Suppose I were to bake you a cake and my ingredient list included the following:
- Baking Powder
- Chocolate icing
What is the problem with the ingredient list? It has integrated inedible and poisonous items into the very fine basic ingredients that make a good cake. This is the exact same problem that the medical profession faces with the “integrative medicine” movement. Insofar as it espouses and promotes well-vetted, healthy ingredients, it is a boon to patients. But when inordinate emphasis is placed on placebos (“sand”) or when dangerous practices (“melamine”) are inserted into the prescription for our patients’ “health and wellness,” that attractive-appearing cake becomes a recipe for disaster.
Many of my shruggie friends have peered at integrative bakery items with vague interest. The fudgy exteriors are pleasing to the eye, the aroma is indistinguishable from cakes of their youth, and the packaging is elaborate and attractive. They simply can’t imagine why some of us would get so worked up about what appears to be a display case of cupcakes.
But as physicians and scientists it is our duty to inspect integrative medicine’s ingredient list, in the same way that it is our duty to learn about the side effect profiles of pharmaceutical items and medical devices. Blandly gazing at the sweet promises of “natural health” without fully investigating the claims made by its proponents, puts us at a serious disadvantage. Our patients have learned about “alternative” bakeries (probably via the Internet) and want to check with us about whether or not they should purchase items from them. It is our job to give them sound advice.
In these economic times, it is more important than ever for us to channel our limited resources into health solutions that work. For example, the supplement industry rakes in 22 billion dollars a year, and that money could be put to far better use. I believe that it would, if we healthcare professionals made a more concerted effort to explain the wasted investment to our patients.
In addition, we must encourage NCCAM to require plausibility as a condition for medical research. We have already wasted millions of dollars on studies that essentially define the properties of sand, when it’s clear to the very casual observer that sand will never add value to food items. As Barker Bausell has so clearly explained in his book, “Snake Oil Science: The Truth About Complementary And Alternative Medicine” there hasn’t yet been a single CAM treatment or practice that has been definitively shown to have an effect beyond placebo. Can someone say, “The Emperor has no clothes?” It’s time to use our common sense in selecting studies that could in fact provide important information about curing illnesses.
And as for those of you who are just beginning this journey of scientific enlightenment, please continue reading the wonderful deconstructions provided to you by the authors of this blog. I doubt you’ll find a clearer explanation of the machinations of the integrative medicine movement – and you’ll learn how to carefully separate the flour from the sand in this jumbled blend of scientific truth and error.
Then we can all have our cake and eat it too.
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