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Jun 7 2009
alternative medicine in hospitals

(This is almost a continuation of our earlier discussion about chiropractors.)

A new article in the New York Times explains how hospitals have started using more ``alternative medicine''. When it discusses the positive aspects of this, the article is completely clear about the fact that the primary benefit of these medicines is essentially the placebo effect.

They are doing Reiki therapy, which claims to heal through invisible energy fields. The anesthesia chief, Dr. Richard Dutton, calls it "mystical mumbo jumbo." Still, he's a fan.

"It's self-hypnosis" that can help patients relax, he said. "If you tell yourself you have less pain, you actually do have less pain."

Even critics of alternative medicine providers understand their appeal.

"They give you a lot of time. They treat you like someone special," said R. Barker Bausell, a University of Maryland biostatistician who wrote "Snake Oil Science," a book about flawed research in the field.

That is why Dr. Mitchell Gaynor, a cancer specialist at the Weill-Cornell Medical Center in New York, said he includes nutrition testing and counseling, meditation and relaxation techniques in his treatment, though not everyone would agree with some of the things he recommends.

Ten years ago, Congress created a new federal agency to study supplements and unconventional therapies. But more than $2.5 billion of tax-financed research has not found any cures or major treatment advances, aside from certain uses for acupuncture and ginger for chemotherapy-related nausea. If anything, evidence has mounted that many of these pills and therapies lack value. Yet they are finding ever-wider use.

But, there are negatives as well:

Even when the ingredients aren't risky, spending money for a product with no proven benefit is no small harm when the economy is bad and people can't afford health insurance or healthy food.

But sometimes the cost is far greater. Cancer patients can lose their only chance of beating the disease by gambling on unproven treatments. People with clogged arteries can suffer a heart attack. Children can be harmed by unproven therapies forced on them by parents who distrust conventional medicine.

"Herbals are medicines," with good and bad effects, said Bruce Silverglade of the consumer group Center for Science in the Public Interest.

Contrary to their little-guy image, many of these products are made by big businesses. Ingredients and their countries of origin are a mystery to consumers. They are marketed in ways that manipulate emotions, just like ads for hot cars and cool clothes. Some make claims that average people can't parse as proof of effectiveness or blather, like "restores cell-to-cell communication."

The Federal Trade Commission is filing more complaints about deceptive marketing. One of the largest settlements occurred last August $30 million from the makers of Airborne, a product marketed with a folksy "invented by a teacher" slogan that claimed to ward off germs spread through the air.

People need to keep a healthy skepticism about that magical marketing term "natural," said Kathy Allen, a dietitian at Moffitt Cancer Center in Tampa, Fla.

The truth is, supplements lack proof of safety or benefit. Asked to take a drug under those terms, "most of us would say 'no,'" Allen said. "When it says 'natural,' the perception is there is no harm. And that is just not true."

Personally, I have serious concerns about the adoption of these bogus remedies in serious hospitals. I understand the doctors who feel that including these things is a harmless way to put patients in a better state of mind, but (a) it is essentially lying to them since anyone who can read the data can see that they don't work (and I don't think doctors should lie to their patients) (b) it promotes their use instead of traditional medicine, and I would not want to see a patient avoiding a real treatment (or denying it to their child) because they prefer the myth of AM and (c) it really denigrates the achievements of human intellect to ignore the tremendous amount of evidence supporting much of traditional medicine and act as if it is somehow inferior to these supposed folk-remedies.

I admit that there are problems with traditional medicine as currently practiced in the US. For one thing, the doctors have not time to get to know their patients...they barely have a few minutes alone with them in the examining room. But, that is a problem with the economic structure of our health care system and not a problem with science based medicine itself. (When I lived in Canada I found that the doctors had plenty of time to talk and listen to my symptoms.) Also, there are some bogus drugs and treatment out there which barely provide any benefit despite their high costs. We can identify these (just as we could identify any "alternative medicine" treatments that actually do work) using science and in no other way. Finally, medical care in this country just costs way too much. Again, that's not a problem with the medicine but with the delivery method that has evolved under market forces.

I'd really like to see renewed interest in using science to determine which treatments work and which do not. I'd like to see everyone (doctors, government, patients, insurers, etc.) demonstrate that they are not interested in treatments that do not work. And, I'd like to see the health care system here revamped to solve the problems that exist in it without having to jetison reason. These do not seem like pipe dreams because those responsible for health care policy in the Obama administration have basically said all of the same stuff -- though in a more politically acceptable way. If you're reading this, please use your political power to help them achieve those goals. Thanks! n-atheist

Jun 12 2009
Re: alternative medicine in hospitals

the issue here is what may be idiopathic..... the doctor who puts patients "under" is correct that pain management includes patient perception and patient self declarations, self suggestions.... improving nutrition, even when adding bogus vitamins, is often tolerable if not slightly beneficial perceived as therapeutic by the self medicating patient.... I do have a problem with doctors who dabble in this shit and of course parents who deny children life saving treatments....if the studies have been done on herb one, herb two, herb 3 and all have been proven completely ineffective if not somewhat harmful, such herbs should be so labeled just as we so label cigarettes. Placebo effect is in a window of efficacy. If an herb can not equal or exceed placebo, brand it bogus. People will still buy it, they should be free to buy it, but no doctor should be prescribing it.

Jun 16 2009
Re: alternative medicine in hospitals

This sure doesn't make me very happy with the doctors who do this. How are you supposed to trust anything a doctor says if they are willing to prescribe bogus alternative remedies? Unless of course they tell the patient openly that it is a placebo, and like all placebos, has a small beneficial effect!

Hospitals that do this are just out to make a buck.

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