018. Alternative medicine

A discussion at the boundaries of the medical sciences

 

Essays of possible interest

  1. The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance?
  2. The use of complementary and alternative medicine in pediatrics
  3. Efficacy of complementary and alternative medicine therapies in relieving cancer pain: a systematic review
  4. Trends in the use of complementary health approaches among adults: United States, 2002–2012

 

Questions to ponder – Alternative medicine

  1. What makes medicine “alternative”?
  2. Is “alternative medicine” distinct from “complementary medicine”? Are either or both situated at odds with “traditional”/”Western” medicine?
  3. In their review of 18 trials involving alternative medicines, Bardia et al conclude that “[t]here is paucity of multi-institutional RCTs [randomized controlled trials] evaluating CAM [complementary and alternative medicine] interventions for cancer pain with adequate power, duration, and sham control. Hypnosis, imagery, support groups, acupuncture, and healing touch seem promising, particularly in the short term, but none can be recommended because of a paucity of rigorous trials. Future research should focus on methodologically strong RCTs to determine potential efficacy of these CAM interventions.” To what extent to do you agree with that conclusion given what you know about “alternative” medicines?
  4. I have an aunt who swears by acupuncture. She has had some of the worst pain you can ever imagine in her life, has gone everywhere, consulted every doctor, undergone every treatment, every therapy. She goes to an acupuncturist and the pain is gone and onlywhen she goes to said acupuncturist does this horrible pain get treated to her satisfaction. Should we recommend she keep going?
  5. On placebo. Is it dismissive to attribute a portion of the efficacy of alternative medicine to the placebo effect? Placebo treatments have often proven slightly effective in alleviating certain disorders––to what extent should medical professionals feel comfortable giving them to their patients?
  6. It is estimated that at least one-third of all adults in the United States have used complementary and alternative medicine. It is an industry generating tens to hundreds of billions of dollars in revenue, accounting for likely over one billion trips to “healthcare” providers. This is not the case in other countries. What are we to make of this?
  7. Do you think more or less CAM therapies should be given CPT codes?
  8. If someone told you snake oil really had a curative effective, who would that someone have to be for you to believe them? And why?
  9. Where does something like yoga fall on the Improving Health Spectrum? Do its effects extend beyond those associated with any other form of exercise?
  10. If I gave you a bottle of homeopathic medicine, how many would you feel comfortable taking?
  11. Is there something approaching what we might call the “mind-body-soul” being that medicine should ultimately be treating? We already incorporate quality of life as a factor into most medical decisions, would it really be any different to perhaps take a more “holistic” approach to medical treatment/therapy/devices?
  12. How important is it that we/someone police the boundaries between “medicine” and “not-medicine”? “Science” and “non-science”? Sense and nonsense?