Is there anything to alternative medicine other than the placebo effect?
Rich asked:
I have an up and coming interview with a medical university and i am wondering what to say if i get asked this question. There has been so much conflict between traditional and alternative medicine that it is difficult to find the real answer. There are many testimonials with people from all over the world stating how they were cured of this and that with alternative treatment and doctors refuse to acknowledge it as a viable form of treatment. Why?
Cell Phone Cash
I have an up and coming interview with a medical university and i am wondering what to say if i get asked this question. There has been so much conflict between traditional and alternative medicine that it is difficult to find the real answer. There are many testimonials with people from all over the world stating how they were cured of this and that with alternative treatment and doctors refuse to acknowledge it as a viable form of treatment. Why?
Cell Phone Cash
Rich;
First of all, in many parts of the world, their main-stream medical doctors use what we would call “alternative medicines”. For example, St John’s Wort is prescribed by Rx in Europe.
Historically, Herbs have been the foundation of much of medical science. Most modern drugs were synthesized from active ingredients found in Herbal plant products. Examples, I’m sure you know, Aspirin from tree bark, and Penicillin from mold.
As a Recognized Therapeutic Touch Practitioner, I’d like to answer your question.
Firstly, the placebo effect is possible in allopathic as well as naturopathic modalities. It is possible for patients to feel better simply because they have confidence in the method of treatment or the attending practitioner.
The question is whether the beneficial effect lasts for a significant period of time. Even allopathic methods, such as pain medications, often involve repeated doses or treatments. I’ve used Therapeutic Touch successfully with clients who have found lasting relief often after one treatment. In other cases, such as with clients who experience chronic pain, regular sessions are necessary.
Studies on the efficacy of Therapeutic Touch are numerous and readily available via the Therapeutic Touch Network of Ontario (see attached website).
It should be recognized that the placebo effect is part of the normal interaction between medical doctors and patients as well. I always tell people the antibiotic or painkiller is very strong and to be cautious.
However the effect of many, if not most AltMed treatments is almost entirely from the placebo effect. This is certainly true of things like homeopathy, Therapeutic Touch/Reiki, magnet/copper bracelets, crystals, etc. In many cases there is no measurable effect at all, even when patients report “feeling better”.
Acupuncture is mostly from the placebo effect….it turns out sticking needles into somebody is a very good way of activating it. However, there may be an actual effect on nerve conduction at the local level. Any real effect is quite minor, and not due to any mystical unblocking of chi. The most recent studies on acupuncture have shown that placement of the needles is irrelevant, as sham acupuncture works as well as traditional acupuncture which is about equivalant to placebo. The only conditions acupuncture has been shown effective is for mild pain or nausea….ie, very subjective, self reported things.
Herbals are certainly at the plausible end of the Alt Med scale (with homeopathy at the implausible end) Another answer alluded to “all pharmaceuticals” being derived from herbs. That’s an overstatement, as the true number is about 25% either directly from or inspired by herbs. Many herbs do have physiological effects on humans, and they may contain dozens or hundreds of chemicals. The problem with herbs is quality control, consistency, dosage. For most herbs, they still haven’t met the standard of proof of safety, efficacy and superiority to standard treatments. Yes, St Johns Wort is used for depression in Europe. It works for mild to moderate depression only, and it works just like the prescription SSRI drugs. What “they don’t want you to know” is that it has the same risk of side effects and a withdrawal syndrome as SSRI. I think herbals will become more widely used by medical doctors once advocates do due diligence similar to what pharmaceuticals have to go through.
Any treatment or drug that has effects, can also have side effects. This is particularly true of herbals which have caused illness, organ failures and death. Again “they don’t want you to know” this. look up any of the altmed treatments here for documented cases of harm.
Finally, testimonials from satisfied customers are not proof of anything. Science based medicine does not base treatments on anecdotes, but on rigorous, objective investigation.
EDIT Bonita. Therapeutic Touch is complete and utter nonsense. I rank it’s probability as similar to homeopathy…almost zero. As an MD, it happens to be one of the areas of Alt Med that I have researched the most thoroughly, and I have read most of the so called landmark studies dating back to the original ones with Dora Kunz and Dolores Kreiger and the original studies on plants.
It is nothing more than the placebo effect combined with gullible practitioners and naive patients
I don’t expect to convince anyone here in this post that alternative medicine is right or wrong. I see some things in it that I like and some that I don’t. But I have a suggestion.
The central one is that in the patient population that you will see as a doctor, a measurable percentage of them will use some form of supplementation, herbs, or therapies that could be classed as alternative. This number could be from 10% to as high as 70% in some cases. And what they do could impact what you are trying to do as a physician.
If your future patients perceive that any of the treatments or uses of alternative medicine will be just met by your criticism and derision, with a superior attitude that condescends to their beliefs, they will not be likely to talk to you about them. They will not change their beliefs or behavior. You will just be left in the dark. You won’t have the whole picture.
So, if you can learn to listen with an open mind or can at least listen without revealing your mind initially, you may find that they will confide in you and trust you more. Health histories that are complete and patients that comply with your instructions are both going to contribute to your being a more effective doctor of medicine.
The Mayo Clinic website is now discussing the alternative medicine angles to some conditions. And they try to be respectful and accurate in what they say. You might find their use as a guideline for discussion in an interview. That way you don’t have to guess as to your interviewer’s personal views on the subject.
You didnt ask for a debate on whether “alt med” works… you asked for the best way to answer this if you’re asked during your med program interviews.
So…
I think your best response would be to acknowledge that it’s a heated issue and that truly it’s irresponsible to judge any science on it’s hype. Your training makes you uniquely qualified to evaluate the science behind any treatment modality (and to extrapolate data in the context of pathophysiology!)
And THAT is the most practical, responsible way to address “alt med.”