Science-Based Medicine

Jan 11 2013

SCAMlandia

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19 responses so far

19 Responses to “SCAMlandia”

1. # Vince Paulon 11 Jan 2013 at 2:55 pm

   For the record, University of Western States is not a physical therapy school.
   http://www.uws.edu/default.aspx

2. # Quillon 11 Jan 2013 at 3:12 pm

   “If we can detect the Voyager spacecraft, over 7 billion miles from earth broadcasting with the power of a refrigerator light bulb**, I think we could pick up a biofield, don’t you?”

   Well of course not! BigPharmaBioMilitaryMedico conspiracy! Quantum!

   But seriously, congratulations to Portland for out-nutting the SF Bay area in terms of SCAM. That takes some work, that does.

   And one other editing note: thou has sinned against the great and eternally awesome Chubby Checker by calling him Cubby. Say ten hippocratic oaths whist doing The Twist and you shall be forgiven.

3. # nybgruson 11 Jan 2013 at 4:25 pm

   Last year my school of medicine offered an elective opportunity in China at TCM hospitals (my SoM has a 1-month clinical elective requirement at the end of 1st year; some take it seriously and some use it as an excuse to vacation at a clinic in Vanuatu and other such tropical South Pacific Islands).

   I, and a few colleagues, derided this since it was an official endorsement by the SoM for an elective that would, by definition, be including heaping helpings of non-reality based medicine. This lit a huge fire with many fellow students harping at us the typical sCAMster tropes and calling us strident and most of all arrogant for dismissing an entire system of healing as worthless. When we made it clear we dismissed it only after careful consideration and understanding of the evidence and history that didn’t seem to make things better.

   Fast forward to this year. One of the reality-based colleagues of mine in the year behind me actually had a friend who went and did this TCM elective. I asked him about it over beers just last night.

   He informed me that the student was impressed with TCM, in particular acupuncture and its healing powers.

   He asked, “How so and why?”

   She stated that she had seen patient after patient helped by acupuncture.

   “Specifics?” he asked.

   Well, it would seem that many a person would come in with a cough/cold/flu for the past couple of days. The “doctor” would do some acupuncture and the person would get better!

   “Amazing!” says my colleague. “So they would no longer have a cold after the treatment?”

   “Well, no. A few days after treatment, the cold would be gone.”

   “Oh. So it relieved their symptoms of the cold then?”

   “Well, no. But in just a few days after the acupuncture they were significantly better!”

   “Have you ever had a cold, dear colleague?”

   “Why yes.”

   “And what did you do for it?”

   “Took some Tylenol, drank some hot tea, rested in bed.”

   “And it got better?”

   “Yes.”

   “So, what exactly did the acupuncture do differently?”

   “It helped the cold resolve!”

   “So if you had a cold and did nothing, it would resolve. If I took a gun and shot you in the leg, your cold would still resolve. Should we shoot everyone in the leg who has a cold?”

   “No that’s ridiculous! I can’t explain it but acupuncture is different and certainly helped the cold!”

   At this point I was in desparate need of another beer.

4. # DavidRLoganon 11 Jan 2013 at 4:31 pm

   Great post!

   I like your point on the n-3 association with MS/etc. (correlation not equal causation). Another explanation for the low levels would be that inflamed/damaged tissues (cringe for typing “damaged”) have lots of superoxides and such around. Those will wreak havoc on the highly unsaturated fats (ie that may be why levels are low in some cases rather than the causation argument). Now that may be totally wrong also…but it’s an alternative to the CAM assumption.

   Have a nice weekend everyone. Gloomy here in Nebraska.

5. # yodeladyhooon 11 Jan 2013 at 10:13 pm

   “and a naturopath or acupuncturist seemingly on every Rose City block—we thought it was high time to provide a local primer.”

   Using this logic, I suppose the comparable slick upscale magazine in Phoenix does an annual review of Palm Readers.

6. # Anthropologist Undergroundon 11 Jan 2013 at 11:11 pm

   I love the holistic dentist’s appeal to imaginary anthropology!

7. # pmoranon 12 Jan 2013 at 4:28 pm

   They do not mention that all of the above have no basis in reality and none have benefit for any objective findings and barely have any effect for the subjective endpoint of pain and that the entire subjective effect of acupuncture can be accounted entirely by bias on the part of the patient and the practitioner.

   “Entirely”? This goes well beyond what the evidence permits us to say. It is true that it is difficult to distinguish reports of subjective benefits from biased reporting, but there is considerable evidence from elsewhere that at least some of them must be “real” benefits, also that any placebo component can be much stronger under highly favorable conditions.

   We skeptics began trying to minimize the potential of placebo responses once CAM supporters began asking “what would it matter if it’s only placebo?” We found evidence to support that viewpoint in the initial work of Hrobjartsson and others. Since then the weight of evidence within placebo research has swung the other way.

8. # Pmanon 14 Jan 2013 at 4:25 pm

   Mark, the first fecal microbiota transplant goes back 1,700 years.

   http://www.ncbi.nlm.nih.gov/pubmed/23160295

   This is a naturopathic medicine tenet. Medicine is having its full circle moment.

   You’re starting to get angry, and it’s creeping into your writing (IMHO making it less effective).

   You need to move past pain and acupuncture. (Look at stroke acupuncture outcomes).

9. # Calli Arcaleon 14 Jan 2013 at 4:35 pm

   Holistic dentistry:
   Honestly, anybody who promotes deliberately drilling out perfectly good mercury amalgam fillings is either a sadist or a profit-hound who simply doesn’t care. It inflicts considerable pain, actually increases the tiny risk from the mercury, and is expensive.
   “They go in your mouth at 50 percent mercury, and when you take them out it’s 20 percent mercury.”
   Maybe he thinks it transmutes to gold? Given how much it costs to have a filling replaced, he maybe would have a point, at least when it comes to his own practice.

   As far as the ancients having less tooth decay, it very much depends on *which* ancients you look at. The Egyptians had quite shockingly horrible teeth, and Egyptologists recently found, upon studying a nobleman’s mummy, that he had died of complications from extremely advanced tooth disease — complete with an attempted restoration, which shows that not only did they get bad teeth, they got them often enough to have invented treatment options. So if someone tries to tell you that tooth decay is a modern disease because X, Y, and Z, rest assured that they have cherry-picked X, Y, and Z.

   “Naturopaths are known for their focus on preventive medicine.”

   BWAHAHAHAHA! Well, I suppose this is slightly true, in that their brief discussions of obvious bits of preventative medicine (lose weight, exercise more, don’t smoke, etc) make them not quite completely useless. They’re like the tea that Arthur Dent got from the drinks machine on the Heart of Gold — almost but not completely unlike tea. Share and enjoy!

   “Oregon needs to use every available provider in order to meet the needs of the giant influx of people the Affordable Care Act will bring to the system.”

   Because quantity is more important than quality, apparently. This is frighteningly like Mao’s attempt to satisfy his promise of free health care for all Chinese.

   “If you have a shortage of pilots, you don’t hire a transcendental mediation practitioner to levitate the plane. At least not a plane I would get on.”

   Well, of course not. They’re trying to *leave* this plane.

   BTW:
   If you want a cite for the Voyager reference, you couldn’t do better than the horse’s mouth — NASA websites. The Voyager transmitters can operate at 12 or 22 watts in downlink mode. This is focused using a 3.7 meter dish on the high gain antenna. On our side, communications go through the three locations in the Deep Space Network, the granddaddy of which is Goldstone’s DSS 14, nicknamed “Mars”, a 70 meter radio telescope in the Mojave Desert. They have moved some distance since you last looked up their positions; Voyager 1 is presently 11.4 billion miles from the Sun (18.4 billion km), and Voyager 2 is 9.3 billion miles (15 billion km). The roundtrip time for the signals between the spacecraft and Earth is now 34 hours, 13 minutes, and 2 seconds for Voyager 1, and 27 hours, 59 minutes, and 28 seconds for Voyager 2.

   (Or at least, it was as of December 7, the last posted operational status report on the Voyager website.)

   Voyager current stats:
   http://voyager.jpl.nasa.gov/mission/weekly-reports/index.htm

   Voyager transmitter technical information:
   http://starbrite.jpl.nasa.gov/pds/viewInstrumentProfile.jsp?INSTRUMENT_ID=RSS-VG1S

10. # Mark Crislipon 14 Jan 2013 at 5:20 pm

    I have ALWAYS been angry. People needlessly suffering, dying and wasting their money and time always pisses me off. That’s part of why I do the blog

11. # Sialison 14 Jan 2013 at 5:55 pm

    We skeptics began trying to minimize the potential of placebo responses once CAM supporters began asking “what would it matter if it’s only placebo?”

    pmoran: What is the difference between a placebo and magical water sold by a physician to treat an illness? You yourself seem to be saying “what would it matter if it’s only a placebo?” You seem to be supporting the use of placebo’s based on your comments on Dr. Novella’s post here about arthritis, correct?

12. # Naradon 14 Jan 2013 at 10:22 pm

    Voyager current stats

    I am reminded of being tasked with gazing at blobs of Pioneer data that were mailed out on fanfold paper as an undergraduate. Nobody ever really explained what I was supposed to be doing, although one of those columns seemed to say “flaking out.”

13. # pmoranon 14 Jan 2013 at 11:51 pm

    “We skeptics began trying to minimize the potential of placebo responses once CAM supporters began asking “what would it matter if it’s only placebo?”’

    pmoran: What is the difference between a placebo and magical water sold by a physician to treat an illness?

    You yourself seem to be saying “what would it matter if it’s only a placebo?” You seem to be supporting the use of placebo’s based on your comments on Dr. Novella’s post here about arthritis, correct?

    Since you want to put it that way, what is your answer?

    It is a very good question, actually, since under most of the circumstances under which patients might be tempted to try “magic water” or the like, or doctors might resort to a “placebo medicine” (no need for an explicit placebo), it is because evidence-based methods have been exhausted, or because there are no entirely safe and effective evidence-based answers.

    There may thus be the potential for some benefit (as placebo and other non-specific influences) with little downside. Remember that studies show that the vast majority of CAM use is complementary to mainstream care.

    However, I also make no apology for challenging an opinion that I dispute, and that I believe the vast majority of doctors and medical scientists would either dispute, or regard as a very risky, given the available evidence..

14. # Lemonson 16 Jan 2013 at 2:32 am

    There may thus be the potential for some benefit (as placebo and other non-specific influences) with little downside.

    How about the down side of chiropractors as primary care doctors?

    How about the down side of patients being told lies?

15. # Lemonson 16 Jan 2013 at 2:34 am

    I have ALWAYS been angry. People needlessly suffering, dying and wasting their money and time always pisses me off. That’s part of why I do the blog.

    <3

16. # Lemonson 16 Jan 2013 at 2:36 am

    I come back here only to find Mr. MissingTheForest still celebrating his five or six leaves.

17. # pmoranon 16 Jan 2013 at 3:48 am

    There may thus be the potential for some benefit (as placebo and other non-specific influences) with little downside.

    How about the down side of chiropractors as primary care doctors?

    I don’t support that.

    How about the down side of patients being told lies?

    Which lie? What about the one that says or infers to a patient who may have already gone through conventional medical care but still be suffering, that “this treatment cannot possibly help you” when our own studies may show 0.5 plus effect sizes from it with subjective complaints?

    I don’t object to giving an accurate summary of the evidence and what we think it means, and leaving the choice up to the patient. They will be far more interested in that patient telling them how it helped them, anyway.

    We are right, or close to being right about most things, but even being right gives us only limited entitlement to intrude in the affairs of others when they have unmet medical needs, are acting at their own expense and risk, and the dangers are minimal.

18. # SomePapaon 16 Jan 2013 at 4:31 pm

    Yesterday, I was privy to a discussion of acupuncturists pushing the idea that they should be just like “doctors.”

    For another look at the pure ludicrous insanity of another move on the part of the SCAM folks, check this out:

    Community Acupuncture: A Non-Consumptive Healthcare Model
    http://postgrowth.org/community-acupuncture-a-non-consumptive-healthcare-model/?fb_action_ids=101513445533

19. # ChopChopChopson 07 Mar 2013 at 9:13 pm

    Regarding the mercury content of amalgam fillings, I did find one paper which talks about it, and they found no decrease in the mercury content based on how long the filling had been in place, from 2 to 25 years: http://www.sciencedirect.com/science/article/pii/010956419090018A . The fillings they analyzed had 40-50% mercury, about the same as when they were placed. Also, even if the mercury content of amalgams was a bit lower than what the manufacturer puts in the amalgam material, there’s an explanation that doesn’t involve the mercury being ingested: when we place amalgam in the tooth, we condense it. Part of the reason is to make sure it gets into all the corners of the hole we’ve cut in the tooth, but the other reason is that condensing amalgam brings the mercury to the top of the filling, where we carve it off, leaving a filling that contains less mercury, making it more resistant to fracture. I have a source for condensation reducing mercury content as well: http://jdr.sagepub.com/content/35/3/458.full.pdf .