Map of life expectancy at birth from Global Education Project.

Tuesday, August 16, 2011

On the rise of quackademic medicine

Dr. Gorski, in case you don't already know it, is highly POd about the infiltration of "complementary and alternative" or "integrative medicine" into medical schools and academic medical centers. Yep, homeopaths, acupuncturists, reflexologists and practitioners of "energy medicine" such as Reiki and "therapeutic touch" are actually teaching courses and touching -- or waving their hands at -- patients in otherwise respectable institutions.

I share his alarm, but I wish he'd give more thought to why this is happening. Obviously the quacks* are filling some sort of need that real doctors aren't, both for patients and for the docs themselves who are encouraging or at least tolerating this jive. Part of the problem is that most people aren't scientifically literate so it's easy to fool them with pseudo-scientific sounding blather, but that is only a necessary, not a sufficient condition. It doesn't explain the attraction.

Some people say (sorry about that but I'm not going to do the work of coming up with links) that real doctors don't spend enough time with people, don't listen well, and don't establish satisfying therapeutic relationships. The quacks give them more time and attention, perform soothing rituals, and leave them feeling healed, not just treated. Maybe so, but letting them come in to do that work so the doctors don't have to is the wrong solution to the wrong problem. It's the lazy way out, and it suborns fraud.

I wish Dr. Gorski would think harder about what true integrative medicine would look like -- real doctors doing science based biological interventions and evidence based but also humane and empathic healing, partnership, and listening. This requires a different set of criteria for admission to medical school, a different emphasis in medical training, and a different concept of what physicians do. Just trashing the quacks doesn't get us there.

*And yes, that's what they are, this is all utter nonsense. If somebody wants to have that fight with me, bring it on.


C. Corax said...

I hope you get your fight! It won't be from me, though....

I have airy fairy friends who just lose it when I dare to suggest it's all a lot of hooey. Sigh. It IS hooey, though--lucrative hooey, which is why it will be with us forever, in one form or another.

Anonymous said...

A few years ago, here, (GE_CH) the voters forced the medical faculty to offer courses in homeopathy.

The Faculty could but comply.

The students boycotted the courses and the whole plan was scrapped.


Anonymous said...

This relates to the post below it as well.

I get the feeling from my friends and contacts that ppl often turn to ‘alternative’ medecine not only because of the friendly, interactive style of the healer, but because they want ‘light’ and ‘circumscribed’ treatment. They don’t want to enter the whole medical machine because they have no idea where that will go, and that is scary. The healer will only do one kind of treatment, for one defined problem.


kathy a. said...

obviously i agree about turning to alternative medicine and against something proven, and that alternatives that may be harmful are awful. but just a couple of additional thoughts.

one is that mainstream medicine is so focused on treating the disease or condition -- and not really on the person who has the disease and condition, but also has a real life. the disease, the treatment, the coldness of the process are all very stressful to actual humans. i'm pretty much in favor of things that lessen the stress in non-harmful ways. massage, for example. therapy dogs in hospitals. one friend recently had a long stint with his wife at a major cancer hospital, and the hospital had a sunny deck, a game room with pool table, craft activities, etc., which really made the quality of life better in very stressful circumstances. also, they loved the oncologist for his sunny, can-do, caring attitude. these amenities are not directly related to medical outcome, but they sure make a difference for patients.

meanwhile, my daughter is taking a medical anthropology course and is Not Happy with the instructor. i think the instructor was trying to get the students to think about cultural traditions and assumptions, although it is possible she strayed to the woo-woo side in this presentation.

example 1 from the first day was that childbirth is too medicalized in the US, many people do well with midwives. (there is actual medical concern about over-medicalizing birth, and specifically the high rates of c-sections.) my daughter was appalled, probably because she and her brother both had complications requiring medical attention (frank breech; vbac + early labor), and home birth was never my thing. but other people choose home births if possible, and i have no problem with that as long as the midwife is trained to recognize when medical help is needed.

example 2 from the first day was some project involving AIDS treatment in africa, where the traditional local remedy was eating beets, and the project went along with the beets. ("how could they do that? there isn't any science to support beets! they need to explain this doesn't work!") well -- if they could do the medicine and respect the culture by also letting the patients eat beets, what's the down side? i see that as an example of using the traditional to help people also use the proven medical.

Home Remedies said...

The doctors should aware of this,,.
Maybe they should be a little hospitable.

Best regards,

Home Remedies