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Re: What's wrong with Alternative Medicine?
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Re: What's wrong with Alternative Medicine? - August 2, 2005 2:46:00 PM
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Synergy
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Jason,
I'm definitely not a vegetarian, but I did have tofu for the first time a week ago and loved it. Actually, I had it in mezo soup and it was very tasty...along with the unagi, spicy tuna roll, and salmon sushi. :)
Now, back to the topic....
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Chris Adams, PT, MPT
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Re: What's wrong with Alternative Medicine? - August 2, 2005 3:04:00 PM
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truthseeker
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Interstella said "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!"
I think the point is that the alternative people do not have the scientific authority for those of us who are evidence based to recommend their services in good conscience. True, some people may benefit from aromatherapy or aura therapy but how much of that is placebo and how much of it is actual biological response that is reproducible and somewhat predictable?
If the "well educated" cannot separate themselves from the charlatans then how are we as professionals to discern between them if there is no evidentiary support for their theory? Further, how is the lay public to know when to believe and when not to?
The charlatans convince people that their treatments or devices or approaches to reducing suffering and it does not have any basis in sound science, then have they not simply stolen from people by playing on their hopes?
A friend of my wife's has a son who has been diagnosed with ADD. She did not want to put him on Ritalin and went to an alternative provider (DC) who claimed that she could cure him and that he did not actually have any type of disorder other than a food allergy. Her evaluation consisted of holding the mother's hand while she in turn held her son's hand. The DC then had the boy hold in his other hand a jar of wheat. the DC then, sensing a disturbance in the boy's aura decided that he had an allergy to wheat products. Her treatment was to have him completely avoid wheat products for one week then he would be able to eat wheat forevermore. Thank you, that will be $90. Come back next week and we will test other food products and go on until his "ADD" is cured. (and her bank account was transferred to the DC)
This is a true story. the boy finally went on Ritalin and has excelled in school ever since.
It is a pitiful human being that convinces someone who is suffering that their treatment will help when if it does, it is only in the patient's mind
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Re: What's wrong with Alternative Medicine? - August 2, 2005 6:22:00 PM
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Randy Dixon
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I agree that such practices are almost criminal, but is it "alternative medicine" or just poor ethics and science. My brother-in-law had his spine fused, not alternative at all, and predictably to me anyway, good results for a year and then a worsening from his original condition.
This happens every day, isn't alternative, and is just as harmful.
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Re: What's wrong with Alternative Medicine? - August 3, 2005 2:27:00 AM
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JLS_PT_OCS
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Yes, but we study those effects, Randy. We make a conscious effort to improve practices and sort the wheat from the chaff. It's science based. The rationale for treatment is also biologically plausible.
I agree that fusion seems overused, and no one's saying conventional treatments are a cure-all.
Tom-
That provider (I'm sure the good DCs that post here are shuddering at the story) was using Nambudripad's Allergy Elimination Technique, or NAET.
For information on it, go here:
http://www.chirobase.org/06DD/naet.html
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 3, 2005 5:46:00 AM
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chiroortho
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[QUOTE]I'm definitely not a vegetarian, but I did have tofu for the first time a week ago and loved it.[/QUOTE]LOL Chris! Good material for a commercial: 'No I'm not a vegetarian, but I DID stay at a Holiday Inn Express last night!'
Did you see the one where the accountant guys were painted up and performing like KISS? One of my favorite commercials.
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Greg Priest, DC, DABCO
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Re: What's wrong with Alternative Medicine? - August 3, 2005 9:19:00 AM
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Synergy
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ROFL Greg!!!
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Chris Adams, PT, MPT
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Re: What's wrong with Alternative Medicine? - August 3, 2005 10:34:00 AM
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interstella
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Tom, it is a problem that the 'well educated' cannot separate themselves from the charlatans. I don’t know what can be done about that really. The public need to be armed with information before they seek out an opinion. I don't know how it works in the US but until last MONTH in the UK anyone; absolutely anyone could call himself or herself a Physical Therapist or Physiotherapist. No wonder patients have been confused!
With regards to your story about the little lad with ADD; that is a sad story. Recently there has been a fair amount of publicity about the *possible* overuse of Ritalin for children with ADD and behavioural problems. There is a fair amount of anecdotal 'evidence' that some children's behaviour responds to major changes to their diet. Some children only eat absolute rubbish and it is not surprising that they have concentration and behavioural problems. I hope the medical profession addresses diet before handing out a psychotropic drug, however I am not sure that this is the case!
Jason, thanks for your kind reply – sorry I was being defensive :)
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Re: What's wrong with Alternative Medicine? - August 3, 2005 9:30:00 PM
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goodlooks58
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Science providing evidence is not always the absolute truth as we all know some "charlatans" are also very "well educated"...so the moral of the story is...take evrything with a grain of salt! and question everything even the scientists who are providing us with so-called facts. A good criminal is the one who never gets caught.....
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Re: What's wrong with Alternative Medicine? - August 3, 2005 10:38:00 PM
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Randy Dixon
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Jason,
I think you are missing my point. You are defining alternative medicine by all that you see bad in it. That is, if a treatment is not based on science, is useless or harmful, is performed by a charlatan then it is "alternative". I think others see "alternative" differently. I see this as an ethics problem, not one confined to "alternative" medicine, although more prevalent in it, largely because their are no other professionals policing each other. Being mainstream though doesn't provide immunity from this type of behavior, and being alternative doesn't mean that one engages in it.
This reminds me of the post Jon gave about the definition of EBM, most people define EBM as using the best available evidence, clinical reasoning and experience and the patients values and situation. In other words, the best practice=EBM, therefore EBM=best practice. While seeming to define both best practice and EBM, it really defines neither but just confuses the issue more.
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Re: What's wrong with Alternative Medicine? - August 3, 2005 10:39:00 PM
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Randy Dixon
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While I'm sure it will piss him off, I think Barrett's techniques would qualify as "alternative" to most. Though I wouldn't place him there under your usage
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Re: What's wrong with Alternative Medicine? - August 4, 2005 12:16:00 AM
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nari
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I think the word 'alternative' is rather out of date. Most therapies outside the medical model are referred to as complementary, and health funds are paying out for them as well.
There are unethical ones amongst them, but so there are amongst PTs, who are simply out to bring in as much moolah as they can muster. I doubt if any of the unethical PTs would ever look at this forum or any others.
Politically and morally, 'complementary' seems a better word to use. People do seem to improve with these complementary therapies, and if it is all placebo based (though we do not KNOW that), then there is no reason to decry that; most of our work has placebo effect, and we do not know for sure whether it is what we do or how we do it that really matters in terms of long term outcomes.
Nari
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Re: What's wrong with Alternative Medicine? - August 4, 2005 2:55:00 AM
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JLS_PT_OCS
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Randy,
No, I think I understand your point perfectly well.
I agree, that there are transgressions on both "sides of the fence" so to speak, and I think you are right to describe this not as an alternative medicine problem, but as an ethics problem. I completely agree.
However, it is my position that those in the alt-med community have this as a serious problem, not just as one facet of their care. Much like placebo, about all we can do is try to control it to the best of our ability, and realize that we shouldn't be engaging in something that we know or have good reason to believe works through placebo alone.
I'll use Barrett's work as an example. I don't consider it alt-med because it has a biologically plausible mechanism and all aspects of it are well supported in the basic science research. He makes no supernatural claims of efficacy or mechanisms, and goes to great pains to illustrate the research and science behind what he does.
To me, that is the difference between him, and say, Reiki, which relies on a biologically nonplausible and supernatural explanation. So does much of other alt-med, from the subluxation to therapeutic touch to myofasical release.
I think everyone who points out the difficulty of defining what is "alternative" also has a good point about how inadequate that term is. Many in the alt-med world think it just means "complimentary" as Nari suggests, but I think that term fails to address some of the core issues with the way alt-med treatments are designed, taught, performed, and billed for.
My use (which I agree is an operational definition only) centers on those other issues, not from the separation from 'conventional' care.
Alternatives to something are OK. Placebo fairy tale treatments are not.
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 4, 2005 3:43:00 AM
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Diane
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Some dictionary definitions, because I'm in a picky mood today...
Complementary: 1.completing; forming a complement. 2.[of two or more things] complementing each other. Often confused with complimentary.
Complimentary: 1. expressing a compliment; praising. 2. [of a service, goods, theatre ticket, etc.] provided free of charge. Often confused with complementary.
And while I'm at it:
Alternative: adj.1.[of one or more things] available or useable instead of another (an alternative route). Use with reference more than two options (e,g, many alternative methods) is common, and acceptable. 2. (of two things) mutually exclusive. 3. of or relating to practices that offer a substitute for the conventional ones (alternative medicine; alternative theatre). n.1. any of two or more possibilities. 2. the freedom or opportunity to chose between two or more things (I had no alternative but to go.)
Note how the word "alternative" sets up an idea that the two or more choices are equally valid (chiro does this by pitting itself as a profession against medicine.)
Note how "compLImentary" means without fee. Yikes.
Note how "compLEmentary" means something that completes or rounds out.
My choice of word for PT as a whole in relation to medicine, complementary. My choice for what I do in relation to "normal PT", complementary usually but sometimes alternative; never mystical.
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Re: What's wrong with Alternative Medicine? - August 4, 2005 4:05:00 AM
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Barrett
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Wonderful addition to this discussion Diane, but maybe the words alternative and complementary now carry so many connotations (and so many negative ones for scientists) that they've become useless if not actually meaningless. There's no fixing this-it's simply the nature of language as the culture forms it every day.
I wrote something (yes, yet again) a few years ago titled "The Third Way" that can be found on my site which states in part: "In his book "Skeptics and True Believers" (Walker and Company 1998) physicist Chet Raymo describes a strong reductionist view of physical law and compares it to the view of those who see things in a way that is far more complex and unpredictable. He likens the simplest explanation of any phenomenon to the number 1, and the complex view to the number 5. Somewhere in between, he says, the human mind dwells most comfortably, its perceptions and knowledge wavering between that which it is sure of (planetary movement, for instance), and that which it strains to understand and predict. The turbulent flow of fluids is a good example of that.
As a therapist who commonly treats painful problems, I often find myself confronted with problems in my patients that are either predictable in their presentation and recovery, such as a post-operative shoulder, or as unpredictable as the weather. I’d place a lot of spinal pain in that second group...What I’m proposing here is that there is yet another way of practicing that doesn’t confine us to the ineffective traditions of practices long outdated, yet doesn’t require we abandon our scientific heritage. I call it “The Third Way,” and I describe it as a practice that never justifies its existence because it “works” (whatever that may mean), but, instead, continually strives to make sense of its methods and conclusions by strictly adhering to whatever physical law or physiological process is known to be relevant."
Randy, the way fierce conversations go, your opinion doesn't anger me at all. Given the opportunity to further interrogate reality with this forum I think we might come to an agreement. Am I right?
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Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: What's wrong with Alternative Medicine? - August 4, 2005 5:26:00 AM
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Diane
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I like the idea of a "third way", one that expands our profession by virtue of taking into account more body systems/ bits of reality/greater number of variables, all operating according to the complex laws of self-organizing principles in nature, through time. What would a good name be for that? "Comple-ter-native", "Completnative", "Alternementary"? How about "Complexementary"?
Complexementary is my favorite so far.
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Re: What's wrong with Alternative Medicine? - August 4, 2005 6:05:00 AM
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JLS_PT_OCS
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Another resource:
http://www.valleyskeptic.com/altmed.htm
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 4, 2005 9:40:00 AM
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chiroortho
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[QUOTE]Some dictionary definitions, because I'm in a picky mood today...[/QUOTE]I'm with you on this...kind of like when someone says 'irregardless' or uses malapropisms repeatedly.
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Greg Priest, DC, DABCO
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Re: What's wrong with Alternative Medicine? - August 4, 2005 10:22:00 AM
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OaksPT
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Sorry Greg,
The I think the word you intended to use was priapism; :)
scott
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Scott Oaks PT,DPT
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Re: What's wrong with Alternative Medicine? - August 4, 2005 11:32:00 AM
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Lukey
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Nari,
That is definitely true of the situation in Australia, where all of the more commonly sought 'alternatives' are now called 'complementary' and have found their way into an EBM university environment. Naturopathy, acupuncture, herbal medicine and massage therapy are all university degrees now. However, I get the feeling we are fairly unique in this regard.
I think eris approach has been very beneficial because it requires of course organisers that the teaching content has a solid basis in biologically plausible and EBM context, thus exposing students to the type of academic rigour we value so much. Because of this requirement shamanism, Reiki, crystal healing etc obviously remain excluded. It also gives the public more confidence in non-medical approaches and lessens the language barrier between complimentary practitioners and medicos.
It has been interesting in my course to watch much of the outdated concepts in osteopathy be either actively challenged by many members of the faculty or quietly swept under the carpet in order to comply with the university requirements for EBM. The course in Melbourne cut cranial technique last year and it is on the way out in the Sydney course.
Luke
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Re: What's wrong with Alternative Medicine? - August 4, 2005 1:09:00 PM
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Randy Dixon
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I'll use Barrett's work as an example. I don't consider it alt-med because it has a biologically plausible mechanism and all aspects of it are well supported in the basic science research. -Jason
Exactly my point about using your negative belief to define alternative.His approach certainly isn't mainstream, well accepted or widely used. I think he suggests the "third way" but I think generally the word alternative would apply. (although I agree that the connotations now attached to the word make it useless).
Four months ago you probably would have agreed with me that it was alternative. Your acceptance of it would have to either change your definition of alternative, or whether it belonged there.
Barrett,
I'm glad you didn't see my comment as being insulting.
Can we come to an agreement about it? I read your post and I think we already have.
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