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Re: What's wrong with Alternative Medicine?
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Re: What's wrong with Alternative Medicine? - July 30, 2005 11:14:00 AM
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Jon Newman
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Ah yes. I think it would be much better for someone who would actually benefit from a psychologist to go to a Reiki practitioner instead. I'd hate to be consistent with our code of ethics which asks us to make appropriate referrals.
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: What's wrong with Alternative Medicine? - July 30, 2005 12:23:00 PM
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interstella
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Jason
As Duffy says, what does it matter if a patient is helped by herbal medicine or acupressure? I can’t see the problem. If swinging from the lampshades and doing Buddhist chanting relieves Mrs Bloggs’ back pain. Let her do it!
On a more serious note, you are implying that only knowledge that comes from research is valid and that only 'people in white coats' know best. Frankly, I find this view old fashioned :) Here in the UK the idea that 'doctor knows best' is gradually being eroded and medical students for example are receiving training in complementary medicine. This can only be good for patients.
I find it bizarre that you can disregard such a massive field. As I mentioned before, there are nutters out there, but there are also alternative practitioners who are well educated and who offer a good service. I think we have to be open minded as a profession, especially as science is never going to give all the answers - we are not dealing with petri dishes where every variable can be accounted for!
Back to your original question, why am I pro alternative medicine? I can only speak from personal experience. After suffering from a medical condition for many years which conventional medicine failed to offer any relief. I sceptically visited an alternative practitioner who has made miraculous difference. It may be placebo, but do I care? Just like Mrs Bloggs all I care is I'm better!
But I guess nothing I can say will change your mind :D
Best wishes
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Re: What's wrong with Alternative Medicine? - July 30, 2005 2:05:00 PM
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Diane
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I just can't agree entirely with you, interstella.. I like to think that a hundred years ago, at the turn of the last century when everything was up for grabs and quackery abounded, when a plethora of "alt" professions were exploding outward into the public domaine... I like to think of PT as having been the sane world's answer to quackery, that we were the first group of secular "healers" and rehabbers that the world had ever seen, that we were sorely needed, and served to provide a neutral zone between members of the public and all the scammers that were replicating like mad out there in the world, ready to separate suffering people from their hard-earned $.
We have managed to get along so far on our rational wits, have strived to carve out a place for science in our profession, indeed have always attempted to give it centre stage, even while we flew by the seat of our intellectual pants and were quite creative in developing treatment plans. At least we allowed no space for vitalism (instead of building professions on it as did Reiki, chiropractic, etc., or giving it a passing nod as did osteopathy), much to our credit. We've got a way to go yet, but there's been a lot of improvement in the last, oh, 20-25 years.
Right now we seem to be in a bit of rough sailing but guess what? We should stick with who we are and what we do and how we cognitively get there. Look how far we've come in a mere century doing just that. We are an invincible profession, really, rational AND caring. Each of us as individuals needs to make a peace with the goals of the profession as we grope through life. This necessitates certain essentials:
1. Not losing mental ground to the quacky memes that surround us;
2. Being careful to not pass them on to patients;
3. Having patience while science pushes out answers that are based on material reality.
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Re: What's wrong with Alternative Medicine? - July 30, 2005 4:49:00 PM
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Lukey
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In many cases, what makes an intervention alternative is not so much the event itself but the explanation for it.
Acupuncture and herbal medicine are good examples of this (and there are many others). Base your reason for putting needles into the body on imbalance of life force and it is alternative, but base your reason on neurophysiology/fMRI studies etc and call it intramuscular stimulation (IMS) and it is then acceptable to conventional medicine, even though on the surface the treatment looks exactly the same. Base your reasons for giving herbs on excess of Liver Yang or Kidney Yin deficiency and it is alternative, but prescribe those same herbs according to their active components and call it phytotherapy (or extract and concentrate them and call it pharmacology) and again it is acceptable to conventional medicine.
The issue is the biological plausibility of the theory, not so much what happens on the surface. Of course the only biologically plausible explanation for many alternatives is the placebo response, and these we should obviously steer clear of if credibility is to be maintained. However, to dismiss a particular intervention because of its original philosophy may be premature, and conversely, to dismiss a plausible intervention because it looks like something ‘alternative’ may also be premature. Science and time will tell.
Luke
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Re: What's wrong with Alternative Medicine? - July 30, 2005 5:02:00 PM
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Jon Newman
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Bulls-eye Luke R.
Also, there is some effort required on the practitioner's part to explain why what they are doing works to the patient especially when there is an historically inaccurate understanding in place. I think skipping this step leaves the implicit understanding that the historic reasoning is accurate. Those are my feelings anyway but I'm sure there are many that don't care why it works. Still, an effort to explain at least leaves the idea that it isn't because chakras (or whatever) are messed up.
jon
_____________________________
[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: What's wrong with Alternative Medicine? - July 30, 2005 5:10:00 PM
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Lukey
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Jon, I totally agree. That is very important.
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Re: What's wrong with Alternative Medicine? - August 1, 2005 3:56:00 AM
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Barrett
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I should first of all thank Jason for sending people to my site to read Stenger’s work. My stats page indicates a few have actually done this.
Luke’s post was especially appropriate regarding biologic plausibility. This combined with physical possibility is what keeps me open to any theory of care. Without them my mind wanders. Alternatives rarely if ever contain both.
Here’s a passage from Michael Shermer’s “Science Friction-Where the Known Meets the Unknown” that I think fits here:
“The anthropologist Bronislaw Malinowski discovered that the level of superstition among Trobriand Island fisherman depended upon the level of the uncertainty of the outcome-the farther out to sea they went, the more complex their superstitious rituals became.”
Shermer goes on to relate this level of superstition to baseball players, the best of whom are unsuccessful nearly seven times out of ten at the plate. Many perform numerous rituals in preparation for this task and will admit to numerous superstitions regarding their offensive performance. The same player will have virtually none of this same activity or superstition about his fielding where his performance flirts with perfection most of the time.
Isn’t it true that alternatives are much more so easily found when the diagnosis includes a chronic and somewhat mysterious disease, including spinal pain? In effect, those of us willing to treat such patients often enough feel “out to sea,” something I’ve written of several times. (See “Lost” on my site)
In the end, the growth of alternatives is more about the presence of hope than the presence of reason. This shouldn’t surprise us.
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Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: What's wrong with Alternative Medicine? - August 1, 2005 6:59:00 AM
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JLS_PT_OCS
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I'm not sure what I can do to improve on Luke, Barrett, and Jon, but...
Interstella-
I can disregard many entire fields.
The entire field of astrology, for example.
Or the subluxation theory of chiropractic. Or the energy theory of Reiki. I disregard all of these. Shouldn't you?
Now, if something has some biologic plausibility to it, is undertaken without a supernatural explanation to the patient, and other more evidence-based methods have failed, then I'm all for trying something different.
But that seems to have little to do with the theory and practice of alternative medicine as it exists in the places I have seen, experienced, and read about it in.
I think a lot of "alternative" methods are being tested now, to determine whether they are successful beyond placebo or random chance, whether the practice or the theory is the important aspect, and what aspects are useful vs what need to be abandoned.
I'm all for testing things and determining where there may be a valuable treatment. But that happens rarely, if at all, in the alternative community. Indeed, even many nationally known healthcare providers who work in the CAM field now have their reputations and funding on the line for whether these many treatments work or not. Not the most conducive academic atmosphere, is it?
It's when making money and superstitious explanations prevail over sensible recommendations and attempts to study practices that I really start to get a sarcastic attitude.
I think this is warranted, and may even be necessary. I see far too many healthcare providers with a very permissive attitude toward quackery that they try to sell as being "open minded". This sort of thing needs to be nipped in the bud.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: What's wrong with Alternative Medicine? - August 1, 2005 11:01:00 AM
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anoopbal
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[QUOTE]It's when making money and superstitious explanations prevail over sensible recommendations and attempts to study practices that I really start to get a sarcastic attitude. [/QUOTE]I this goes back to what I said about care takers who really want to help people or who just do it to make more money.
Jon agrees with mixing some alternative medicine to relieve pain by giving them what they want and then proceed with proven techniques. Black magic practioners recommends alternative medicine either because they are trying to make money or bcos of sheer ignorance. The big difference between two of them is that Jon really wants to help people whereas black magic guy just wants to make money thohg they both advocate alternative (but to different degrees).
For all the people who believes in alternative medicine, what advise would you give to someone who comes with a chronic pain and ask about the best alternative medicine? If you recommend a particular therapy, on what basis did you select the particular therapy?
Anoop
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Re: What's wrong with Alternative Medicine? - August 1, 2005 1:26:00 PM
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interstella
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"I disregard all of these. Shouldn't you?"
Jason, you miss my point. As I mentioned, there are plenty of lunatics that spout a complete load of crap, I am not defending everyone who practices 'alternative medicine.' I was disputing the fact that your posts on this subject suggest you disapprove of all forms of practice that aren't conventional. To me this is blinkered. We have a lot to learn from other cultures and practices. We aren’t always right, in fact we are often wrong.
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Re: What's wrong with Alternative Medicine? - August 1, 2005 9:16:00 PM
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goodlooks58
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Barrett: "Presence of hope" without the "presence of reason" is same as the power of placebo. There are numerous instances of spontaneous remission of cancer in the medical literature probably from power of hope and/or power of prayer. So what is wrong with some hope filled therapy when there is no hope left for treminally ill patient given a few months to live? Another example of alt med is the power of Meditation. Meditation does not require any pill to take or money to spend so drug cos. are making no money...so meditation has very little place in our western society. A few months ago TIME magazine did a full write-up on Transcendental Meditation--has been proven to reduce blood pressure and in my opinion, high blood pressure is the reason for high cholesterol. If the blood is being pumped fast in the arteries, the body's reaction is to put up plaques in it's way to reduce the flow...just like how we put up cement blocks around our house when there is flooding. Mediatation takes time and discipline, and since we all want a pill to solve all our problems, drug cos are making billions. Immediate gratification is root of all beliefs in pills and chiros!
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Re: What's wrong with Alternative Medicine? - August 1, 2005 10:16:00 PM
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Lukey
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goodlooks,
Another good example. Call it meditation and it is alternative, but stick monitors on yourself and call it bio-feedback and it is not. As to why meditation is not practised more widely, it is probably a little more complicated than you suggest. I think meditation (self-reflection) is more an 'alternative behaviour' than an 'alternative medicine', and as Barrett points out, alternative behaviours aren't often encouraged in our society.
As has been mentioned, absence of biological plausibility and physical possibility are the main problems with AM. Did the cancer patient go into remission because of some kind of spiritual intervention, or because the human emotion/thought of hope changes our physiology in some unknown way (PNI perhaps)? We don't yet know why, but saying 'it worked' isn't reason enough to not persue the answer objectively.
Obviously there is nothing inately wrong with hope, but generating that state via fanciful philosophy or unsubstantiated treatments and charging for it is wrong. At its worst this can generate a false hope which may be extermely damaging to patients and their families in the end stages of terminal disease (visit quakwatch.com for more on this).
Luke
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Re: What's wrong with Alternative Medicine? - August 2, 2005 1:49:00 AM
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Barrett
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Goodlooks,
This is a complicated subject that we discuss while walking through a religious minefield. I'm reminded of the feeling I get when I point out to a patient that they are distinctly improved in several ways. "I hope so," they say, and my heart sinks.
Assigning improvement to the "power of hope and/or prayer" also carries with it questions about the "faith" within those who don't get better. See what I mean about a minefield?
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Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: What's wrong with Alternative Medicine? - August 2, 2005 3:11:00 AM
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Jon Newman
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[URL=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11657244&query_hl=1]This article[/URL] might help inform the topic a bit more.
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: What's wrong with Alternative Medicine? - August 2, 2005 3:21:00 AM
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JLS_PT_OCS
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interstella-
I'm not against anything that isn't conventional medicine. If you think this, please reread my posts.
I am against specifically the belief system, money making schemes, and philosophy parts of alternative practices, which Luke summarized quite well above.
You mentioned Andrew Weil before... I bought his "Six weeks to Optimum Healing" (is that the right title?) several years ago when I developed an interest in medical quackery. Needless to say, it's been way more than 6 weeks, and I don't consider myself optimally healed. Especially not with the philosophy garbage he was spouting.
I support efforts to study and bring to light and use beneficial aspects of alternative practices. But not the philosophy baggage, and those other aspects. I earlier used acupuncture to illustrate this point.
Scientific pursuit of mechanisms and usefulness = good.
Philosophy and money making without studying a practice = bad.
Jon, nice link.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: What's wrong with Alternative Medicine? - August 2, 2005 8:10:00 AM
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interstella
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Jason
I have never read anything by Andrew Neil in fact I have never heard of him until this week! I said he was talking sense about medicine being open minded - I was replying to the quote listed in the previous thread. I think we are at crossed purposes - I might eat tofu, and use some alternative medicine but I'm not some weirdy sandle wearing, tree hugging, hippy, looking to heal the energy within.
*sorry to disappoint ;) *
With reagrds to acupuncture - western practitioners have adapted a modality used within a different belief system. Without the eastern belief systems we probably wouldnt be using it right now.
Anyway ... I best go I have to go and ground my life force.
x
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Re: What's wrong with Alternative Medicine? - August 2, 2005 8:20:00 AM
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JLS_PT_OCS
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interstella-
I didn't presume a thing about you, actually.
Plus, being probably the only Vegan in the audience, it seems "I'm" the tofu eater around here... :)
If our purposes are to explore the use of alternative medicine practices and what our profession should think of them, then I think we are lined up pretty well.
I'm not sure acupuncture needs the belief system to attract interest in the scientific community --indeed, my opinion is that the philosophy lengthened rather than shortened the time it took to begin to be tested.
Weil's implication that "open minded" equals surrendering critical thinking skills is what irked me. FAR more research is being done in medicine than the alternative methods Weil supports. What's more open minded than a dispassionate study of one's practice? Alt med types seem to think that open minded is the same as beleiving fairy tales. I beg to differ.
My beef isn't with you, I hope you're not offended.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: What's wrong with Alternative Medicine? - August 2, 2005 8:30:00 AM
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OaksPT
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Jason,
Beef=Freudian slip
Is it difficult to control your cravings? :)
Scott
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Re: What's wrong with Alternative Medicine? - August 2, 2005 8:58:00 AM
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JLS_PT_OCS
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Heh, heh... nice one. :)
My cravings for the flesh of dead animals?
Those are long gone.
Food is to eat. Animals are to love. Whether cats or cows.
:)
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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