Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

Anecdotal Medicine Lives – This Patient May Not Be So Lucky

Shadowfax writes about a heartbreaking case of a victim of alternative medicine. The Human Cost of Woo. Woo is a term for alternative medicine, or anecdotal medicine, or unicorn medicine, but one thing that all of these terms lack is the ability to make clear that the one thing these are not is medicine.

Medicinenoun – something that treats or prevents or alleviates the symptoms of disease.

The problem in the definition is the word treats. Treats does not require that the anecdote-based treatment be effective, or be based on research, or be more effective than placebo, or even that it be as effective as placebo.

We need to do a better job of defining medicine, so that people may understand that there is a difference between fraud and medicine. Fraud is not harmless.

Medicine is supported by evidence that repeatedly and consistently demonstrates that it is more effective than placebo.

Fraud repeatedly fails that requirement.

Acupuncture, homeopathy, naturopathy, reiki, et cetera repeatedly fail that requirement. These are examples of alternatives that repeatedly fail to outperform wishful thinking. Even when studied by people who are proponents of wishful thinking. Wishful thinking is not an alternative to real medicine.

The only acceptable complementary treatment is prayer, but prayer is most definitely not an alternative to real medicine. Except as religions, these treatments hold no value. If these treatments are not religions, they are nothing but carnival freak shows.

The US government has spent a lot of money on studies by alternative medicine practitioners evaluating the claims of these treatments. Funding these failures takes money away from evaluating potentially effective treatments. At the same time, this conferred respectability encourages people to believe in magic.

Still, the advocates of these treatments do not admit that the treatments are just theater. Dr. Sen. Tom Harkin claims that the job of NCCAM is to ignore reality and prove that CAM works. His complaint is that he does not like the results of science. He appears to think that he is Tinker Bell. That he can wave his wand to make it so. Tinker Bell only left fairy dust in her wake. Dr. Sen. Tom Harkin and alternative medicine practitioners will not leave as benign a trail.

Then there is another alternative way to kill – the anti-vaccination movement. A group that feels it is acceptable to bring back vaccine preventable illnesses as a safer alternative to vaccines. Why do we act as if this is respectable? Why do we give a stripper equal time more time to present her case for child abuse, than we give to any real doctor to explain the benefits of vaccines?

In the August 27, 2009 issue of NEJM there is a related article worth reading. Dr. Holmes at 200 — The Spirit of Skepticism by Charles S. Bryan, M.D., and Scott H. Podolsky, M.D.

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