posted
I read a few of the articles on the quackwatch.org site that Sara linked to about Craniosacral therapy and them some others about massage therapy.
Here is my question. How far do we want to go in discouraging quackery? I certainly don't approve of people making money by manipulating their patients into thinking they're getting treatment that they're not, but on the other hand, the effects of certain wacky cures, though they may be entirely psychosomatic, really work for some people.
If getting massage therapy helps someone with a chronic health problem, should we try to convince them that it doesn't, scientifically speaking?
My mom is kind of a sucker for "miracle cures," and relies on a lot of silly solutions (from my perspective) for common maladies. I have a hard time, though, telling her that things are bunk when she has such a firm anecdotal convication that they aren't. Also, my family tends to be rather healthy on average and the over-use of melaleuca certainly isn't doing anyone any harm.
I really don't know where I stand - it's one of the issues I'm quite conflicted on.
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posted
I'm comfortable with adults making decisions for themselves based on accurate information. I'm not comfortable with the unchallenged dissemination of inaccurate information, for the same reasons that I am not comfortable with deceptive or misleading advertising.
When I make claims of fact (or interpretation of facts) about the world, I try to give reliable and accurate sources for further information on the subject. However, I am supremely uninterested (especially at this point in my life) in telling people what they should and should not do. There is a difference between that and promoting accuracy of information, and (IMHO) the latter is even more important in a public forum where people may be influenced who are not visibly engaged in the discussion.
Accurate information, autonomous choices.
And, for what it is worth, massage therapy has been well-validated as a medical therapy for many musculoskeletal complaints, including both acute and chronic back pain. A good, certified massage therapist is a medical professional, in my book.
*shrug
But I'll be the first to say that this post represents no more than my opinion, and I am certain that many who I respect here may take a different perspective.
[Annie, were I not a physician, I don't know how I would handle physiological and medical claims. That is, I'm pretty sure I notice political claims much less, and evaluate them less rigorously, but then that isn't a professional matter for me. I have a hard time not being a physician, though. It might be more healthy (and certainly easier) to turn off that switch. As it is, I don't expect anyone to take my word as gospel on something -- which is why I make it a practice to provide external links -- and I am policing myself about offering advice.]
[ October 09, 2004, 02:44 PM: Message edited by: Sara Sasse ]
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quote: How far do we want to go in discouraging quackery?
Geez, Annie. When I am approached by a patient that has a question about the validity of a procedure or cure, I insist on answering them when I am certain of my information. Otherwise, I refer them to their physician as to whether they can debunk the information and answer a question.
Let me give a quick example:
I do not know if reflexology or homeopathy really have much credibility. I personally believe that they have little medical validity, but I do not discourage patients from subscribing to them. I simply give my opinion and what information I have to support my decision. But I tell a patient that the mind is a powerful tool and if the treatment seems to help, then stick with it so long as it is beneficial. However, there are other areas like magnet therapy that have no usefulness whatsoever. I tell patients to save their money, FDA-approved magnets or not. Still, my dad sleeps with magnet in his pillow to prevent headaches. [sigh]. And I tell my patients this anecdotal story. I just want to empower them to make an informed decision, and not to make their mind up for them. If they want to buy the insoles with magnets in them, I caution them and tell them happy shopping.
I did not see the link to the information you are discerning over, so I cannot be much help there. But when a physician (Sara ) is reserving her advice and a pharmacist is very conservative in dispensing advice, I am not sure what we can do to discourage quackery.
I have people in my life that I can ask when I am not sure. I think that is the best ruler when measuring information that you are unsure of.
posted
I think Alucard and I are on the same page, Annie. (And, as I highly respect and rely on Alucard, this causes me no little amount of happiness. )
If something is not directly harmful (such as overdosing on Vitamin A) or indirectly harmful (such as telling a person with severe epilepsy to stop her meds and not be concerned about three days of seizures because she was being cured by other means*), I don't see much harm in doing it, even without supportive evidence. The placebo effect is quite powerful, and there are also individual idiosyncratic responses. I still think it's worth knowing what the science is when making such a decision, especially if the decision is advocated in a public forum.
*Edit: to be clear, this incident does not represent standard chiropractic practice, as far as I am aware, and there are certainly similar egregious incidents by criminally inept allopathic medicine practitioners
[ October 09, 2004, 02:54 PM: Message edited by: Sara Sasse ]
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posted
Thanks for your answers. I was honestly curious, and I hope my question didn't come across as antagonistic or self-righteous.
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posted
I agree with what Sara said...as long as it's not harmful, and someone is not using it in lieu needed therapy, the placebo effect can be very helpful. Take mild herbal teas for example ( it's important to note that some herbs are dangerous and should be used only under medical advisement). I don't know of any proof that chammomile actually has a calming effect on the brain. But if you're a nervous person, the very act of sitting down and sipping a cuppa will relax you. If you're fighting off a cold, hydration itself will be helpful. I do think some of my fellow crunchy types go overboard with chiro several times a week and over $100/month in supplements
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I am just concerned after seeing and hearing so many anecdotal cures that make my shackles rise. The truly frightening part of this is that some patients will try anything (or as Sara eluded to, stop doing something) so long as they see no immediate or imminent threat of death.
The other part of this that bothers me is that patients are generally hesitant to ask for advice:
"My doctor was too busy."
"I don't know the pharmacist that well."
"The nurse was in a hurry."
But if the neighbor tells them to put an aspirin against their gum for a toothache, it sounds like it just might work.
Got a wart? Just stick household bleach on it. If that doesn't work, try a penny.
Don't even get me started on hiccups...
But the satisfactory answer to your question is very difficult to answer. There IS no effective way to police quacky practices other than to inform patients to the point that they can make a solid decision.
P.S. Double S, you rawk severely as well.
P.P.S. DPR, 80% of pharmaceutical products are derived from natural products. Teas and herbs can have many beneficial effects, and are generally more mild than pharmaceutical products. But as you eluded to, some have very serious drug interactions with antiarrythrmic and anticoagulant meds, for example. But herbal therapy, in moderation and in conjunction with your physician, can be very beneficial.
There are many paths to good health, and people need to find experts in the area they subscribe to that will help them make the most informed decisions possible. But I watched a friend die from cancer, who chose not to undergo chemotherapy, but natural vitamin therapy instead. She left a 5-year-old son behind. What made it hard for me to watch was that she abandoned the natural therapy when she realized it was doing nothing. By then, the cancer had metastasized and chemotherapy and irradiation therapy were too late. She recieved both, but died a few months later. Her sister took her to buy a birthday card for their father. She was probably too sick to go, but did anyway. She collapsed in the parking lot, people walking by and wondering why this woman was screaming over her fallen sister. No Good Samaritans this day. By the time the ambulance came 10 minutes later, it was too late.
Sure there are patients that have defeated cancer without chemotherapy, but this was a hard thing for me to watch. I hope that no matter what discipline of medical therapy people subscribe to, they are able to prevent tragedies like the one above.
If you do not know, ask. If you watch someone making a mistake, tell them, and tell them to not just take your word for it. Tell them where they can get the information they so desperately need.
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) is reserving her advice and a pharmacist is very conservative in dispensing advice, I am not sure what we can do to discourage quackery.
