Regular readers know that I've long been dismayed at the increasing infiltration of non-evidence-based "alternative" medical therapies into academic medical centers (1, 2, 3, 4, 5, 6, 7). It's gotten such a foothold that it's even showing up in the mandatory medical curriculum in at least one medical school. I've speculated before that academic medical centers probably see alternative medicine as both a marketing ploy to make themselves look more "humanistic" and a new revenue stream, given that most insurance companies won't pay for therapies without solid evidence of efficacy, meaning that it's usually cash on the barrelhead for such woo, without all that nasty hassle of filling out insurance forms and getting preapprovals from tight-fisted claims handlers.
One area of medicine that's always been fairly immune to the lure of non-evidence-based alternative medicine therapies is trauma. After all, unlike the usual panoply of ailments that alternative medicine practitioners like to treat with their therapies, conditions which are usually not life-threatening and which are prone to a large degree of variation, regression to the mean, and psychological overlays, trauma is concrete. You can see the injuries. Broken bones show up on X-rays. Bullets rip holes in bodies. If alternative medicine modalities are good for anything, it's been generally assumed that they wouldn't be much good in trauma, and, for the most part, academic trauma centers have eschewed them.
Not any more. Arguably the most prestigious trauma center in the U.S., the University of Maryland's Shock Trauma Center, is getting into woo in a big way:
Kim Holland's biker-chick days were over not long after they began, with the 46-year-old smashed between her Harley and a guardrail in Elkridge, and a bystander saving her right leg by taking off his belt and making it into a tourniquet before paramedics rushed her to the hospital.A week after she arrived at the University of Maryland's Shock Trauma Center - a week filled with operations and skin grafts, narcotics by pill and by pump - she lay in bed. The lights down low, soft music playing to drown out the buzzing and beeping and ringing that make up a hospital's soundtrack, two women slowly waved their arms over Holland's broken body, as if trying to push away the pain.
Their motions resembled part modern dance, part pantomime, as they used a technique of laying on hands called reiki (pronounced ray-kee) to help Holland relax and, they hope, heal more quickly by restoring her "energy balance."
In a strange pairing, high-tech Shock Trauma is opening its doors to a fuzzier sort of medicine, one that focuses less on the physical and concrete and more on the spiritual. As part of the Baltimore hospital's pain management options, patients are being offered acupuncture, reiki and music therapy alongside OxyContin and morphine.
Reiki? They're using reiki Maryland Shock Trauma? I can see trying acupuncture, although I'm still very skeptical that it does anything that can't be accomplished as well or better than conventional therapy. At least there's some evidence, albeit weak, that acupuncture is useful for certain types of pain. I would have no objection to doing clinical trials on acupuncture in a university medical center, even though I don't buy its whole schtick of "unblocking the flows of qi" as the "mechanism" by which it "works," and the justification at Shock Trauma for its efficacy borders on the ludicrous:
Dr. Lixing Lao, the center's director of traditional Chinese medicine research, said acupuncture has so many possibilities because, unlike a drug, it has no specific receptor in the body. It stimulates the body to heal itself, he said. That is what gives it the power to treat diarrhea as well as constipation, he said.
"No specific receptor"? That's why it can do so many things? Ugh. That's pseudoscientific nonsense at its worst. If acupuncture truly does have objectively measurable therapeutic efficacy, then you can be damned sure that it works through a physiologic mechanism that can be worked out, a mechanism that will no doubt involve receptors of some sort. Just because we haven't discovered them yet doesn't mean that acupunture doesn't work through receptors.
But reiki? One of the woo-iest of alternative medicine therapies out there? I used to make jokes about using reiki on trauma patients, but it would appear that it's no joke.
Reiki, for those who haven't heard of it, is a Japanese alternative medicine modality that claims there is a universal life energy that trained practitioners can channel by laying on hands in order to induce healing. It is arguably the purest woo among popular alternative medical therapies, given that it has practitioners who seem to honestly believe that they can channel this "universal energy" through themselves and into the patient in order to heal. Among alternative medical medical modalities, to me reiki is among the least likely to be of any use for trauma patients. As the article describes it:
Historians say reiki was developed in the early 20th century by a Japanese physician and monk, Mikao Usui, and came to the United States in the 1930s. Reiki is a Japanese word, derived from rei, which means universal, and ki, which means life energy.
Practitioners say they use the technique to quiet the body and mind. This form of laying on hands often involves very little touch, only what looks like a massaging of the air around the body, as practitioners transmit their ki to the patient.
Reiki is nothing more than religious mumbo-jumbo. Unlike acupuncture, there isn't even a hint of a plausible mechanism, aside from the placebo effect, by which it might work. No one can measure this "ki," much less demonstrate that reiki practitioners can do anything at all to manipulate it, much less that they can manipulate it for healing effect.
So how do the physicians at Maryland Shock Trauma justify the use of reiki? Easy. They fall prey to what alternative medicine mavens the world over routinely use to claim that their favored form of "woo" works, anecdotes:
"I was very skeptical. I was like, 'OK, so you wave your hands over people and there are these energy fields and this makes you feel better?'" recalled Dr. David Tarantino, an anesthesiologist who runs Shock Trauma's pain management service. "I said, 'Obviously it isn't going to cause the patient harm so let's try it.'
" ... The more I have become involved with this and seen firsthand what it does for our patients, the more it has piqued my interest."
If you look at what's actually being done, it looks more like relaxation therapy melded with guided imagery, which can be effective, grafted onto religious woo:
The mood in Holland's hospital room is quiet and relaxed as the 10-minute session comes to an end. Audia and fellow reiki master Bonnie Tarantino (no relation to the doctor) have spent 10 minutes sharing their positive energy with Holland, slowing down her breathing to try to clear whatever blockage is keeping the energy from freely flowing. They have had her travel to happy places in her mind and to think of things the landscaper will do once her long rehab is complete.
"See yourself standing strong in the garden," Tarantino whispers. "I want you to see yourself bending and doing everything you want to do. See yourself dancing."
Tarantino walks to a large, milky-white quartz crystal bowl sitting on the cold tile floor. She taps the side with a mallet and the room fills with a deep sound that seems to penetrate to the core.
Holland tells them her whole body is relaxed, much like after the previous night's treatment, which allowed her to get a good night's sleep by shedding some of the emotional damage of the crash. Her main regret seems to be that she didn't get in more riding before the accident. That, and giving her nay-saying husband and college-age son prime opportunities for "I told you so."
[...]
She says a shooting pain in her leg has subsided and her four broken ribs and punctured lung are hurting a little less. She says she feels the good energy coming in and the bad flowing out.
Like almost all alternative medical therapies, reiki gets the credit for improvement even when it's used in conjunction with conventional therapies, and the physicians and woo-meisters at Maryland Shock Trauma are facilitating this impression.
I'm beginning to wonder if I should just give up this quixotic battle to try to insist on evidence-based medicine in academic medical centers. I'm clearly losing the battle, and sooner or later I'll be relegated to the sidelines along with the other dinosaurs who advocate scientific medicine over unproven, non-evidence-based therapies. If I were to join the Dark Side, I could probably attract a bunch of grants to fund clinical trials to look at whatever the woo du jour is.
I'd never do that, of course, if only because as a former skeptic I'd represent a truly valuable scalp for the world of non-evidence-based medicine, but I feel as though I'm increasingly alone in holding out.
More like this
...that's it, I'm adding "DON'T SUBJECT ME TO ALTERNATIVE MEDICAL TREATMENTS, NO MATTER WHAT" to my Last Will And Testament. I'm not taking ANY chances.
I am a somewhat retired Critical Care nurse, and I've always rolled with the woo. On the theory that certain rituals help blunt a patient's anxiety and enhance the placebo effect,well then, woo on. And no reason to object to having a medical student be aware of the universe of rites and wierdness they may encounter at the bedside. But trauma? Lord-or somebody-have mercy!
gee, i gess we have to add this to all ourr living wills too? fr cryin owt lowd!!!
I'm curious about the idea of using acupuncture for patients who have broken limbs etc. after coming off a bike. Don't they have enough pins in them already?
Bob
At least they waited until after the conventional medicine was used to bring in the "reiki masters". We know we're in trouble when they try the woo first. All this stuff comes down to guided relaxation, really. Relaxation is good. Toning down stress can help healing because stress is not good for us. But let's call it what it is. If I were injured and in pain, I certainly wouldn't mind someone coming into my room and helping me relax - AFTER I'd gotten all the necessary surgery and was pumped full of medication.
Absolutely amazing! Hard to believe.
The boredom of a hospital room makes pain more intense. The sight of someone 'altering my energy fields' would give me a good laugh and make me feel better. But I think Monty Python tapes would be cheaper and just as effective.
Dr David Tarantino recalls:
Who is this guy? Doogie Howser? Does he shave yet? Blow my mind, dude.
Hey, I've watched plenty of magicians in action, and most of them do a lot of hand-waving, so there must be some strong medicine going on. If hand-waving can make a beautiful woman disappear, surely it can make a wound heal!
"The boredom of a hospital room makes pain more intense. The sight of someone 'altering my energy fields' would give me a good laugh and make me feel better. But I think Monty Python tapes would be cheaper and just as effective."
I think this is a great idea - after all Normal Cousins cured himself this way. As a plecebo this is probably as effective as any, and as it changes your mood maybe better than most. It is also WAY CHEAPER than all the others that need practicioners. I don't know what we do with people with no sense of humor though.
I'm a big fan of your blog and your cynicism and share many of the same notions about woo. On the other hand, as Allison mentioned, this patient had conventional therapy first and the reiki was largely for pain control, yea and healing, maybe even giving the patient a sense of well-being. But even you must admit there is a huge mental/psychological aspect to pain and perception of pain. If this person benefits and has less pain then why not? Compared to many woo's it has little potential to harm, and although I agree it may be a large placebo effect if the patient believes and it has helped her then thats good right? I'm sure for many people, including myself, it would be of no benefit, but just as there are many personalities, many learning styles, many beliefs if used in the appropriate setting and with the appropriate patient...
I love Reiki. It's a classic. Some guy just sits down and pulls the whole "practice" out of his butt one fine day. And people buy it.
I swear. Someone needs to write a web-based woo-generator that just churns out ridiculousness... uh. wait. Better not, huh?
Holland tells them her whole body is relaxed, much like after the previous night's treatment, which allowed her to get a good night's sleep by shedding some of the emotional damage of the crash.
Wow - it sounds like she's getting a bit of "time therapy" effect. You know: we heal over time. I bet she does feel better than the day before, and the day before that. That's because her body is healing. Too bad about the brain.
My cat is apparently a reiki master. Sleep is often difficult for me due to chronic pain, but when he lays next to me purring, I can often drift off more easily. WooWoo!
Seriously, I can see where trauma reiki might help. I'm in the ER busted up three ways, and someone starts waving his hands all over me. I'm thinking; "If I could get off this table I'd kick your ass!" See? Totally distracted from the pain.
The idea that someone in the ICU, with all the tubes and monitors and therapy that involves, might claim recovery due to reiki is pretty amusing. On the other hand, as other commenters have said, the value of distraction and relaxation is probably greater than zero; one would assume that if they're really interested in proving something, they could run some sort of long-term study of no intervention vs reiki vs having attractive people read stories or wave their hands in non-reikiesque ways.
Richard Dawkins has commented on some of the critiques coming at him from other atheists ("atheist buttery" -- "I'm an atheist, but.."), and he mentions an argument which goes like this:
"Yes, you and I can handle reason, science, and hard facts over comforting fables -- but they can't. They don't have the intellectual capacity, or the strength of character, or the habit of reflective analysis -- AND they don't WANT it. They're happy where they are, and want more of the same. So it's much kinder to not make these kinds of demands of the common people. Don't make them think or give them science. Why? They're not like us. Give them what they can handle -- or let them alone. They'll be more comfortable, and it's easier on both them and us."
I kept thinking of this when I read this post. It seems to me that -- in the name of diversity and comfort and finding "what works for the individual" -- many scientists and doctors are getting comfortable themselves with telling lies to other people.
No, not real lies, are they? Not if they work in some sort of way, for some sort of benefit. So what would ordinarily be seen as dishonest pandering and condescension is translated into being practical and showing respect.
It bothers me. As you point out, the parts of reiki that work have nothing to do with reiki. But throw in the other stuff, the nonsense, because you do have to play pretend for some people. Not us, of course. But them.
Leave it to Richard Dawkins to have said exactly what irritates me about this. The guided imagery and relaxation techniques that have become fused to reiki may have value (although the data is somewhat mixed), but what is the value of having them administered by a person who believes that he or she can channel the energy of the universe into the patient being treated? It's no more than religion.
Orac, It is the placebo effect, pure and simple, which is mediated through basal nitric oxide.
http://daedalus2u.blogspot.com/2007/04/placebo-and-nocebo-effects.html
Which I happen to know a fair amount about. Once you raise the basal NO level to where maximum physiological resources are diverted to healing, additional placebos can do nothing more. This is how the placebo effect can be "saturated". I think I can do that pharmacolologically, that is stimulate the "placebo effect" by raising basal NO, such that no further increase in NO would have any physiological effect.
Once you have a pharmacological method for maximally inducing the placebo effect, woo will be seen as the inferior placebo effect inducing method that it is. Compared to the right control (a maximal stimulation of the placebo effect), woo will always turn out to be less effective.
I know they have DNR's, but do they have DNUAMs (Do not use Alternative Medicines)? Maybe NAM (No Alty Morons) is a better acronym.
Sillyness.
Er, isn't that a bit late? I can imagine adding no séances, no ouija boards, and no other contact-the-dead nonsense to a will, but medical treatments?
Daedalus, why can't it be NO2 instead, so at least we can have fun having a a plecebo....
Can I use this universal life "energy" to recharge my cell phone's battery? We are so fortunate that the japanese dude discovered how to utilize life energy to heal ourselves instead of charging batteries. Because charging batteries is easy. Phew. That would have been a waste.
For once I want woo for somewhat stuff, like charging batteries or removing tough stains.
...that's it, I'm adding "DON'T SUBJECT ME TO ALTERNATIVE MEDICAL TREATMENTS, NO MATTER WHAT" to my Last Will And Testament. I'm not taking ANY chances.
It would probably be more effective to have it tatooed on your chest.
Sailor, you mean N2O, nitrous oxide, the gas used as a (not so great) anesthetic. NO2 is nitrogen dioxide the brown gas that come off of power plants, which has a TLV (threshold limit value) in the low PPM range, and which accumulates in silos sometimes (as a product of silage fermentation), a single breath of which can cause death.
Anyway, inhaled NO doesn't work to raise basal NO levels. NO is destroyed at near diffusion limited rates by oxygenated hemoglogin in the lungs. Your nasal passages make a few hundred ppb anyway to match perfusion in your lungs with ventilation of the air you breathe.
Inhaled N2O doesn't work as an uber-placebo either.
I saw reiki being administered once, and I thought "What the fuck are these people doing?" This was at a time when I was prepared to buy acupuncture and homoeopathy, which indicates just how far-out reiki is.
Thank God for Orac and people like him, who are prepared to stand up and say "No! This is a load of crap, and the Emperor has no clothes."
I can understand the psychological comfort it might bring, as a result of the prolonged personal attention, but that's about all.
I work at a top 10 hospital that has nurses using and promoting Healing Touch, which is similar to Reiki. I was originally open to this, but the more I learned the stronger I feel that health professionals need to speak out against these modalities being used by healthcare providers. When a nurse presents HT (or Therapeutic Touch or Reiki), the patient is deluded into thinking it has a scientific basis because it is being advocated by a trained healthcare professional. The inherent dishonesty prevents the patients from making an autonomous, informed decision. Also, I've found the whole enterprise very cult-like. The training (which costs hundreds of dollars for each 'level' of HT training) inculcates the practitioners into buying into anything termed alternative. Also, don't forget, outside of the hospital these practitioners charge for their services (approx $60/hr here). It is also being promoted at childrens hospitals. To see how big this is becoming check out the Healing Touch international website.
I wish I could say something, but a dear, long-time friend has taken this up, and I really am not ready for the fallout if I state outright what I think about reiki. If I could go back in time, I'd have said it to this friend the very first time I heard of it, before it became so important. It kills me to keep quiet while the stories of the wonders of this crap keep coming, and when "healings" are done at parties, so I just avoid it as much as I can.
What I can say, though, is that if these reiki "masters" were so good, they wouldn't be teaching it along with so many other things. They'd be in too much demand as healers ("if it actually worked" remains unsaid at this point.) And I have pointed out that the insistence that the courses are so expensive in order to weed out people who aren't serious is an outright lie. It's to weed out people who won't balk at spending thousands of dollars for a beginning course and might therefore just as easily throw away thousands more for additional courses. Ugh. I need to stop now.
So, can I put "allergic to reiki" (or homeopathy, or echinacea--which I actually AM allergic to) on a medicalert and have it paid attention to?
The spread of Woo is very discouraging. There was a recent article in a local paper puplicising the new offering of Reiki throught the nursing department at the community hospital in Farmington. When I was commenting about thsi mindlessness to a friend he informed me that that his sister in law practices theraputic touch at Maine General which our premier medical institution in theis state.
The practice is protected in a number of ways. The attitude is that it "works" and "what harm can it do?". It is also offered by the nursing department so objections can quickly be considered sexist attacks.
I can only hope that the designers of the Boeing Dreamliner are using science and will not be depending on chants and levatation!
AFTER I'd gotten all the necessary surgery and was pumped full of medication.
If you are pumped full of the appropriate medication you should be plenty relaxed. ;-)
Maybe the idea is to dilute evidence based medicine to homeopathic levels so that it works better?
I like to say "I'm allergic to 'alternative' medicine" and if I'm ever in the hospital, I plan to put it on my chart. I'm also making my point person on my living will my epidemiologist best friend rather than my boyfriend, so science-based decisions will be made about my medical care.
Unfortunately, I'm not so lucky in life. When I reported via e-mail (as a slim, extremely healthy-eating, exercising 43-year-old) to my doctor that I was having episodes of constant burping sans pain or any other symptoms, she actually "diagnosed" me as having GERD (Gastrointestinal Reflux Disease) and told me I could either change my lifestyle (what do I do, eat one less green bean and exercise for 10 more minutes weekly and drink one glass of wine a week instead of two?) or take drugs (with a host of side-effects). I may indeed have GERD, but but I prefer diagnoses based on more than speculation.
Hear that whirring sound?
That's R. Adams Cowley, spinning in his grave.
AFTER I'd gotten all the necessary surgery and was pumped full of medication.
I wonder how much of the increasing interest in woo-based pain management grows out of the increasing reluctance to use narcotic-based pain management?
As anyone who's had surgery knows, doctors can be awfully stingy with the Percoset, and I suspect it has more to do with the fear of running afoul of law enforcement than it does with the patient's own pain levels.
When I had my C-section last September, I had a nurse tell me that I ought to be off the narcotics, and I didn't really need anything more than ibuprofen... less than 18 hours after delivery. I'd have been willing to try acupuncture after my recent ACL surgery, too -- anything is better than nothing, when your other choice is staring at the clock and waiting for it to be time for you to stop hurting.
With apologies to Ross Perot: Hear that great sucking sound? That's the sound of insurance your premiums being sucked up to pay for woo.
Just curious, do all these patients have private rooms? It seems kind of unfair to subject their neighbors to the chanting, waving, woo-wooing, "relaxing" music and chimes. And what about the consequences of energies spilling over, or do they aim straight? Does laughter disturb the chi/ki/qui?
I have to wonder whether this is, at least in part, an effect of the "patient-as-customer" hospital business model that I, at least, view as having become more prevalent in recent years. I suppose it boils down to "Give 'em what they want. After all, it's not like it'll hurt anyone, and we'll have more satisfied customers. Everybody wins."
Oh dear.
Can I be the first to advance the hypothesis that Star Wars is partly to blame for the resurgence of Woo in teh last three decades?
"Reach out with your feelings, Luke! Use The Force...!"
I like the idea of misdirected Reiki energy possibly causing the person in the next bed to have an inadvertent relaxation of an unfortunate sphincter or two. Of course, laughing might do the same thing.
If it is any consolation, you aren't alone. I recently found that laying-on-of-hands and reiki were being used at University College Hospital (run by the NHS, not, thank heavens, UCL where I work). The application form for the job (posted at http://dcscience.net/?p=34 ) defies belief. It is a typical example of the (lack of) mentality of HR departments who seem to think that if you have ticked the box and done the course, everything is OK.
'Getting' comfortable? They've done it for centuries.
Honestly, I'm considering a tattoo that says "for the love of all that's good and interesting, don't use 'alternative' therapy on me" for the use of medical practitioners in the event of me suffering a serious injury or illness. I'd like to live, you see.
Dr Aust, actually you are correct. The internal anal sphincter is controlled via nitric oxide, the same NO that mediates the placebo effect (which is the only plausible mechanism by which any of this woo could possibly have any effect). A side effect that might be expected from any increase in basal NO levels would be the relaxation of smooth muscles controlled by NO, including the internal anal sphincter.
Involuntary diarrhea might be one of the first signs that the woo is actually doing something, but I think it would be premature to use that as a clinical endpoint.
Reiki is actually awesome. You guys don't know what you are missing out on. The body and mind rarely feels so alive and satisfied as when you are giving a Reiki session. Being a Reiki practitioner is like being calm within the storm, and it grows over time into an experience of life that can only be called love.
It seems to me that Shock Trauma could reach a completely new dimension of care if Reiki or other energetic healing methods were incorporated with care and wisdom. What if we left behind the old "us vs. them", and the MD's began learning Reiki? The joy and vitality would be infectious!
Millions of people, including myself, look to MDs with trust and respect. It is immature to reject a method of healing before looking into it fully. If you want to be an extraordinary physician, following the crowd is not likely to get you there. Integral medicine is the wave of the future.
We are barely seeing the beginning of what human beings are capable of in medicine and healing. Imagine what we could accomplish if we were to work together toward a unified goal.
That's a very convincing argument. I for one am now totally converted from my previous position of scepticism.
There are so many points you guys are missing - forget the one-on-one stuff with the patient:
You're allowing a whack job (the reiki healer) into medicine - as a professional.
That whack job has family and friends - who probably were trying to get them to stop this nonsense before the hospital bought into the idea - this leads to family break-down. And the re-inforcement of delusions. And it's all the hospital's fault.
The whack job - now that they're a professional - gives people (wrong) medical advice outside of the hospital.
As mentioned, your insurance premiums go up, and the hospital is now paying for the whack job's delusions.
The whack jobs (eventually) start a union.
The whack job union starts protesting THE DOCTOR'S medical care. (Of course.)
And on and on and on,...
In the west, we have a habit of rejecting as inferior, or fraudulent, those practices which we have not yet learned to explain in our embraced logos and whose results we cannot quantify for comparison and contrast with competing practices.
We have turned empirical science into a new religion, to replace the old tyrannies of mysticism. My fear of this is that in our embracing of the empirical, the measurable, the logical we lose the ability to investigate and appreciate experiences that do not fit neatly into our scientific view of the world.
I have never experienced an alternative medicinal practice. Additionally, I expect that in fields like chiropractic, acupuncture or faith healing (of which reiki can be tenuously lumped) there are a lot of frauds, and not a few who really believe in what they are doing. That being said, however, I am saddened by the dismissive and caustic nature of these attacks on reiki being attempted in a trauma center after the patient has been stabilized. While a few of the posters have voiced their well-considered concerns, the vast majority seem to be barking at shadows.
As a martial artist, I have seen that there is something to the idea of Ki (qi, or chi). As a philosopher, I understand that the poetic interpretations proposed by martial artists, reiki practitioners and other groups, from many cultures, that describe this sort of energy that flows within people, or perhaps connects people to the world at large, are not objectively true. However, there may be, just maybe, something real lying under the poetry that so many cultures have developed. Maybe some real phenomenon exists that can be utilized in working to heal the human body. Scientists in Russia believe that they have been photographing the "ki" for years now, only they call it "electromagnetic field" - yet I posit that this answer may yet be another form of poetry.
I would like to see the bright minds of this day and age throw off the blinders imposed by strict empiricism and scientism. It is good and well to seek some organized way to measure the world and communicate our findings to one another, and a debt is owed to the scientific method for casting back the shadows of dark age mysticism, but this bright torch may be creating shadows of its own. Folly lays in the way of rejecting experiences outright because they don't fit our paradigm, and shame in doing it so proudly.
OK, hot shot, what better "organized way to measure the world" is there than the scientific method? Be specfic.
Your entire comment is nothing more than an appeal to other ways of knowing.
I'm cracking up!!!
hey Wait!!! you have not snatched the the grasshopper from my hand yet hey!!!!
Master Woo; if my chi is has been disrupted by the forces of science, how can I regain my chi in the face of such stiff opposition?
Mewly return to the pwace from which you came Gwasshopper. Do not weside with those that doubt ta woo, for they are woowess about woo.
Sorry I just pictured Orac standing next to master chi saying "OK Hot shot!!"
Orac -
The trap in your question is that to meet your criteria, i need to appeal to your metrics. For me to propose a "better" way to attain and transmit knowledge, i will need to justify it according to your standards of evaluation - those very standards you ask me to defy.
But your question is irrelevant. I am not arguing that the scientific method is flawed as a tool to make empirical claims about the world. The beauty of the scientific method is that it can, and in the best cases does, offer us a means by which to constantly challenge accepted knowledge and further develop our thought.
My concern, rather, is that the elevation of empirical and rational knowledge as the absolute approach to all Truth can and often does trap us in the limited box of our understanding. Plate tectonics, today widely accepted as a factual description of our planet, was dismissed as quackery well into the twentieth century.
So, you can use cute little names for me, and link to fallacies you attribute to me in your flawed understanding of my perspective (or perhaps my flawed attempt to communicate it). I expected upon posting that my perspective would not meet your criteria for "worthwhile" thought. But if your readers would like to find writers more eloquent than I that touch on this subject, i recommend Nietzsche's Twilight of the Idols, Heidegger's The Question Concerning Technology or Adorno and Horkheimer's Dialectic of Enlightenment. There you will find real "hot shots" arguing, well and logically, that our struggle to see leaves us blind to some really beautiful sights.
I just don't understand why Orac is so opposed to allowing a patient to have a mind and free will. He acts as if the masses are all dumb, naive, and gullible to all the alternative scams on the market, and how somehow he is the almighty evidence-based master of the Universe. There are so many cases where evidence-based medicine fails miserably, or causes serious harm and/or death (alas, malpractice). Those who live the longest without major illness are typically people who avoid traditional medicine altogether, only seeking it out when they are in a true medical crisis as a last resort. If I'm in a car crash and need help, I'll go to you almighty Orac. But if I'm suffering from high blood pressure, obesity, and high blood pressure, with a high risk for cancer, I much prefer going to my nutritionist, physical trainer, and spiritual counselor at the Church. Those are far better healing techniques than our current evidence-based health system.
Don't let any open flames near that one; it'll ignite the straw man.
You're perfectly free to pursue your non-evidence-based therapies, and best of luck to you, but it is not the job of academic medical centers to facilitate your doing so because they are charged with promoting scientific medicine, not modalities based on religion or spirituality.
By the way, why do you think that physical training and nutrtion are "alternative"? They're not, at least as long as the nutritionist isn't claiming to cure serious diseases with supplements.
Serious diseases are cured all the time with vitamin and mineral supplements.
Examples of cures with nutritional supplements:
B12 for pernicious anemia, C for scurvy, niacin for pellagra, thiamine for beri-beri.
Goiter is cured with a common supplement called iodine which can be purchased at the grocery store.
Magnesium is a common mineral which is given IV and curative for eclampsia and migraine.
Table salt is found at the grocery store can be given IV in the ER as normal saline which is curative treatment for volume depletion and dehydration.
Most people are unaware of this information because the supplement companies are restricted by an unconstitutional gag order which prevents them from placing this information in their sales literature.
Of course, those are not the claims that I'm talking about, as you well know. I'm talking about the sort of quacks who claim that you can cure cancer "naturally" with supplements and the like. If supplement companies stated on their literature that vitamin C can cure scurvy, for example, nothing would happen to them because it a claim supported by science. Where supplement manufacturers get into trouble is when they make claims for nutritional supplements that are not supported by science.
In the meantime, none of your examples are anything other than mainstream science, which makes my point.
Conventional medicine will embrace treatments that can be shown through science to work, be they nutritional or otherwise. As for most people being "unaware" of this information, last I checked, all of the information you mention is freely available in books and on the Internet.