Respectful Insolence

Along with Dr. R.W. and few others, I’ve made a bit of a name for myself in the medical blogosphere by bemoaning the infiltration of non-science- and non-evidence-based medicine into academia. It’s not a particularly popular viewpoint. The prevailing attitude seems to be: Why be so negative? It’s all good. Moreover, with a credulous media eager to publish stories of “healing” and “humanistic” medicine, those of us who remain skeptical of applying unproven and/or untested remedies in an academic setting, thus giving them the imprimatur of academic medicine and the respect associated with it, are easily painted as dinosaurs, unable to get with the plan, unaccepting of the new order of medicine.

About a month ago, I mentioned how the mainstream media is starting to take notice of what had heretofore been primarily discussed among physicians concerned with the issue and bloggers alarmed at the infiltration of pseudoscience into what should be the bastions of scientific medicine. For example, Julie Deardorff, the resident antivaccinationist and woo-friendly columnist and blogger for the Chicago Tribune, recently gloated about the newfound “respectability” of alternative medicine. However, as annoying as she might be, Julie’s strictly small fry. Granted, the Tribune is indeed an important newspaper. However, it’s primarily a regional paper servicing, aside from Chicago, the Midwest.

Now, it appears, the national media have started to stand up and take notice. A couple of weeks ago, there was a report in the U.S. News & World Report about how academic medical centers are “embracing” complementary and alternative medicine (CAM), a.k.a. “integrative medicine,” starting with, of course, an anecdote:

“To be blunt, if my wife and I didn’t think it was helping him, we wouldn’t have continued with it,” says Dan Polley. He’s talking about Mikey, the Polleys’ 2½-year-old in the next room, who was diagnosed with acute lymphocytic leukemia when he was 6 months old. Chemotherapy, radiation, and a bone marrow transplant have been crucial elements of Mikey’s treatment. But the “it” his father speaks of is nothing like these aggressive, costly, and heavily researched exemplars of western care–it is a kind of touch therapy, from the camp of alternative medicine. Gentle and benign, “healing touch” is intended to rebalance the energy field that its practitioners believe surrounds the body and flows through it along defined pathways, affecting health when disrupted. Several times a week, therapist Lynne Morrison spends 20 minutes unblocking and smoothing Mikey’s energy field, which energy healers like Morrison say they can feel and correct.

Before a recent session, Mikey was grouchy, drawing up his legs and issuing periodic yowls. His stomach hurt, said his father. But as the little boy nestled in his father’s arms and Morrison moved her hands around his body, lightly resting them here and then there, his tenseness loosened and he quieted for a few minutes at a time. The Polleys believe that the therapy not only calms their son but is aiding his return to health.

The setting for the unorthodox therapy–an academic medical center–would have been startling just five or 10 years ago. Morrison is on the staff of Children’s Memorial Hospital in Chicago, a hard-nosed, tough-cases, research-oriented emblem of western medicine. It perennially ranks among America’s premier hospitals and is the principal pediatric teaching hospital for Northwestern University’s Feinberg School of Medicine. And Mikey is only one of many children there receiving care that not long ago was called alternative medicine. Now it is more often called CAM, for complementary and alternative medicine, or integrative medicine, to avoid the loaded “alternative.” The message the new labels are meant to convey is that the therapies more often go hand in hand with traditional medicine than substitute for it.

As much as I’m sympathetic to parents of children with cancer, it irritates me to see an anecdote presented as though it means that the therapy is effective. With all due respect to Mr. Polley, I have to point out that his assessment of whether the reiki therapy being administered to his son is close to useless. Confirmation bias, regression to the mean, and all sorts of other biases make his assessment of whether the therapy has done anything for his son unreliable at best. Be that as it may, I guess that I’ll have to add Children’s Memorial Hospital to my Academic Woo Aggregator. After all, it offers all sorts of energy healing, along with this embarrassingly credulous description:

Our bodies are always trying to move toward balance and health. Energy healing encourages the flow of our natural energies. The term “energy healing” covers a wide range of styles and techniques which serve to positively affect the human energy field.  Hands-on energy work assesses disturbances in the human energy field, and helps to aid the individual’s body to enhance the natural flow of healthy life force.  Patients and their families report that energy healing often provides a sense of deep relaxation, and reduction in the experience of pain.  Energy healing is also called “touch healing” in our studies.  Research is presently being conducted to provide evidence to show how the disturbances and movement of these subtle energies may affect the physical condition of the human body.

The woo, it hurts. This is the sort of language I’d expect to find on Whale.to or Dr. Mercola’s website, not on that of a hospital affiliated with a major academic medical center. But, back to the article. It’s a bit of a mixed bag. On the one hand, it serves up risible quotes form luminaries such as Dr. Andrew Weil:

Most academic hospitals are fairly conservative when it comes to CAM; the usual menu offers acupuncture, yoga, meditation, and variations on massage such as reiki. This tracks the philosophy of Andrew Weil, founder of the University of Arizona Program in Integrative Medicine and CAM’s public face, if there is one. “I teach and urge people to use a sliding scale of evidence,” says Weil. “The greater the potential to cause harm, the greater the standard of evidence should be.”

The wag in me can’t help but point out that, using Dr. Weil’s “logic” (such as it is), the über-woo that is homeopathy should require no evidence whatsoever before widespread adoption. After all, true homeopathic remedies are nothing but water, given that the dilutions involved would result in not a single molecule of active substance remaining.

Although, overall the article is overly positive and solicitous of unscientific CAM modalities, dutifully repeating anecdotes that show nothing and could be due to confirmation bias or regression to the mean, it does include some skepticism and a few quotes pointing out how regression to the mean, the placebo effect, and confirmation bias can account for much of the apparent “efficacy” of CAM interventions. Unfortunately, the article is marred by credulous reporting of glowing patient testimonials. Too bad Avery Comarow, the reporter responsible, seems unaware that testimonials are almost useless as far as determining whether a particular therapy “worked” or not. Fortunately, he was able to put the myth that more than half of Americans use “alternative” therapies into perspective:

CAM’s ascendance isn’t entirely driven by money–researchers make frequent references to obligation. “We want patients to have access to these therapies in a responsible fashion,” says Lisa Corbin, medical director of the Center for Integrative Medicine at the University of Colorado Hospital. That implies a public clamor for such services, and patients may indeed talk about and ask for CAM more than they used to (although that isn’t clear). But surveys showing widespread use–like one issued by the Centers for Disease Control and Prevention in 2004 reporting that 62 percent of adult Americans had used some form of CAM in the previous year–are highly misleading. The big numbers reflect activities such as prayer, which few would consider CAM, and meditation, now routinely prescribed to help lower high blood pressure. The Atkins and Zone diets (“diet-based therapies”) were counted in the CDC survey, too. A more selective reading indicates that about 5 percent used yoga, 1.1 percent acupuncture, and 0.5 percent energy therapy, to pick three more-representative offerings.

This actually confirms what I had suspected, that the estimate of how many Americans use non-evidence-based modalities is grossly exaggerated, most likely because modalities not generally considered “alternative” by most (such as prayer) are included, as are modalities that have been coopted as “alternative” when in fact they are completely conventional (such as nutrition) were lumped into the total. Unfortunately, it also confirmed what I had feared, namely that serious, serious woo has become acceptable in some academic medical centers. I’ve already ranted about how several medical schools are offering homeopathy and “energy medicine” to patients, not to mention even reflexology and Rudolf Steiner’s “anthroposophically extended medicine.” Little did I suspect that detoxification woo could be found at what is otherwise a stronghold of scientific medicine:

Still, some academic hospitals give patients access to highly controversial therapies. Thomas Jefferson University Hospital in Philadelphia and Maryland’s integrative medicine center, for example, provide homeopathic services. And patients at Oregon Health and Science University Hospital in Portland and the University of Pittsburgh Medical Center can see a naturopath, generally a non-M.D. who advocates nonmedical aids such as proper nutrition, colonic irrigation (a polite term for enemas), and special water baths to stay healthy without drugs or surgery.

Noooo! Not the University of Pittsburgh! Colonic irrigation? Say it ain’t so!

I say this because I know that the Department of Surgery, at least, at the University of Pittsburgh is one of the most highly academic and scientific research-oriented departments of surgery there is.

The question that remains after looking at the increasing acceptance and even boosterism for CAM and integrative medicine in academia documented in this article is a simple one: Why? Insurance doesn’t pay for most of these therapies, insurance companies, whatever their greed and other shortcomings, having decided that there is no evidence that they work. Consequently, it’s cash on the barrelhead for academic medical centers reeling from recent cuts in Medicare and Medicaid reimbursement.

Still, that’s not enough to explain it. So what is? It turns out that, if you look closely at these centers, many of them are the result of a wealthy donor (or donors), as is the case for Duke University, Thomas Jefferson University, Columbia University, UC Irvine, Children’s Memorial Hospital, just to name a few. If it’s not a wealthy donor, it’s the Bravewell Collaborative. Alternatively (if you’ll excuse the term), it’s funding from the National Center for Complementary and Alternative Medicine (NCCAM) that drives the creation of these centers, which is a reason why I’m becoming more and more soured on the very concept of NCCAM. Finally, as Dr. Wally Sampson points out, the assault on science-based medicine being taken to the very heart of academia appears to be part of a broader agenda designed to transform the very nature of medicine away from science and evidence. That NCCAM is actively promoting this transformation is reason enough, as far as I’m concerned, to echo Dr. Sampson’s criticism of NCCAM, and, either willingly or as a useful but unwitting ally, NCCAM appears to be doing a lot to promote this transformation. Remember, NCCAM was not created because scientists or doctors clamored for it; it was created because powerful politicians with a penchant for alternative medicine demanded it.

The adoption of CAM in so many medical schools, with many more clamoring to jump on the bandwagon, appears to be a step backward for academic medicine. After all, medicine has finally, after over a hundred years, evolved to the point where it can actually become truly science- and evidence-based. Unfortunately, the growing uncritical acceptance of CAM in academic medicine is a threat to the continuation of that evolution. I’ve said it many times before, and I’ll emphasize it once again, there should be no such thing as “alternative” medicine (or “complementary” or “integrative” medicine). There is medicine that is effective, as determined by basic science and clinical trials, and there is medicine that is not or is as yet unproven. There is no good reason that I can come up with to justify “integrating” the latter with the former, particularly in academia.

Comments

  1. #1 Chris
    January 21, 2008

    In order to gain some knowledge on CAM, I attended a lecture series at my medical school which covered the basics of a variety of CAM therapies. What I heard was always interesting, mostly benign, and rarely scientific or EBM (the one exception being an accupunturist who presented some studies). I majored in physics as an undergrad, and I found some of the pseudoscience being presented in the homeopathy lecture absolutely appalling. One psychiatrist started talking about the quantum effects of homeopathic concoctions on water molecules. Fool. Quantum is an easy target for the pseudoscientist. I hope all of the electrons in his car tunnel through a bridge someday.

    Despite the lack of science, I think CAM does have a place in academic medical centers. The child with ALL wasn’t healed by ‘touching,’ but his pain/anxiety was alleviated. Perhaps it is purely placebo, but the risks associated with ‘touching’ are none. So, it seems harmless and anecdotally helpful in this case. It absolutely did not cure the ALL, but curing isn’t the only concern physicians should have. CAM could help western medicine beter treat the patient rather than the disease. I agree that pseudoscience should be ousted from academia, but don’t throw the baby out with the bath water.

  2. #2 inkadu
    January 21, 2008

    This is a bummer, man.

    But, on the plus side, if alternative therapies are offered by mainstream insitutions, at least they will be truly complementary — that is they will be completely ancillary to treatment that is actually effective. People will go to their standard institutions for chemo and for a touch of woo, instead of just foregoing the doc altogether.

    On the one hand, yes, it’s completely ineffective. On the other hand, patients want it and helps them feel more comfortable. There’s a real limit on how you well you can educate patients, and you risk alienating them or losing them entirely if you can’t adapt to their views.

    The danger, however, is that doctors will become confused about what is really effective. I wonder how long it will be before an MD prescribes completely alternative treatments, gets sued when it doesn’t work, yet mounts an effective defense saying that CAM is acceptable treatment as demonstrated by both custom and training. That would be a real disaster. Is there any chance of that defense working now or in the future?

  3. #3 Caledonian
    January 21, 2008

    Physicians routinely underestimate how much of standard treatment is truly effective. There’s no way they’ll be able to tell what’s nonsense and what’s valuable once the walls between effective and “complementary” medicine come tumbling down.

  4. #4 Paul
    January 21, 2008

    Orac, I share your concerns, but your piece does show what science is up against. You show that the statistics on how many use CAM are inflated because it includes, among other things, prayer. I’d say the fact that a large proportion of the US population hopes that a verbal appeal to a deity (or one of their representatives) whose existence cannot be proved by any scientific means to will help treat illness goes a long way to illustrating why it is so difficult to prevent the infiltration of medicine by woo.

  5. #5 Sastra
    January 21, 2008

    When my kids were babies and toddlers I found that the best way to sooth them out of fits was to hold them gently in my arms and then ignore them completely while I calmly walked around the room and slowly described the elements of the stove, how to put curtains on a window, the capabilities of the vacuum cleaner, using a light switch, whatever. I wasn’t paying attention to their problems, and pretty soon they weren’t either. Their curiosity was piqued. Small children are information sponges, and anything unexpected or new will sometimes distract them out of a crying fit. I suspect that the “Therapeutic Touch” (which involves no touching by the way — not to be confused with massage) worked the same way my parts- of-the- furnace lectures did. Never underestimate the Power of “Huh?”

    The assault on science-based medicine is not only “part of a broader agenda designed to transform the very nature of medicine away from science and evidence.” It’s part of a broader agenda to transform the very nature of reality away from science and evidence. When you have science and technology gaining more and more power and prestige and a culture which values faith and religion, sooner or later there will be strong efforts made to “integrate” them into “complementary” modalities which work best together, by recognizing the whole person — flesh and spirit.

    You can’t see the cosmos as infused with magic and meaning and purpose and plan, but keep it all out of how you actually live your life.

  6. #6 Sastra
    January 21, 2008

    Yeah, what Paul said…

  7. #7 Sid Schwab
    January 21, 2008

    It’s all of a really depressing piece; in the US, we seem happily to be ceding reason to magical thinking, whether medical, economic, political, or evolutionary. I guess at some point it becomes self-perpetuating: as the damage done by people who “think” that way becomes more insoluable, people turn even more to craziness to cope. On the other hand, as we spin our way down into irrelevance, the rest of the world ignores us while passing us by; or buys us up on the cheap. Maybe that’s the only solution.

    Oregon, too? Geez. That’s where I grew up.

  8. #8 Clare
    January 21, 2008

    Another problem with the list of non-evidence based therapies is that, in some cases, users may not necessarily buy into the the claims made on their behalf. I do yoga for example, and I routinely ignore the patter of the instructor when it strays into serious woo-land. I do not think it’s doing anything particularly miraculous for me; I think it’s good for flexibility and balance, and it reduces stress, and that’s it. It’s harder case to make for something like acupuncture, but even there, I suspect many people seek it out not because they either believe, or even know much about the exotic notions of the body that underlie it, but because someone else recommended it to them, or they’d heard it might be helpful — the same kind of testimonials described in the post. Practical results, not the fulfillment of exotic philosophies, is what is important to them. Housing such practices in hospitals adds the stamp of authority to the persuasiveness of testimonials, and makes the practices more credible. It is not unreasonable, in such circumstances, for patients to adopt non-evidence based “therapies,” since they are relying on the word of trusted friends and trusted authorities, although not necessarily the tortured logics and faulty explanations of the therapies in question. In other words, I don’t think we’re looking at a tsunami of irrational patients so much as a failure of nerve among medical authorities to make Orac’s simple point: either it works or it doesn’t, or we don’t know.

  9. #9 Dawn
    January 21, 2008

    I wonder how much the “gentle touch” is calming the child over anything else. Children, especially early verbal ones like this one, respond more easily to non-verbal cues. And, at least the article states it works only for a “few minutes at a time”.

    OT…at work on Friday was a sign URAC is coming….I read it as ORAC and was all excited at the chance to meet you….darn.

  10. #10 Marilyn
    January 21, 2008

    Please explain the term “woo.”

    My brother and his wife send their kids to a Waldorf school and sometimes take them to a doctor who is a follower of Rudolph Steiner. They live in the SF Bay Area, which seems to be a hotbed of alt med. I have to keep my mouth shut, though, to avoid getting into an argument.

  11. #11 jen_m
    January 21, 2008

    How much has surgery progressed in terms of the standard of evidence? I’m not a physician, but I wonder, because when I’ve needed medical care and had to talk to surgeons, I’ve heard a lot of “I find that X works better,” and other first-person case-series type language, instead of “the literature says that Y produces less morbidity.” I also have heard some “my mentor taught me this technique and I find it produces X.” Lancet and other high-profile clinical publications still provide case reports and case series as evidence for the success of novel surgical techniques. Is surgery really as traditional/historical as it seems? If so, how does medicine justify integrating surgery into its training?

    I’m not trying to be cute, or aggressive – it just seems to me as a bystander that there is still a lot of non-scientific basis for “traditional” physician’s training and work. I’d be pretty relieved to hear how wrong I am.

  12. #12 Capt. Craig
    January 21, 2008

    Ok Orac, I know that you are a sawbones and not a mind-bender but the following appeared in the local paper. It is conveniently unavailable on-line but can be obtained by request from the editor.The piece bothers me on several levels not the least of which is the fact that we have a full professor at a medical school using the meanderings of an artist and social weirdo as a basis for psychiatric analysis. The underlying thrust of the piece and the religious affiliations of Amin always seem to go hand in hand, don’t they?
    Your, and anyone else’s thoughts?

    Hyperreligiosity and culture: the role of mental health

    By Dr. Amin A. Muhammad
    Religion has an influence on its followers in terms of psychological solace, spiritual well-being and adoption of righteous path in life. All religions teach humanity and love for mankind. Faith-driven inner peace, by its virtue, has much to do with a preconceived harmonious life pattern.
    Culture dictates a pattern of customs, beliefs, rituals, language, thoughts and generation-transmitted rules which are pathognomonic of a given community or tribe. Many a time, religion and culture get blended together and become difficult to differentiate, resulting in serious complications merely because of misunderstanding and misinterpretation.
    With the influence of media, new information and technological advancements, the cultural beliefs and rituals are weakened and the current generation is more open to new ideas and modernization. However, the traditional mindsets of many people have shown more rigidity and tough ego boundaries when it comes to innovation and accepting enlightenment in thought processes.
    Ironically, many such traditional cultural beliefs have found religious approval by perpetrators who are not yet ready for the Cultural Revolution. There are many individuals who migrate from developing countries to western developed countries but do not wish to accommodate the good values of local culture but rather, at times, develop resistance for any change at all.
    Disinhibition, immoral acts and liberty beyond decent boundaries are condemned by even western cultures and are in no way unique to eastern or traditional cultures. Problem arises when such values and beliefs are given the cover of religion and attempts are made to oppose in the name of religion.
    Of late, many such incidents have been reported in Canadian media, the most recent one is the “hijab” issue and subsequent killing of a 16-year-old girl in the Toronto area. A few cases were also reported which probably fell under the context of “honor killing” — as a result of cultural beliefs, rather than being sanctioned or approved by any religion.
    There are global reports about extremism, fanaticism and killings in the name of religion which would raise concerns about the mindset of the individuals who would perpetuate this reign of terror. The one possible reason is “hyperreligiosity,” which calls for a little understanding in psychological terms.
    According to artist and author R.S. Pearson, hyperreligiosity occurs when the outward forms and other aspects of religion become life-disabling; it is an ill-fitting grasp of the role of religion and God in one’s life.
    Pearson believes that psychiatrists see hyperreligiosity in someone having episodes of gross mental illness or epileptic fits in which they experience God. Politicians see this in the way terrorists use religion to justify murder and other criminal acts. This is also described as a type of obsessive mental illness in which a person cannot use their thinking faculties in a rational manner.
    Extensive work has been done on the mental-health aspect of hyperreligiosity. An Indian study found association of this phenomenon with epilepsy. Mystical experience is also a well-recognized seizure phenomenon. Some other western studies have identified a particular personality and behaviour pattern with temporal lobe (region of the brain) epilepsy. Some structural CT lesions were observed in persons with hyperreligiosity phenomenon. Mental illnesses with problem of hearing voices or seeing things when there is no real existence (hallucinations) have a role here; some personality disorders and even pre-mental illness states are also associated with this type of behaviour.
    There is also an indication from scientific work that a non-conducive environment during childhood can result in mental disturbances, and this also has much to do with hyperreligiosity.
    In its pure form, its existence is rare as no religion has room for extremism, but in those cases where it was induced it is secondary to brain-washing and designed misguiding.
    It is important that mental-health issues are to be looked for in the event of such behaviour and, if found, should be addressed. Cultural rigidity can be addressed by mass education and appropriate guidelines, and there should be an identified demarcation between culture and religion. The rare and induced cases can be dealt with by the legal and administrative authorities of the territories in question.

    Dr. Amin A. Muhammad is a professor of psychiatry at Memorial University of Newfoundland.

  13. #13 HCN
    January 21, 2008

    Marilyn asked “What is Woo”:

    http://scienceblogs.com/insolence/2006/08/reader_mailbag_what_is_woo_1.php

    You may be interested in this also:
    http://www.waldorfcritics.org/

  14. #14 Matlatzinca
    January 21, 2008

    Paul: You nearly hit it right on the money. The crucial piece of information I would add is that most people believe in the power of prayer, despite multiple studies showing it does not work. Who cares if you can’t prove the existence of god(s)/saints/angels/karma, etc. We can prove whether our thoughts can influence the world or not – turns out that they don’t.
    I left Children’s Memorial before they had their institute, though I now find myself at another academic institution that harbors a strong altie element (including reiki). I’ll just keep challenging the residents’ assumptions, and demanding critical thinking on clinical decision-making.
    Orac: I appreciate your candid disapproval of both academic institutions promoting woo, as well as exposing NCCAM for what it is (as you say, a political agenda). Another area (though I don’t know if this is too far off field for you) is woo being funded by the Defense Department.

  15. #15 Schwartz
    January 21, 2008

    Orac,

    “…as are modalities that have been coopted as “alternative” when in fact they are completely conventional (such as nutrition) were lumped into the total. ”

    In honest curiousity, what do you consider the criteria to determine a therapy that has been “coopted” by “alternative” medicine? If you look at an example like diet, I think you would find that practitioners of naturopathy dedicate a lot more study and training to diet than medical doctors (from what I understand, diet is hardly studied). If you were to take the collective knowledge of practioners like that compared to medical diet specialists, I suspect the “alternative” group would also have more collective and accessible knowledge on the topic. This is not fact, and I might be completely wrong, but that’s my impression on the topic of diet anyways.

    I remember asking both our pediatrician (who is actually pretty good and whom I like) and a Doctor of Naturopahty about infant diets, and although I was disappointed in the answer from both of them (this was an eye opener) the Naturopathist was able to provide us with more (albeit still inadequate) information.

    I know from personal experience, that when I got Mono during my final exams in University, I saw both a Naturopath and a doctor. The doctor told me to rest and wait it out. The Naturopath was much more specific regarding instructions of diet and vitamin suppliments. I was pleased by the outcome of that experience as I was able to complete my exams and my recovery period was very short. Anecdotal, I know, but in hindsight, even simple dietary advice was far more beneficial than the limited instructions received from the doctor.

  16. #16 Freddy the Pig
    January 22, 2008

    Chris in referring to someone invoking quantum woo “I hope all of the electrons in his car tunnel through a bridge someday.”

    That made my day. However given that the dufus is so dence that his head blocks neutrinos, what would happen in such an occurance.

    My own impression is that most doctors do not have good critical thinking skills. Now just as EBM is making headway agaist this it looks like an infiltration of woo into medical schools with the attendant double standard for evidence of efficacy will undermine the recent gains.

  17. #17 Dr. Matthew
    January 22, 2008

    I’m a clinical psychologist in a large medical center; my specialization is in behavioral medicine. At times, I offer minor instruction in empirically-supported meditation techniques (there’s some literature that suggests a difference between these and simple relaxation techniques). I am not, by and large, a supporter of CAM, however. There is plenty of good, empirical work being done to assist pt’s with psychosocial correlates of medical illness, that even as placebo I doubt their value in medical settings.

    I do have a great model for how these approaches SHOULD be handled. I have a friend that practices reiki. He has even…. I dunno…. reiki’d me (without my knowledge… I just thought I was getting a head rub). On the other hand, he does not charge for this, and has a day job at a design firm. Can’t these pseudo-spiritual practices just be treated like prayer, and kept on a private level?

    As an aside, that friend is also an ordained santeria priest. I don’t even ask what’s involved when he offers to pray for me!

  18. #18 Joe
    January 22, 2008

    Schwartz,

    Naturopaths are a exemplify the coopting of dietary advice. The advice and dietary supplements they sell are worthless insofar as they deviate from science-based knowledge. And you cannot tell where they depart from sensible ideas; except, you can be pretty sure that supplements are useless (unless you have a medically documented deficiency).

    Sure, naturopaths talk a good game (for those who cannot tell mud from shinola); that is not the same as offering better advice.

  19. #19 DermDoc
    January 22, 2008

    This is a bit off topic, but I feel the same way about cosmetics and dermatology.

    There has been such a rush to cosmetics (what some derms call the dark side) that the science is shoddy at best and spurious at worst.

    Cosmetics as well as alternative medicine should be held to the same high (read: randomized controlled trial) standard as alopathic medicine.

  20. #20 Yossarian
    January 22, 2008

    Perhaps Childrens’ Memorial is being extremely clever, offering this “treatment” primarily for the parents’ benefit, so they won’t be the annoyances and impediments they might otherwise be. After all, chemotherapy and radiation – therapies that are indeed effective a great deal of the time – are profoundly unpleasant, especially if you’re not quite three years old yet. I can’t imagine what it would be like to have a kid of mine treated with radiation and chemo. A “therapy” that appears to make the kid feel better is probably a real blessing to these parents, regardless of the fact that it’s objectively and in fact New Age voodoo bullshit.

  21. #21 Liesele
    January 22, 2008

    Sure. When my son who has eosinophilic enteropathy (gastroenteritis to be specific) was an infant, we kept a toy vacuum cleaner with him in his playpen. The vibrations helped soothe a baby who was in constant pain. Did that cure him? Obviously not. It didn’t hurt, and it seemed the vibrations helped him feel better, so we did it. Did I confuse this with medical treatment or therapy? No. Therapeutic touch? Sure, being held or snuggled or massaged will likely make a small child feel better. Is it curative or therapeutic in the sense of causing medical, quantitative improvement? I’d like to see that data.

  22. #22 Schwartz
    January 22, 2008

    Joe,

    There are vitamin treatments for illnesses that have been shown to work scientifically. Given that I was actually quite sick (and a student at the time, which we know live such healthy lifesytles…), I’m sure it was not unreasonable to believe that I had some sort of deficiencies in my ill state. She did not suggest any suppliments once I was healthy. Additionally, her physical exam was more thorough than the doctor I saw as was her assessment of my current diet (the doctor never even asked).

    Same goes for the Naturopath who we asked about infant diets. No suppliments were suggested. Only dietary suggestions were made and I was also provided with a bit of literature.

    My personal anecdotal evidence does not jive with your broad brush evidence-void accusation. I don’t see how studying/advising others on healthy diets consists of co-opting anything. Expecially when they take the time to actually inform people about it.

    I’m sure you can find examples of Naturopaths that prescribe useless suppliments that are useless, just like I can find doctors that prescribe medications that are useless. That doesn’t make the whole profession guilty.

  23. #23 isles
    January 23, 2008

    I am so, so disappointed in these institutions. How do they expect parents/patients to follow through on what they advise on scientific grounds when they go around offering treatments that have no scientific basis?

  24. #24 Joe
    January 23, 2008

    Schwartz,

    Everyone knows that dietary deficiencies can be treated with supplements. If you want dietary advice, see a Registered Dietitian (R.D., who can probably give you “a bit of literature” as well).

    Naturopaths are thoroughgoing quacks, and it is difficult for laypeople to tell when the common-sense advice ends and the lunacy begins. That is why you think it was reasonable to think that you had some deficiency when you were ill. Go to http://www.naturowatch.org/ and read about it.

  25. #25 khan
    January 23, 2008

    Therapeutic touch? Sure, being held or snuggled or massaged will likely make a small child feel better. Is it curative or therapeutic in the sense of causing medical, quantitative improvement? I’d like to see that data.

    I don’t know about the particular case referred to above, but ‘therapeutic touch’ often does not involve any actual touching.

  26. #26 Schwartz
    January 23, 2008

    Joe,

    I guess that just goes to show that broad brush strokes don’t always apply everywhere. Here in Ontario, they are regulated by law, and I never even heard any mention of any “Life force” descriptions that your site talks about.

    I suspect your biggest complaint about the Ontario practitioners would be that some of them might employ homeopathy — none of the ones I saw ever suggested it — as one of their treatment options, but this is no worse than my pediatrician who recommended cough medicine for children.

  27. #27 Liesele
    January 24, 2008

    Khan, whether or not “Therapeutic Touch” involves actual skin-to-skin contact (and I believe you are correct, and that the proponents of this technique sort of wave hands over the client), my point was jut that the personal attention and soothing would likely calm an ill child to some degree but that there is nothing to suggest it would actually be a medically useful tool as opposed to a parenting technique, just like snuggling and rocking a baby. I am all for any kind of infant massage, woo-type hand waving, and whatever else works to make a sick or stressed child and his parent feel more comforted, I just don’t want anyone claiming that people should pay them to do this or to teach them to do this or that doing this will somehow cure a child’s medical ills. Similarly, my adolescent daughter claims that yoga breathing helps her calm down and fall asleep; her related experience may or may not be valid but certainly are not clinical evidence of the value of yoga as a treatment for insomnia. If when feeling sick my son wants to try this, I don’t see how it would hurt but there’s no way I would pay someone claiming it would “cure” him to teach him to do this.
    Orac, sorry if this has beens something of a threadjack.