May 23 2008
Passive acceptance of Alternative Medicine has eroded the quality of medical care in this country. With the DSHEA of 1994 and political correctness, we have lost the reverence afforded to us in times past. Our professional knowledge is called into question as our standards deteriorate. There no longer exists a line separating proven fact from speculation. There is no border separating reality from mythology. Our colleagues treat with antibiotics and homeopathy. With beta-blockers and energy fields. Qi and narcotics.
For many years, it has seemed that I was nearly alone in my skepticism. Anytime I would bring up an alternative medicine topic, (in reality: criticize it) others in my field would have a ho-hum reaction to it. It was politically incorrect to rant about the growth of alternative medicine, the growing use of herbs, and how something should be done about it. We family and internal medicine doctors are a generally easy lot to live with. We accept patients and their faults, and it is hard to suddenly become judgmental when it comes to our colleagues. I had no idea as a resident that there was so much woo in Colorado. Specifically, I had no idea how much there was at my academic institution. This was in the late 80s, early 90s! Oh my, how things have changed, and not for the better.
I was a naïve resident in 1990, when a nurse practitioner at my residency called me about one of my patients. She wanted to help a 20 year old woman stop smoking by… wait for it….Therapeutic Touch. I was post call, and had trusted this NP as she had been with the residency for many years. I said “yes, go ahead,” not knowing what exactly it entailed. When I did have time to look into it, I was appalled. I was guilty by association. The patient never returned to me, and I don’t blame her. She must have thought I believed in magic. It turns out that the School of Nursing at the University of Colorado had to be called out by the Rocky Mountain Skeptics on their aggressive promotion and advocacy of Therapeutic Touch.
Of course, we have been cajoled, encouraged, and forced to accept alternative medicine. Several years ago, the doctors practicing alternative medicine went to the Colorado Legislature to specifically change the law regarding the practice of medicine in the State of Colorado. They were successful, of course, since it was a case of political correctness. That meant giving everyone, even quacks, equal footing under the law. The Colorado Medical Practice act now includes a provision that states:
The board shall not take disciplinary action against a licensee solely on the grounds that such licensee practices alternative medicine.
The encouragement has also come from insurance companies giving discounts or even coverage for alternative medicine. As more and more people hear of alternative medicine in a positive way, they are more apt to use it, believe in it, and encourage it in others. It is easier to just live and let live. We have been told: “Ask your patients if they use alternative medicine, supplements, etc.” It certainly is important to know what a patient is using. But by not following it with “You might not want to do that..” we passively condone it, almost expect it. The actual number of people using alternative medicine is actually quite small. It should stay that way. Many others have addressed the flawed conclusion of the prevalence of Alternative Medicine use in the NEJM seminal article of 1/28/1993. It was not true that 1/3 of people use alternative medicine. Not in 1993. Unfortunately, due to our passive acceptance, it is possibly that high now, if you include vitamins with unsubstantiated claims and herbal supplements.
It used to be easy to spot the consumer of alternative medicine. He or she had a profound connection to “earth” and “nature.” They distrusted the establishment. They are becoming the establishment. Unfortunately, their decisions are based on belief and passion, not logic or reason. That is why they are so unbending in their devotion. For the rest of the public, their initial skepticism has been eliminated by repetitive exposure. Most people can remember a time that false advertising was rare. Our FTC and FDA had regulations and resources to combat the fraudulent. Most people don’t have a clue about DSHEA of 1994. It was safe in the 70s and 80s to see a television ad and trust that the claims have been validated. Now the supplement companies make millions of dollars before any complaint gets investigated, and those that get caught, pay a miniscule fraction of their profit in fines.
Some of those earthy people became physicians. They continue their reverence for natural, organic and unproven therapies. They have a golden opportunity to excel in the post DSHEA era. We other physicians are taught to be politically correct, and simply tolerate them. They are, unfortunately, leaders of the dumbing down of the public. We other physicians let our hospitals open Alternative and Integrative Centers without so much as a peep of disagreement. There exists a critical mass in this transformation. When enough physicians accept and advocate for unproven therapies, we have lost our direction. Our thought leaders will be replaced by politically savvy, scientifically suspect people who advance their own agenda. I, for one, want to trust that my father’s physician spent his or her continuing medical education time and money on stroke, heart attack and cancer knowledge, not herbs, acupuncture and energy medicine.
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