Yet another hat tip this morning to anjou, a regular reader, commenter, and human RSS feed on all things cancer and alternative medicine (not to mention turning me on to Vanessa Hidary, the “Hebrew Mamita” spoken-word artist).
Last night anjou brought to me a superb AP Impact article, Alternative medicine goes mainstream, from medical writer Marilynn Marchione. I know that AP has been skewered as of late by various science bloggers but this particular article by Marchione is one of the best treatments I have seen in the last two years regarding the truth behind the alternative medicine industry and its infiltration into academic medicine.
It’s no surprise then that this article is being picked up extensively by US newspapers this morning.
[See also commentary from my academic physician-scientist colleague, Orac, at Respectful Insolence.]
We in academic medicine are complicit:
They are doing Reiki therapy, which claims to heal through invisible energy fields. The anesthesia chief, Dr. Richard Dutton, calls it “mystical mumbo jumbo.” Still, he’s a fan.
“It’s self-hypnosis” that can help patients relax, he said. “If you tell yourself you have less pain, you actually do have less pain.”
Like “Big Pharma,” there really is such an industry as “Big Woo” that co-opts a little science with classic marketing techniques:
“Herbals are medicines,” with good and bad effects, said Bruce Silverglade of the consumer group Center for Science in the Public Interest.
Contrary to their little-guy image, many of these products are made by big businesses. Ingredients and their countries of origin are a mystery to consumers. They are marketed in ways that manipulate emotions, just like ads for hot cars and cool clothes. Some make claims that average people can’t parse as proof of effectiveness or blather, like “restores cell-to-cell communication.”
“An Associated Press review of dozens of studies and interviews with more than 100 sources found an underground medical system operating in plain sight, with a different standard than the rest of medical care, and millions of people using it on blind faith.”
And while I have long held that alternative medicine is something that must be taught to future physicians and pharmacists (as I have done for 14 years), my critical approach is neutralized by something that I have seen firsthand at several major academic medical centers: the role of philanthropists and advocates in influencing the medical school curriculum:
Some medical schools are teaching future doctors about alternative medicine, sometimes with federal grants. The goal is educating them about what patients are using so they can give evidence-based, nonjudgmental care. But some schools have ties to alternative medicine practitioners and advocates. A University of Minnesota program lets students study nontraditional healing methods at a center in Hawaii supported by a philanthropist fan of such care, though students pay their own travel and living expenses. A private foundation that wants wider inclusion of nontraditional methods sponsors fellowships for hands-on experience at the University of Arizona’s Program in Integrative Medicine, headed by well-known advocate Dr. Andrew Weil.
The reason I think that alternative medicine must be taught in academic health professions program is that the more we understand and can speak to patients with non-judgmental authority on these topics, the greater chance there is that patients will choose modalities that will provide them the most benefit – so I am encouraged by this quote from Mitch Gaynor:
That is why Dr. Mitchell Gaynor, a cancer specialist at the Weill-Cornell Medical Center in New York, said he includes nutrition testing and counseling, meditation and relaxation techniques in his treatment, though not everyone would agree with some of the things he recommends.
“You do have people who will say ‘chemotherapy is just poison,’” said Gaynor, who tells them he doesn’t agree. He’ll say: “Cancer takes decades to develop, so you’re not going to be able to think that all of a sudden you’re going to change your diet or do meditation (and cure it). You need to treat it medically. You can still do things to make your diet better. You can still do meditation to reduce your stress.”
Once their fears and feelings are acknowledged, most patients “will do the right thing, do everything they can to save their life,” Gaynor said.
In light of this quote, it’s interesting to read the closing of an Archives of Internal Medicine review that a certain science blogger wrote with a chief medical resident 11 years ago:
Classically trained physicians cannot ignore herbal medicines anymore. We must realize that patients are using herbal medicines, and insurance companies are beginning to cover the costs and are even asking us to oversee the use of herbs in certain situations. We must all become educated about these products, and at the very least know where to find information when we need it.
Asking patients about supplement use during the initial history is thus imperative. Patient disclosure of herb use may provide an opportunity for the physician to redirect the patient toward effective conventional health care. By taking a complete drug and supplement history, a dialogue can be initiated to rationally compare the appropriateness of herbal remedies and regulated pharmaceuticals in relation to the severity of the condition. Until herbs in this country are more strictly regulated, however, no classically trained physician should recommend an herbal product to a patient. For the herb-using patient who views conventional medicine with ambivalence, the physician can foster a more open and communicative relationship by demonstrating an objective understanding of both alternative and conventional approaches. [emphasis mine]
But I digress.
So I don’t run afoul of AP, go and read Marchione’s article yourself. She does an exceptional job near the end of explaining to critics that conventional medicine and pharmaceuticals have brought us debacles such as Vioxx and its cover-up, “The safety net for alternative medicine is far flimsier.”
There something in Marchione’s article for every blogger who writes about alternative medicine.
Readers: go forth and read. . .and thank you Ms. Marchione and colleagues for this superb report.