Map of life expectancy at birth from Global Education Project.

Thursday, November 18, 2010

Buddy, have you got the wrong blogger

One of the interesting perks of blogging is that I get all sorts of pitches from publicists. It's surprising how many academic physicians are paying flacks to promote their breakthrough research, that the Nobel committee has somehow overlooked. Medical device manufacturers, drug pushers and even outpatient surgery centers think I might just throw them a mention here.

Not to be.

Even weirder, I would say, or maybe not, are the woo-meisters, the purveyors of the mystic arts and the miracle cures that "They" don't want you to know about. I consider these pitches weirder because, while I'm likely to ignore the former category, I'm likely to trash the latter. As I shall now proceed to do.

The first comes from a "manufacturer and marketer of leading natural supplements that promote optimal joint health." Well, no they don't. There was a flurry of interest a few years back in glucosamine and chondroitin, constituents of cartilage, as possible treatments for osteoarthritis. Later, more rigorous trials have been largely negative -- i.e., it doesn't work -- though perhaps equivocal in allowing some modest benefit for some people with moderate to severe joint pain. While no benefit of these supplements has been demonstrated, they probably won't hurt you, but they aren't likely to do you much good either.

So okay, selling this stuff isn't the worst scam out there. However, what is definitely a scam is the pitch this company uses. Their press release is headlined "Patients fire doctors over trust issues; PATIENTS GROWING WEARY OF DOCTOR/DRUG COMPANY RELATIONSHIPS SEEK ALTERNATIVES; More People Trust Own Instincts Rather than Endure Misleading Consultations." They cite a report in the Archives of Internal Medicine to the effect that most physicians accept items of value from drug companies. They exaggerate -- mostly we're talking the triangular plastic pen and the Post-it pad, but they go on about trips to exotic locations, speaking fees, and fancy dinners. Only a small minority of physicians nowadays get major gifts from drug companies, but it does still happen, it is corrupt, and I'm agin' it.

Nevertheless, it does not follow that you should stop consulting physicians, abandon their prescriptions, and depend on your own "instincts" to treat yourself from the snake oil aisle. In case you didn't notice, this company is itself making money by selling the stuff. So why should you trust them? Your doctor might have gotten a free pizza during his residency, but he isn't getting kickbacks from the drug companies. Probably. And he does at least have treatments available for which there is good evidence.

Worse is an "Ayurvedic M.D. and Naturopathic Physician," who is co-founder of a company that markets "ayurvedic herbs." He wants me to practice breathing exercises appropriate to my "dosha," or "natural constitution." I was once told that I'm a Pitta, meaning I "tend to run warm, get easily irritated and impatient and experience heated digestion." Fortunately I'm not a Vatta, or I would be "be anxious and absentminded and experience flatulence and constipation." As a Pitta, I'm supposed to:

1. Open your mouth to form an “O” shape. With your mouth in this position, form a funnel with your tongue and place it between your lips*

3. Slowly inhale through your tongue and feel the breath reach your heart

4. Relax the tongue and mouth, and then exhale through your mouth

5. Repeat this exercise 16 times, twice a day

* If you cannot form a funnel, bring your teeth together and inhale through your teeth instead

While the joint supplements are dodgy, this is total bullshit that the guy pulled out of his orifice of flatulence and constipation, after first getting his head out of the way. He then reinserted it. The mystery is why anybody believes this garbage.

The medical profession needs to clean up its act in many ways, not least because the ethical lapses create an opening for con artists. I hope the top docs will take this to heart.


Anonymous said...

As much as this type of crap annoys me, it annoys as almost as much when the mainstream medical community is completely ineffectual in combating it! I am currently in a research assistant position assessing access to health information related to Lyme disease (and other arboviruses), and man is it ever crazy out there! The mainstream medical community needs way better health communication skills if it ever hopes to remain relevant to people in the coming years and decades. Yes, it's sad people are turning away from MDs and mainstream medicine, but ignoring the problem or taking a reductionist view will only make things worse, for everyone.


Nosmo said...

My dermatologist told me glucosamine is the only supplement that has been proven to be effective (but not in the context of osteoarthritis). Do you think he is wrong? Guess I should look it up.

Only other supplement I regularly take is Vit D. I've tested low for it and my primary care physician wants me to. I'm skeptical but do it anyway.

Cervantes said...

Glucosamine has not been proven to be effective. As I say, there is still some doubt about whether it might do some good, but that's all.

Vitamin D is one of the few micronutrients for which people in rich countries often do have deficiencies and may benefit from taking supplements.