Health care systems around the world are being pressured to “do more and spend less”, to make healthcare more cost effective. Owing to aging populations and the growing cost of providing health services, there’s more scrutiny than ever on the value of different health treatments, with the goal of reducing the use of treatments that don’t help. The Choosing Wisely initiative was establishing expressly for this purpose. Regrettably, while well-intentioned, Choosing Wisely hasn’t had as much of an effect as you might expect. Medicine can be slow to change, as David Gorski discussed earlier this week. Unless we ruthlessly scrutinize what we do for effectiveness, and are willing to act on what we learn, self-driven change is unlikely. One way that governments (and insurers) can dramatically reduce the use of a health service or treatment is to simply stop offering it, or paying for it. Yet stopping funding is something that is relatively uncommon in health care. It seems to be much more difficult to stop a practice, possibly owing to inertia, a reluctance to change, and the sometimes-vociferous protests that can emerge from patients or physicians that may feel that their preferred therapy is effective. The formidable challenge of stopping health care funding, once it has started, is one reason why this blog has been very critical of the expanding scope of practice being granted to alternative medicine purveyors – the legislative alchemy that is the first step towards insurance coverage. Because once that’s in place, it will be far more difficult to stop it. So it’s essential to understand the evidence. (more…)
A stay-at-home mom recently e-mailed me. She is a former CAM user who once treated her infant’s colic with homeopathy but has since seen the light and is now thinking skeptically. She asked that I look into the dōTERRA company, seller of essential oils: concentrated extracts distilled from plants, containing the “essence” or distinctive odor of the plant. She said:
…moms, well educated and seemingly rational moms, will believe anything. This isn’t a big deal if we are talking about sugar pills trying to cure crying that has no cause. However, I recently attended a dōTERRA “talk” (aka pressure to buy) about how essential oils can cure everything and anything, including one woman’s mother’s skin cancer. I didn’t want to offend this mom by calling her a quack, so I walked away spending 60 bucks on oils to be polite (this was the least amount I could spend and I used these oils to make my home smell nice, even though they were intended to solve all sorts of skin and digestive problems. I didn’t want to use them without knowing if they actually worked).
Instead of stressing the aromas, the focus was on the need to spend hundreds of dollars on these products to keep your family healthy. A handout showed how you could replace everything in your medicine cabinet with an essential oil alternative. She said:
The reps talked about how conventional medicine failed them and how they never go to the doctor anymore because the oils are a better cure.
A correspondent asked me to review the book What to Expect When You’re Expecting by Heidi Murkoff and Sharon Mazel. She wrote “I’m very worried about this book.”
She had just seen an NPR article about the book and was alarmed because it provided an excerpt from the book recommending that patients with morning sickness “Try Sea-Bands” and “Go CAM Crazy.” She knew from reading SBM and other science blogs that “going CAM crazy” is not a good idea. She was savvy enough to search Google Books with the title and “CAM” and found more alarming advice. (more…)