Sunday, March 23, 2014

Alternative and Complementary Medicine, Placebo Effect or Panacea?

Readers know that I am skeptical over the efficacy of complementary and alternative medicine.  This is not merely a demonstration of my inborn skepticism, but doubt based on the fact the so much of their claims are untested, unproven or refuted.

I don’t regard the above comment as controversial.  It is factual.   I’ll let readers decide if it is but another example of the arrogance of conventional physicians who worship on the altar of evidence based medicine. 
Recently, I read a column in The New York Times by a university professor who was treated for a cold in China by drinking fresh turtle blood laced with grain alcohol.  In a day or two, he felt better.  Cause and effect?

 It’s not easy to talk someone out of a view that a pseudoscientific remedy healed them.  Why should we do so?   If a patient tells me that his fatigue has finally lifted after giving up guacamole, do I serve him or the profession by pointing out the absence of any scientific basis for his renewed energy level?   Or, is the better response for me to celebrate his progress and urge him to continue his ‘treatment’ which clearly poses no health risk?

Guac anyone?

Certainly, if I felt a patient was pursuing an alternative medical treatment, or any remedy, that threatened his health, I would plainly state this so the patient was making an informed choice.  If a patient was suffering from a bleeding ulcer, and wanted only herbal medicines, I would make sure that the risks of this choice were well understood.

I need to make a confession here.   Physicians face a huge knowledge vacuum with regard to the human body which is the product of millions of years of natural selection.  We are no match for comprehending its nuances and complexity.  Taking care of patients is a hugely humbling experience.  Consider how microscopic germs, organisms that are not sentient and have no brains, can wipe out millions of humans.   We should acknowledge that we’re not that smart.

There’s another possibility to be considered when a patient relates the success of remedy that we don’t support or understand.  It might actually be working.

Have you been tired lately?  Fatigued?   How much guac have you had lately?  

6 comments:

Third News said...

Oddly, complecting with your gravedo 'cure', I just read Oswell Livingstone's (son of Dr. David L) mention of a rouser produced by his father:

"Dr. and Mrs Kirk have boon extremely good to us, putting themselves to no end of trouble on our account. If it were not for them we should be nowhere. Since we came both Dr. and Mrs Kirk have boon down with fever. 1 found two of our Nassick boys dying yesterday; but after a dose of 'rouser' (Dr. Living stone's prescription) and quinine, they have recovered most wonderfully."

Interesting that the duo remedy proved to recure with only one dose but both resile situations could be iatrochemical, or related to the effects of poculation

Henry Ehrlich said...

By coincidence, I wrote about the same column by Stephen Asma about Chinese medicine. My take on it, however, was that whatever the merits of turtle blood, some traditional Chinese medicine (TCM) is not only clinically effective, but can be proven in the laboratory. As this link will tell you, I am the author of a new book about Dr. Xiu-Min Li at Mount Sinai in New York who has been using TCM to treat conditions that have defied mainstream treatment, and in parallel verifying their action via NIH/FDA protocols. http://www.asthmaallergieschildren.com/2013/10/01/chinese-medicine-minus-the-enigma/

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Anonymous said...

Thank you, Dr. Whistleblower, for being open-minded. I am in the alternative health care field, and acknowledge that many of the treatments in this field are nothing more than 'faith-based cures'. However, many of them are science-based (the term 'alternative medicine' refers to a very broad spectrum of different approaches), they just have not been thoroughly studied yet, and therefore earn the title 'unproven'. Regardless, patients find them to be efficacious time and time again, when their evidence based docs have failed them. I just finished reading another blog post of yours about chronic abdominal pain, and how conventional medicine rarely can do anything to alleviate it. This is exactly the kind of condition that alternative medicine often has success in treating. I wish more MDs would be open-minded enough to realize that while there are some conditions that evidence-based medicine does very well to treat (you really don't want a naturopathic doctor for a broken bone, for example), there are some conditions, usually chronic, where naturopathic or alternative treatments are far more successful.

Michael Kirsch, M.D. said...

Unproven or untested doesn't mean ineffective. Nevertheless, we need to be forthright and admit when a proposed therapy has no supportive science behind it.

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