Academic medicine is supposed to be different. It is supposed to exist for the purpose of applying scientific principles to medicine and thereby making new discoveries to use to treat disease, testing them in clinical trials to find out if they are effective, and then applying them systematically. Uncritically introducing therapies that are by their very nature unscientific, therapies like homeopathy, reiki, reflexology, and “energy medicine” taints the entire scientific enterprise at these institutions. Worse, offering such therapies outside the context of a clinical trial in academic medical centers gives the patina of scientific credibility to therapies that have not earned it, promoting the impression that science supports their efficacy....Medicine has finally, after over a hundred years, evolved to the point where it can actually become truly science- and evidence-based. From my perspective, the growing uncritical acceptance of CAM in academic medicine is a major threat to the continuation of that evolution. There should be no such thing as “alternative” medicine, anyway. There is medicine that is effective, as determined by science and clinical trials, and there is medicine that is not or is as yet unproven. We should not be “integrating” the latter with the former, and especially not in academia.
-Dr. David Gorsky; "The infiltration of complementary and alternative medicine (CAM) and 'integrative medicine' into academia."
Excellent article. Do read: http://www.sciencebasedmedicine.org/?p=28
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4 comments:
Interesting.
I agree wholeheartedly about medicine that works vs. that which doesn't. I happen to be in a profession that some still consider to be "CAM" (you can email me privately to discuss if you wish). I've always had a very sensitive bunk detector. Thankfully, my profession seems to be shedding it's CAM-iness, except for the inevitable fundies still out there (and any new ones who are attracted).
That said, there may be some value to certain so-called CAM therapies. I've always wondered why, if the claims CAMT proponents make are true, and are so simple to verify with RCTs, such RCTs haven't been done. It shouldn't be that difficult to design a study to test some of these things. Perhaps NCCAM can be retooled a bit to weed out the outlandish stuff, and "weed-in" the therapies that have value.
A lot of the proponents of alternitive medicines sound a lot like religious zealots. They talk about their technique of choice is emotional terms and often claim it as the cure for everything. Studies that show it doesn't work are dismissed as an attempt by the medical establishment to discredit their One True Way so that pharmecutical companies can push drugs on the poor ignorant masses who haven't been forutnate enough to hear about the wonderful therapy that can cure all.
NJG,
I sent you mail.
"I've always wondered why, if the claims CAMT proponents make are true, and are so simple to verify with RCTs, such RCTs haven't been done."
I think many CAM practitioners are simply nonscientific. I mean, they're already doing these 'therapies' without data - what have they to gain by possibly undermining them?
"Perhaps NCCAM can be retooled a bit to weed out the outlandish stuff, and "weed-in" the therapies that have value."
At the very least, those modalities which supposedly operate by mechanisms unknown or counter to modern science need to be dismissed. They are prima facie BS and are a waste of public funds.
OP,
I agree. It either has evidence or it doesn't -- and everything at some point was alternative. One positive slant though-- Don't forget the best tested and most powerful medicine of all time: PLACEBO!!! Clinical effect is therapeutic effect PLUS placebo effect. If it doesn't hurt, is cheap, and it works for that particular patient - good for them. Obviously this mainly holds for issues more like depression and pain - but placebo can help the nasty things too.
I was also suprised that some seeming BS things like low level laser therapy for pain (basically point a cheap laser pointer where it hurts) has pretty good RCTs for it. So just because we don't understand it, doesn't mean it doesn't work.
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