Respectful Insolence

In a week and a half, Harriet Hall, Kimball Atwood, and I will be joining Eugenie C. Scott at CSICon to do a session entitled Teaching Pseudoscience in Medical (and Other) Schools. As you might imagine, we will be discussing the infiltration of pseudoscience into medical academia and medical training, a phenomenon I frequently refer to as “quackademic medicine.” It’s a topic that has been much discussed on this blog; so I am quite confident that we are the people to tell our audience just how bad it is, why it’s happening, and why you should be concerned about it. Also, from my perpective, bringing Eugenie Scott, the executive director of the National Center for Science Education into the mix is entirely appropriate, because there are parallels between how the pseudoscience that is creationism has been infiltrating K-12 education and how various forms of pseudoscience are creeping into medicine.

If there’s one consistent theme that I’ve hammered at over the years, it’s the influx of medicine based not on science, but on prescientific notions of disease, including—and I do not exaggerate—vitalism and magic. Examples abound and include homeopathy (which is nothing more than a form of sympathetic magic), reiki (which is faith healing), other forms of energy medicine (which are also variations on the theme of faith healing or wishing makes it so), In general, we expect professional societies to maintain and support the scientific basis of medicine. Unfortunately, increasingly, medical societies have been failing us. I happened to be working on my talk when I became aware of a perfect example of just such a failure. It’s a story that illustrates how a professional organization that really should know better unfortunately does not. I first became aware of part one of this particular story back in August.

This time, as I pointed out a couple of months ago, it’s the American Academy of Family Physicians that has failed utterly, abjectly, and embarrassingly to maintain even the most basic scientific standard in how it conducts its business. What I’m referring to specifically is a particularly misguided choice it made for its keynote speaker at its 2012 AAFP Scientific Assembly:

The 2012 Assembly will commence with a captivating, inspirational keynote address from Dr. Andrew Weil speaking on “Why Our Health Matters.” Dr. Weil is one of the world’s foremost authorities on health and wellness. He founded the field of integrative medicine which endeavors to create an intersection of alternative and conventional medicines.

Dr. Weil is in demand. He was ranked the #1 choice for keynote speaker by recent Assembly attendees.

I’ve written about Andrew Weil on multiple occasions. The reason should be obvious. If there’s one single person who has had the most influence in promoting pseudoscience in academia, in facilitating—nay, actively pursuing—the infiltration of magical thinking into medical academia, it is arguably Andrew Weil. In many ways, he is the most important figure in the movement to “integrate” quackery with scientific medicine. He considers his influence and what he as accomplished a good thing. I do not.

Let’s take a look at what I mean. As hard as it is to believe, it’s been a year since I wrote about how Andrew Weil is trying to create a board certification in “integrative medicine” and the rather amusing reaction of his fellow woo-meisters to the proposal. Unfortunately, Dr. Weil has has considerable success, at least in medical schools. Indeed, he has almost single-handedly birthed a distinction track in quackery for medical students to pursue. This particular misbegotten specialty, regular readers will remember, is often sold as “integrating” the “best of both worlds” into medical care. In reality, it involves “integrating” pseudoscience and magical thinking, like the aforementioned reiki, “energy medicine,” and various other pseudoscience into medicine. Before that, it was known as “complementary and alternative medicine” (CAM) because supposedly the quackery was being used to “complement” science-based medicine. CAM morphed into “integrative medicine,” as I’ve described before, because “”complementing” science-based medicine still implies a subsidiary, lesser value than the actual science-based medicine. CAM practitioners couldn’t abide that; so they came up with a name that implies a co-equal status of their woo with science-based medicine. Even Dr. Josephine Briggs, the director of the National Center for Complementary and Alternative Medicine (NCCAM) buys into this terminology to the point where she defends it on the NCCAM Research Blog.

That’s not all that Weil has done. For one thing, he is very much He sells supplements. Lots of supplements. For another thing, he has on more than one occasion demonstrated that he most definitely does not like evidence- and science-based medicine, his protestations otherwise notwithstanding. It’s depressing to think that Weil was the number one choice of AAFP members who attended recent Assemblies.

But it’s even worse than that.

Jumping into the breach, the Institute for Science in Medicine (ISM) wrote a letter of protest to the AAFP for implicitly endorsing quackademic medicine by featuring Dr. Weil as its keynote speaker. It hits all the right notes (and is a lot less—shall we say?—insolent than any letter that I might have penned). I think it’s worth reproducing in its entirety:

I am writing on behalf of the Institute for Science in Medicine. We are gravely concerned about AAFP’s invitation to Dr. Andrew Weil to keynote at the AAFP Scientific Assembly on October 17, 2012.

We know that after years of hosting scientific assemblies AAFP knows full well that a keynote address is not mere entertainment for the attendees. What AAFP bills as an “exciting opportunity” is actually an authoritative statement of policy on what AAFP now considers acceptable standard practice in family medicine.

AAFP has told attendees that the topic of the keynote address for this year’s Scientific Assembly is “Why Our Health Matters,” and that Dr. Weil, author of a 2010 book with that same title, will “speak peer-to-peer on how you can remain healthy and best able to care for your family, your patients, and your community.” Presumptively, the AAFP policy being put forth this year is to be found in Dr. Weil’s book.

Among the many scientifically objectionable pronouncements in Dr. Weil’s book, the following seems pertinent to AAFP:

Some qualities that I value very much are … “The doctor exemplifies and models health and health-promoting behavior … [and] The doctor knows all the factors that influence health and all the strategies for treating disease.” As I have written, many doctors don’t know much about key elements of health care, such as the body’s ability to heal itself, dietary and other lifestyle influences on health, and non-drug-based methods of treatment.

Doctors of the future must also be open-minded and intellectually flexible. … [M]y independent thinking caused friction with some of my [medical school] instructors. The more I saw conventional medicine in action, the more wary I became of drastic interventions that too often caused harm. [page 79]

ISM’s fellows find Dr. Weil’s hostility to scientific practice disturbing, but what is even more unsettling is that AAFP would take this step towards abandoning science, and transmogrifying family practice, by embracing Weil’s vision:

[Thomas Edison declared in 1902], “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease. … [T]he simple truth [is] that you can’t improve on nature.”

The wisdom of Edison … holds true today and should guide us to the future. Tomorrow’s doctors will differ from most of today’s in all four of the most basic aspects of a physician’s professional life: his or her personal qualities, education and training, philosophy of treatment, and ways of interacting with the community. [page 81]

In point after point in his book, Dr. Weil ignores or defies the practice of scientific medicine in vital areas of patient care. As if to underscore that attitude, at the very time that Weil was writing his manifesto, he was the target of a joint enforcement action by the FDA and FTC, demanding that he stop marketing his herbal “Immune Support Formula” for alleging, without objective evidence, that it possesses anti-influenza properties.

Though acclaimed by AAFP as a leading authority on “integrative” medicine, Dr. Weil is in reality committed to re-introducing pre-scientific beliefs—such as homeopathy—into medicine, an unfortunate return to what far-sighted Abraham Flexner decried over a hundred years ago as “sectarian” (i.e., belief-based) medicine.

It is especially alarming to us to see AAFP adopt Dr. Weil’s antediluvian agenda at a time when the “medical home” model is coming to the fore in the reform of American health care.

Dr. Weil will fairly claim that his AAFP keynote is acceptance into one of the bastions of conventional medicine. That is bad enough. But the scientific integrity of medicine will have received a self-inflicted wound, and that is tragic.

Tragic indeed. Weil has basically never met a form of woo that he didn’t like with perhaps one exception. OK, I’ll admit, that one exception is so utterly quacky that even Andrew Weil can’t handle it. I suppose that’s one point in his favor, but barely.

Unfortunately, the AAFP’s response, which I also consider to be worth reproducing in full so that you can see its utter intellectual bankruptcy and refusal to accept responsibility for a decision made on behalf of the organization, basically boils down to “hey, it’s what our membership wants.” And, oh, by the way, this isn’t the “scientific” part of our assembly; so we can bring in whatever quackery that we want in order to “celebrate” our family docs. That’s why we don’t give any CME credits for this nonsense. We know it’s nonsense but we’re doing it anyway:

Thank you for reaching out to the AAFP on behalf of the Institute for Science in Medicine.

I want to clarify your interpretation of the purpose of our Scientific Assembly opening ceremony. While our Scientific Assembly is focused on providing four days of quality continuing medical education, the opening ceremony event is designed purely as a time to celebrate our family physician attendees. We do this via touching video presentations, award recognitions, and energetic, entertaining speakers. Past keynote speakers have been as varied as Irish tenor Ronan Tynan, high-powered political couple James Carville and Mary Matalin, and mountain climber Aron Ralston. This session is not about AAFP policy, nor is any continuing medical education credit given to those physicians who choose to attend.

The selection of Dr. Andrew Weil as the keynote speaker for this year’s opening ceremony was based directly on feedback from AAFP members who are past Assembly attendees. In 2010, we conducted focus groups of Assembly attendees during the meeting; one of the questions we asked was for participants to rank a listing of 18 potential keynote speakers – people ranging from “Tuesdays with Morrie” author Mitch Albom to (then) CMS administrator Dr. Don Berwick, from Dr. Georges Benjamin, Executive Director of the American Public Health Association to Dr. Andrew Weil. The overwhelming choice of these members — receiving both the most total points and the most first place votes – was Dr. Weil.

Finally, having Dr. Weil speak in no way indicates our endorsement of any of his work or products.

I realize that this information may not sway your opinion of Dr. Weil as the keynote speaker, and I certainly respect that, Ms. Rosa. However, I did want you to have the background provided above.

Regards,
Douglas E. Henley, M.D., FAAFP

My friend and collaborator Harriet Hall has come up with a totally spot on analogy for having someone like Andrew Weil give the keynote address for the AAFP annual convention. She has described it as being akin to having an astrologer give the keynote address for an astronomy convention. Imagine, if you will, astronomers using excuses like the ones that Dr. Henley uses for doing the equivalent thing in medicine. Carl Sagan would be doing high speed backflips in his grave. No doubt Abraham Flexner is doing the same. Think of it this way. What the AAFP is doing is akin to Harriet’s most apt analogy. It’s also akin to having a flack from the Discovery Institute like Casey Luskin give the keynote address at a conference of evolutionary biologists or, at the risk of skating a bit too close to Godwin territory, having David Irving give the keynote address at a meeting of Holocaust scholars. It’s giving the most important speaking gig in a meeting to someone whose very world view is antithetical to that of the organization hosting the meeting.

Or maybe Weil’s views aren’t antithetical to the views of the AAFP. In fact, that would be even more concerning. After all, what Weil stands for is the “integration” of quackery like reiki, acupuncture, “energy healing,” and various supplements with scientific medicine. Sure, he also “rebrands” what should be science-based modalities, such as exercise, a healthy diet, and the like as somehow being “alternative” or “integrative,” but that’s not the main problem. Unfortunately, as I’ve pointed out time and time again, if you integrate quackery with real medicine, you do not produce better medicine. Instead, you turn quackery into medicine and medicine into quackery, which is exactly what’s happening in medicine right now. Much of the so-called “integrative medicine” that Weil champions represents a return to the past, and not in a good way. Rather, it’s a return to the past where the four humors qi determined health and disease, miasmas unspecified and unknowable “toxins” were responsible for many diseases, and praying to God (or the gods) for healing energy healing and reiki was the order of the day. That’s what we’re “integrating” into scientific medicine.

And that’s what the AAFP has just implicitly endorsed, or at least has decided to be unimportant to the mission of its yearly conference, no matter how much Dr. Henley tries to use weasel words to argue otherwise. He ought to hang his head in shame.

Comments

  1. #1 Darwy
    Røde grøde med fløde
    October 15, 2012

    “Finally, having Dr. Weil speak in no way indicates our endorsement of any of his work or products”

    Uh… yeah. Yeah it does.

  2. #2 thenewme
    October 15, 2012

    Wow. Weil, the guy who claims “… many doctors don’t know much about key elements of health care…” is the one setting the mood to “celebrate the family physician attendees” in the audience???

    Yikes!

  3. #3 Daniel
    October 15, 2012

    What Darwy said.

    Henley seems to be (willfully? intentionally?) ignorant of the difference between an entertainer doing the keynote at a doctor’s conference, and a doctor doing the keynote at a doctor’s conference, and how these different circumstances reflect back on the speaker and the organization.

    The entertainer gives you plausible deniability. The doctor will be seen as endorsed by you.

    If you don’t see that, you’re not qualified as executive vice president and chief executive officer of your organization.

    Damn. Now I’m angry.

  4. #4 dandover
    Andover, MA
    October 15, 2012

    Anytime a doctor creates a “brand” for themselves, they’ve instantly lost all credibility, IMHO. Whether its, Dr. Phil, Dr. Weil, Dr. Oz, Dr. Mercola, Dr. Sears, or “The Doctors”. The creation of the brand image marks the transmogrification (I love that word) of the physician into the businessman, and with it, the loss of objective reasoning to unmitigated greed and narcissism.

    Organizations such as AAFP should distance themselves, as much as possible, from this type of branding activity in the medical profession, regardless of the type of medicine the practitioner preaches. Although I must admit it’s probably not mere coincidence that all the biggest offenders also happen to preach one form of SCAM or another.

  5. #5 dandover
    October 15, 2012

    I forgot to say, except for Dr. Pepper and Dr. Strangelove. They’re cool.

  6. #6 Science Mom
    http://justthevax.blogspot.com/
    October 15, 2012

    The entertainer gives you plausible deniability. The doctor will be seen as endorsed by you.

    If you don’t see that, you’re not qualified as executive vice president and chief executive officer of your organization.

    Spot on Daniel! And the problems with the AAFP embracing woo is far worse than we think:
    http://www2.aap.org/sections/chim/default.cfm
    http://www.aafp.org/online/en/home/policy/policies/c/complementarypractice.html
    http://www.aafp.org/fpm/2001/0300/p37.html

    The AAFP has embraced pseudoscience to the point where it has formed a section headed by a notorious anti-vaxx and woo-loving physician Larry Rosen. The AAFP refuses to speak out against even the most egregious examples of anti-vaxx activities by it’s members and refuses to speak out against dangerous and unproven “therapies” administered to special needs children, namely the DAN! doctors who promote it. Dr. Henley’s weasel words don’t surprise me and do seem to represent the AAFP’s directive which seems to be migrating away from evidence-based medicine and promoting what is politically-correct.

  7. #7 palindrom
    October 15, 2012

    dandover @ 7:51 — What about Dr. Denton? I like having cozy little footies and a trap door ’round the back.

    But seriously, folks, this is dreadful. I’ve brought this to the attention of the chair of family medicine of the major med school associated with my university, which is (AFAIK) still pretty much a woo-free zone.

    One last note: This choice is still more evidence of the fact that physicians are not trained as scientists, and in too many cases tend not to think like scientists. There are many exceptions — MD/PhDs such as our esteemed host, and others who simply tend to think that way — but by and large, working physicians are not scientists. Too many look back at their basic science courses as a hoop through which they had to jump, rather than a series of amazing revelations about the basic workings of the world, as revealed by experimentation and the most rigorous intellectual processes.

  8. #8 Anj
    October 15, 2012

    I’m beginning to understand how actual, practicing, licensed physicians go to the woo.

    I’m thinking

    “What the heck? You were educated. You were trained. You know how things work and how they don’t work. You know that no treatment works perfectly every single time and that you will always have disappointed patients, combative patients and noncompliant patients.”.

    In the land of woo – people who Want To Believe come to you. You are going to have fewer disappointed patients because it’s a self selected patient base. You can “help” these people most of the time. There’s the added bonus of almost no one scrutinizing your work for outcomes.

    Happier, more compliant patient base. Fewer difficult patients. No one telling you how to do your job. And the money never hurts.

    I can see how it is attractive. Of course, the pesky detail that you are leading people away from proven treatment probably discourages the scrupulous.

  9. #9 Eric Lund
    October 15, 2012

    palindrom @0847 said: Too many [MDs] look back at their basic science courses as a hoop through which they had to jump

    I’ve seen this firsthand, and it’s likely that you have, too. I had to TA a premed physics course once when I was in grad school, and it was a teacher’s nightmare: a course full of students who had no desire whatsoever to be there apart from the need to fulfill a requirement. You’re never going to reach a student who named his lab disk (floppy, as this was the early 1990s) “I Hate Physics”.

    I suspect that med schools and advisors encourage this mode of thinking by setting up a syllabus of courses that applicants have to take, and not making it clear why applicants should take these courses. Although many premed students (at least at universities which do not have a distinct premed major, which includes every institution I have been affiliated with) major in biology, or less frequently in chemistry or physics, there are many others who do not. I don’t recall the majors of all of my students in the aforementioned physics course, but I’m pretty sure some of them were from the history/government/English side of campus.

  10. #10 lilady
    October 15, 2012

    O/T All the cranks from AoA are posting now on the latest LaCrosse Tribune blog. CIA Parker just posted a comment about her diagnosis of vaccine-induced encephalitis…and I just replied:

    http://lacrossetribune.com/news/opinion/michael-winfrey-former-doctor-was-not-invited-to-uw-l/article_77a7ee6a-13ea-11e2-9389-001a4bcf887a.html?comment_form=true

  11. #11 lilady
    October 15, 2012

    A Science Mom:

    Great links. Your comment about Larry Rosen is spot on…however his affiliation is with the AAP, not the AAFP :-)

    From your link to the AAFP, I find this Q & A gem:

    “What would you say to a patient who’s taking Coumadin for atrial fibrillation when he tells you he wants to start taking Gingko biloba to improve his memory?”

    “This combination of herbs and prescription drugs definitely falls into the unsafe category. Ginkgo biloba is thought to stimulate functioning nerve cells and protect nerve cells from pathologic influences. It also increases cerebral blood flow by inhibiting platelet-activating factor. Thus, it will potentiate the effect of Coumadin and can lead to an increased risk of bleeding. I would let the patient know of the possible devastating outcome that may occur if he combines these drugs. If he chooses to use Ginkgo biloba, I would stop Coumadin therapy immediately and document the reason for it in the patient’s record. However, I’ve found that most patients willingly follow their physicians’ advice if they appear to be well-educated regarding CAM therapies.”

    Sweet Jeez, how about discussing the dangers of uncontrolled internal bleeds, or how about discussing the risks of throwing blood clots to the lungs and to the brain, if the patient takes ginko biloba, in lieu of Coumadin?

  12. #12 Mu
    October 15, 2012

    It will all go away once enough “integrative” med schools get hit by the Uncle Vernon syndrome “I AM NOT PAYING FOR SOME CRACKPOT OLD FOOL TO TEACH HIM MAGIC TRICKS!”

  13. #13 BG
    October 15, 2012

    @ palindrom: amen, my friend. Some folks who hold “only” MD degrees are working scientists, and others definitely have the intellectual gifts and think along those lines yet don’t conduct original research in their daily lives, and then…there’s the “I’m a physician, therefore I’m also a scientist” crowd. For a really depressing recent example of the latter, one needs to look no further than Rep. Paul Broun (R-GA). Maybe the AAFP can book him for next year’s keynote address, if Broun isn’t already scheduled to talk to a group of geologists about how the earth is only 9,000 years old.

    A related question for the AAFP and organizers of other medical CE is why they bother with these nonsenical general sessions in the first place. When I go to a meeting for CE, it’s for one purpose only, and I don’t want or need to be “celebrated”. I don’t bring my family and don’t turn it into a vacation, but then I’m an outlier, I guess.

    Orac: Thanks for your writing and for fighting the good fight. You rock! (And thanks for the occasional giggle–the mental picture of Carl Sagan doing back flips in the grave was good for several this morning!)

  14. #14 Mark Thorson
    October 15, 2012

    No CME credits for the Weil talk? Too bad you’re not a nurse or dentist. Then you could have gotten credits for something much more woo-derful.

    http://www.cancercontrolsociety.com/meeting2012-html.html

  15. #15 dan s
    b
    October 15, 2012

    Orac-

    Nutritional supplements are good medicine, in many cases proven by randomized controlled trials, and on others by our understanding of biochemistry and biology. Homeopathy, faith health, and crystals may be deserving of criticism, but use of nutritional supplements is not.

    You demonstrate your own ignorance of nutrition by criticizing nutritional supplements along with these other, very different “treatments”.

  16. #16 Denice Walter
    October 15, 2012

    I’m certain that the woo-meisters will declare victory as they proclaim *paradigm shift*; however Weil is a weak force in their universe because he admits that SBM has utility at all. Still, he enables them to spread their message far and wide- albeit in diluted form. ( insert obligatory homeopathy jibe HERE)

    But as salesmen ( women) can avow, it’s important to get your foot in the door before you barge right in and take over..

    lilady highlights up an interesting phenomenon that I have ( unfortunately) encountered many times ( courtesy of PRN’s pernicious poliicy of having listeners call the woo-in-charge for medical advice/ Talk Back show archives):
    they ask about ‘switching over’ from SB meds to more Gaia-friendly herbs, supplements, super-foods and diverse whimsy-based treatments which our most esteemed and gracious host has calumniated on FAR too many occasions to enumerate.

    Remember that previously the woo-meister has already heaped derision upon all meds in a prescribed routine:
    first, the drug is ‘shown’ to be in-effective and dangerous as volumes of ‘studies’ and ‘side effects’ are detailed;
    then reliable, earth-friendly products like herbs and supplements are spoken about lovingly as appropriate SUBSTITUTES for the aforesaid, dangerous drugs.

    Shockingly, I’ve heard about replacement woo for conditions INCLUDING heart conditions and SMI: a whole list of herbs, supplements and green juices ( usually) will be acclaimed as *superior* to the pharmaceutical products as will meditation, EFT and other non-reality-based religious activities.

    You can imagine that my very, long fuse often smoulders ominously as I listen to this tinderbox of incendiary advice.

  17. #17 Chris
    Neither here nor there...
    October 15, 2012

    dan s, yes there is a reason for supplementing if there is a known nutritional deficit like rickets or scurvy. But Weil promotes them beyond medical necessity. Go back to the article and click on the link about the supplement Weil sells.

    And one wee bit of advice: Always avoid doctor websites that has a link to its “product sites.”

  18. #18 Mike
    October 15, 2012

    dandover, don’t forget The Doctor. He’s cool too.

  19. #19 BG
    October 15, 2012

    @ Mark Thorson: you’ve given me my weeks’ quota of belly laughs, and it’s not even noon on Monday!

    “Meet Recovered Cancer Patients with Encouraging Reports” ! (I was looking for the next line, written in a circus poster font with 1880s spelling: “Sign Up To-day!”)

    On a much more depressing note, CE credits for this crapola? What an embarrassment for the dental and nursing professions.

  20. #20 BG
    October 15, 2012

    oops–week’s quota, not weeks’

    And in my excitement, I forgot to gush about the tours of “Mexican Cancer Clinics”! For $75, I hope they threw in free colon cleansings or at the very least, a palm reading.

  21. #21 Science Mom
    http://justthevax.blogspot.com/
    October 15, 2012

    Great links. Your comment about Larry Rosen is spot on…however his affiliation is with the AAP, not the AAFP :-)

    Aack, you’re correct and the AAP is worthy of criticism along with the AAFP.

    Nutritional supplements are good medicine, in many cases proven by randomized controlled trials, and on others by our understanding of biochemistry and biology.

    You’re barking up the wrong squirrel dan s. No one is criticising nutritional supplements from reputable sources that are used for what their known mechanisms of action and effects are. Weil et al. sell a lot of crap and make claims that aren’t proven. There is a difference you know.

  22. #22 Beamup
    October 15, 2012

    Indeed. Nobody here objects to, say, iron supplementation for anemia (other than perhaps to ask whether dietary adjustments might be more appropriate for particular cases). What we object to, but Weil promotes, are claims akin to “megadoses of vitamin C will cure cancer” or “vitamin D will prevent/cure the flu” and the like. Or, selling untested drugs of unknown concentration and poor purity (i.e. herbs) while evading all regulation because they’re labelled as “supplements.”

  23. #23 Interrobang
    October 15, 2012

    On Sunday afternoon this week I had the misfortune of turning on the local radio station, which was featuring a call-in show with a naturoquack, who was advocating taking 2g (2000 mg) daily of vitamin C, for perfectly healthy people who want to “boost their immune systems.” I nearly put my fist through the wall in my haste to shut it off. That kind of thing is pure-D (or C, in this case) bunkum, easily contradicted by my old doctor, and his question to me when my mother pretty well insisted to him that I should be taking calcium supplements: “You eat food, don’t you?” He then turned to her and said, “We wouldn’t want her to get kidney stones.” Good for him.

    Shame I couldn’t think of anything to e-mail to the host, but I was rather disappointed they’d be so credulous, even if commercial radio in this burg sucks diseased donkey doodoo.

  24. #24 herr doktor bimler
    October 15, 2012

    “What would you say to a patient who’s taking Coumadin for atrial fibrillation when he tells you he wants to start taking Gingko biloba to improve his memory?”

    If he turns to Gingko then his dementia will remain untreated, so it doesn’t matter what you say, he’ll forget anyway.

  25. #25 herr doktor bimler
    October 15, 2012
  26. #26 Ron Edwards
    DePaul University
    October 15, 2012

    @ dan s,

    What, precisely, distinguishes your concept of “nutritional supplements” from “food,” if anything?

    Medical advice concerning eating properly is science-based medicine; supplementing with extra substances such as iron, when called for, is similarly ordinary practice. When someone calls this “alternate,” it’s yet another example of co-opting good SBM practice into woo talk. When someone like Weil is selling something else (not food, not related to food) as a nutritional supplement, then see the comments directed to you above.

  27. #27 Denice Walter
    October 15, 2012

    @ Ron Edwards:

    Ah, but you see, alt media informs us that the standard requirements as stated by SBM/ dieticians/ governmental agencies are entirely too low : one could NEVER eat enough of the arcane phyto-nutrients and vitamins/minerals necessary for healthy natural living by actually EATING.
    It’s more natural to gobble down diverse factory-made supplements by the handful washed down by dried vegetable-fruit powder-laden concoctions by the quart..
    Or so they tell me.

  28. #28 Grant
    http://sciblogs.co.nz/code-for-life/
    October 15, 2012

    Orac (well, anyone who could be bothered reading anything I write…),

    “Dr. Weil is in demand.” == argumentum ad populum. Ugh.

    “the opening ceremony event is designed purely as a time to celebrate our family physician attendees.” – this is like saying that TED(x) lectures can be about any nonsense. Entertaining speakers are a good idea, but you want their content to be sound. (Disclosure needed perhaps – this is an issue I’ve been tackling myself.)

    “She has described it as being akin to having an astrologer give the keynote address for an astronomy convention.” – we have direct counterpart of this in New Zealand in Ken Ring, who infamously predicts (sic) weather and more notoriously earthquakes using astrology.

    Regards “a session entitled Teaching Pseudoscience in Medical (and Other) Schools” – my thinking is that a key is that these ought not to course in ‘alternative’ remedies per se as a course offering a critical examination of a range of remedies/ideas, including so-called ‘alternative’ remedies. Thoughts welcome.

  29. #29 Grant
    October 15, 2012

    Anj,

    “I’m beginning to understand how actual, practicing, licensed physicians go to the woo.”

    Everyone wants to help others, to make them happier, but doctors need to do this via making critical judgements. (Critical in the sense of examining the merits and faults of a thing.)

  30. #30 Grant
    http://sciblogs.co.nz/code-for-life/
    October 15, 2012

    Edit:

    Regards “a session entitled Teaching Pseudoscience in Medical (and Other) Schools” – my thinking is that a key is that these ought not to be courses in ‘alternative’ remedies per se but courses offering a critical examination of a range of remedies/ideas, including so-called ‘alternative’ remedies. Thoughts welcome.

    Sorry about this. Now for some coffee…

  31. #31 Narad
    October 15, 2012

    O/T All the cranks from AoA are posting now on the latest LaCrosse Tribune blog.

    In other news, Anne Dachel has endorsed the work of Jeffrey “gifted yogic flyer” Smith over at Emily Willingham’s Forbes entry.

  32. #32 Skeptical Medicine
    United States
    October 15, 2012
  33. #33 Denice Walter
    October 15, 2012

    @ Grant:

    If only.
    But seriously I wonder if that would be the case: more likely it is to familiarise real students with the secrets of alt med. When hospitals offer woo-ish services, are they catering to what they believe is patient demand? To me, if people want spa services and coddling, shouldn’t they just go to a business that offers those choices? I suppose a particular business model states that offering woo serves the bottom line or else they wouldn’t be doing it. I HOPE that it boils down to money because it doesn’t say much if it reflects what they think is useful or beneficial.

    I venture a guess that people like woo because it is comforting and perhaps they seek that out when they feel extremely vulnerable when being hospitalised or needing out-patient services long term. I’m thinking especially about services for cancer patients.

  34. #34 sailor
    October 15, 2012

    ” people ranging from “Tuesdays with Morrie” author Mitch Albom to (then) CMS administrator Dr. Don Berwick, from Dr. Georges Benjamin, Executive Director of the American Public Health Association to Dr. Andrew Weil.: Does not seem like much of a choice, at least they could have offered Dr Oz!

  35. #35 palindrom
    October 15, 2012

    Eric Lund — it seems we’re talking about the same pre-meds, as you’ll understand.

    A testimonial about how not all docs are mindless technicians: My oldest bestest friend from high school is regular ol’ pediatrician. He is the sharpest observer of human beings I have ever seen. His dad was a brilliant researcher in hematology. My friend absorbed this scientific outlook through his pores, and has a powerful, wide-ranging understanding of how the body works. I am sure he is a wonderful physician on many levels, and I’m sure he’d be among the last to fall victim to the charms of qucakademia.

    So no, I do not have scorn for “mere” MDs.

  36. #36 Roberto
    October 16, 2012

    Quacks, like con men, tend to assert whatever they can get away with unchallenged, which often seems to be their most notable distinguishing feature.

    I was recently perusing some (somewhat less than obvious) woo which actually sounded somewhat plausible, up until the point where the author stated that “sodium ions found in cells transmutate directly into potassium ions via an atomic reaction mediated by ATP”. This “researcher” ( who claimed to be a medical doctor) even included a “balanced chemical equation” to show how this process would work.

    Wow! Actual nuclear reactions at body temperature in every living cell of our bodies! Who knew?? Surely, turning the unwanted lead in our bodies into gold can’t be far behind! Although refuting such alternative “doctors” often seems futile, someone has to do it, if for no other reason than to protect the gullible and the innocent from their quackery.

  37. #37 Dangerous Bacon
    October 19, 2012

    I wonder how much effect the Affordable Care Act’s emphasis on linking payments to patient satisfaction will have on the promotion of woo by hospitals.

    If “meeting patients’ needs” is defined as “giving them what they want”, it would seem that providing various sorts of cuddly woo, if it drives up scores on patient satisfaction surveys, will be seen as the way to go.

    If the woo is kept strictly on a “complementary” basis and carefully monitored, it probably won’t conflict with the need to keep complications down and get quicker discharges. However, we’ll all end up paying the bills for woo practitioners and their ministrations.

  38. #38 LWS
    October 19, 2012

    To add to the disturbing nature of all this, an early report on some of what the Vile One said, and the “repeated” applause he received, indicating he was well received:

    http://www.philly.com/philly/blogs/phillypharma/Dr-Andrew-Weil-tells-family-docs-Urge-bans-on-soda-and-pharmaceutical-advertising.html

  39. #39 LWS
    October 19, 2012

    And an early report on some of what the Vile One actually said (and got repeated applause for):

    http://www.philly.com/philly/blogs/phillypharma/Dr-Andrew-Weil-tells-family-docs-Urge-bans-on-soda-and-pharmaceutical-advertising.html

    And ever the huckster, he played to his audience with: “The glut of specialists we have is one of the great obstacles to effective health care in our country.” Oh, yeah, we have way too many heart surgeons in this country. (Well, admittedly we do have *one* too many — Mehmet Oz.)

  40. #40 Jon
    October 20, 2012

    I’ve said it a thousand times: Looney attracts looney. Nothing new there. Getting Godwin out of the way, Nazis were huge fans of everything from homeopathy to Welteislehre to astrology. New Age is basically a contest to see who can believe the most improbable things. (I’ll see your UFO abduction and raise you aliens built the pyramids.) I could go on.

  41. #41 Peggy Thatcher
    October 27, 2012

    I think ISM made a pretty good stab at insolence, what with wording such as “Weil’s antediluvian agenda.”

  42. #42 Robin
    Atlanta
    November 4, 2012

    Although I agree with much of what is said here, there seems to be an underlying assumption that medical doctors know what they are doing. Unfortunately, I can’t agree with this, having multiple doctors mis diagnose and treat incorrectly to the detriment of the patient. I understand statistically that there cannot be 100% correct diagnosis, but I also see much higher mis diagnosis than should be acceptable.

    To address another point about branding turning doctors into businessmen. Coming from the UK originally, I find that doctors in general do not seem to be in the profession for the greater good at all. I’m sure there are a few, but not in my experience. Becoming a doctor un the US seems to be more about earning a good living than helping patients. I understand you could argue why not have both, but I have not experienced that in my interactions with doctors in general in living int he US for 14 years,

    I understand this maybe somewhat off topic, but being skeptical means being skeptical of everything based on personal evidence…

  43. #43 lilady
    November 4, 2012

    @ Robin

    “I understand this maybe somewhat off topic, but being skeptical means being skeptical of everything based on personal evidence…”

    (Translation)

    “I just want to take this opportunity to engage in ‘doctor dissing’, based on my medical history for an (unknown) ailment…and based on an anecdotal study (n=1).”

  44. #44 Denice Walter
    November 4, 2012

    @ Robin:

    I have often heard the tale that doctors are ‘more concerned with their business prospects rather than their patients’ welfare’ coming from alt med partisans who are first of all, merely nutritionists, homeopathtists, herbalists or other whimsy-based specialists, and therefore ill-equipped to accurately evaluate SBM, doctors or research in general.

    Secondly, because most of them have entrenched alt med/ alt media business interests of their own that are in direct competetion with SBM, they are hardly independent critics.
    ( see ANH; Natural News; Progressive Radio Network et al)

  45. #45 Antaeus Feldspar
    November 4, 2012

    Robin -

    Sadly, I do not remember who the commenter here that long ago summed it all up in two sentences, nor do I recall the exact phrasing of those sentences, so I’ll have to paraphrase. Here it is: “It’s not that we think we know everything. It’s that the alt-medders know nothing.”

    That’s really it. Is modern medicine perfect? No. Do those who practice it practice it perfectly? No. But the important question is not “is it perfect?” but “does it beat the alternatives?” What good is it to visit a homeopath who has an absolutely perfect grasp of the principles and practice of homeopathy and will flawlessly execute them with no thought of recompense in his mind if he’s still using homeopathy which means the only treatment I’m actually getting is water?

  46. #46 Les
    NW USA
    November 16, 2012

    I recommend my patients buy Weil’s Vitamin E supplement all the time. It’s the best reasonably priced mixed tocopherol and tocotrienol product I can find. Perhaps if more providers knew the difference between the shown-to-be-toxic alpha tocopherol, and a mixed product that doesn’t reduce gamma tocopherol levels, patients would be deriving benefit more frequently.
    Don’t tell me you are one of the guys that hated biochemistry so much you don’t read nutrition papers?