Popping into my mailbox this morning (after a night wondering if whether Jackie Chan’s history of doing adverts that urge people not to use wild animals in medicine means that “complementary and alternative medicine” -“CAM” – will not have a place in the Science center that features his name at ANU… I’ll have to check!), was this article: Placebo Effect –Why We Need Less Research on Alternative Medicine, Not More by R. Barker Bausell in the Chronicle Review of the Chronicle of Higher Education.
It starts with a short history of the popularity of “bizarre, pseudomedical practitioners” and goes on to say:
Nothing has changed in recent years. In fact, the supplement and herbal industries had become so powerful by 1992 that their supporters were reputed to have sent an estimated two million letters to members of Congress, urging them to prevent the Food and Drug Administration from imposing restrictions on unsubstantiated health claims made on behalf of supplements and herbal products — restrictions that might have prevented the significant loss of life and thousands of adverse effects attributed to the herb ephedra, which was marketed as a weight-loss and athletic-performance supplement before it was finally banned a few years ago.
An interesting contrast to the recent shutting down of the BBC website for Complimentary Medicine due to public pressure. Maybe times are changing, in little ways.
What is new is the role of reputable institutions in propagating such nonsense: The NIH now awards both research and educational grants in alternative medicine. According to the Web site of the National Center for Complementary and Alternative Medicine, “the immediate goal” of the latter program is “to encourage and support the incorporation of [complementary and alternative medicine] information into medical, dental, nursing, and allied health professional school curricula, into residency training programs, and into continuing education courses. An important longer-term goal [is] to accelerate the integration of CAM and conventional medicine.” Many medical schools now work with complementary and alternative clinics, offer fellowships in alternative medicine, and both include material on alternative medicine in required courses and offer optional courses about it.
This shouldn’t come as a surprise to many, after a broad international recent market research study reporting that
The internet has had a large impact … with consumers being given access to unlimited health information online. In the US for example, where we have seen a slow but steady increase in the proportion of people who say that they ‘prefer alternative medicine to standard medicine’ over the past five years, a third of the population now gathers healthcare information on the Internet. … people aged 35 and over are generally more likely than their younger counterparts to turn to alternative medicine, and acceptance of the practice appears to increase with age.
So – should the Internet be emphasised as an important resource when it comes to promoting correct information about herbal remedies, et al? Certainly the network of science blogs and sites are supportive of each other’s summarised investigations by links and references – such as outlining the lack of evidence regarding autism being linked to vaccinations, for example (she writes, demonstrating at the same time how easy it is to grab a whole buncha links and linky linky linky… !).
The issue that Bausell has revolves around the enormous amount of spending that goes into testing the efficacy (or not finding evidence of efficacy, as the results seem to indicate – placebos ahoy!) of the CAM-claims by the National Center for Complementary and Alternative Medicine – “Not surprisingly, almost all those trials found no difference between the two, but that information has not come cheaply: The NIH has allocated approximately $860-million to the center since the 2000 fiscal year alone.”
The issue of testing such claims and the existence of the National Center was presented by Professor Barrie Cassileth and Professor Ray Lowenthal at the 2007 Australian Skeptics conference in Hobart. In their lectures, they gave an overview on the efforts of integrative oncology to investigate and use medicine that does work, researching and clarifying exactly what herbal remedies exist in popular use which do prove to have a scientific benefit – featured on the site www.mskcc.org/aboutherbs.
The article continues with:
Wouldn’t it be wiser to allocate that money to other NIH agencies whose mission is to try to find an actual cure for a real disease, or to try to find better ways to manage patients’ symptoms for those conditions that can’t be cured? Or, if that is not politically feasible, in the spirit of transparency shouldn’t the alternative-medicine center be renamed the National Center for the Study of Placebo Effects? And should we really keep this nonsense as part of our medical-school curricula?
About now I remember Daniel Loxton’s essay featured on Skepticality in regards to paranormal claims – ‘Because people get hurt.’ And people indeed get hurt (as the site What’s The Harm.net shows) and they will point at outdated reference papers and bad research continually.
I only have to remember comments on a YouTube video of a TV homeopathy debunking, posted up by Richard Saunders, where a persistent homeopathic supporter (persistently dreadful, I might add – referencing papers from the early 1900s as support for homeopathy? Sheesh…) kept up a barrage of ‘it’s true! It’s true!’ posts that made readers roll their eyes.
Sure, people will insist the claims have validity and have nothing beyond poor research and anecdote to back it up with. But it doesn’t mean that there potentially couldn’t be something behind some of the claims – hence the creation of integrative oncology.
Popularizing and emphasizing good research, rigorous studies and easy-to-find papers that show ‘no, this particular claim just does NOT work and I have more than just skeptical sites that say so’ could help when you’re faced with the situation that James Randi writes about in SWIFT – reader Greg Stokley objected to a “naïve – if not simply fraudulent – report featured on TV station WKYC Channel 3, NBC-TV in Cleveland” that was touting pro-homeopathic claims, ending up with the JREF and CSICOP sites being slammed :
” … you’re going to have to do better than cite James Randi and CSICOP as grounds to refute anything. Had you watched closely, you would have seen the homeopathic practitioner was an MD… Skepticism is fine, but huffing and puffing cynicism helps no one. If you are going to lambaste Ms. Robins’ reporting, your will need to offer far more than indignity and a couple of cultural websites.” [emphasis mine]
Yes. We do need more. Because that is the attitude that people can have in regards to claims and many of us have faced that in casual conversations and professional interactions.
The battle does continue, regardless. I know that Michael Baum, Emeritus Professor of Surgery at University College London, caused a storm by criticizing Prince Charles’s support for the Royal London Homeopathic Hospital after a £20 million refurbishment with money that ‘would have been better spent on drugs like Herceptin’ – but this is working towards testing to ascertain what works and perhaps do find elements that work, rather than just blind faith support of homeopathy or herbs like ephedra; not taking away money that could be used for drugs that already have evidence for their efficacy.
In my opinion, because “…if even Benjamin Franklin couldn’t stem the ever-rising tide of alternative medicine, no one can” doesn’t mean that there isn’t hope. The research that demonstrates that people can shut down a website in the case of the BBC’s site (which is one key element in continuing the popularity of the claims) and the growing number of interactions between science blogs and networking… does it not help too in the theory that if it’s the older generation which tend more towards “CAM” – then we could reflect upon how to appeal to the reasonings of the Internet-literate younger years too? What will make them be more skeptical than the older years? Could good research evidence online help?
And what if we’re wrong? What if there’s other elements that contribute to belief in homeopathic claims and the like? Then to at least have a bet-each-way, part of the diversification in addressing concerns about people’s health should include a places that which prompts students how to look at “CAM” claims with the scientific method and produce well-written and well-researched papers that can demonstrate that science will test and does test – regardless if you get no evidence that it works – especially with students. Because that’s still something that informs us. I certainly hope that places like the National Center for Complementary and Alternative Medicine will provide this need.
Because in the end – if this sort of product in the video here is touted alone as ‘a great way combat credulous trusting of “CAM” claims’ – we are not going to maintain the fight.