alternative health practice

Robert Todd Carroll

New Alternative medical degrees 'harm' universities

Suckers: How Alternative Medicine Makes Fools of Us All by Rose Shapiro Feb 2008

an insider's look at how clinical evidence is manipulated to package and market the placebo effect

UK universities are teaching "gobbledygook" following the explosion in science degrees in complementary medicine (3/22/07)

Why the National Center for Complementary and Alternative Medicine (NCCAM) Should Be Defunded by Wallace I. Sampson, M.D.

Too many quacks in alternative medicine By Michael Bradley May 31, 2004

"alternative" health practice

A health or medical practice is called "alternative" if it is based on untested, untraditional, or unscientific principles, methods, treatments, or knowledge. "Alternative" medicine is often based upon metaphysical beliefs and is frequently anti-scientific. Because truly "alternative" medical practices would be ones that are known to be equally or nearly equally effective, most "alternative" medical practices are not truly "alternative," but quackery. If the "alternative" health practice is offered along with conventional medicine, it is referred to as "complementary" medicine.

It is estimated that "alternative" medicine is a $15 billion a year business. Traditionally, most insurance companies have not covered "alternative" medicine, but American Western Life Insurance Company is typical of a growing trend. It offers a network of about 300 providers in California, Arizona, Colorado, New Mexico, and Utah specializing in acupuncture, aromatherapy, biofeedback, chiropractic, herbal medicine, massage, naturopathy, reflexology, and yoga, among other therapies. Also, Mutual of Omaha Insurance Co. has reimbursed clients for the costs of a non-surgical "alternative" therapy for heart disease. Dr. Dean Ornish, an internist and director of the Preventive Medicine Research Institute in Sausalito, developed the therapy, which includes a vegetarian diet, meditation, and exercise. Mutual of Omaha was quick to note that they were not opening the door to covering all forms of "alternative" therapies. They considered Dr. Ornish's treatment to have been proven effective.

The National Institutes of Health's Office of Alternative Medicine has supported a number of research studies of unorthodox cures, including the use of shark cartilage to treat cancer and the effectiveness of bee pollen in treating allergies. The most popular "alternative" therapies are prayer, relaxation techniques, chiropractic, herbal medicine, and massage. Very few scientific studies are done by "alternative" practitioners. Indeed, many disdain science in favor of metaphysics, faith, and magical thinking.

On the other hand, many questionable products touted as cure-alls or as cures for serious illnesses such as cancer or heart disease are promoted with scientific gobbledygook and misrepresentation or falsification of scientific studies. Jodie Bernstein, Director of the FTC's Bureau of Consumer Protection, offers the following list of signs of quackery:

** The product is advertised as a quick and effective cure-all for a wide range of ailments.

** The promoters use words like scientific breakthrough, miraculous cure, exclusive product, secret ingredient or ancient remedy.

** The text is written in "medicalese" - impressive-sounding terminology to disguise a lack of good science.

** The promoter claims the government, the medical profession or research scientists have conspired to suppress the product.

** The advertisement includes undocumented case histories claiming amazing results.

** The product is advertised as available from only one source.

The general rule is "if it sounds too good to be true, it probably is."

DAILY MAIL (London)
Hidden risks in alternative therapies (December 21, 1998).

"Potentially life-threatening problems have been caused by treatments such as homeopathy, acupuncture and chiropractic, a survey has found. Hepatitis B infections, nerve damage, allergic reactions and delayed diagnoses of
cancer were reported by GPs to researchers at the University of Exeter's Department of Complementary Medicine. It wants tighter controls on alternative therapies, which have not been properly tested and are mostly unregulated.

One in ten of the 686 GPs reported serious side-effects suspected to have been triggered by complementary therapies. A further third reported non-serious side effects such as inappropriate treatment. About half the serious side-effects, including nerve damage, spinal cord compression and worsening of existing conditions, resulted from spinal manipulation, usually by chiropractic or osteopathic techniques, according to the survey published in the International Journal of Risk and
Safety in Medicine. Acupuncture was blamed for two hepatitis B infections and a lodged broken needle, aromatherapy triggered allergic reactions and hypnotherapy caused one patient to suffer severe hallucinations.

Homeopathy was held responsible for at least one 'avoidable death' from pneumonia, there were delays in cancer diagnosis and asthmatics needed hospital treatment after being told to stop medication."

Why is "alternative" health care so popular?

The New England Journal of Medicine reported on a study in January 1993 which showed that about one-third of American adults sought some sort of unorthodox therapy during the preceding year. Why is "alternative" health care [AHC] so popular? There are several reasons.

Drugs and surgery are not part of AHC. Fear of surgery and of the side effects of drugs alienate many people from conventional medicine. AHC is attractive because it does not offer these frightening types of treatments. Furthermore, conventional medicine often harms patients. AHC treatments are usually inherently less risky and less likely to cause direct harm.

Selective thinking and confirmation bias can easily lead one to focus on cases where surgeons amputate the wrong limb, remove the wrong part of the brain, or kill a patient by administering too much anaesthetic or radiation. Many people ignore the millions of patients who are alive and well today because of surgery or drugs. They focus instead on the cases of patients who die after "routine" surgery, who are permanently disabled because of an adverse reaction to a drug, or who are killed by a deranged nurse acting as a self-appointed "mercy" killer.

This fear and skepticism regarding drug treatment, hospitalization, and surgery is not without foundation. Some harm is caused by malpractice; some is the tragic but inevitable outcome of unpredictable reactions to drugs or surgery. Because there are often legal issues involved, physicians and hospitals are often not forthcoming with details of patient deaths for which they might be responsible. Confidence in medicine erodes with each report of "therapeutic misadventures."

Are these "therapeutic misadventures" rare? As far as I know, there has never been a national study of the issue. There was a study done in New York in 1991 (The Harvard Medical Practice Study) which found that nearly 4 percent of patients were harmed in the hospital and 14 percent of these died, presumably of their hospital-inflicted injuries. Lucian L. Leape, a Boston physician, extrapolated from this data that as many as 180,000 Americans may be dying each year of medical injuries suffered at the hands of medical care providers. He notes, for dramatic effect, that this is the equivalent of three jumbo-jet crashes every two days. ("Truth about human error in hospitals," by Abigail Trafford, editor of the Washington Post's health section, printed in the Sacramento Bee, March 21, 1995, p. B7.)

On the other hand, the risks of being positively harmed by an "alternative" practitioner such as a homeopath, for example, are negligible when compared to the risks of being harmed by a conventional physician dispensing powerful drugs and performing risky surgeries. This is because a homeopath is not intervening in any significant way. The doses they give are not likely to have any effect on anyone. A homeopath is not likely to ever kill a patient by mistake. "Alternative" medical treatments are essentially non-interventionist and their risks are generally negative, not positive. The harm to the patients comes not from positive intervention but from not getting treatment (drugs or surgery) which would improve their health and increase their life span.

While it is true that conventional medicine is not without its risks--even fatal risks--it is unreasonable to reject it altogether on these grounds. Reasonable people can't ignore the diabetics now alive and well, thanks to their drugs, or the millions of people who owe their lives to vaccinations against lethal or crippling diseases. We can't ignore the millions whose pain is gone thanks to surgery, or who owe their continuing existence to successful medical treatment involving both drugs and surgery.

A reasonable response to the very real risks of treatment by conventional health care providers is to take greater responsibility for one's treatment. A reasonable patient cannot have blind faith in his or her physician, no matter how godlike the doctor may seem or try to present himself. (A very dear friend of mine who lived to be 80 thanks to pills and surgery, found great humor in telling her physicians she knew M.D. stands for "medical divinity.") We have to become more knowledgeable of the drugs prescribed to us. We have to participate more in our own treatment, which means we have to ask lots of questions and assume nothing. We can't assume that the drug the nurse wants us to swallow is the one our physician has prescribed. (Just ask, "What's this pill?" You should know whether you're supposed to take it or not.) We need to seek second and third opinions, which doesn't mean look for another doctor who will tell you what you want to hear. It means do research. Read about your illness and the prescribed treatment for it. We can never eliminate risk altogether when we must depend on human beings, fallible and imperfect as we are. But we can reduce our risk by being more responsible for our health care and being less passive. Some faith in the competence of our health care providers is necessary, but it need not be blind faith. You may have to have surgery to have a limb removed or an artery widened, but you may need to make sure that the surgeon ready to operate doesn't think he's supposed to remove your gall bladder. The young boy who was to have a leg amputated and had written in large ink letters on his good leg "NOT THIS ONE" may have gotten a laugh from the hospital personnel. We can admire the boy's humor, but it is his lack of blind faith that is most admirable to a skeptic.

Conventional medicine often fails to discover the cause of an illness or to relieve pain. This is true of AHC as well. But conventional practitioners are not as likely to express hopefulness when their medicine fails. "Alternative" practitioners often encourage their patients to be hopeful even when the situation is hopeless.
When conventional medicine does discover the cause of an illness, it often fails to offer treatment that is guaranteed to be successful. Again, AHC offers hope when conventional medicine can't offer a safe and sure cure. A local television news anchor rejected chemotherapy for her breast cancer in favor of Gerson Therapy, a treatment approved of by Prince Charles. Pat Davis followed a rigorous 13-hour-a-day regimen of diet (green vegetables and green juices), exercise, and coffee enemas (four a day) developed by Dr. Max Gerson. Davis’ mother had had breast cancer twice, undergoing chemotherapy and a mastectomy. Davis knew the dangers of chemotherapy and the effects of breast surgery. She refused to accept that there were no alternatives. Gerson therapy gave her hope. When it was clear that the Gerson treatment was ineffective, Davis agreed to undergo chemotherapy. She died four months later on March 20, 1999, at the age of 39, after two and one-half years of fighting her cancer. Could chemotherapy have saved her had she sought the treatment earlier? Maybe. The odds may have been against her, but the slim hope offered by scientific medicine was at least a real hope. The hope offered by Gerson is a false hope through and through.
AHC often uses "natural" remedies. Many people believe that what is natural is necessarily better and safer than what is artificial (such as pharmaceuticals). Just because something is natural does not mean that it is good, safe, or healthy. There are many natural substances that are dangerous and harmful. There are also many natural products that are ineffective and of little or no value to one’s health and well-being.
AHC is often less expensive than conventional medicine. This fact has made "alternative" treatments attractive to Health Maintenance Organizations (HMOs) and to insurance companies, both of whom are coming to realize that it is cheaper and thus more profitable to offer "alternative" treatments. If "alternative" therapies were truly alternatives, it would make no sense to pay more for the same quality treatment. However, most so-called "alternative" therapies are not truly alternatives; they are not equally effective treatments. Thus, the fact that they are cheaper is of little significance.
AHC is often sanctioned by state governments, which license and regulate "alternative" practices and even protect "alternative" practitioners from attacks by the medical establishment. Chiropractors, for example, won a major restraint-of-trade lawsuit against the American Medical Association in 1987. A federal judge permanently barred the AMA from "hindering the practice of chiropractic." Being government licensed, regulated, and protected is seen as legitimizing AHC. Actually, much of the licensing and regulation is aimed at protecting the public from frauds and quacks.
Many doctors of conventional medicine treat diseases first and people secondly. Alternative" practitioners are often "holistic," claiming to treat the mind, body and soul of the patient. Many people are attracted to the spiritual and metaphysical connections made by AHC practitioners. Many AHC patients claim that their "healers" treat them as persons and seem to care about them, whereas conventional doctors often seem to lack good "bedside manner."
Conventional physicians often work out of large hospitals or HMOs and see hundreds or thousands of patients for their specialized needs. "Alternative" therapists, on the other hand, often work out of their homes or small offices or clinics, and see many fewer patients. More important, those who seek help from a conventional physician usually do not care what his or her personal religious, metaphysical, or spiritual beliefs are. Those who seek "alternative" medicine often are attracted to the personality and worldview of their practitioner. For example, a person with diabetes who goes to an endocrinologist probably will not be interested in his or her physician’s belief in chi or any other spiritual or metaphysical notions. Whether the doctor believes in God or the soul is irrelevant. What matters is the doctor’s knowledge and experience with the disease. If the doctor is kind and personable, that is all the better. A cold and indifferent "alternative" practitioner would not have much business. A cold and indifferent conventional physician may have patients standing in line for treatment if he or she is an excellent physician.
Many people apparently do not understand that conventional medicine has the same shortcomings as all other forms of human knowledge: it is fallible. It also is correctable. Systems of thought that are fundamentally metaphysical in nature are not testable and can therefore never be proven incorrect. Hence, once they get established they tend to become dogmatically adhered to and never change. The only way to change dogma is to become a heretic and set up your own counter-dogma. When scientific medicine errs, it errs in ways that can be corrected. Treatments and practices that are ineffective or harmful are eventually rejected.
"Alternative" practices and treatments are often based upon faith and belief in metaphysical entities such as chi and lend themselves to ad hoc hypotheses to explain away failure or ineffectiveness. In scientific medicine there will be disagreement and controversy, error and argument, testing and more testing, etc. Decisions will be made by fallible human beings engaging in the fallible practice of scientific medicine. Some of those decisions will be bad decisions, but in time they will be discovered for what they are and treatments which were once standard will be rejected and replaced with other treatments. Medicine will grow, it will progress, it will change dramatically. Homeopathy, iridology, reflexology, aromatherapy, therapeutic touch, etc. will not change in any fundamental ways over the years. Their practitioners do not challenge each other, as scientific medicine requires. Instead, "alternative" practitioners generally do little more than reinforce each other.
"Alternative" therapies appeal to magical thinking. Ideas with little scientific backing, such as those of sympathetic magic, are popular among "alternative" practitioners and their clients. Conventional medicine is rejected by some simply because it is not magical. While conventional medicine may sometimes seem to work miracles, the miracles of modern medicine are based on science not faith.
The main reason people seek "alternative" health care, however, is that they think it "works." That is, they feel better, healthier, more vital, etc., after the treatment. Those who say "alternative" medicine "works" usually mean little more than that they are satisfied customers. For many AHC practitioners, having satisfied customers is all the proof they need that they are true healers. In most cases, however, a person's condition would have improved had he or she done nothing at all. But since the improvement came after the treatment, it is believed that the improvement must have been caused by the treatment (the post hoc fallacy and the regressive fallacy). In many cases, the successful treatment is due to nothing more than the placebo effect. In some cases, treatment by conventional medicine is very painful or it causes more harm than good and the improvement one feels is due to stopping the conventional treatment rather than to starting the "alternative" one. (One reason spiritual healers in pre-modern medicine times may have had better success rates on the battlefield than conventional healers is due to the fact that conventional healers often harmed their patients: e.g., infecting them while treating them. Spiritual healers, who did nothing to the wound, didn't infect the patient, who often healed thanks to the body's own internal healing mechanisms.)

In many cases, the cure was actually effected by the conventional medicine taken along with the "alternative" therapy, but the credit is given to the "alternative." Also, many so-called cures are not really cures at all in any objective sense. The patient may have been misdiagnosed in the first place, so no cure actually took place.ⁿAlso, a patient subjectively reports that he or she "feels better" and that is taken as proof that the therapy is working. Psychological effects of therapies are not identical to objective improvements, however. A person may feel much worse but actually be getting much better. Conversely, a person may feel much better but actually be getting much worse.
Finally, many advocates of "alternative" therapies refuse to admit failure. When comedian Pat Paulsen died while receiving "alternative" cancer therapy in Tijuana, Mexico, his daughter did not accept that the therapy was useless. Rather, she believed that the only reason her father died was because he had not sought the "alternative" therapy sooner. Such faith is common among those who are desperate and vulnerable, common traits among those who seek "alternative" therapies.

See Topical index for entries on numerous "alternative" health practices.

ⁿA study by researchers at the Johns Hopkins Hospital in Baltimore of 6,000 patients diagnosed with cancer found that one out of every 71 cases was misdiagnosed (a 1.4% error rate). See "Misdiagnosing Cancer" by John McKenzie, May 9, 2001, ABCNews.com.

further reading

Medical Suburban Myths (from the Suburban Myths Page)

Myth 2. Prescription drugs are one of the leading causes of death.

Myth 3. Most medical treatments have never been clinically tested.

Myth 19. Medical doctors typically know nothing about nutrition.

Myth 21. Faith healing works.*

Myth 22. Dr. Randolph Byrd scientifically proved that prayer can heal.

Myth 23. Even if Dr. Byrd failed, others have succeeded in proving scientifically that prayer heals.

Myth 25. Transplant organs carry personality traits which are transferred from donors to receivers.

Myth 31. Crimes, mental illness, suicides, and emergency room visits increase when there is a full moon.

Myth 43. Suicide increases over the holidays.

Myth 46. Switching to a low-tar, low-nicotine cigarette will reduce one's chances of being exposed to the carcinogens in cigarette smoke.

Myth 47. Vaccination* of children with the (MMR) vaccine to prevent measles, mumps and rubella causes autism.*

Myth 53. Sugar causes hyperactivity in children.

Myth 54. Alcohol, especially red wine, is good for your health.*(read this one carefully and to the end) and *

Myth 55. A migraine is a bad headache.

Myth 58. The moon can trigger ovulation and bring on fertility depending on what phase the moon was at when you were born.

Myth 59. The mercury in dental amalgam is poisoning people.*

Myth 60. You should drink eight glasses of water a day for good health.* One study, however, does seem to have good evidence that drinking five glasses a day is better than drinking two or fewer with respect to fatal coronary heart disease.

Myth 71. A diet low in animal fat will prevent high cholesterol which will prevent atherosclerosis which will make you immune to having a heart attack.

Myth 72. Pasteur renounced all his works on his death bed.

Myth 73. Laetrile is an effective cancer treatment whose humanitarian discoverer has been persecuted, depriving millions of people of the benefits of this wonder drug.

Myth 74. Peptic ulcers are caused by stress and eating spicy food.*

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