Articles

Quackademic medicine trickles out to community hospitals

One of the major themes of this blog has been to combat what I, borrowing a term coined (as far as I can tell) by Dr. R. W. Donnell, like to refer to as “quackademic medicine.” Quackademic medicine is a lovely term designed to summarize everything that is wrong with the increasing embrace of so-called “complementary and alternative medicine” (CAM) or, as it’s increasingly called now, “integrative medicine” (IM) into academic medical centers. CAM/IM now a required part of the curriculum in many medical schools, and increasingly medical schools and academic medical centers seem to be setting up IM centers and divisions and departments. Fueled by government sources, such as the National Center for Complementary and Alternative Medicine (NCCAM) and private sources, such as the Bravewell Collaborative (which has been covered extensively recently not just by me but by Kimball Atwood, Steve Novella, and Mark Crislip), academic medical centers are increasingly “normalizing” what was once rightly considered quackery, hence the term “quackademic medicine.” The result over the last 20 years has been dramatic, so much so that even bastions of what were once completely hard-core in their insistence on basing medicine in science can embrace naturopathy, Rudolf Steiner’s anthroposophic medicine, reiki and other forms of “energy healing,” traditional Chinese medicine, and even homeopathy, all apparently in a quest to keep the customer satisfied.

Of course, in a way, academia is rather late to the party. CAM has been showing up in clinics, shops, and malls for quite a while now. For example, when I recently traveled to Scottsdale to attend the annual meeting of the American Society of Breast Surgeons, I happened to stop in a mall looking for a quick meal at a food court and saw this:


Basically, it’s a massage and reflexology stand. I’ve seen its like popping up in many malls throughout the country. Some go beyond a stand in the middle of the mall and actually have a storefront in the mall. More recently, unfortunately, I been noting similar stands selling various forms of woo in malls, but with a difference. For example, last year over the Christmas holidays, we visited friends in Cleveland and, while doing a little shopping at Beachwood Place, we noticed this:

Yes, it’s the Cleveland Clinic’s “Wellness” Institute, which offers acupuncture, “holistic psychotherapy” (whatever that is), reiki, chiropractic, and many other CAM modalities. (Look upon the CCF’s reiki page and weep at the spiritualistic mumbo-jumbo that is used to justify using reiki.) Then, just last week, a Facebook friend posted this on my wall:

Yes, it’s the Mayo Clinic providing its CAM services in the Mall of America. If you take a look at Mayo’s CAM program, you’ll see that it offers a lot of the same things that the Cleveland Clinic offers, including supplements and botanicals, acupuncture, traditional Chinese medicine, Ayurvedic medicine, hypnosis, and meditation.

One of the more insidious consequences of the infiltration of pseudoscience into academia in the form of quackademic medicine is that it gives the imprimatur of science to modalities that can best be described as pseudoscience. When people start seeing highly respected names in academic medicine, institutions generally viewed as the leaders in advancing the frontiers of medicine, such as the Mayo Clinic and the Cleveland Clinic selling acupuncture and reiki in malls, what are they supposed to think? Most of them, trusting in these hallowed names, will conclude that this stuff must be OK. It must be scientific. It must work. After all, would the Mayo Clinic and the Cleveland Clinic put their names on services offering these modalities if they didn’t work? Would they be selling them in stands and shops in malls if they didn’t work?

Alas, regular readers know the true answers to those questions (“yes” and “why not?”), but few others do. Quite reasonably, the average consumer might conclude that this stuff is actually medicine rather than quackery. In fact, even non-academic community hospitals, which previously hadn’t offered much in the way of CAM services, might conclude that they should get in on the act. And they are. Let me tell you the story of one example that is, unfortunately, right here in my own state. It’s a disturbing little tale, particularly given that the vast majority of health care is delivered by private physicians, the vast majority of whom have their admitting privileges not at huge academic medical center conglomerates like the Cleveland Clinic and the Mayo Clinic, but rather at hospitals like Oaklawn Hospital in Battle Creek, MI.

Quackery infiltrates the heartland

It’s not new that quackery has been infiltrating the heartland. Indeed, naturopathy, for example, has been showing up in places as remote as rural Montana. However, up until now, most of the hard core quackery has been restricted to clinics and individual practices, with maybe a little of the “gateway woo” that many academic medical centers promote, such as massage, acupuncture, and various “mind-body” interventions, making it to community hospitals. Then, a while back, Ed Brayton of CFI-Michigan contacted me because a reporter had contacted him for the skeptical viewpoint of a story he was doing on Oaklawn Hospital’s new Holistic Center. Ed sent me this press release:

Oaklawn Hospital is pleased to announce the April 2nd opening of a holistic care center that is located at 15217 W. Michigan Avenue on their Bear Creek campus, a quarter-mile west of I-69. “Our vision is that Oaklawn Holistic Center will provide health care choices that offer complementary therapies that can integrate with conventional medicine to enhance healing and promote wellness,” said Oaklawn President & CEO Rob Covert.

Holistic medicine dates back thousands of years and is focused on therapies that treat the patient as a whole person, as opposed to mainly treating a particular symptom or ailment. Its techniques are centered on improving the body’s immune system and looks at an individual’s overall physical, mental, and emotional well-being before recommending treatment. The practice of holistic medicine does not rule out allopathic or conventional medicine, and the Oaklawn Holistic Center will work closely with Oaklawn primary care physicians to assure that their patients are receiving effective complementary care.

Martin Holmes, MD, of Oaklawn Medical Group-Albion is the Center’s medical director and Karla Anderson, RN, CNHP oversees the daily operations and treatments that come from nutritional therapists, massage therapists, naturopathic practitioners, and other practitioners of complementary treatments.

It’s all blather, of course, standard boilerplate about CAM that we’ve heard time and time again and that inspired Kimball Atwood to produce his infamous serious of posts under the title of the Weekly Waluation of the Weasel Words of Woo. (In fact, I encourage you to do a W^5 “waluation” of this press release in the comments, along with commentary on the subject matter at hand.) Of course, I was more than happy to speak to the reporter, Andy Fitzpatrick of the Battle Creek Enquirer about this “holistic center.” I was even happier to do so after I read this part of the press release:

Anderson is a strong advocate of the holistic approach and using naturopathic therapies to strengthen the body’s immune system. “I’ve seen a lot of people turn to holistic medicine who suffered chronic ailments and were not experiencing much success through allopathic treatments. Often times these patients not only found relief for their chronic conditions, but found that other health problems improved as well due to improvement in the performance of their immune systems.” Naturopathic therapies emphasize using diet modification, nutritional supplements, herbal medicine, acupuncture, hydrotherapy, massage, joint manipulation, and lifestyle counseling.

The Center offers classes and treatment that include numerous modalities, initially specializing in Therapeutic Body Work, Functional Normalization, Pregnancy Massage, Trigger-point Therapy, Healing Touch, Reflexology, Migraine Headache Relief, Injury Rehabilitation, Essential Oil Massage, Hot stone Therapy, Lymphatic Drainage Therapy, Comprehensive Holistic Assessments, pH testing, Aromatherapy, Bach Flower Therapy, Loomis Digestive Health Assessments, Fastech Foot Forms, Ionic Foot Baths, Ear Candling, Natural Health Life Classes, Holistic Life Coaching Club, QiGong, and Live Foods.

My reaction after reading that last paragraph was stunned silence. I couldn’t believe that a reputable hospital would offer what I consider to be so much rank quackery. I was relieved, if you can call it that, that this center apparently doesn’t offer colon hydrotherapy or iridology. Yet. In any case, most hospitals are fairly careful. They offer modalities like acupuncture, for example, because they know that, if challenged, they can point to studies that seem to indicate that acupuncture works. We at SBM, of course, have written time and time again about how these studies do not show what advocates of acupuncture think they show and how acupuncture is almost certainly nothing more than an elaborate placebo. Usually, even the most die-hard quackademic institutions stay far away from the more hard core quackery for fear of damaging their reputations. Oh, sure, there are some academic centers that will delve into naturopathy and even occasionally homeopathy, but for the most part they tend to stick with the “safe” and (semi-)”respectable” CAM, such as meditation, massage, healing touch (and/or reiki, which is more or less the same thing), acupuncture, and maybe a few supplements here and there.

Not for Oaklawn Hospital is such a wimpy approach! Oh, no. Oaklawn has, for whatever reason, decided to offer what I consider to be some serious quackery to its patients. And I expressed my own amazement at this to Mr. Fitzpatrick, as I had never seen a hospital, academic or otherwise, offer ear candling. Ear candling, as you might recall, is a form of quackery in which a candle is inserted into the ear canal and lit. Supposedly, so it is claimed, this practice will “detoxify” by leeching out toxins, the better to relieve all manner of ailments, from sinus pressure and pain to vertigo to tinnitus to a number of other maladies. At the very least, it’s claimed to be able to remove ear wax. (It can’t.) Ear candling is pure quackery, of course, and potentially dangerous. How a reputable hospital could put its imprimatur on such a practice I’ll never know.

The same is true of ionic footbaths. These “detox footbaths” are infamous in the skeptical community. Basically, they involve putting electrodes in a salt water bath, having the patient put his feet in the bath, and then running a low level electric current through it. It is claimed that by doing this one can remove toxins, enhance the bioenergy (qi), realign the body’s energy field, increase vitality, and, of course, rid the body of toxins, chemicals, radiation, pollution, synthetics, and other foreign material trapped in the skin layers that have clogged up the body’s systems of elimination. But that’s not all! You might not believe this, little fella, but it’ll cure your asthma, too (or at least remove liver parasites). As “proof” that it works, they’ll often show you impressive pictures like this:

Wow! It really must work, right? What is all that nasty brown stuff showing up in the water? Ironically enough, one of the best deconstructions of this bit of quackery comes from, of all people, a denizen of CureZone, an alternative medicine online community:

I recently saw my wife and several friends get duped about supposed benefits of an Ionic Detoxification Unit. Don’t get suckered into buying or paying for a session in an ionic detoxification foot bath! Guess what, the water turns “toxic” colors whether your feet are in there or not, because it is just the corrosion of the electrodes that causes the water to change color. The manufacturer below says that “sales pitches” are used to make people think that different colors mean different toxins were ionically removed from the body through the soles of the feet; in reality it is just the results of passing an electric current between electrodes in a conductive solution of water. Their own studies (backed by other independent fraud investigation analyses) find only what you would expect to find in water where electrolysis took place, i.e., no “toxins” released from the body were found.

Think about it, how likely are your feet to start “leaking toxins”, if that happened then you’d find that happening in whirlpool spas etc. It doesn’t happen.

It turns out that the water changes color whether a person’s feet are in there or not. In fact, many manufacturers even admit this, but try to discount the fact that the change in water color is all due to electrolysis and claim that the exact shade of color indicates what organ is being effected or to argue, regardless of whether the water changes color or not, the feet are a great part of the body through which to “absorb negative ions.”

I could go on and on about how reflexology, pH testing, Bach flower remedies, aromatherapy, and the like are beyond utter nonsense, but regular readers already know this. Even so, I can’t help but note that even I didn’t know what Loomis digestive health assessments are. It didn’t take me long to find the Loomis Institute home page, and, let me tell you, I do think that a future post might be indicated on this, given that it appears to be a form of dietary pseudoscience that claims that dietary manipulations involving enzymes are the key to health.

In the meantime, I’d like to get to the article for which I was interviewed. Fitzpatrick did a decent job, but even with his known skeptical bent that led him to talk to CFI, his article turned out to fall too hard for the “tell both sides” trope that infects journalism. I have no way of knowing whether it was Fitzpatrick or his editor who was most responsible for this, but it is a frequent problem I see whenever journalists write about topics like the Oaklawn Holistic Center.

When “telling both sides” isn’t

The article appeared about a week ago in the Battle Creek Enquirer under the title Oaklawn Hospital gives alternative medicine a try: Holistic methods spark controversy. It starts out, as these stories often do, with a patient anecdote about a woman with lupus named Dorothy Height who believes that “holistic care” saved her life. It then proceeds to tell the tale of the center’s director, Dr. Martin Holmes, who gives his reasons for turning to CAM thusly:

Dr. Martin Holmes, the center’s director, said he’s been a family practice physician for about 40 years. However, he was struck by the number of patients who came to him that he couldn’t help by using only the skills and tools of what he calls an allopathic doctor.

Allopathy is a term used by those in the holistic or naturopath fields to refer to traditional, science-based medicine.

“I brought them the concept of going outside of the box of North American allopathic medicine, primarily giving evidence on essential oils, massage therapy, nutritional counseling, acupuncture, acupressure, which I use in my practice quite a bit, and, something I’ve recently learned, which is therapeutic qi- gong,” Holmes said.

You know, I don’t remember whether the issue of the use of the term “allopathy” ever came up in my interview, but if it did, I would have informed Mr. Fitzpatrick never to use that term. Why? It’s a derogatory term coined by the founder of that quackery of quackeries, homeopathy, to describe medicine that was not homeopathy; i.e., conventional medicine. The term is a false dichotomy. Unfortunately, it’s a false dichotomy that even too many science-based physicians accept. Be that as it may, Dr. Martin has fallen far down the rabbit hole of vitalism. Indeed, he explicitly calls qi the “life force,” and says that if you don’t have any qi, you’re “on the slab and you’re done.” Not surprisingly, he is also hostile to science-based medicine:

Holmes, of Oaklawn, described a reliance on double-blind, placebo-controlled studies a tragedy of mainstream medicine. In such a study, one group is given the treatment and another group is given a fake treatment without being told. These studies also account for the placebo effect; that is, an increase in health due to a reason other than being given a medication or procedure being tested.

“There are people who jump out of airplanes without parachutes who survive, and there are people who have jumped out of airplanes with parachutes who have not survived,” Holmes said. “There hasn’t been a placebo-controlled double-blind study (of parachutes), so we can’t in conscience give evidence that it’s better to jump out of a plane with a parachute.”

I’ll give Dr. Holmes credit for boldly stealing an example that skeptics and supporters of science-based medicine use to criticize the obsession of evidence-based medicine with only clinical trials. Indeed, this example is frequently used to criticize, what has been called methodolatry, or the profane worship of the randomized clinical trial as the only valid method of investigation. In fact, as Kimball Atwood has pointed out, the whole point of the analogy, which was used in an infamous BMJ article to ridicule the excesses of evidence-base medicine, is that there are some things that are so self-evident based on basic science considerations alone (such as the fact people without a parachute will reach terminal velocity and slam into the ground at a speed that is, except in very rare cases, incompatible with further life) that they do not need to be tested in randomized clinical trials. Ironically enough for Dr. Martin, other examples of such things that require no RCTs to dismiss include his reflexology, ear candling and several of the modalities he offers at his holistic center, because they are completely incompatible with well-established understandings of anatomy and physiology.

In addition, Karla Anderson, Dr. Holmes’ nurse, who also happens to be a naturopath, invokes placebo responses to claim that it’s impossible to test something like acupuncture using an RCT. This is a fallacy that we’ve dealt with time and time again, and it is quite possible to test such modalities using RCTs. what Anderson doesn’t like is that whenever treatments like acupuncture are tested in RCTs, they fail to do better than placebo. Particularly amusing is this little blurb:

Anderson added that in something such as acupuncture, which involves placing needles in the body’s various points that are believed by practitioners to be tied to a person’s well-being, a placebo-controlled study is impossible.

Even without doing a double-blind, placebo-controlled study, there is still real evidence for holistic practices to work, Anderson said. She said such evidence is on the Internet, although she did not specify any particular studies.

I declare a new logical fallacy: Argumentum ad Internetium!

Among the proponents of these modalities interviewed by Mr. Fitzpatrick, another popular argument is the argument from antiquity that says that the fact that these remedies have been around a long time means that they must work. In all fairness, Fitzpatrick did let us skeptics have our say. In particular, we refuted the argument to antiquity, pointed out how many of these treatments are pure quackery, and tried to answer the special pleading that whines that these treatments can’t be tested in RCTs. But we’re up against it when we come across statements like this from NCCAM that state unequivocally that acupuncture can relieve pain, as well as nausea and vomiting after surgery, when the state of the evidence is anything but that, and it is certain that acupuncture effects are anything above and beyond placebo effects.

All of which brings us back to the beginning.

I started this post by lamenting how when academic medical centers like the Mayo Clinic and the Cleveland Clinic start not only studying “alternative” medicine but embracing it to the point where they sell it in malls their aura of science and respectability encompasses the quackery they sell. Clinics offering various pseudoscientific treatments have existed for a long time and would probably exist regardless of whether quackademia existed or not. They do not depend upon their respectability and reputation to attract marks patients in the same way that community hospitals do. Moreover, the latest innovations in treatment tend to be developed in academic medical centers and then, over time, filter out first to the larger community hospitals and then to even smaller community hospitals that have the resources. Unfortunately, the “innovation” of “integrative medicine” appears to be following that pattern just as much as the latest surgical breakthrough or latest form of chemotherapy does. From my perspective, I very much doubt that Oaklawn Hospital would be willing to offer so much pure quackery to its patients if it weren’t for institutions like the Mayo Clinic, Cleveland Clinic, Harvard, Stanford, and many others paving the way.

It is only part of the harm that quackademic medicine does.

Posted in: Acupuncture, Herbs & Supplements, Medical Academia, Medical Ethics, Science and the Media

Leave a Comment (41) ↓

41 thoughts on “Quackademic medicine trickles out to community hospitals

  1. Jimmylegs says:

    With quackademics being more common place, I have no idea how to combat it. By this I mean I wish to attend medical school and I hope I am on track, but that’s neither here nor there, if a prospective medical student applies to a school that does have quackdemics, how should one handle that?

    Should the student ask what exactly what the course is? Should you speak against it (give your opinion)? I’m at a complete loss, it feels as if you were to speak out and say it’s utter nonsense to have that class you would be rejected. Rejected for standing for science no less!

    It truly pains me to see this parasite, this virus, spread across academics…

    On a lighter note, I love the SBM and affiliated blogs and support what you and every skeptic does. Keep up the good work!

  2. BillyJoe says:

    “You might not believe this, little fella, but it’ll cure your asthma”

    Hey, where did you find that?
    Oh, here…

    http://www.youtube.com/watch?v=Dp6LT2MdaPI&feature=youtu.be

    “So don’t you waste none of your time on me”.

    I love it.
    And Frank Zappa as well (well, not like that).
    (And groovy musicianship as well!)

  3. David Gorski says:

    I did actually include a link to a an FZ video of the song. :-)

  4. BillyJoe says:

    “Karla Anderson, Dr. Holmes’ nurse”

    Actually, Karla Anderson is my nephew’s daughter, and she’s only ten.
    I’m not going to tell her about this.

  5. BillyJoe says:

    “I did actually include a link to a an FZ video of the song”

    Well, yes you did, but the copy and paste didn’t come up as a link so I found a way to include it. ;)
    (I see you equivocated about “a Frank Zappa video” and “an FZ video” and left them both in :D)

  6. bluedevilRA says:

    Jimmylegs, first off, I wish you the best of luck on getting in. I’m finishing up my second year of medical school at a DO school and I have to be extremely careful about the battles I fight. I have asked some challenging questions of quacktastic professors from time to time regarding evidence, scientific plausibility, etc and this one prof in particular started getting upset with my line of questioning so I backed off. We are at the very bottom of the totem pole and there’s no point in potentially damaging your relations with faculty this early in the game.

    Granted, I’m at a DO school and there’s a small chance MD schools are different, but I seriously doubt it. The OMM department might be a bit quackier than the rest, but everything else is more or less the same. Two of my best friends attend MD schools and they often complain about the same problems. In an ideal world, science should always win. But unfortunately, it doesn’t. People do not like to have their views challenged, particularly by some uppity young student-doctor. I restrict a lot of my SBM advocacy to the class facebook page. I post relevant articles from NL, SBM and RI and deconstruct lunch talks that particularly bother me. It may not be the most aggressive approach to tackling quackademic medicine, but it’s all that I am prepared to do at the moment.

    On an unrelated note, I stumbled upon this new Gary Null documentary last night. Did you know that the FDA is a rogue gubment police force that uses gestapo terrorist tactics! I would laugh if it weren’t so sad…

    http://www.youtube.com/watch?v=H-Zz5GjUcQ0

  7. cervantes says:

    Money makes the world go ’round. That’s the essence of the problem here — as long as there’s a market for this crap, lots of people who really, really do know better will take the money. That is, of course, dishonest, unethical and reprehensible, but you can be a prominent physician and medical executive, and all those adjectives can still apply.

  8. Calli Arcale says:

    “It’s not new that quackery has been infiltrating the heartland. Indeed, naturopathy, for example, has been showing up in places as remote as rural Montana.”

    I think you’ll find that woo has long been available in rural areas, especially given the constant (and increasing) shortage of real doctors in those areas. Just like acupuncture under Mao Zedong, most people will regard something as better than nothing, even if it’s not what you really want. I remember driving my husband’s grandmother to a chiropractor in rural South Dakota; the town was big enough to support a chiropractor, but had no doctor. (Not even a drugstore, actually, although it did have a general store which had some OTC medicines.)

  9. Narad says:

    I thought “Qi is, for most westerners, energy” was pretty cute. Somehow, I doubt that those “westerners” not in the “most” was supposed to mean people who have the slightest background in physics.

  10. RedBear says:

    When people start seeing highly respected names in academic medicine…such as the Mayo Clinic and the Cleveland Clinic selling acupuncture and reiki in malls, what are they supposed to think? Most of them, trusting in these hallowed names, will conclude that this stuff must be OK.

    Unfortunately, the reverse is true for me. I have often used the Mayo Clinic’s website when initially researching symptoms and health related issues for my family. Now I’m not sure I can trust any of the information there. To be fair, their CAM offerings are quite limited, but I expect it will be a slippery slope for them. Interestingly, their own website states their CAM program was “created to address growing patient interest in wellness-promoting treatments that are not typically part of conventional medical care…” (emphasis mine) Nothing about a growing body of data to support the efficacy of CAM treatments.

  11. nybgrus says:

    @jimmylegs:

    I am in the middle of my 3rd year of medical school and have also run into these issues. I have, in fact, called out professors on the topic as well as attendings. I also happen to be a bit older and a lot more brave than most of my colleagues.

    I believe that you can always handle disagreement professionally and respectfully. I also believe that if you are sound in your reasoning, have evidence to back you up, and make it a point to never resort to anything beyond a dispassionate discussion of that evidence you can never get into trouble over it. The right people will recognize you for who you are and reward you for it. If the wrong person tries to get you in trouble for it all you need to do is continue your dispassionate discussion of the science and evidence. I can assure you that at some point, probably not too far up, you will encounter someone who will agree and side with you on the matter. Granted, that can be a real headache and certainly not 100% risk free. Sometimes I avoid such battles when I have little to gain and don’t feel up for the headache.

    But as the old saying goes – “In the land of the blind, the one eyed man is king.” Stick to being science based, rationally critical, and professional in all your interactions and you will inevitably rise above your peers and ultimately be recognized for it. I certainly have.

    So I would say go ahead and speak out… but obviously not before you are accepted! You must work from within to make change. Critique a class you are taking – not one you are about to take. Work within your limits and stick to things you know very well. Then, as you gain status you can speak out more freely.

    bluedevil talked about backing off when a prof became upset at the line of questioning. That may indeed have been the best choice. I personally have never backed off. Once, a professor realized I wasn’t about to back off and quickly claimed he had a meeting and left. Another time a classmate and I would not back off the questioning and simply kept at it, demonstrating quite clearly (and yet professionally) that the lecturer was incorrect and inconsistent. We also spoke for an hour after class and ultimately concluded with the prof copping out and saying she was just following the prescribed syllabus and that we should get to the point where we can change that because we had some very good points to say! Just like anything else, no waves allow the problem to stagnate and spread. I say be willing to make a little splash from time to time.

  12. windriven says:

    “Mayo Clinic and the Cleveland Clinic start not only studying “alternative” medicine but embracing it to the point where they sell it in malls their aura of science and respectability encompasses the quackery they sell.”

    Upside for the quacksters: $$$
    Downside for them: … nada

    Apparently medicine is first a business activity, second an exquisitely refined craft, and somewhere down the line a scientific endeavor. It would be easy to despair. But I for one believe that science will ultimately prevail. It always does. Unfortunately the wisdom of science, like the wisdom of markets, sometimes has a very long lag time.

  13. ztaw15 says:

    I have been an avid reader of this blog for about two years now, and I have never felt compelled enough to actually log in to make a comment. But I want to address the other medical students here.

    I am in my fourth year, at a state medical school (MD).

    You need to be very tactful in dealing with this stuff as a student, and even a resident. During years 1-2 you still feel like you are in an advanced version of undergrad., and it feels safe to argue or question the professors. Of course, a large portion will be PhDs, and so it isn’t really an issue. Actually I will give a lot of credit to my school and say that I didn’t notice any endorsement of this garbage in the first two years. We had a series of lectures on “alternative medicine” mainly by our pharmacology dept., but it was very well done and was really focused on informing you of what these things where that people did, and what you needed to be aware of to prevent any bad outcomes (mostly things that would have a physiologic effect like herbal stuff; st. john’s wort or black cohosh, etc.)

    But when third/fourth year roll around, you need to remember that your entire career hangs on every resident/attending’s evaluation of you. And you do hear people say some really unbelievable things. Again, a lot of the affiliations people have with the institution are quite distant, so I don’t really take it as the school’s endorsement when an adjunct attending or resident makes a weird statement. But I have heard a resident claim that an acupuncture treatment was just as good as external cephalic version for a breech pregnancy; of course when you read the paper she cited, from china, they come to the same conclusion, but when you look at their data it doesn’t support any thing of the sort; it’s insane! I also had an attending tell me that he didn’t think there was any reason to believe repeated imaging with ionizing radiation would increase the risk for malignancy.

    Sometimes you just have to smile and nod. You don’t have to agree, and you can of course state your point TACTFULLY, but you need to do what you can to get a good evaluation, and often that means not rocking the boat – just keep it in mind and cross that program off your list. Of course, with the patient’s you can be a lot more open.

    Again, I don’t think this stuff is rampant in the medical community by any stretch of the imagination. It’s almost the opposite of the norm; this stuff is sprouting in major institutions but has not trickled into the “middle tier” of academia. By far most of my attendings joke about this stuff, as do my fellow colleagues – barring a very strange few. Sure the patient’s may use it, but for most of the patient population in urban medical centers you will not see them using any form of medical care, much less acupuncture.

  14. bhami says:

    The larger issue is this: CAM will continue to have credibility as long as the huge problems with standard medicine persist, including but not limited to:

    -failure to routinely discipline and remove quacks from practice
    -control of medical schools, medical journals, medical research, and the FDA by big pharma.
    -”scientific research” by big pharma that consists mainly of promoting the latest overpriced drug and trying to ignore side effects, and failing to publish non-confirming research.
    -standard medical practice that consists of dispensing drugs and surgery to address symptoms instead of root causes.

    If you ask a typical cardiologist why he advocates a $50K (of our taxpayer’s Medicare, Medicaid, or insurance funds) bypass operation (which will not, on average, extend life) instead of zero-cost dietary and exercise interventions (proven by Esselstyn, Ornish, McDougall, Fuhrman, and many others to prevent and reverse cardiovascular disease), he’ll probably just wave his hands and mumble something about “compliance”.

    As other posters here have commented, follow the money. Organizations such as Joel Fuhrman’s Nutritional Research Foundation http://www.nutritionalresearch.org/ are decades behind in being able to implement scientific studies to counter big pharma.

    Physicians, heal thyselves!

  15. bhami says:

    I support the ongoing efforts on this board to expose CAM quackery. But to understand the appeal of CAM vs. traditional medicine, we can see that the average CAM quackery is low-cost, harmless, and may invoke helpful placebo effects. In contrast, the average traditional quackery is expensive and often invokes life-threatening side effects. Drug side-effects are now one of the largest causes of death in the US.

  16. WilliamLawrenceUtridge says:

    Bhami, your comments are problematic, mixing several issues and containing some frequent and erroneous CAM talking points.

    failure to routinely discipline and remove quacks from practice

    Since most quack fields have no standard of care, aside from identifying what “quackery” is and forbidding its use, there’s not much to do here. And probably only the most ardent skeptic here (by which I mean Skepticalhealth) would argue for this. I see it as unduly draconian, I just don’t want money wasted on this nonsense. That means no public or private health insurance should cover it, and ideally federally-funded research should be minimal.

    -control of medical schools, medical journals, medical research, and the FDA by big pharma.

    Straw man. None of these are “controlled” by Big Pharma – witness the number of policies around disclosure of conflict of interest, awareness regarding the ethics of interacting with pharma reps, editorials and clinical trials published by medical journals criticizing drugs, drug trials and related phenomena. The influence of big business on medicine is an issue, but this issue is being discussed and resisted by medical schools, medical journals, medical research and the FDA. It can be done better, but it’s not like all of these participants are helpless stooges before the might of Pfizer.

    -”scientific research” by big pharma that consists mainly of promoting the latest overpriced drug and trying to ignore side effects, and failing to publish non-confirming research.

    Possibly, fortunately it’s not like research and monitoring stop after the first trial. Drug development is expensive, time-consuming, and currently entails a lot of stumbling. The fact of the matter is – we need new drugs, and better drugs, along with better surgical techniques (if we didn’t – that would mean we cured all diseases, lifestyle conditions and humans exist in a state of perfect health; boy, that’d be nice). This means research to develop drugs (and equipment, and procedures), and a company to make them. Big Pharma will always exist (unless you want the government producing all drugs – paid for by your taxes) and I would suggest at least part of the answer is increasing the authority, independence and budget of the FDA. We can’t get rid of Big Pharma, nor can we expect them to act ethically of their own volition – that means oversight. It will never be a perfect system, but we don’t have a lot of choices until we reach a state of perfect human health.

    -standard medical practice that consists of dispensing drugs and surgery to address symptoms instead of root causes.

    This one always pisses me off. If you’re fat, and your doctor doesn’t tell you to lose weight – you should report your doctor for malpractice. However, a doctor can’t make their patients exercise, eat better or get enough sleep. Part of the problem is, humans are lazy. But to say the problem is doctors rather than patients seems bizarre. That’s like blaming a homicide detective for the murder. Unless the detective shot the victim, you’re doing something wrong. Please identify a situation where a doctor simply treats a symptom and ignores the disease, I am keen to know what specifically is being discussed. Any doctor who gives a patient with appendicitis aspirin for the pain while ignoring the inflamed appendix will probably lose their license rather quickly. Doctors treat causes when they can, but often those causes are the patients behaviour, genetics or something else incurable by pill.

    You do comment on “compliance” – but in some cases that bypass is necessary to avoid acute death. A doctor who doesn’t recommend diet and exercise to someone in danger of a heart attack should lose their license. However, a doctor who recommends only diet and exercise to someone suffering from an acute myocardial infarction or congestive heart failure also deserves to lose their license. It would be hard, at this point, to not be aware of the need to exercise and eat healthy foods. Such recommendations are ubiquitous, but are also very hard to implement over the long term.

    You can’t blame doctors for fat patients, but you can blame the patient.

    I support the ongoing efforts on this board to expose CAM quackery. But to understand the appeal of CAM vs. traditional medicine, we can see that the average CAM quackery is low-cost, harmless, and may invoke helpful placebo effects.

    CAM isn’t always harmless, it is only low-cost in comparison to some interventions (compare acupuncture treatments versus baby aspirin), and the idea of paying for a placebo effect is outrageous to me. I’d rather see a therapist.

    In contrast, the average traditional quackery is expensive and often invokes life-threatening side effects. Drug side-effects are now one of the largest causes of death in the US.

    Heh, bullshit. Bull. Shit. Adverse effects are now beating out cancer, heart attacks and car accidents? I frankly don’t believe you. Using “traditional quackery” to refer to real medicine completely misunderstands the distinction between actual quackery and actual medicine – real medicine has a demonstrated history of effectiveness, and adopts any intervention proven to work. It may be expensive (not always – off-patent medicines still work, baby aspirin is cheap and exercise can be free) and involve risks – but they also work. In contrast, few CAM procedures and interventions have any proof of working, and many quite clearly violate the laws of chemistry and/or physics.

    What you have here are talking points, not an argument.

  17. Scott says:

    I note a complete absence of consideration of the fact that CAM provides no benefit, while real medicine does… hence a substantially greater degree of risk is reasonable and acceptable. (Though of course it should be minimized as far as possible without giving up the benefits.)

  18. nybgrus says:

    But I have heard a resident claim that an acupuncture treatment was just as good as external cephalic version for a breech pregnancy; of course when you read the paper she cited, from china, they come to the same conclusion, but when you look at their data it doesn’t support any thing of the sort; it’s insane!

    I would call out that resident. Professionally, respectfully, and with as much tact as I could muster, I would do it without a moment’s hesitation. If you are only afraid of getting a bad review and that is your sole motivating force for getting through years 3 & 4 then you are not aiming very high. Getting a good review is absurdly easy. Following up on a bad review is as well. And if that retarded resident gave you a bad review because you called him/her out on utter bullshit, trust me that is something you can easily take to higher ups and demonstrate your competency. And simultaneously demonstrate how incompetent your resident is.

    And, quite frankly, if you are in an environment where such a thing becoming out of hand is genuinely a concern for you, you have bigger issues than your idiot resident. I have corrected attendings on the evidence for (or rather against) Swan-Ganz catheters and peri-operative anticoagulation risk profiles and management in the last week alone. I was complimented on my knowledge and my willingness to engage in discussion.

    I stick with what I said before – there are times when you will let it lapse simply because you are not up for the discussion. But you should try to not let obvious bullshit slip past you whenever you can, and you should certainly never do it because you are worried about a bad review.

  19. nybgrus says:

    @WLU:

    Spot on. bhami – your characterization of how medicine is practiced and what doctors do or don’t say and do is incredibly incorrect. On our board exams it is common to have a question such as:

    “Mr. Jones presents to your care for the first time and has not seen a doctor in 10 years. He is [blah blah blah] obese…. hypertensive…. smoker… etc. What is the appropriate first line of management?

    A) ACE inhibitor (blood pressure med)
    B) Thiazide (blood pressure med)
    C) bypass surgery
    D) Counsel on diet and lifestyle changes including exercise, better eating, and cessation of smoking”

    I’ll give you one guess as to the only correct answer.

  20. bhami says:

    @WilliamLawrenceUtridge: concerns about the magnitude of iatrogenic harm, such as drug side effects, are not “BS”. According to Barbara Starfield, MD, MPH, writing in 2000 in JAMA,

    http://jama.jamanetwork.com/article.aspx?volume=284&issue=4&page=483

    “…deaths due to iatrogenic causes … constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer.”

    and I’m not aware of any major changes to this in the past decade.

  21. Chris says:

    So using the handy dandy search box at the top right of this page, I plug in the name “Barbara Starfield.”. What I get is this article: Be careful what you wish for, Dr. Dossey, you just might get it:

    First, there’s the claim that “Dr. Barbara Starfield, writing in the Journal of the American Medical Association, estimated that between 230,000 and 284,000 deaths occur each year in the US due to iatrogenic causes, or physician error, making this number three in the leading causes of death for all Americans.” Quite frankly, this figure has actually always bothered me, as it’s clearly the highest of the usual apocalyptic estimates for how many people doctors supposedly kill through error or negligence, and the reason is simple math. Each and every year in the U.S., approximately 2.5 million people die. If Dr. Starfield is to be believed, approximately 10% of all deaths are from iatrogenic causes, which would make iatrogenic death the third leading cause of deaths in the U.S. after heart disease and cancer.

    Followed by an explanation of why the numbers are bogus. Among them are:

    Yet the patient will surely die without treatment, and the drugs save far more people than they kill; so the benefits outweigh the risks and we treat with these drugs — and, these days, we do it with careful informed consent. In other words, to compare these apocalyptic numbers honestly, you have to look at them in comparison to the number of lives saved every year by scientific medicine.

    Please in the future use the search box to see if something you wish to use in your argument has already been addressed. Then, if you are going to claim that real medicine causes death, then show us how CAM would save more people. Because the way you prove CAM works is by showing it works, not by pointing out the problems with something else.

  22. WilliamLawrenceUtridge says:

    bhami, you’ve just underscored my point – there is active interest in, and research on, iatrogenic harms. Mainstream medical journals, schools and researchers are aware of the problem, and attempting to address it. Considering the complexity and variability of human biology, the number of diseases that exist that require chronic or acute treatment, and the number of drugs that exist, this is a daunting task. “Big Pharma is evil” is not an argument, nor is it an answer. Would you prefer we forbid the production of drugs (and vitamins, and herbs, and supplements – since the same companies make all these products)? What would you tell little Billy, a child with leukemia, that he can’t have purine analogues because they might experience adverse effects?

    Medications have risks. This is know. This is being addressed. The solution is not to abandon science, medicine or medications – it is to develop methods and approaches that reduce the risks, study them, and attempt to offset them. If your solution is to embrace acupuncture and homeopathy instead – congratulations, you just killed Billy.

    If CAM works, it becomes part of mainstream medicine. If it doesn’t, it should be discarded. Unfortunately, most CAM promoters are incredibly unethical and refuse, or ignore, scientific tests of their treatments. If Pfizer wants to produce a new drug, they have to show it works, and that it’s not more deadly than the disease it treats. Why is it unreasonable to ask the same of acupuncture, homeopathy or herbs before they are sold as effective? Seems a little hypocritical to me.

  23. jmb58 says:

    Long time reader, first time commenter.

    @bhami.

    Let me just add to the excellent responses above.

    I’m a surgeon. I spend a lot of time counseling patients on lifestyle modifications. Sometimes I beg them. But you know what they say, “you can lead a horse to water, and you can shove its face in the water, and you can massage its throat and plug its nose, but you can’t make it drink”.

    Regarding “big pharma” concerns. If you follow the medical literature you know that doctors can be the biggest critics of pharmaceutical supported studies. But its true, drugs cost money. Developing a drug costs money too. A lot of money. They have a right to offer a product and charge for it. No CAM is free either. I’ve seen patients spend their life savings on worthless woe. As a physician I spend a lot of time considering the risk/benefit ratio (including cost) of all the drugs, surgeries, and other treatment modalities I recommend.

    The cardiologist paragraph is commpletly ridiculous. All physicians I have met advocate for diet and excercise. As I said, I beg patients. But when they show up to the ER with crushing chest pain and a 95% occlusion of the LAD coronary artery, it’s time to intervene.

    I’ve made a ton of sacrifices in my life to be a physician, so comments like the one bhami made above really piss me off. I’m the one on the front lines dealing with patients. I’m the one up at 3am keeping your mom/brother/friend alive. When someone says medicine is just a money making scheme for big pharma that only treats symptoms and kills hundreds of thousands a year it frustrating. And wrong.

    @Jimmylegs.

    Interviewing for med school is not the time to worry about making a big statement about CAM. Just go to the best school you can, in a fun city if possible.

    Be careful how you “call out” a resident. You might burn a bridge that you really want to cross later.

  24. Jann Bellamy says:

    Oaklawn might be interested in knowing that the Federal Trade Commission succeeded in getting an injunction against a marketer making similar claims to that of the detox foot bath. http://www.ftc.gov/opa/2010/11/xacta.shtm

    Oaklawn might also be interested in knowing that the FDA has issued a warning against the use of ear candles:
    “The Food and Drug Administration (FDA) is warning consumers not to use ear candles because they can cause serious injuries, even when used according to the manufacturer’s directions. FDA has found no valid scientific evidence to support the safety or effectiveness of these devices for any medical claims or benefits.”
    http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PatientAlerts/ucm200896.htm?utm_campaign=Google2&utm_source=fdaSearch&utm_medium=website&utm_term=

    Oh, what very, very bad publicity it would be for the FDA or FTC to come down on Oaklawn for selling detox footbaths and ear candling to patients!

  25. Ali771 says:

    Re Oaklawn Hospital’s new Holistic Center:

    “…its techniques are centered on improving the body’s immune system and looks at an individual’s overall physical, mental, and emotional well-being before recommending treatment.”

    This “holistic” idea is just ridiculous and really irks me. (I know I am preaching to the choir here). What thorough practitioner does not look at the “whole body?” What do they say, “I’m only discussing things with your liver right now, Mr. Jones, I’ll speak with you later.”

    I know I have mentioned this before in a post, but I am a former student-of-quack. For whatever psychological reasons I was drawn to the idea that I knew better then those with years of training and I was going to “fix things myself.” I tried that. Gosh, three years later nothing had worked. Then I went to a doctor, who recommended a specialist. A few years later, I have never felt better. I can say with great certitude that my GP took a long, hard look at my body’s immune system and my overall “physical, mental, and emotional well-being” before recommending treatment.”

  26. nybgrus says:

    The beauty of it, Ali771, is that you have just effectively dispelled every sCAMster out there in one single paragraph. Because the evidence you have just provided is completely antithetical to and yet of equal calibre to that presented to us by the woo-meisters.

    bee tee dubs – glad you managed to realize the error of your ways. To err is human. To refuse to learn from it is stupidity ;-)

  27. herbalgram11 says:

    As this chart shows, hospitals and drug based medicine are as dangerous as being at the war front; natural (herbal and nutritional medicines) are safe: http://www.anheurope.org/sites/default/files/UK_Bubbles_Graph_2012_9_July_Fin.pdf, not to mention cheap compared with the alternative.

  28. herbalgram11 says:

    … as to whether or not vaccine refuters are smarter (than proponents, presumably), it goes without saying, yes!
    Haven’t you read the damning reports by your ‘gold standard’ Cochrane collaboration that vaccines are sham medicine?

    First of all, the very premise on which the vaccine theory is based (antibody mediated immunity) has finally been established as untrue:

    Harvard Med School researchers in co-operation with other institutes have debunked the imperative of anti-body mediated immunity via vaccination (never mind that there are less risky and actually healthful ways of ensuring robust immunity).
    It seems that our innate, not acquired, immune system is the first gate-keeper in protecting us against viral attack.

    Source:
    Immunity 2012 Mar 23; 36(3): 415-426:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359130/pdf/nihms-377739.pdf

    Moreover, according to a recent Cochrane review, the scientific evidence that flu shots protect the elderly is weak. The authors concluded that:

    “The available evidence is of poor quality and provides no guidance regarding the safety, efficacy or effectiveness of influenza vaccines for people aged 65 years or older.”

    Cochrane reviewers also evaluated whether or not flu shots given to health care workers can help protect the elderly patients in nursing homes with whom they work. The research did not find an effect from the vaccinations on laboratory-confirmed influenza. Influenza vaccinations were also not linked to a reduction in either pneumonia or deaths from pneumonia. In conclusion, the authors state that:

    “[T]here is no evidence that vaccinating health care workers prevents influenza in elderly residents in long-term care facilities.

    Ditto for children. A large-scale, systematic review of 51 studies, published in the Cochrane Database of Systematic Reviewsin 2006, found no evidence that the flu vaccine is any more effective than a placebo in preventing influenza in children under two. The studies involved 260,000 children, age 6 to 23 months.

    Two years, later, in 2008, another Cochrane review again concluded that “little evidence is available” that the flu vaccine is effective in preventing influenza in children under the age of two.
    As for the general adult population, Cochrane published the following bombshell conclusion last year:

    “Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.

    WARNING: This review includes 15 out of 36 trials funded by industry (four had no funding declaration). An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size. Studies funded from public sources were significantly less likely to report conclusions favorable to the vaccines.

    The review demonstrated that reliable scientific evidence confirming that influenza vaccines are effective is thin and there is plenty of reason to suspect that there may be a manipulation of conclusions when the studies are funded by drug companies. The content and conclusions of this review should be interpreted in light of this finding.”

  29. WilliamLawrenceUtridge says:

    As this chart shows, hospitals and drug based medicine are as dangerous as being at the war front; natural (herbal and nutritional medicines) are safe: http://www.anheurope.org/sites/default/files/UK_Bubbles_Graph_2012_9_July_Fin.pdf, not to mention cheap compared with the alternative.

    Your link is dead.

    Herbal medicine is indeed cheap compared to some drugs. The difference of course is that drugs are tested for safety and efficacy before being released. For an analogy, putting cigarette butts in my gas tank is cheap compared to gas (free, so long as I pick them up off the road). They’re just not very good in terms of being a fuel source.

    Moreover, according to a recent Cochrane review, the scientific evidence that flu shots protect the elderly is weak. The authors concluded that:

    You might try looking up “influenza vaccine” on this site, you might learn something. Dr. Crislip has reviewed influenza vaccine efficacy before, I believe he addresses the Cochrane review (if not that post, then another certainly does). My recall is that the Cochrane review takes equivocal, sub-optimal evidence and uses this to proclaim you can’t trust the vaccine to protect you, while another interpretation of the data is that the vaccine isn’t perfect but it does reduce morbidity and mortality. Same data, different interpretation, so it depends on how full or empty the reader wants the glass to be. Dr. Hall reviewed high-dose influenza vaccines in the elderly

    As for this study, I will point out three things. One, it is in mice (and using a specific virus). Two, this might suggest, at best, that the current understanding of how vaccinations work may be flawed or wrong, but that doesn’t change the fact that vaccines are extremely effective if administered appropriately. I’m not sure about that last point, I’m not an immunologist. Three, a single study never proves anything, but are often used in isolation by people to support conclusions they already held (known as cherry-picking). May I ask why you are so convinced about this one study in one heavily-inbred species? And if the conclusion were the opposite expressed here, would you be convinced that the results supported vaccination? If not, that suggests that data is less important to you than preserving the conclusion you have already reached. If that is the case, then you have no interest in science. But please, stick around. These sorts of issues are raised quite often here, and it’s possible that if you read enough posts you may realize that you are wrong, and understand why.

    I personally urge you to look up the posts by Dr. Crislip on influenza and vaccination, they are quite interesting. You might also want to look up Dr. Gorski’s post on an article in The Atlantic which looks into the very Cochrane group you so laud.

  30. nybgrus says:

    lol. the only thing you have demonstrated is that you have no idea what you are talking about or how to read a study. I don’t have the time to waste to clearly demonstrate how incredibly wrong you are, but it was so bad that I had to make a brief comment. I’m sure one of the other regular commenters here can have a field day (BTW – puddlejumper, if you are reading this: this would be a good thread to take up and start getting your chops) with it though.

    Here’s a hint though – the Harvard study does not in any way say what you claim it says :-D

  31. weing says:

    I second nybgrus. Please read the first article and telll us where the article supports your conclusion. We is slow folks. Well, at least I am. I have to have everything splained to me.

  32. herbalgram11 says:

    I don’t laud the Cochrane group – it’s the orthodoxy’s gold standard reference

  33. herbalgram11 says:

    Re dead link: This should work…
    http://www.anh-europe.org/sites/default/files/UK_Bubbles_Graph_2012_9_July_Fin.pdf

    Herbal & nutritional medicines are effective. Inspite of paltry funding into these modalities, there are research sources you could look up – e.g.

    Lesley Braun’s / Marc Cohen’s evidence based guides on Herbs & Natural Supplements, Churchill Livingstone / Elsevier or the online database: http://www.greenmedinfo.com/

  34. herbalgram11 says:

    If the very premise on which vaccination supposedly works has now been debunked as untrue (see my post above), why do you still keep advocating vaccination?

  35. Chris says:

    Herbalgram11, what is the herbal medicine solution to hypotension from obstructive hypertrophic cardiomyopathy? And what herbs prevent measles?

  36. weing says:

    “If the very premise on which vaccination supposedly works has now been debunked as untrue (see my post above), why do you still keep advocating vaccination?”
    You obviously have not read the article. Where does it say that? Please read the article and don’t refer to your assertion as evidence. Then come back and explain to us, in simple language, what you think the article says. Hint. It doesn’t say what you think it does.

  37. Chris says:

    Is it time to bring out my “what happened to measles in one decade question?

  38. WilliamLawrenceUtridge says:

    I don’t laud the Cochrane group – it’s the orthodoxy’s gold standard reference

    I know, and greatly respect, the Cochrane group. But that doesn’t mean they are always right, and it doesn’t mean they don’t interpret and report the data without any bias. Again I urge you to look at the linked sciencebasedmedicine posts, or search for articles discussing the Cochrane’s influenza group. According to Drs. Crislip and Gorski (possibly others, my apologies if I don’t remember all those who discussed it) the influenza section puts a definite opinionated stamp on the influenza vaccine; despite equivocal data, they seem to really like summarizing it like the data is negative. So please read the SBM posts, you might learn something.

    Question though, since apparently you respect the Cochrane group that you’re willing to take them at their word unquestionably, I wonder what you think of their reviews of herbal preparations, which pretty much conclude as a unit that no good trials have been done on herbs proclaimed to be effective?

    Regarding the graph you provide, did they do an analysis of the benefits of those drugs? For instance, is there a second graph that details deaths due to untreated medical conditions? Because in my experience, my doctor has never given me a drug without there being a good reason, and therefore just looking at deaths and adverse events without looking at benefits (in particular saved lives) is either gross oversight or pretty much blatant lying to support a pre-held conviction. For instance, another interpretation of that graph is that not many people die in general. Did you also note the conclusion at the top, “Medical injury poses a greater risk to society simply because vastly more citizens are exposed to that risk and hence die”? In other words the denominator is quite large, thus you can’t really say “medicines are risky” as a flat statement.

    Lesley Braun’s / Marc Cohen’s evidence based guides on Herbs & Natural Supplements, Churchill Livingstone / Elsevier or the online database: http://www.greenmedinfo.com/

    Since you are aware of the esteem with which the Cochrane review is held, rather than that website may I suggest you present us with individual Cochrane reviews? Or perhaps pubmed links? Both for specific herbs, since a random website isn’t much help. Also, we already know about St. John’s wort and it’s adverse effects.

    If the very premise on which vaccination supposedly works has now been debunked as untrue (see my post above), why do you still keep advocating vaccination?

    Well, first of all that’s a single study. Has it been replicated? Second, are you sure it says, or even implies, that that finding in mice completely invalidates the effectiveness of vaccination in humans. Third, have you had smallpox or polio lately? Even if that study is correct, all it implies is that our knowledge of the mechanism is perhaps flawed – but vaccines still demonstrate in real-world settings considerable effectiveness. So even if the study suggests the mechanism is wrong, that means we just need to learn the actual mechanism, not that vaccines don’t work.

  39. nybgrus says:

    lol. I actually kinda thought that herbal would go away but I guess we’ve got our next troll.

    And weing is correct – the Harvard article does NOT say what you think it does nor does it support your claim in ANY way.

    I also read through the other article about naturopaths and diabetes. Totally worthless and stupid article. It demonstrated absolutely nothing except what we already knew – if people get coached and encouraged more and pay more attention to their diabetes and their diet, then they do better. We have a program at my hospital that does exactly the same thing… without bullshit naturopathic masturbatory cogitations.

Comments are closed.