Friday, August 3, 2012

Snake Oil

If it's true -- and it is -- that conservatives tend to ignore reality when it comes to politics, economics, human rights, foreign policy, it's also true -- sadly, embarrassingly, incomprehensibly -- that liberals have blinders on when it comes to "alternative and complementary medicine." The Huffington Post, for example, is so filled with medical woo that it's hard to go there at all.

I've said it before, and it's not an original thought: if a therapy can be shown, by proper studies, to work, it's not "alternative" or "complementary," it's medicine. And, since virtually all of the woo has either been shown to be ineffective, or hasn't been studied at all, what it is is bullshit. And whereas I don't know how far it's penetrated into the right side of our political divide, it sure as hell doesn't belong on the left. But there it is.

Anyhow, the reason I bring it up is this article, which, in turn, refers to another:

Paul Offit’s editorial in The Journal of the American Medical Association (JAMA. 2012;307(17):1803-1804.) goes through the history of the National Center for Complementary and Alternative Medicine(NCCAM) and nicely points out that studies funded by NCCAM have failed to prove that complementary or alternative therapies have any more benefit than placebos.

Offit points out how NCCAM spent $374,000 proving lemon and lavender scents do not promote wound healing, $750,000 to prove that prayer does not cure AIDS, or improve recovery from breast reconstruction; $390,000 to find that ancient Indian remedies do not control type 2 diabetes, $700,000 to find that magnets to not treat arthritis or even carpal tunnel syndrome; and $406,000 to show that coffee enemas do not cure pancreatic cancer.

As much as we would love to find the new treatment that is available in your grocery store, or Ace Hardware, or Starbucks – it just has not been found.

Still, proponents of acupuncture, homeopathy, naturopathy, and even HCG diets, insist they have proof it is always in their own journals, with less than rigorous studies, and never reproduced in major medical journals. But clearly, science is less important to those who take these “treatments” than the potential of placebo effect.

As a surgeon I welcomed anything that might make a patient feel better about their upcoming operation or recovery. As long, that is, as it didn't lead them to rejecting rational therapy. "I don't think it can hurt," is something I often said. But I also saw the consequences of people who chose obvious bullshit over something that would have helped. A post I wrote a few years ago on Surgeonsblog still gets comments, most of them righteously huffy. There's nothing I can say that will convince believers that curds in their turns are not gallstones. (None, of course, has taken my suggestion to have them chemically analyzed, or simply to get before and after ultrasounds of their gallbladder.)

For whatever reason, the human brain is prone to magical thinking. In the case of medical woo, it only hurts one person at a time; and, as long as it's used along side real medicine, it might not even do harm at all. The teabagger form of magical thinking, on the other hand, has the potential to harm millions at once, and, in fact, to take down our entire country. So I guess it's worse than woo.

But neither form ought to have a place at anyone's table.

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