Alternative Medicine– I want to believe, but show me the evidence!

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Having been a physician for over 30 years, I am fascinated by the many alternatives to traditional medicine that the media constantly puts before our patients.  As more and more patients peruse the internet prior to seeking direct medical attention from a physician, the opportunity to be exposed to all sorts of potential treatments will be greater than ever.  It seems like every other commercial on TV is hawking some kind of new miracle cure or remedy.  These ads are full of emotional testimonials describing how life before that product was miserable, and now they are almost miraculously transformed.

Historically, most physicians have been understandably very skeptical of these products….even referring to such practices as downright quackery or snake oil .  And maybe some of these claims of charlatan medicine are correct, and that these promoters are simply trying to take advantage of a hurting patient and make a quick buck.  Yet, there are some patients that fervently believe in these products, truly feel that their lives have been changed for the better, and enthusiastically recommend the treatment to their friends.

As a practicing physician, I have always tried to remain open minded about such alternative practices, and at times even giving them the benefit of the doubt if my patients sincerely believes it is helping them.  At a minimum,  the placebo effect can be profound— the literature documents that even a sugar pill can have a 30-40% placebo effect.

As physicians we have learned since medical school to practice evidence-based medicine.  First, do no harm !  We are trained from the start to respect the literature, examine studies for the power of their evidence, and be willing to provide literature support for all therapeutic interventions that we do.  In training we have regular peer-attended meetings where we are held accountable for our medical decisions.

Personally, I am very open to any and all solutions that might alleviate my patients’ pain and suffering. But I need the answer to a very straightforward  statement:  Show me the evidence !!

In order for a traditional pharmaceutical medication to get to market,  or even a new surgical procedure, it has to go through a gauntlet of barriers and tests… and maybe too many,  as potential advantageous therapies may never have the opportunity to get to the market.    And simply making it to market is not the final step;  there are many medications and procedures that have had to be recalled or found not efficacious after the fact despite this arduous process.  But I do feel that I can in good faith recommend any medication that has made it through this professional, peer reviewed process.

I want to believe in the potential value of a new medical product, but I can only do so if I know that the evidence is there to support the claim.   As physicians, we need to demand the evidence…. Show me the clinical trials !!

Simply saying that a treatment has been available in some exotic country for over a thousand years doesn’t cut it.  All sorts of horrible things have been around for a long time.   Emotional personal testimonials, zealous as they may be,  in reality rank pretty low on the totem pole of evidence, especially when these individuals may have been paid for their endorsements.

I am all for expanding the therapeutic armamentarium.  I am all in for giving any modality a chance.

Just produce for me the evidence and let that evidence be reviewed by peers.

And to my patients, don’t just buy something because it is on a fancy website or because you know the celebrity advertising the product on TV.

Be serious, demand the evidence.  You are putting a product inside your body.  Shouldn’t you be darned sure it is safe?  Many of these alternatives are not cheap.  At the least, don’t throw your hard-earned money away.

The stringent demands of the FDA, flawed as they can be at times, do not apply to many of these over the counter pills and concoctions.  The consumer is absolutely on his own.

If the product is really as good as it is claimed, that evidence should be forthright.  Physicians will respond to this evidence and be your biggest advocate.  As physicians, we want to do the right thing for the patient.

To these alternative product promoters… Show me the evidence.  Let it be reviewed by peers.

To the patient… Demand the evidence of effectiveness before trusting it to your body.

First,  do no harm !

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