Blog | Thursday, April 17, 2014

Alternative and complementary medicine, placebo effect or panacea?

Readers know that I am skeptical over the efficacy of complementary and alternative medicine. This is not merely a demonstration of my inborn skepticism, but doubt based on the fact the so much of their claims are untested, unproven or refuted.

I don’t regard the above comment as controversial. It is factual. I’ll let readers decide if it is but another example of the arrogance of conventional physicians who worship on the altar of evidence-based medicine.

Recently, I read a column in the New York Times by a university professor who was treated for a cold in China by drinking fresh turtle blood laced with grain alcohol. In a day or two, he felt better. Cause and effect?

It’s not easy to talk someone out of a view that a pseudoscientific remedy healed them. Why should we do so? If a patient tells me that his fatigue has finally lifted after giving up guacamole, do I serve him or the profession by pointing out the absence of any scientific basis for his renewed energy level? Or, is the better response for me to celebrate his progress and urge him to continue his “treatment,” which clearly poses no health risk?

Certainly, if I felt a patient was pursuing an alternative medical treatment, or any remedy, that threatened his health, I would plainly state this so the patient was making an informed choice. If a patient was suffering from a bleeding ulcer, and wanted only herbal medicines, I would make sure that the risks of this choice were well understood.

I need to make a confession here. Physicians face a huge knowledge vacuum with regard to the human body which is the product of millions of years of natural selection. We are no match for comprehending its nuances and complexity. Taking care of patients is a hugely humbling experience. Consider how microscopic germs, organisms that are not sentient and have no brains, can wipe out millions of humans. We should acknowledge that we’re not that smart.

There’s another possibility to be considered when a patient relates the success of remedy that we don’t support or understand. It might actually be working.

Have you been tired lately? Fatigued? How much guac have you had lately?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.