Originally posted 19 June 2009
There’s been a lot of talk lately about the AP Impact series bashing “alternative medicine”. And it got us to thinking about how this term is kind of a straw man.
Self-proclaimed skeptics like to say there is only medicine: that which works. Everything else, they argue, is non-medicine, and they lump it all under the word “alternative.” But here’s the catch: you seldom hear serious, qualified naturopaths, acupuncturists and other natural and traditional healers use this word to describe what they do. (When they do, it’s typically as a buzzword or heavily armored in irony quotes.) Rather, the main groups who use it tend to be 1) those wanting to sell you something, 2) establishment physicians who support a limited number of traditional healing methods (CAM practitioners) and 3) those who put their faith in industrial medicine.
We use the word “faith” deliberately here, for despite the claims of the medical establishment, their treatments are far less scientifically supported than many admit – or perhaps even know. According to Kenneth R. Pelletier, Clinical Professor of Medicine at Arizona State University and the University of California, San Francisco,
To provide a baseline against which to measure complementary and alternative medicine (CAM), it is important to point out that as much as 20–50% of conventional care, and virtually all surgery, has not been evaluated by RCTs [randomized clinical trials]. According to Richard Smith, editor of the British Medical Journal, “Only about 15% of medical interventions are supported by solid scientific evidence… This is partly because only 1% of the articles in medical journals are scientifically sound and partly because many treatments have never been assessed at all.”
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In addition, a frequently cited report from 1978 by the Office of Technology Assessment found that only an estimated 10–20% of allopathic medical interventions are empirically proven. That figure remains accurate nearly 25 years later.
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Again, the focus here is upon conventional medicine only since advocates of an evidence-based approach consistently cite conventional practice as the gold standard. Therefore, it is entirely appropriate to gauge the standard that is clearly found to be grossly deficient in a rigorous evidence base.
Yet sometimes, apparently, no proof is okay with those in conventional medicine – just so long as it doesn’t conflict with its tacit mandate to keep hospital beds full, medical equipment in constant use and people as perpetual patients. This was pounded home to us by a quote in a recent WSJ Health Blog item on the AMA’s move away from white coats for doctors, because of their role in transmitting pathogens.
“As with many things in medicine, just because we can’t prove it doesn’t mean it’s not true,” said Peter Ragusa, a student at the Yale School of Public Health who was involved in drafting the proposal. “It’s hard to do randomized double-blind controlled trials with something like this. But I’m a med student and I can look down at my sleeve and see it’s dirty, I can look down at my tie and see it’s dirty.” (emphasis added)
Now, if a homeopath or acupuncturist were to say such things, for instance, he or she would be hooted down as “unscientific.” There’s definitely a double standard.
The best holistic healers tend to be quite diligent in giving their patients the scientific information they need in order to understand treatment recommendations and risks – as well as alternative treatments, including those of establishment medicine. They are teachers as well as healers, wanting patients to understand their own role in the healing process. They give the support for what they propose to do. In this way, their patients can give truly informed consent.
Now, do all holistic healers do this? No – just as not all allopathic practitioners are hostile to all forms of traditional healing. Any generalization breaks down fast. Yet somehow, the “alternative medicine is all quackery” line is considered immune from the strictures of logic, as is its converse: “Only allopathic medicine can cure dysfunction or disease.”
Of course there are some things that conventional medicine does very well. If you break a leg, you don’t treat it with homeopathics or acupuncture. You may use such supplemental therapies to help relieve pain and support healing. But for your injury, you want a doctor who can set the bone so it can heal.
Indeed, when it comes to acute injury or mono-causal disease, conventional medicine is great. But its fundamental assumptions about disease and health make it less able to deal with multifactorial illnesses, which most chronic conditions are. Consider the overwhelming lack of success we’ve had in treating cancer, despite the millions upon millions of dollars spent in the search for a “cure.” (This failure, by the way, is described very well in the recent New York Times article on the “elusiveness” of a cure.)
Good research depends largely on asking the right questions and using models of inquiry that are appropriate to what is being observed. With cancer and other “no-cure” diseases, we may well be asking the wrong questions, using the wrong models, ignorant of any others, such as Enderlein’s work in pleomorphism or Reckeweg’s work in homotoxicology, both arising from Antoine Beauchamp’s theory of the biological terrain. If you consider a disease like cancer from the fundamental understanding that the terrain – a body’s internal environment – dictates the development and progression of illness, you can begin to see possible avenues for cure: change the terrain, and you change the course of illness. In fact, this is the kind of thing that health officials imply when, for instance, they talk about “underlying conditions” being a risk factor for other illnesses, as in this recent New York Times article on H1N1 (“swine flu”)worries. Illness thrives when the terrain is polluted and disordered. Add another insult (toxin) to the system – here, the H1N1 virus – and things can get worse. Much worse.
As Louis Pasteur is said to have insisted on his deathbed, “The microbe is nothing. The terrain is everything.”
Last week, Dr. Deepak Chopra published an excellent commentary on the medical establishment’s lashing out at Oprah Winfrey for “spreading ‘dubious advice’ in a wide range of health issues” – a charge leveled at length in a recent Newsweek feature and subsequently discussed on many blogs. Chopra cuts to the heart of the matter, which we suspect may be at work in the more recent AP articles condemning “alternative medicine”:
The criticism the medical establishment is directing at Oprah through this article only exposes their own frustration in having squandered their credibility with the public. They hope that if they can successfully attack the Oprah’s immense credibility, then they can magically get some of that credibility back for themselves. However, if people still trusted the health care industry to act in their best interest the way they did decades ago, then it would be unnecessary to brand Oprah for “crazy talk” simply because she occasionally provides a forum for ideas outside of mainstream medicine.
The medical profession is burdened with a host of problems that Oprah addresses with more candor and force than the AMA. She promotes wellness and prevention, two areas that drastically need improvement. She brings up creative solutions to problems that medical science is baffled by, such as the healing response itself and the role of subjectivity in patient response. These are issues that few M.D.s are willing to explore, yet she has done so for decades.
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Scientific medicine by and large ignores wellness, prevention, and alternative medicine in general. On a daily basis doctors don’t deal in these things; few take courses in medical school centered on them. That’s why a massive movement has arisen driven by patients themselves. Oprah serves as a public outlet for a conversation that needs to be ongoing. As long as official medicine, backed by huge pharmaceutical companies, denies the existence of the problem, much less alternative solutions, the movement will remain patient-centered and the attitude toward alternative medicine will be one of unfounded disdain, suspicion, and ignorance on the part of physicians.
The whole thing is worth a read – and we say this despite our not being big fans of Chopra and Winfrey. You can check it out at AlterNet.