Medicine

Orac gets fan mail. Yes, as hard as it is to believe, my blog sometimes ticks certain people off, and sometimes I even hear from them. For instance, last week a reader wrote me. The subject header read, "Why do you hate naturopathic physicians so much?" and the letter went something like this (OK, exactly like this other than the name of the reader, which I've withheld, and to whom I will refer as "T"): Having stumbled across one of your diatribes against licensed naturopathic doctors, I can't help but wonder what that profession has done to hurt you? If you have examined the evidence,…

In pseudomedicine, fake diseases predominate. Basically, fake diseases are diseases that do not exist in conventional medicine as diagnostic entities because there does not exist sufficient sufficient evidence to support them as one or there exists compelling evidence that they are not. Naturopaths, for instance, like to diagnose people with "adrenal fatigue," which is one of the prototypical "fake diseases." Basically, it involves a constellation of vague symptoms that may include a combination of several of the following: fatigue, inability to handle stress, cravings for salty foods,…

If there's one form of quackery that is among the most "respected," it has to be acupuncture. I've often speculated about why this might be, and the best that I can come up with is that doctors are a bit more open to acupuncture because it involves sticking actual needles into the body. It's very easy to ignore the mystical, vitalistic BS about "redirecting the flow of qi" because doctors can easily handwave and postulate other, more scientific-sounding explanations, such as that it releases endorphins or adenosine. If that doesn't work, then acupuncturists add electricity and thereby rebrand…

Well, I'm back. Hard as it is to believe, during my vacation I went a whole two weeks without writing a truly new post. That's something that hasn't happened in probably 12 years. Yes, as a result of the lack of original material for two weeks, my traffic appears to have taken a noticeable hit and is now lower than it's been in several years, but you know what? For the first time I actually don't really care that much. It was good to unplug. It's also good to be back, though. Although we arrived home Saturday afternoon, I remain jet lagged, and it's also Father's Day, which means I need to…

Orac note: While Orac is on vacation (fear not, he'll be returning on Monday!), he's rerunning some of the "best of" the blog (if you can call it that). Actually, he's rerunning whatever strikes his fancy. This one struck my fancy because I used to use the term "altie" all the time, but haven't used it in years. It was a good shorthand for someone like Gwyneth Paltrow. This post originally appeared on April 11, 2008; so some of the references are a bit dated, and some of the links no longer work. But the sentiment is true. Feel free to add your updates to the list until I return on Monday. It…

Last year’s emergency Zika funding is about to run out and there’s no new money in the pipeline. It’s emblematic of the kind of short-term, reactive policymaking that public health officials have been warning us about for years. Now, as we head into summer, public health again faces a dangerous, highly complex threat along with an enormous funding gap. “The Zika threat will get worse,” said Claude Jacob, chief public health officer at the Cambridge Public Health Department in Massachusetts and president of the National Association of County & City Health Officials (NACCHO). “And the…

This is the sort of story that I really hate but feel obligated to discuss. I hate these stories because they usually portend the unnecessary death of a cancer patient, often a child with cancer whose parents refuse chemotherapy or who refuses chemotherapy and is unfortunate enough to have a parent who either has alternative medicine proclivities herself, lacks the guts to tell the child that he's getting treated for his own good and he doesn't have a choice in the matter, or, in a couple of cases that I've discussed, conflates using indigenous people's medicine instead of chemotherapy as a…

As hard as it is to believe, it was over seven years ago that I started my Annals of "I'm not antivaccine" series. The idea was (and continues to be) to point out how the claim that many antivaccine activists proclaiming themselves to be "not antivaccine" but rather "vaccine safety advocates" is, depending on the specific antivaxer making it, a lie, a delusion, or perhaps both. I do that by simply highlighting bits of over-the-top rhetoric I see on antivaccine websites likening vaccines to all sorts of evil things, particularly the Holocaust. In the case of the very first entry in this series…

“Oh Beautiful for smoggy skies, insecticided grain, For strip-mined mountain's majesty above the asphalt plain. America, America, man sheds his waste on thee, And hides the pines with billboard signs, from sea to oily sea.” -George Carlin When you think of helium, you very likely think of balloons, birthday parties, and blimps. But this inert, lighter-than-air gas has a number of unique properties among all the elements, including that it’s liquid at very low temperatures and it enters a superfluid state. It’s scientific applications include particle accelerators, MRI machines, and anything…

When I first started to take an interest in medical marijuana, I was struck by how much it reminded me of herbalism. Although herbalism is scientifically the most plausible of modalities commonly associated with "complementary and alternative medicine" (CAM), the use of herbal medicines still involve a number of problems, the biggest of which is what I like to call either the delivery problem or the bioavailability problem. In brief, herbs, when they work, are adulterated drugs. The active ingredient is often a relatively small, embedded in thousands of other constituents that make up herbs,…

As much as I like to deconstruct pseudoscientific claims, particularly about health, medicine, and health care, Sometimes it gets a bit draining. There's just so much pseudoscience, so much credulity, so much sheer idiocy out there that trying to refute them and encourage a more skeptical mindset often feels like pissing into the ocean, for all the effect it has. In the age of fake news and Donald Trump, it even feels as though we're going backward—and not slowly, either. That's why I felt it was time for a bit of a break, a bit more optimism than I've been able to muster before. So it was a…

Last week, I wrote about acupuncture, specifically how acupuncturists are unhappy that the UK National Institute for Health and Care Excellence (NICE), which provides guidelines for recommended treatments for diseases and conditions, does not recommend acupuncture for the treatment of knee osteoarthritis but does recommend arthroscopic washouts and debridement, for which the evidence is weak. My retort was simple: If this is true, the answer is not for NICE to start recommending quackery like acupuncture, but rather for it to stop recommending conventional medical and surgical treatments with…

Acupiuncture is a system of treatment rooted in the prescientific vitalism of traditional Chinese medicine (TCM). It doesn't work. For anything. As Steve Novella and David Colquhoun put it, acupuncture is basically a theatrical placebo, which is why rigorous studies consistently fail to find a treatment effect due to acupuncture that is detectably greater than placebo. Not that that's stopped acupuncturists and acupuncture advocates from trying desperately to show that acupuncture "works," even if it means hooking up acupuncture needles to electrodes and turning it into transcutaneous nerve…

Of all the modalities of alternative medicine currently in use, arguably acupuncture is the one that has achieved the most mainstream acceptance in medicine. I've often asked why it has become so common in academic medical centers and elsewhere, despite the evidence being overwhelmingly in favor of the conclusion that it is nothing more than a theatrical placebo. It doesn't matter that acupuncture is part of a prescientific system of medicine now known as traditional Chinese medicine (TCM), whose concepts are rooted in vitalism. It doesn't matter that what has passed for acupuncture since the…

I'm having flashbacks now. I feel as though it's 2012, and I was just in the midst of examining the Houston cancer quack known as Dr. Stanislaw Burzynski. As you recall, he's the Polish expat doctor who discovered peptides in the blood that he dubbed "antineoplastons" and postulated to be endogenous cancer suppressors. He ultimately made them into a cancer treatment that he's been using on patients for over 40 years now, despite never having demonstrated its efficacy or safety. Despite that, he's become a rock star in the world of alternative cancer cures, with two propaganda movies disguised…

There are many harms attributable to the antivaccine movement and its promotion of antivaccine beliefs. Certainly, the harm those of us who have been combatting antivaccine misinformation fear is the return of vaccine-preventable diseases, which is something we've seen in the form of outbreaks, such as the Disneyland measles outbreak two years ago and, in my own state, pertussis outbreaks. The Disneyland outbreak was a wake-up call to California legislators, who in its wake passed SB 277, a law that eliminated personal belief exemptions (PBEs) to school vaccine requirements. Now, only medical…

I was going to write about this yesterday, but seeing a family of a child with terminal cancer seduced by the siren call of Stanislaw Burzynski and his antineoplaston quackery distracted me and I had to blog about it. It's actually an appropriate lead-in to this story, which was based on an announcement by the FDA that it was sending warning letters to 14 companies for selling products that they claimed were treatments for cancer: The U.S. Food and Drug Administration today posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently…

When last I wrote about Houston cancer quack Dr. Stanislaw Burzynski nearly two months ago, he had, as I characterized it, just mostly slithered away from justice once again. The Texas Medical Board had not removed his license and had only fined him relatively lightly given his offenses. True, he had conditions placed on his continued practice (more on that later), but it hasn't slowed him down, as you will soon see. Another family is raising funds, this time from the UK, to travel to Houston for his nostrums. Basically, by failing to revoke Stanislaw Burzynski's medical license, the Texas…

More than 8 million U.S. children depend on the Children’s Health Insurance Program for access to timely medical care. The program is authorized through 2019, but its federal funding expires in September and it’s unclear what Congress will do. That uncertainty stresses all the systems and families that depend on CHIP, but it may be especially risky for the 2 million chronically ill children who get care through the program, which was originally designed for families falling in the gap between market affordability and Medicaid eligibility. In a study published this month in Health Affairs,…

March seemed to be naturopathic quackery month. Let's face it, though, every month is naturopathic quackery month. It's just that in March there were two stories that really caught my eye. The first was the story of a naturopath in Bowling Green named Juan Sanchez, who was gunned down in his office one Friday evening, allegedly by the distraught widower of a cancer patient whom he had treated, after having told her and her husband that "chemo is for losers" and claiming that he could eliminate her cancer in three months. The second was even more shocking. Basically, a naturopath in Encinitas…