Respectful Insolence

Earlier this year, I wrote about Senator Tom Harkin’s attempt to hijack President Obama’s health care reform plans in order to inject quackery in the form of “alternative” or “integrative” medicine into the effort. Specifically, he wants to legitimize quackery by including it in any federal plan under the guise of “preventative care.” He even went so far as to invite the Four Horsement of the Woopocalypse into the Senate to testify and castigate the National Center for Complementary and Alternative Medicine for being too scientific and not proving that any of his favored woo works. Of course, his latest antics are merely the latest in a long line of his support for quackery. After all, he’s the Senator who, more than anyone else, is responsible for the scientific atrocity that is NCCAM, starting with the Office of Unconventional Medicine 17 years ago, which he nurtured as it grew into the Office of Alternative Medicine and ultimately into the woo juggernaut that it is now.

We haven’t heard much from Harkin lately, but, have no fear. He’s still hard at work on the Senate Health, Education, Labor and Pensions (HELP) Committee pushing “wellness” and “prevention,” which in Harkin-speak are codewords for everything from the reasonable (diet and exercise) to complete quackery, and he’s doing it totally under the radar. For example, buried in a news report on the Senate’s work on the massive 600-page health care reform bill, along with measures on malpractice and other issues, is this little gem:

“This prevention and wellness section — if we can hold this and keep it in the final bill as we go all the way through — is going to make a huge difference in how we practice medicine,” said Sen. Tom Harkin (D-Iowa)

Among the amendments adopted by the committee this week were:

  • A provision to allow medical students to defer loan repayment until they finish their residencies
  • Limits on the types of expenses medical students cover with loan funds
  • An provision to promote and fund research on pain management
  • Inclusion of alternative medicine workers in the bill’s definition of “healthcare workforce”

Ah, yes. “Prevention and wellness.” The “alternative” medicine Trojan Horse that looks so sturdy, so reasonable, on the outside but in whose belly resides all forms of pseudoscience. And Harkin’s doing it all completely under the radar, out of site. He knows how few people, faced with a 600+ page bill, will read every last section of it. Fewer still will understand just what is being proposed by this one little change in the definition of “healthcare workforce.” It opens the door to acupuncturists, reiki practitioners, homeopaths, and chiropractors to be considered part of the “healthcare workforce.” (Actually, chiropractors already are in essence considered part of the health care workforce, which is tolerable as long as they stick to back complaints; the problem is, as Simon Singh has shown, is that many of them think they can treat allergies, and all manner of other diseases through spinal manipulation.) Heck, come to think of it, what’s to keep someone like Hulda Clark from being considered part of the “healthcare workforce”? What sorts of standards would determine who would and would not be part of the healthcare workforce”? Anyone want of hazard a guess?

Be afraid. Be very afraid. Senator Harkin is a savvy operator, an, unless something is done, he is the one who will determine the face of healthcare reform.

Comments

  1. #1 Magnus
    July 2, 2009

    The deceptiveness of people who promote pseudo-science never ceases to amaze me.

  2. #2 teddlesruss
    July 2, 2009

    I am afraid, very afraid. But not of quackery. Of the attitude that thinks “woo” and derision is the way to go.

  3. #3 Scooter
    July 2, 2009

    teddlesruss:
    Perhaps you would like to share your actual comment here – rather thann expecting everyone to follow the link to your blog?
    No matter – I replied in your blog anyway.

    To everyone else – I apologise for other Australians. The woo is strong over here too . . . . unfortunately.

  4. #4 pinky
    July 2, 2009

    WTF? It really scares me when so called intelligent folks are buying the woo. Didn’t we all have middle school science?

  5. #5 Rogue Medic
    July 2, 2009

    This has Lysenkoism written all over it. What Sen. Harkin is working on is nothing but a hand out for people more corrupt than Bernie Madoff.

    I wrote about it in How to be a Part of the Healthcare Workforce.

    Maybe we will find out at Sen. Harkin’s sentencing, if he lives that long, whether he is a true believer in unicorn medicine or just another corrupt politician with his hand out to the big money people in alternative medicine. They will make billions off of this scam.

  6. #6 Jud
    July 2, 2009

    This is no worse than woo already enshrined in government health care paybooks, such as Medicare reimbursement for Christian Science facilities, brought to you courtesy of Ted Kennedy. (I can’t recall ATM whether there is higher payment for more intensive prayer.)

    This is not to say Harkin’s stuff isn’t bad – it is – or to criticize what Ted Kennedy has done overall to try to bring health care to more Americans.

  7. #7 Scott
    July 2, 2009

    I’m not clear on precisely what the implications are here. Is this just a labeling issue (which would be bad enough from a propaganda perspective) or does it have direct implications (e.g. insurance would be obligated to cover reiki)?

  8. #8 Orac
    July 2, 2009

    Actually, what the effect of relabeling alternative medical practitioners as being officially part of the government-sanctioned healthcare workforce remains to be seen. However, knowing that Harkin wants to legitimize alternative medicine, my guess is that it won’t be good and that it’ll be the foot in the door that leads to the government and private insurers paying for reiki and homeopathy.

  9. #9 Paul Browne
    July 2, 2009

    I have to say that I almost choked on my corn flakes when I saw Sen. Harkin included in a list of “three of the leading proponents of biomedical research in the US congress” in a comment piece in Nature Today.

    http://www.nature.com/news/2009/090701/full/460024a.html

    I suppose he got that title through his support for embryonic stem cell research, it’s a pity they didn’t take a closer look at his other views when it comes to science and healthcare.

  10. #10 James Sweet
    July 2, 2009

    teddlesruss:
    Perhaps you would like to share your actual comment here – rather thann expecting everyone to follow the link to your blog?
    No matter – I replied in your blog anyway.

    WTF, if I make cryptic comments vaguely critical of the blog author, will that get more hits for my blog too?!

    Uh… I am very afraid too, of something I found in Orac’s basement.

  11. #11 daedalus2u
    July 2, 2009

    What about getting faith based treatments labeled what they are, religious practices. As religious practices, the government is prohibited from sponsoring them by the first Amendment.

    The Catholic Church has already branded Reiki as a religious practice that is unacceptably at odds with the religious teaching of the Catholic Church. Who are we to disagree with their assessment?

    If a treatment isn’t based on science, it is based on unsupported belief.

  12. #12 James Sweet
    July 2, 2009

    WTF? It really scares me when so called intelligent folks are buying the woo. Didn’t we all have middle school science?

    Two things:

    1) No, actually, you’d be surprised. My wife, for example, dropped out of school due to a messed-up home life, and was “homeschooled”, which in this particular case basically meant doing nothing. She later went on to get her GED and go to college — which has the result of producing a very intelligent person who has never taken a physics or chemistry class (you can get the GED with relatively little knowledge in those areas). The contrast between her depth of knowledge in some areas vs. surprising gaps in others is disconcerting at times. :)

    There are probably lots of other intelligent people who took science classes but did poorly and/or were focused on other things. So yeah, there’s lots of intelligent people who either never had middle school science, or else they might as well have never had it.

    2) Not all middle school science classes are created equal. Now granted, my anecdote applies to math and not science, but: I have a friend who moved from NYS to a southern state when she was in, I think 6th grade or something. I won’t name the southern state for fear of offending anyone, but it’s not even one of the ones with, shall we say, a reputation for ignorance. Anyway, when she transferred, the math class was teaching stuff she had learned two grades previous in the NYS class.

    So depending on where you are from, what you think of when you think of “middle school science” may not be what everyone in the country experienced…

  13. #13 wfjag
    July 2, 2009

    And, exactly why is any of this surprising?

    According to the Congressional Budget Office, under the current proposal, at a cost of approx. $1.6 Trillion over 10 years, approx. 1/3 of the asserted 47 million uninsured will receive coverage, leaving somewhere between 25 to 35 million people in the US still without insurance or government coverage. This last assumes that in response to a government mandated plan and/or one of he “comprehensive” immmigration reforms being proposed that a new wave of illegal immigration won’t occur (i.e., if you’re unemployed, living in poverty, and don’t have access to medical care where you are, going somewhere where you still are unemployed, living in poverty but have access to government mandated free medical care is an improvement for you and your family).

    However, a huge limiting factor is that there are not enough “health care” providers to provide the care mandated under the proposed government plan. And, even if the government decided to build new medical schools so that there would be enough trained MDs, DOs, nurses and other traditional medical providers (and assuming that there are enough people who are qualified and meet the acceptance standards who have been turned away merely because there are not enough spaces in existing med schools, and assuming that there are enough qualified persons who can be hired as professors at the new schools), it would still be 6 to 10 years before the new students completed their academic training, residencies, internships, etc., and the increased numbers began to be felt. But, there is no proposal for new schools or training programs. Costs will be contained, however, likely by refusing to allow increases in reimbursements for care provided, or cutting those reimbursements (again, as the administration has already done that once), or refusing to authorize payment for tests and procedures in various categories of cases (as is done in the UK. When you reach a certain age, certain procedures are no longer authorized, whatever the medical justification). Accordingly, under the proposed plan, the will continue to be a huge shortage of traditional medical providers, and little economic incentive for new people to receive training in traditional health care professions.

    There is, however, a quick way to deal with the shortage of qualified providers — simply declare that other people are qualified providers and other “treatments” are acceptable “medical care.”

    At the townhall, the President indicated that under his plan, substituting pallative care for care to address the med. problem will be acceptable. If someone waiving their hands around and mumbling makes you think that maybe you may feel somewhat better, that will qualify as pallative care. Containing cost is the goal. You’re going to die anyway. Why should extra amounts be spent on you?

  14. #14 rob
    July 2, 2009

    i believe the proper term is “homskoold.”

  15. #15 Jen
    July 2, 2009

    “Not all middle school science classes are created equal.”

    I completely agree! I changed schools a lot when I was younger (before high school, the longest I stayed at one school was 2 years, and that was a one time occurence). I was constantly having to switch gears when I moved from a “poor” district to a “moderately wealthy” district or vice versa. I’d change schools and sit through lessons (in multiple subjects) I had already mastered one to two years previous, and then change schools again and have to madly catch up on concepts my classmates were familiar with but I had never been exposed to. Very frustrating, to say the least!

  16. #16 Scott
    July 2, 2009

    Actually, what the effect of relabeling alternative medical practitioners as being officially part of the government-sanctioned healthcare workforce remains to be seen. However, knowing that Harkin wants to legitimize alternative medicine, my guess is that it won’t be good and that it’ll be the foot in the door that leads to the government and private insurers paying for reiki and homeopathy.

    Makes sense. I was just wondering if there was some legal impact of it I didn’t know about.

  17. #17 Sailor
    July 2, 2009

    The irony of it is that I think acupuncture was pushed out to satisfy the the need of the Chinese masses to have some sort of health care. It was a substitute for real medicine which was way too expensive.

  18. #18 kneil
    July 2, 2009

    @Scott:

    The bill is 600 pages. There probably aren’t more than a few hundred people who know (or think they know) what calling woosters part of the “healthcare workforce” will mean.

  19. #19 Rogue Medic
    July 2, 2009

    wfjag,

    Palliative care is not alternative medicine.

    Palliative care is an important part of caring for the person with a terminal illness. Managing their pain is the most familiar part of that, but it is a part of real medicine.

    Palliative care is not just offering placebo treatment.

  20. #20 Enkidu
    July 2, 2009

    I was visiting a friend during his chemo treatment today and almost fell on the floor when I saw what was sitting on his hospital bedside table… a flyer for reiki treatments. I asked him if he was getting reiki done and he said he had no idea what reiki even was, a hospital staffer had handed it to him. There was a little checklist on the back, you were to check a box if you wanted the treatment and hand the paper back to the nurse. This was the University of Pennsylvania promoting this stuff!

  21. #21 Michael Simpson
    July 3, 2009

    I wouldn’t mind if the Senate moved to 59 Democrats, despite the fact I sorely want a filibuster proof majority in the Senate. Someone needs to toss this guy out of office.

  22. #22 DrWonderful
    July 3, 2009

    Have you actually read the bill yourself? Harkin’s amendment simply protects non-MD providers from the discrimination brought on by narrow-minded individuals like yuorself. First of all, the amendment includes the entire PARCA coalition of chiropractors, dentists, podiatrists, nurse practitioners, naturopaths, physicians assistants, etc. This hardly emphasizes alternative treatment but rather assures that adequate qualified non-MD providers will be available to the public. It also protects these providers form the type of crap spewed on your blog. Get over it. There is more to good medicine than MD’s and the days of maintaining total control over the system by trying to scare everyone away from competing and very qualified types of provers are way over, brother. Move on. How do you claim you are credible yourself when you lie worse than the people you criticize? Shameful how you manipulate the truth in an effort to force a lie and then claim you, yourself, are above reproach. Fact- these providers are just as qualified, in many cases more effective, definitely safer, and very cost weffective compared to modern medicine. That’s really what you’re afraid of. Fact- they are also much more popular than MD’s despite your efforts to slander them.

  23. #23 Orac
    July 3, 2009

    First of all, the amendment includes the entire PARCA coalition of chiropractors, dentists, podiatrists, nurse practitioners, naturopaths, physicians assistants, etc. This hardly emphasizes alternative treatment but rather assures that adequate qualified non-MD providers will be available to the public.

    Dentists, podiatrists, nurse practitioners, and physicians assistants are fine. They are health care practitioners who generally practice science-based medicine. Leave out the naturopaths, acupuncturists, etc. They do not practice science-based medicine and should not be lumped together with dentists, podiatrists, nurse practitioners, and physicians assistants. Indeed, if I belonged to any of these health care disciplines, I’d be very insulted to be lumped in with the woo brigade.

  24. #24 DrWonderful
    July 3, 2009

    Why not include chiropractic physicians in your list? They are currently on staff at dozens of VA and Military Hospitals including Bethesda. There also are chiropractic physicians in the Office of Attending Physicians on Capitol Hill treating Member of Congress and staff. Rumor has it they are so busy even a Senator sometimes has to wait a few days to see one. Also, are you aware that many private orthopedic and neurology group practices are now replacing the physical therapists with soft tissue and rehab oriented chiropractic physicians? Chiropractors are the masters of the entire musculoskeletal system. Much more so than even a PT or ortho.

    If you speak with an ortho or neuro or attending physician at a Hospital that employs a chiropractic physician they usually tell you they are shocked to see first hand how popular the chiro’s are with the patients and, yes, how evidenced based they are. For example, did you know there are more studies demonstrating the efficacy of chiropractic manipulation (39) than there are for the treatment of dental caries (7)?

    Also, when working with a chiropractic physicians the MD’s are typically very shocked to learn that chiro’s have a much greater ability to differentially diagnose and treat musculoskeletal conditions than just about anyone. why deny people access to these wonderful providers?

    Is it even posisble Senator Harkin knows a little more than you do? Is it even possible that you simply do not know everything?

  25. #25 Joseph C.
    July 3, 2009

    @Dr. Wonderful,

    Chiropractic: 4 years of training to be no better than a couple of Motrin.

  26. #26 Shay
    July 3, 2009

    “Is it even posisble Senator Harkin knows a little more than you do?”

    No, it’s not. Harkin trained as a lawyer; Orac as a doctor. I might turn to Harkin if I got a traffic ticket but not for medical advice.

  27. #27 Orac
    July 3, 2009

    Is it even posisble Senator Harkin knows a little more than you do? Is it even possible that you simply do not know everything?

    In the area of medicine, it’s highly unlikely that Senator Harkin knows more than I do. Nice strawman though. I never claimed to know everything.

    In any case, the reason I haven’t emphasized chiropractors is because there are two varieties of chiropractors. One variety knows its limitations and does not do anything other than, in essence, physical therapy. The other claims that back manipulation can cure asthma, migraines, allergies, colic, and a whole variety of woes not related to the spine. Some even claim to be able to prevent or treat malaria or cancer. I can tolerate the former, even though their philosophy is not evidence-based (there is no such thing as subluxations, for example), their methods are in essence physical therapy. The latter variety, however, is pure quackery.

  28. #28 DrWonderful
    July 3, 2009

    Joseph C,

    Chiropractic: more clinically effective, safer, and more cost effective than Motrin…or anything else for musculoskeletal conditions.

    We’re here, we’re safer, we’re better, we’re evidenced based, we cost a lot less, we’re wildly popular with the patients…deal with it.

    Man, I love poking at you small minded folks and your fear based agenda. God love ya all.

  29. #29 Joseph C.
    July 3, 2009

    Chiropractic: more clinically effective, safer, and more cost effective than Motrin.

    A $100 office visit is more cost effective than $0.25 worth of pills?

    Please show me the math on that.

  30. #30 DrWonderful
    July 3, 2009

    Joseph C- spend much time on on the data do you? The data is not analysed on a per encounter basis.

  31. #31 Joseph C.
    July 3, 2009

    I’m still waiting. Please show me.

  32. #32 DrWonderful
    July 3, 2009

    Orac, you are 100% correct when say there are two types of chiropractors, except the good kind does alot more than your typical PT. The problem is that the “good” kind that would get your approval far outnumber the bad. We estimate less than 10% of active chiro’s practice subluxation based chiropractic (but even they get people well).

    I appreciate your objective view but you’d be surprised at the amount of evidence appearing in chiro, osteopathic and PT literature about how much the vicera is actually influenced by structural distortions. If you lit search “chiropractic manipulation” you really get only a small slice of what physical medicine and manipulation can do. Everything you listed as being “bad” about chiro is actually happening in droves in osteopathic and PT clinics on a daily basis now because the anecdotal evidence is shocking even to them. In many cases the chiro is more evidence based that the PT or oestoepath treating the same conditions.

  33. #33 DrWonderful
    July 3, 2009

    Joseph C- I believe it was your baseless comment so maybe you should try to prove yourself correct. Maybe your comments should be supported by evidence? I would suggest however, that you look at long term cost data for simple muscuskeletal conditions instead of a single encounter. I think we can agree that if a patient has knee pain they do not take Motrin just once. Also, you may want to change your unsupported assumption that a single chiropractic encounter is designed soley to provide palliative relief. Chiropractors actually created the outcome based care with clear goals with end point decades before it was incorporated by PT’s.

    Anyway, the data shows prolonged use of NSAID’s yields a very poor long term clinical outcome and many, many, many side effects that dramatically increase overall systemwide costs as well as increased morbidity and, actually, mortality rates such as terminal end kidney and liver failure. Meanwhile the conditions the patient took the NSAID’s for in the first place remains completely unaddressed.

    Meanwhile the physical medicine practitioner addresses underlying structural distortions and corrects them. If there is a permanent anatomical derangement then lifestyle issues must be addressed to reduce the frequency, severity and duration of episodes..therby reducing the need for drugs and surgery…which are also much costlier. Poof, overall long term savings an, a better clinical outcome, and a whol eheck of alot safer.

    Hands down, my undereducated and narrow minded cynical colleague, comprehensive conservative and corrective physical medicine, including chiropractic services, has a much greater clincal efficacy, cost effectiveness and is much safer than taking NSAID’s.

    Are you that clueless not to consider the exposure to the system of prolonged NSAID use, including mortality and co-morbididty rates, before you opened your mouth and shoved your foot in it?

    But like I said, since you opened your mouth so maybe you should provide the evidence behind your statement and then I’ll be the judge and jury and tell you omnipotently if it’s acceptable science. so fa rint his dialougue you have yet to bring a single piece of evidence to the table and I challenge you to do so. Can you?

  34. #34 Joseph C.
    July 3, 2009

    It’s fun touching nerves in the obviously sensitive. Maybe you can do a manipulation on yourself to correct this.

  35. #35 EllenDiann
    July 4, 2009

    You amaze me in calling alternatives, which are natural and safe, quackery, while drugs are the biggest FRAUD in health care as drup pushing doctors kill, steal and destory the lives of Americans. The prices are insane and so are the therapies. It lacks any common sense to take poisons that can create worse problems. Drugs have NO PLACE in our body and do NO GOOD. Masking a symptom while creating deadly results is not health, it is fraud and greed at its worse and it is QUACKERY. The quacks are in control of medicine now, but when ALTERNATIVES are allowed the people will CHOOSE what therapy they want and not have to listen to you LIARS that push drugs. The people are SICK and TIRED of it. We are taking control of our own health and doing a great job of it. You pharma companies should be afraid because you are being exposed for the murderers you are and those you control and force to push your drgus will be made free in this REFORM.

  36. #36 DrWonderful
    July 4, 2009

    Joseph C- so, uh, like you got nothing, huh? Let me get this straight. You made a claim that had no evidence behind it? And now your only response is to try and arrogantly rise above your own question and act as if your statement is self evident? Hmm, who do you sound like? Yes, my friend, you sound like the very people you criticize with such arrogance. Do you know what that is commonly referred to as? Yes, ooops, wait for it, here it comes…based on your comments which have no evidence behind them and your refusal to admit that fact…you, sir, are a complete fraud and hypocrite. Pot and kettle are one here.

    Orac himself very obviously is aware of the plethora, no make that overwhelming abundance, of very solid evidence demonstrating the safety, efficacy and cost effectiveness of conservative chiropractic management of musculoskeletal conditions. So, yes, it’s better than Motrin. And, yes, Senator Harkin knows more about developing good public policy that you do.

    Joseph C, I ask you this one question and I’d like to see if you actualy have the true true heart and courage to answer it…Under the guise of being a smarty pants skeptic, are you actually a defender of organized medicine rather than a protector of real science?

    You are total fraud shielded by your own arrgoance.

  37. #37 Joseph C.
    July 4, 2009

    @DrWonderful,

    You’re so easy to mess with that it’s almost boring. Does your defensiveness come from feelings of inadequacy about your profession?

  38. #38 DrWonderful
    July 4, 2009

    Joseph C- Can you answer your own statement with any evidence? We are all waiting and your own personal credibility is clearly on the line.

    You have not messed with me at all. I am perched in a very nice position because I already know the answer to your questions…what is more clincally effective and cost effective for the treatment of musculoskeletal conditions? Chiropractic or Motrin? The evidence is crystal clear if you’d bother to study it before you open your little mouth.

    Can you, or are you willing to, defend your stament with any credible evidence? Or are you going to punch and run? I have not run or backed down. I stand here, directly in front of you, waiting very patiently for you to stand up with any credibility and defend your own statements with any sort of evidence. Is it possible you were wrong? Is it possible it is you, and not the chiropractic physicians, who actually make claims that have no credible evidence behind them? Are your feelings about chiropractic based in a fear that we might be right and the only chance you have is to hide behind assumptions and then use the power of cultural authority you hold so dear as a shield? Is it pure science or your cultural authority that you want to protect? You have a lot of questions to answer now. But do you have the guts?

  39. #39 Joseph C.
    July 4, 2009

    You have not messed with me at all.

    When someone constructs several paragraphs in response to disinterested, two sentence comments, this suggests that person is riled up.

  40. #40 DrWonderful
    July 4, 2009

    Joseph C- Riled up I am. That is for certain. It’s more from the excitement that I bagged myself a fraud and have him hanging out to dry in his own yard.

    To quote a great scientist: “I’m still waiting. Please show me.”

    Well? What have you, sir?

  41. #41 Joseph C.
    July 4, 2009

    But there’s nothing to respond to because you haven’t offered any evidence. You’ve merely offered up speculation.

  42. #42 DrWonderful
    July 4, 2009

    Chiropractic: 4 years of training to be no better than a couple of Motrin.

    Joseph C, I am asking you to back up your statement with some evidence. Can you?

    Since you included Motrin I am left with the assumption you wanted to narrow your discussion to the chiropractic treatment of musculoskeletal conditions. Since you used the word better I assume you want to use the current standrd as being used by policy makers…clinical efficacy, safety, and cost effectiveness.

    Now, show us all how Motrin beats Chiropractic with regards to clinical efficacy, safety and cost effectiveness. It was your statement so we can assume you have the evidence? Or, do you just say stuff because it supports your agenda?

    By the way, a close personal friend of mine who works on a HELP Senator’s staff is now watching this thread closely and is interested in seeing firsthand how organized medicine and pharma slanders natural therapies without any evidence themselves. Yes, it is true, we use this crap you guys spew out against you and in our favor. There is a reason why the HELP committee felt compelled to protect non-MD providers from blatant discrimination and, of course, we used this site as a constant source of examples of that discrimination. So, thank you. Oh my gosh, you did it to yourselves…and I helped make sure it happened. Man, that’s gotta suck, huh? Not only is DrWonderful right but he has kicked your asses all over DC.

    So, I ask again, can you support your own statement with any evidence? Or will you dig yourself deeper by trying to avoid any responsibility yourself? People are watching and want to know if you just blindly discriminate and then hide behind your cultural authorit…or do you practice what you preach?

  43. #43 Joseph C.
    July 4, 2009

    By the way, a close personal friend of mine who works on a HELP Senator’s staff is now watching this thread closely and is interested in seeing firsthand how organized medicine and pharma slanders natural therapies without any evidence themselves.

    Now you’re just getting funny. Is this supposed to be intimidating? How do you even know that I work in medicine. Hint: I don’t.

    Also, you might want to look up the definition of discrimination. As well as fraud. And you might want to know that the word data is plural.

  44. #44 DrWonderful
    July 4, 2009

    Joseph C.- Been funny this whole time, duh.

    So, seriously, when push comes to shove you’re really not that evidenced based are you? A fraud like many of your partners here. There really is no credible science behind your claim, is there? So, I guess we win?

  45. #45 Orac
    July 4, 2009

    By the way, a close personal friend of mine who works on a HELP Senator’s staff is now watching this thread closely and is interested in seeing firsthand how organized medicine and pharma slanders natural therapies without any evidence themselves.

    Really? I hope this is true, at least if the Senator isn’t Tom Harkin himself. That staff member might learn something. In fact, please, have that staffer e-mail me, and I’d be happy to send him or her some posts showing how Harkin is promoting pseudoscience in the name of “wellness” and “prevention.”

  46. #46 Michael Ralston
    July 4, 2009

    Comparing Motrin and Chiropractic for cost-effectiveness for muscular pain is straightforward, if not easy.

    First, we can compare costs.
    Motrin is … well, someone earlier said 25 cents a pill. That sounds about right to me.

    Chiropractic is, again using previous numbers, $100/visit.

    Next question: Effectiveness. Well, I’ve taken Motrin. It works for a few hours, and when I’ve had nasty pain I need to take four to six over the course of a day.

    I don’t know how often one is supposed to visit the chiropractor … but if it’s any more often than once every three months – and I think it is – then Motrin wins …

    … assuming you have a chronic pain condition that doesn’t ever die down for a few days or anything, anyway, since then the fact that you can not use Motrin those days makes it cheaper.

  47. #47 Rogue Medic
    July 4, 2009

    By the way, a close personal friend of mine who works on a HELP Senator’s staff is now watching this thread closely and is interested in seeing firsthand how organized medicine and pharma slanders natural therapies without any evidence themselves.

    The commenters on this blog are no longer Pharma Shills. We have received a promotion to organized medicine and pharma. Do we get a raise. Show me the money, Dr. Wonderful.

    Dr. Wonderful, is there a Mrs. Dr. Wonderful? Does she have the same inflated opinion of Dr. Wonderful that Dr. Wonderful demonstrates?

    It is interesting how you have changed from defending only good chiropractic, to defending natural medicine. Is Dr. Wonderful a synonym for Bait and Switch? Maybe Dr. Wonderful is synonymous for Bogus?

    Here is what you wrote about there being good and bad chiropractors: Orac, you are 100% correct when say there are two types of chiropractors, You have changed your tune significantly. Do you stick with anything longer than a few minutes? Are you so accustomed to making things up as you go along, that you cannot remember what you wrote a few comments earlier?

    how organized medicine and pharma slanders natural therapies without any evidence themselves? I have seen hundreds of well done studies cited in the comments of this blog. Your comments are the example of baseless, here.

    Yet, Dr. Wonderful has decided that the comparison is not between chiropractic use and ibuprofen use, instead Dr. Wonderful frames the debate as between chiropractic use and ibuprofen abuse.

    If you only see the side effects and refuse to see the benefits of medication, of course you will take the ignorant and biased view that you have taken.

    Let’s look at your criteria: Now, show us all how Motrin beats Chiropractic with regards to clinical efficacy, safety and cost effectiveness. It was your statement so we can assume you have the evidence? Or, do you just say stuff because it supports your agenda?

    A person injures a knee. Ouch. The person goes to the chiropractor. The chiropractor tells the patient that there is a subluxation in the back causing the knee pain. The chiropractor has the patient return 3 times a week at $100 per visit. This goes on for a month, until the knee gets better all by itself. That chiropractic does wonders, doesn’t it? As long as the patient’s knee heals on its own.

    1 month/3 visits per week = 10 visits X $100 = $1,000.

    As an alternative to this big money approach, the patient goes to the local pharmacy, buys some generic ibuprofen at $5 for 100 pills in 400 mg strength. He takes two every 6 hours. Total daily dose is 3200 mg. This is the maximum recommended dose.

    The horrible side effects are rare, just as the horrible side effects of chiropractic are rare. That Dr. Wonderful thinks these are so much worse than going to a back doctor for a knee problem, indicates where his bias is

    Back to our patient. He has to buy more pills 2 times. 1 month/8 pills per day = 240 pills = $15. Let’s splurge and have him spend big bucks for the Big Pharma name brand at the full price of about $15 for 100, or $45 for the full supply for this example.

    The result is the same. After a month, the patient feels better and does not need any further treatment. A more realistic approach would have been the patient decreasing the dose as he realized that the pain was decreasing. Gee, did I forget to take my ibuprofen, again. Maybe I don’t need as much. But let’s ignore sense, since we are not addressing Dr. Sensible.

    The patient gets better because we are dealing with a common case and that is what commonly happens. It does not matter if the patient goes to the chiropractor and spends $1,000 to cut back on the high cost of healthcare and only goes to a medical doctor if there is a complication. Or the patient spends $45 out of pocket and only goes to a medical doctor if there is a complication.

    Chiropractor = $1,000.

    Name brand ibuprofen = $45.

    In both cases the patient recovers on his own. Getting up and moving about helps, even if it is just to go to the chiropractor. The pain medicine helps the patient to get up and move about even more.

    As was pointed out in the post, this bill is just about earmarks for alternative medicine quacks. It is an economic stimulus that will do much more harm than good. This bill is full of toxins.

    Yes, it is true, we use this crap you guys spew out against you and in our favor.

    We?

    Well, you do appear to want to represent your self as Legion. Why should I disagree?

    There is a reason why the HELP committee felt compelled to protect non-MD providers from blatant discrimination and, of course, we used this site as a constant source of examples of that discrimination.

    As a non-MD provider, I am grateful for the help and – Hey, you haven’t done a thing for me. You are only interested in promoting fraud. You are advocating things that have no scientific basis. You, Dr. Wonderful, are a charlatan. You only help charlatans. You promote fraud. You are not helping patients.

    So, thank you. Oh my gosh, you did it to yourselves…and I helped make sure it happened. Man, that’s gotta suck, huh? Not only is DrWonderful right but he has kicked your asses all over DC

    After a few sentences, the fake concern for patients drifts away and the juvenile behavior comes out. I expect that not all of the people in the legislature are as gullible as Sen. Harkin.

  48. #48 AussieMarcus
    July 5, 2009

    Amazing how every alt-med supporter thinks writing page-long rants with lots of block capitals and childish insults will convince us to see the light.

    Literally every one of them dissolves into exactly the same ‘I WRITE WITH CAPS LOCK ON THEREFORE I MUST BE RIGHT HAHA KICKED YOUR BIG PHARMA ASSES!’ nuttiness. You don’t even have to scratch the surface that much….

    Do they all receive an instruction manual from BigAlta or something, telling them this is how to ‘debate’ with scientists?

  49. #49 Alternative Medicine
    July 5, 2009

    Chiropractic: more clinically effective, safer, and more cost effective than Motrin…or anything else for musculoskeletal conditions.

  50. #50 Chris
    July 6, 2009

    Spammer:

    Chiropractic: more clinically effective, safer,… for musculoskeletal conditions.

    Prove it. Show us the real evidence.

  51. #51 Michael Ralston
    July 6, 2009

    Chris: The spammer is just taking a paragraph from one of “DrWonderful”‘s posts as ‘cover’, and then their name is a link to a site.

    If scienceblogs didn’t automatically add rel=nofollow, this might do something for them, but as it is they’re pretty much just worthless spam that slips through the cracks of moderation.

  52. #52 dave™©
    July 16, 2009

    …it opens the door to acupuncturists, reiki practitioners, homeopaths, and chiropractors to be considered part of the “healthcare workforce.”

    Acupuncturists are already on staff at Kaiser. Other “alternative” treatments that were once considered “quackery” including meditation to relieve stress, which is now an established part of nearly every stress-reduction regimen. Pardon me if I don’t get all up in arms about “quackery,” esp. since the people doing the loudest squawking are usually the ones with the most to lose financially.

  53. #53 dave™©
    July 16, 2009

    …it opens the door to acupuncturists, reiki practitioners, homeopaths, and chiropractors to be considered part of the “healthcare workforce.”

    Acupuncturists are already on staff at Kaiser. Other “alternative” treatments that were once considered “quackery” include meditation to relieve stress, which is now an established part of nearly every stress-reduction regimen. Pardon me if I don’t get all up in arms about “quackery,” esp. since the people doing the loudest squawking are usually the ones with the most to lose financially.

  54. #54 outlandish josh
    July 16, 2009

    As a man of science, I find the arrogance on display here to be both unsettling and unhelpful.

    While I don’t believe much in alternative therapy myself, the existing medical establishment is hardly an unquestioned paragon of objective scientific virtue. Not only is such a thing humanly impossible, but you don’t have to dig very deeply into the past to see how culturally-warped “medical science” can be, not to mention how economic forces play into things.

    Given that, the real danger here is in cementing the authority for defining what constitutes an effective course of action for a healthy and happy life. In real terms, the actual harm caused and cost of alternative medical therapy is negligable on the national scale, so what’s the big deal then?

    What stokes the bile is a cultural reaction. Y’all don’t like anything you label “woo” and it angers you to see it given any standing. This is a question about authority, not about health. From a systemic standpoint, the best long-term and generalized outcomes will emerge from an open system which admits alternatives and challenges. In that respect, carving out space for alternatives can be seen as a positive in that it sets up better “rules of the road” for the course of all manner of phisiological practices in the 21st century.

  55. #55 outlandish josh
    July 16, 2009

    As was pointed out in the post, this bill is just about earmarks for alternative medicine quacks. It is an economic stimulus that will do much more harm than good. This bill is full of toxins.

    Actually the post points out that this is about the technical definition of who can be considered part of the healthcare workforce. There are plenty of reasons to support a broad definition here.

  56. #56 mjshep
    July 16, 2009

    It is a great mistake, and a sign of both hubris and ignorance, to lump together highly disparate therapies into one mish-mash called “CAM.”

    Chiropractic has long been recognized by the scientific and medical community as effective for a range of skeletal and nerve related disorders. There is no longer significant debate about this. Acupuncture as well, especially electro-acupuncture, has gained acceptance among the medical and scientific community for its use in certain situations, especially pain management, Bell’s Palsy, IBS, insomnia, primary dysmenorrhoea and others. There are an increasing number of clinical studies, both in the U.S, and abroad, that indicate genuine medical benefits from acupuncture. The usefulness and efficacy of herbal medicine is likewise gaining legitimacy as more and more clinical studies indicate its therapeutic value.

    These modalities should not be conflated with the real woo-woo quackery like aromatherapy, homeopathy, Reiki or “spiritual healing.” It’s a poor way to make an argument.

    As for “what sorts of standards would determine who would and would not be part of the healthcare workforce,” the schooling and licensing of chiropractors is so established as to need no comment and let me cite that here in California, and nationally as well, there are strict requirements for the practice of acupuncture, not the least of which is a post graduate degree which includes years of study that encompasses much of what becoming an RN would require, such as anatomy, physiology, pharmacology, western medical diagnosis and terminology, biology, etc. and hundreds of hours of supervised clinical practice, along with a comprehensive state administered exam.

    Hardly “woo-woo.”

  57. #57 Lucy
    October 10, 2009

    I am dismayed by how many people here are willing to dismiss non-chemical and non-conventional healthcare so easily. It’s hardly scientific or even rational to reject something just because you haven’t used it or don’t know anyone who has benefited. (To do so in such surprisingly vitriolic manner further undermines your assumptions).

    I’ll counter using your own troubling methodology: I, and many people I know, are highly educated, rational thinkers raised to believe that chemicals and five-minute, symptom-focused doctor visits were the only credible kinds of healthcare. But once I had a nearly debilitating illness that did not register in conventional circles, I had nowhere else to turn. Acupuncture, shiatsu, and various forms of massage — ALONG with a pharmaceutical treatment — have been transformative. Even my scientist husband is a “convert” (to use the lazy religious language of some of you “scientists” above).

    In other words, just because you don’t know about it doesn’t mean it doesn’t exist. That’s not a religious argument, that’s… logic. When millions of people are spending billions of dollars on “alternative” therapies, but not enough “scientific” studies can figure out why… well it might be time to examine your investigative framework (and the people funding it).

    P.S. Many of you exhibit anger and frustration that could well manifest in physical pain at some point in your lives. Good luck wtih that ibuprofen.

  58. #58 Chris
    October 10, 2009

    Lucy:

    It’s hardly scientific or even rational to reject something just because you haven’t used it or don’t know anyone who has benefited.

    So when the data do not show that a treatment is not effective why would “try it” be scientific, versus going by the evidence?

    Acupuncture has been tested, and has found to be no more effective than placebo. That is science. Trying it to see how the placebo effects work on a sample size of one (yourself) is not science.

    For a more complete explanation please read Snake Oil Science for a better explanation.

  59. #59 Joseph
    October 10, 2009

    ut once I had a nearly debilitating illness that did not register in conventional circles, I had nowhere else to turn. Acupuncture, shiatsu, and various forms of massage — ALONG with a pharmaceutical treatment — have been transformative.

    @Lucy: Oh, do tell. By what means did you determine that it was the woo and not the pharmaceutical treatment alone that helped you?

  60. #60 Joseph
    October 10, 2009

    When millions of people are spending billions of dollars on “alternative” therapies, but not enough “scientific” studies can figure out why… well it might be time to examine your investigative framework

    That’s a bullshit argument, BTW, Lucy. Millions of people are spending billions of dollars on, say, gambling, tobacco, prostitution, astrology, Windows Vista, “as seen on TV” stuff, and so on. Does all of this stuff “work”? Mass delusion is very real. At various times in human history, large groups of people have believed bullshit. Reality is not determined by majority vote.

  61. #61 Joseph C.
    October 11, 2009

    P.S. Many of you exhibit anger and frustration that could well manifest in physical pain at some point in your lives. Good luck wtih that ibuprofen.

    If I’m reading you correctly: Anger = bad. Condescension = good.

    If you’re going to talk down to people, consider taking a few minutes to figure out their actual positions. As it stands, you’re just beating straw men.

  62. #62 Todd
    November 19, 2009

    Thought I’d share this. After moving in May I suffered with pain in both hands for 3 months. Went to two doctors. Their diagnosis – arthritis (I’m 45); their “solution”: steroids and pain meds.

    Not really interested in either. I go see an “alternative” health care guy – a chiropractor; he says take this whole foods chrondroitin msm complex. Two days later, no pain.

    meds: 35 bucks: chiropractor appointment, 75.

    That, vs. 900 bucks worth of pain meds and steroids and monitoring PER MONTH.

    I think there’s a little tiny bit wrong with your holy and revered “medical science”, and competition based on getting results is GOOD, so kiss it.

    Who’s the real quack here ?

  63. #63 Rogue Medic
    January 26, 2010

    Todd,

    I think there’s a little tiny bit wrong with your holy and revered “medical science”, and competition based on getting results is GOOD, so kiss it.

    Who’s the real quack here ?

    If competition based on getting results is good, why does your quackery continually fail to produce results in scientific studies with oversight by alternative practitioners?

    Alternative medicine is not medicine, because it does not consistently work. It does not consistently work, because it is not the treatment that is working. Alternative medicine only appears to be working, while the patient is recovering on his/her own. This would happen regardless of the treatment used.

    Real medicine works consistently better than placebo does.

    Alternative medicine does about the same as placebo.

    Placebo is not a treatment. Placebo is just confusing the body. Real medicine beats placebo. Alternative medicine is just real quackery.

    I am not kissing anything for you, you fraud.

  64. #64 MD Quackery
    October 13, 2010

    I think you need to lump the people who deny the benefits of chiropractic care for musculoskeletal and neuromuscular problems, in the same catagory with people who deny we landed on the moon and the people who think the CIA blew up the twin towers. There are hundreds if not thousands of research papers out on said benefits. Denying this makes you look as silly and irrational as all the above mentioned conspiracy theorists.

    REAL scientists do not even debate these benefits. This is why PT’s are going after the doctorate of PT and incorporating more manual therapy and hospitals are integrating manual therapy on their medical staffs. The house just passed mandatory chiropractic care for ALL veteran hospitals with ZERO votes against. The US olympic team has a DC as its director and five other DC’s on their team. You can find DC’s in every professional baseball and football locker rooms in the country.

    The healthcare provisions introduced by Senator Harkin simply prevent people like yourself from discriminating against ANY other health professional that is qualified to perform that service as directed by their state institutions.

    The medical community needs to get over their fear of chiropractic, the profession is over 100 years old and is not going away. It has lasted this long because their patients recogize it’s benefits and in many cases, have been failed by “tradional medicine”. The general public needs more health care options not less. Complementary and Alternative medicine has a real and valuable part to play and medicine needs to look at improving it’s own services, instead of trying to minimizing the service of others.

  65. #65 Chris
    October 13, 2010

    Oh, goody, it is another Necromancer!

  66. #66 MD Quackary
    October 14, 2010

    Isn’t your post guilty of the same? I was merely looking for some information on Harkin when I came across this quaint forum. Don’t worry, I won’t be posting after this. I can clearly see that posting anywhere on this forum should automatically deduct 10pts off your I.Q. score. Have fun with your consipracy theories and self-rightous denial of proven scientific facts.

  67. #67 Chris
    October 14, 2010

    Well, you do seem to have issues with reading comprehension.

    Would you have preferred that I ask why it took you ten months to think of a comment, which was only tangentially applicable to the article?

  68. #68 Ken Pruitt
    November 5, 2010

    Dear senator harkin,

    If you or any of your bastard cronies try to pass a 1% tax bill on all our financial transactions you will see the end of your career.

  69. #69 Chris
    November 6, 2010

    Mr. Pruit, please read the page you are responding to, because right now you look like an idiot. At least look at dates.

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