It’s been a while since I had the opportunity to post on Talk Health Partnership. This is despite a range of subjects interesting and moving me to want to comment. As ever, time is one of a select few commodities that is ostensibly free, unlimited but ultimately beyond our control to claw back.
However in recent weeks I have been thinking about putting in place the long promised third part of my larger article on a skeptical approach to medicine. On the basis that my personal worldview is one that the scientific method should predominate over any modality that simply is not nor can be scientifically proven.
With this in mind I am going to finish the series of articles by discussing the thorny issue often raised by proponents of Supplements, Complimentary and Alternative Medicine (or SCAM modalities as we might shorten this to). The point often raised, once we’re done arguing about double blinded trials, effect size, return to the mean and other favourites, is :
“Well, <insert alternative or complimentarty modality here> has never done me/anyone I know any damage and we/he/she/they/them all felt better afterwards – so what’s the harm ?”
The answer is actually very simple. None. If you’re receiving alternative, non mainstream treatment for a condition that is minor and self limiting (i.e. will cure itself anyway in the fullness of time) -coughs, cold, minor head aches, heart burn, muscle strain, mild bruising (arnica anyone!!!) and so on and so forth.
However, if we are discussing anything other than the above the answer is it could be catastrophically damaging. The reason is of course, not that the treatment – homeopathy, acupuncture, chiropractic, ear candling, reflexology etc does anything, because for the most part they have in common a complex operational but ofttimes non-sensical procedure that is dependent on the process of visiting the ‘clinician’ and going through the rigamarole (needles, candles, foot massage, neck popping and so on) of their treatment to create a non-specific placebo effect. In essence they seem (in so far as we can understand the placebo effect) to create a positive feedback loop triggering the (as yet still not fully understood) positive placebo effect within the ‘patient’. Certainly there is no reliable scientific evidence that the actual complimentary modality is having any noticeable physical effect.
Putting aside the fact that the placebo effect is real and that using it as a medical treatment by itself could be deemed unethical – it is not the alternative treatment itself that helps. Rather, it is the non specific placebo effect initiated by the alternative practitioner. In and of itself this isn’t a problem although the amount spent on these kind of non effective treatments seems to me a feat of substantive financial misdirection.
The problem though arises when either the self limiting condition is masking a more serious underlying problem (i.e. headaches as a symptom of a more serious neurological problem) or the patient is visiting their practioner in preference to a real doctor.
What I do not intend to finish this series of articles with is a list of real world cases where people have died or been significantly harmed as a result of pursuing alternative and complimentary therapies and other ‘woo’ treatments – as we skeptics tend to call these type of unproven modalities. That would be very easy and I suspect a trifle gauche – I could list a dozen cases off the top of my head. Instead I would suggest those interested in expanding on the issues covered in this article should perhaps google some of the SCAM therapies and get an understanding of how these so called ‘treatments’ are supposed to work. Homeopathy is hilarious, as is Reflexology. Acunpunture and Chirporactic sound at first glance more ‘scientific’ but neither is ancient, nor do they conform to any cause of action that is remotely scientifically proven – although no doubt proponents will cherry pick poorly constructed studies and a slew of anecdotal ‘evidence’.
I would suggest that you also check out the excellent website : www.whatistheharm.net
The point of this series of articles ultimately is to ask or suggest that readers think a little more critically about the information given to them on their health and perhaps do some of their own research into how medicine and their body works. To adopt a skeptical attitude simply means to ask questions, gather evidence and look critically at what doctors and medical practitioners tell us and seek some justification that the treatments recommended actually work.
Can I leave you with one last thought.
If one person died because they went to see their homeopathic practitioner thinking they could get relief from their asthma symptoms and they later died following a severe asthma attack because that same Homeopath told them to stop taking their ‘Western’ asthma medicine – would that be sufficient justification to question the world of complimentary and alternative medicine ?
Obviously, that event sadly did happen (in 2001 in County Mayo in Ireland – this is the first of dozens of similar examples just for Homeopathy on the above website) and similar situations arise all the time and will continue to do so until people stop accepting the word of SCAM practitioners and begin thinking more rationally.
Phil
Phil Knight started work in the National Health Service in Leeds in 1989 before going to Hull University to read American Studies and then moved into private medical sales and marketing in 1994. He now owns two business focused in the private medical sector and works with senior clinicians and healthcare providers on a daily basis advising on a variety of healthcare issues. He is also a Member of the Leeds Teaching Hospitals NHS Trust. He is interested in all aspects of healthcare and regularly blogs on related medical, business and technology issues and also hosts the only podcast in the country focusing on private medical insurance. He is lives in Leeds, West Yorkshire but has clients across the UK and internationally. He is married to Hazel, a Senior HR Manager with two children : Megan aged 13 and Ryan, 7. His interests include technology, podcasting, science fiction and martial arts - he is a Second Dan Black Belt in Tai Sabaki Do Karate and 2nd Kyu Brown Belt in Shukokai Karate so health and fitness dominate both his business and personal life. Read his blog at http://www.localventure.blogspot.com and visit his websites : http://www.premierchoicehealthcareltd.co.uk/consultants/phil-knight/ and http://www.medicolegalmarketing.co.uk
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