Respectful Insolence

I’ve lamented the infiltration of woo into academic medicine. I’ve even gone so far as to try to keep a list of all the academic medical centers in North America that have “integrative medicine” programs that credulously teach and promote non-evidence-based medicine as though it were evidence-based with my Academic Woo Aggregator. I’ve speculated that the reason academic medical centers are susceptible to the blandishments of woo-meisters is because patients want it and are willing to pay for it. Given that insurance companies won’t pay for this stuff, it’s cash on the barrelhead direct from the patients without all that nasty mucking about with third party payer forms and fighting for reimbursement for services rendered.

Now I know it is indeed all about the money. Thanks, Abel. I had always suspected as much.

Comments

  1. #1 howard
    April 17, 2008

    ORAC,
    You have my complete agreement about woo. As a pharmaceutical/medical writer who believes in Samuel Johnson’s observation, it’s most certainly about the money. However, in 29 years of reading medical literature, I can still be amazed at the versatility of placebos. Perhaps CAM’s infiltration into academic medicine can be explained by the possibility that patients feel better (or believe they feel better) when getting what they believe. Perhaps medical centers would be better served by departments of placebo studies, or placebology.

  2. #2 Eamon Knight
    April 17, 2008

    But…but…I thought it was you allopathic doctors and Big Pharma who were out to rob the unsuspecting public. Now I learn that alt-med is doing it too! Who can I trust? I’m so confused….

  3. #3 T. Bruce McNeely
    April 17, 2008

    Big CAM?
    Big Woo-woo?

    = Big Money.

  4. #4 dean
    April 17, 2008

    Given that insurance companies won’t pay for this stuff…

    Woo is starting to creep into insurance coverage too. My medical insurance covers acupuncture.

  5. #5 Sastra
    April 17, 2008

    Someone once suggested the label “Big Mommy” for alternative medicine, and it stuck with me.

    Mommy doesn’t know science, but she does know what really works, and she knows it without all that elitist study and book-learning. She uses instincts, intuitions, traditions, and all sorts of natural folk remedies lying around the house and garden. After all, that’s what her mother did, and her mother’s mother before her. Her “experiments” consist only of “try it and you’ll see.” Why think negatively?

    It’s okay for mommies to lie to their little charges, and tell them a kiss which will “make them all better.” If you feel better, even a little bit, then they’ve done their job. They dispense magic feathers, miracle teddy bears, and lemon drops with special powers. It doesn’t matter if they’re all placebos — they “please,” and that’s what it’s all about. Believe.

    You can relax and trust Big Mommy, because if she lies it’s for your own good.

  6. #6 Dr Aust
    April 18, 2008

    I like “Big Mommy”.

    Given the way that CAM has the potential to screw people over by taking lots of their money in exchange for palcebos and sympathy, and sometimes to bamboozle them into neglecting to have propert treatment, can I suggest the following possible mnemonic for what happens to the users:

    “CAM-shaft-ed”

  7. #7 Lenora
    April 18, 2008

    I love Sastra’s Big Mommy. It is a great decription of well-meaning CAM practioners as well as the field itself. My own mommy was a tough as nails real estate saleswoman. Maybe that’s why the woo mommies (especially the woo midwives) scare the crap out of me.

  8. #8 Matlatzinca
    April 18, 2008

    Have you seen Skeptoid’s take on this? http://skeptoid.com/episodes/4003
    I was discussing the use of “integrative” practices at academic centers with a colleague. The main thrust of the “pro” argument was to provide things that many patients would seek out anyway, but by providing them in a “controlled” environment you ensure that they are also getting effective therapy. The main thrust of the “con” argument is that this provides legitimacy to quackery.
    I can’t bring myself to condone the practice, however, simply based on the fact that one would knowingly be providing a fraudulent service.
    Big Mommy – good one

  9. #9 Ken Connor
    April 19, 2008

    Woo is thriving because ordinary citizens have lost confidence in medical quacks like you, Orac.

  10. #10 Phoenix Woman
    April 20, 2008

    Want to make this go away? Back universal free health care for all. It’s not a coincidence that alternative modalities started gaining popularity as a) trad-med costs started going up and b) insurance companies started to cut back on coverage. Altie therapies can be pricey, but most are still cheaper than, say, a week’s stay in a hospital. And if you’re someone in a desperate situation — in need of cancer treatment yet unwilling to drive your family into bankruptcy for it — then guess what? You’re easy meat for the woo brigade.

  11. #11 Orac
    April 21, 2008

    No, that won’t do it. Need I remind you that the U.K. has universal health care, and its government also funds a homeopathy hospital, while Prince Charles pushes for ever greater funding of woo by the NHS.

    Sorry, universal health coverage won’t solve the woo problem.

  12. #12 BB
    April 24, 2008

    Sorry this is late but another reason it is here is that medical students demand to learn it.

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