Category: Altie Meds

  • Speaking out against quacks

    In light of recent discussions in this corner of teh intertubes, I’ve been thinking about anti-quackery writing. To what extent does our debunking actually feed the ducks?

    Many of us don’t link to crank sites—that makes sense, since click-throughs probably put money in their pockets.

    But speaking out works. Most people don’t know medicine. It’s a profession that takes years to learn. People count on information from experts, and most doctors are too busy working to put together slick ads for their services (that plus the whole ethics thing). That leaves the field wide-open to any idiot who wants to take your money.

    The world is filled with people who believe, or are at risk of believing, in “other ways of knowing“, eschewing science for cult medicine. There are as many types of cult medicine as there are hucksters—there is only one kind of science-based medicine, and science is really the only appropriate way to approach healing. Science, of course, does not exclude compassion and empathy. The doctor-patient relationship is critical to applying science to medicine.

    But quacks are crooks, plain and simple. The HIV denialists, anti-vaccine wackos, and homeopaths want you to join their cults and give them your money.

    Many people are looking for good information on health. They may be easily sucked in by crooks, but we can get them back. That doesn’t mean we have to go easy on the like of Joe Mercola and Gary Null. We need to call them out for being the immoral, unethical, evil swindlers that they are.

  • Cult medicine vs. professional medicine

    So-called alternative medicine beliefs are an interesting and perhaps inevitable phenomenon. They make use of uniquely human qualities such as our intelligence, our pattern-recognition abilities, and our tendency to over-estimate how well we understand things. Most “science”, including medicine, relies on similar human qualities, but modern science has made some improvements. Medicine used to be based on observation mixed with superstition and other non-evidence based ways of understanding the world. Many of these systems were internally consistent, but ultimately failed to accurately describe the real world.

    The gradual transition of medical science (the use of evidence to evaluate medical practice) has revolutionized medicine. We no longer rely on the glorified shamanism that existed before the mid-20th century.

    This also means that medicine has become a true “profession”; it isn’t something you can just “pick up”, hang out a shingle, and practice from your front room. I’ve taken to calling practices that aren’t evidence-based “cult medicine“.
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  • Herb prevents sudden death–or your money back!

    I gotta admit, this is one of my favorites. I was browsing around the alternative health corners of the web when I came across a lovely site peddling “alternative” remedies. My gaze was immediately drawn to a link for “shock and emergency: rescue remedies”.

    For a physician, shock means something in particular–something very bad. Shock is a medical state wherein multiple organs stop working for a variety of possible reasons, such as severe infection or physical trauma. Patients with shock die quickly without immediate medical attention. So I followed the link to the product page:
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  • Quack Miranda Warning

    “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”

    This “Quack Miranda Warning” is on every just about every woo-meister’s website. I see dozens of patients every day, and I never Mirandize them, so whats the deal?

    There are three ways to look at this: the truthful way, the sinister way, and the bat-shit insane way.

  • Truth: Anyone who wants to sell you something that’s a load of crap must use this statement to cover themselves legally.
  • Sinister: Variation of above–someone wants to sell you something that you are supposed to believe is medically useful, but at the same time they tell you in fine print that it is not medically useful. When it doesn’t work, they don’t get sued. I wonder why anyone would buy something with that disclaimer attatched to it? When I treat someone for a medical problem, I pretty much say that I intend to diagnose, treat, cure, or prevent a disease. Why would I say otherwise? It would be a lie. Also, who would go to see a doctor that told you that they didn’t intend to diagnose or treat disease. The whole thing is bizarre.
  • Bat-shit insane: The FDA and Big Pharma are in cahoots with the AMA to keep you from learning all the simple ways to treat diseases. They want your money, and they’ll do anything they can to get it from you, including suppressing the knowledge that anyone can learn to heal cancer.
  • I can’t really help the people who believe #3, but people who are willing to suspend their paranoia should read #’s 1 and 2 a few times. Unless you’re being arrested, no one should be reading you your rights. The Quack Miranda Statement is the red flag that should send you running.

  • Why am I here? To bother you, of course

    When I use the word “scientist”, I mean something pretty specific—someone actually doing experiments and publishing the results. Some physicians are scientists. In fact, the MSTP that Mark H is a part of exists specifically to train doctors to do research and bring the results to the bedside.

    Most doctors aren’t scientists, by my definition. But good doctors these days have to be able to read and interpret scientific literature if the wish to practice science-based medicine.

    I think of ScienceBlogs as a community of scientists communicating with the lay-public and other scientists. I’m happy I’ve been allowed to contribute as well, and I think it’s justified. When I see patients, I do so with a head full of knowledge that is based on reading scientific literature. I then have to digest and regurgitate that literature in a form palatable to everyday folks.

    So, now that I’ve justified my existence, it’s time to get back to annoying people.

    Steve Novella over at NeuroLogica recently posted a piece on a new “mystery illness“. These are always fun. Epidemiology is a fascinating field, and has helped discover HIV, hanta virus, SARS, and many other emerging diseases.

    But there is the other kind of “emerging disease”: the folie à news. There have been many descriptions in the past of so-called folie à deux, a shared delusion. In the information age (God, I hate that phrase), the internet and television can bring people with similar delusions closer together to share their “folie”. One of the most recent examples is so-called Morgellons syndrome. This is a disease named by a woman who thought her child had parasites in his skin. The cause has been taken up by a “scientist” at the University of Oklahoma, and by several websites and support groups.

    This “syndrome” differs from emerging diseases such as West Nile Virus in several important ways. Over the next few days, I’ll examine some of the reasons that “Morgellons” is not a real illness. Some of the material will be familiar to readers of my old blog, but I’m buffing it up for a fresh discussion. For the first installment, go below the fold…
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  • Another victim of cult medicine

    This is another one migrated from my old blog. It is the first in a series that generated an unusually large number of comments. Thanks, PalMD

    This particular woo-encounter was non-fatal. A patient came to see me. He’s middle-aged, generally quite healthy, and physically active. After a recent return to physical activity, his elbow began to hurt, so rather than call his internist, he visited a chiropractor. Not surprisingly, the back-cracker was unable to effect a cure. What did he do next? Asked his friend for the name of a “better chiropractor” (which is a bit like trying to find a better wrench to turn a screw). This one took a totally different approach to not helping the patient, but that damned elbow still hurt.

    Like most cult medicine, there is little that chiropractic will not claim as their own. How tennis elbow could possibly be helped by back manipulation is beyond me. One website did, however, give some good insight:

    Not always thought of as a “chiropractic” condition by patients, chiropractic’s conservative approach to elbow pain is often very effective, avoiding more invasive, risky treatment options.

    An excellent example of “hurry up and do nothing”, which is not always bad advice, but is not unique to chiropractic. I guess when all you have is a hammer, and nails are notably absent, a wise chiropractor steps back and says, “abra cadabra!” I’m sure chiropractic cures the common cold as well—whereas the common cold, when left untreated, usually lasts a week to a week and a half, visit the chiropractor and your cold is gone in 7-10 days.

    Anyway, I gave the guy a tennis elbow strap, told him to rest and ice it, and take ibuprofen if he needed it. If he’s patient and follows my advice, he’ll probably save a few bucks. A strap is usually covered by insurance, but cheap anyway. Ice is basically free. And a visit to me is about sixty bucks—and if he gets better, he doesn’t have to return for multiple “manipulations”.

  • Woo hurts—it really hurts

    A frequent argument of (weak) support for alternative medicine is that, well, maybe it doesn’t help much, but it couldn’t hurt.

    Wrong!

    Aside from the usual arguments that it wastes resources, distracts people from real medical treatments, etc., there are more, real dangers. One of the hallmarks of woo is that treatments are humorously broad. One idea or treatment is often touted for many different illnesses, and even different species. How is it that, despite all my years of training, I’m only an expert on adult human disease, and yet Gary Null, with a cracker jack box Ph.D. not only knows people, but pets, too?

    But lets start with a story…

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  • Woo at San Marcos

    Just returned from an excellent trip to Guatemala, where I spent some of my time at Late Atitlan, near San Marcos. So, San Marcos is known as a hippie town, and I thought you’d love to see the various services offered at local businesses. They include (click for full size):

    Past-Life Regression, “Introject,” Soul Agreements…

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    Emotional stress release (hmmmmm)

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    Emotional Freedom Technique (EFT, for those of you who use this term frequently), and Neuro-Lymphatic Massage…

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  • Ack! ChopraWoo!

    Usually Deepak Chopra’s nonsensical writings at the Huffington post about mind-body healing are so vague and bland I don’t bother addressing them. The mind controls the body, the mind is powerful, blah blah blah, who cares right? Well, today Chopra pulled back the curtain and we see the crank within. It’s a reminder that behind the facade of all the touchy-feely nonsense of the alties is a campaign against science and legitimate medical practice. We start with the standard quack appeal to the individual, which sounds nice, but in practice basically means they have no consistent method to apply their nonsense.

    The great promise of mind-body medicine will never be fulfilled as long as the treatments are unpredictable. This has been a major stumbling block in the West, ever since the original excitement over acupuncture in the Seventies and Ayurveda in the Eighties. Patients who have been helped sing the praises of alternative medicine while official clinical trials don’t satisfy the skeptics. In the East it is more easily accepted that each patient is unique, and therefore one cannot expect that the same therapy will lead to the same results in everybody.

    You know, I simply don’t believe the alties when they tell us that they treat each patient differently. Whenever I see their writings they are always recommending specific treatments for specific diseases. Where is all this tailored treatment they talk about? And further, what is their method for determining which individuals need which treatment? Reading auras? They should just admit they’re full of it right here.

    But then Chopra shows the real objective of altie medicine quacks – the undermining of evidence-based medicine and with standard denialist tactics no less.

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  • Ben Goldacre on Homeopathy

    Sometimes people wonder why the skeptic types get all worked up over a behavior that is usually seen as at-worst harmless. Ben Goldacre explains why, in one of the best, and clearest articles on the problem of homeopathic medicine.

    This is exactly what I said, albeit in nerdier academic language, in today’s edition of the Lancet, Britain’s biggest medical journal. These views are what homeopaths are describing as an “attack”. But I am very clear. There is no single right way to package up all of this undeniable and true information into a “view” on homeopathy.

    When I’m feeling generous, I think: homeopathy could have value as placebo, on the NHS even, although there are ethical considerations, and these serious cultural side-effects to be addressed.

    But when they’re suing people instead of arguing with them, telling people not to take their medical treatments, killing patients, running conferences on HIV fantasies, undermining the public’s understanding of evidence and, crucially, showing absolutely no sign of ever being able to engage in a sensible conversation about the perfectly simple ethical and cultural problems that their practice faces, I think: these people are just morons. I can’t help that: I’m human. The facts are sacred, but my view on them changes from day to day.

    It’s awesome. Read it.