What the Alternative Medicine Debate Is Really About
Last week, after my story on complementary and alternative medicine (CAM) went up on our website, I did a bit of keyboard out-loud thinking—can I call it blogmusing?—on the topic. The volume of comments has been unusually heavy, with the expected bright line separating those who castigate me for publishing nonsense from those receptive to CAM. It has been a useful discussion, but I'd like to clarify a couple of points.
I did not state in the story or argue in my blog post that CAM can cure—that it can address the underlying cause of an illness and treat it effectively. I did not write that the explanations put forward by CAM proponents and practitioners for the supposed mechanisms powering their techniques are logical. And I did not say that CAM studies have been well designed and executed or have produced noteworthy findings.
I did report in the story, and repeat on this blog, that CAM often makes people feel better by relieving their symptoms. I suggested that this is not necessarily a bad thing, if a therapy does not cause harm or if the risk is rare, small, and clearly stated.
A physician I know who is prominent in the movement to improve hospital quality E-mailed me after reading my post. He's not a big fan of CAM as a cure. As he wrote: "[E]very now and then, we see somebody who barked up the alternative tree, only to let their real disease go untreated or undiagnosed until it was too late. It doesn't happen often, but when it does, it's very sad and very memorable."
And then he added this: "For many of the things that CAM has attacked—stress, pain syndromes, stuff like that—western medicine doesn't have much to offer, so if it works for people (whatever the reason), God bless it, and them."
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Alternative Medicine story
In October of 2007, the University of Connecticut Health Center held a debate on homeopathy. It was very insightful and surprising. There does in fact seem to be good research emerging that suggests efficacy. See transcript that follows. [note from Avery: I deleted the transcript--even the abridged version would have made the comment impossibly long, and the URL for the debate video was included.]
A Debate: Homeopathy - Quackery Or A Key To The Future of Medicine?
University of Connecticut Health Center
Farmington, Connecticut
October 25, 2007
Homeopathy is used by tens of millions of people around the world. On October 25, 2007, six internationally renowned experts examined the basic science as well as the clinical and historical evidence around this 200 year old system of medicine. Is homeopathy pure quackery as some contend or perhaps the future of medicine? What follows is an abridged version of this debate. To watch the full debate go to www.sonicfoundry.com/uconn.
Participants: Steven Novella M.D. (Yale), Rustum Roy Ph.D. (Penn State), Donald Marcus M.D. (Baylor), Iris Bell M.D., Ph.D. (Arizona), Nadav Davidovitch M.D., MPH, Ph.D., (Ben Gurion), Andre Saine N.D. (Canadian Academy for Homeopathy)
I believe that conventional medicine has become hostage to formailism: the so called gold standard study has put blinders on researchers and those who believe them. Have they noticed that no country in the world now uses the gold standard for currency valuation? It is all about the relative market value of currencies, not their value in relation to real gold bullion.
So, by analogy, maybe gold standard medical enthusiasts should consider unmooring themselve from the oh so correct studies and see how people get better in the real world.
Also, this obsession with suppressing the placebo effect is finally, bizarre. Let's allow it.
Meanwhile, real people are getting help from alternative medicine, and not from conventional medicine. If it is all placebo, we should ask why are conventional doctors so miserable at placebo healing, while alternative practicioners are so good?
Complementary/Alternative Medicine
What drove me to CAM: I woke up from routine heart surgery in 1995 with the left side of my body paralyzed by a stroke, caused by a wayward piece of tissue that broke away from the surgical site. I was 43 years old, married with two young children. My (very conventional) surgeon said, "Sorry you stroked, but heart-wise you're fine." He had done his job, the rest of my life was up to me. After a couple of months of occupational and physical therapy, my insurance company advised me that I had "plateaued," would regain no further function, and I should now "adapt" to my still considerable disabilities. Instead, I assembled my own rehab program of acupuncture (used o treat stroke for thousands of years in China), yoga, Pilates, Alexander technique, craniosacral therapy, massage, tai chi, and within a year had recovered completely, with only some residual weakness. the CAM approach treated me as a whole person - body, mind and spirit. Without it, I would still be the invalid that the conventional doctors had predicted. The experience led me to write several books with integrative physicians about the efficacy and value of this approach to healing. (More details of my experience here: http://www.ownyourhealth.wordpress.com)
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U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since their debut in 1990. In his reporting on all aspects of clinical medicine from the latest cholesterol guidelines to robotic surgery, he has kept one question in the front of his mind: What does this mean to patients? That perspective uniquely qualifies him to observe and comment on the efforts by hospitals and other healthcare providers to improve care and patient safety.
