi should be translated to the nervous system, or whatever). Language = an essential part of the package typically = con artist.