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home : columnists : columnists November 18, 2017


10/25/2017
Complementary and alternative medicine

By Dr. John Roberts
thedoctor@thetimes24-7.com


I'm frequently asked by patients to comment on the use of "non-traditional" treatments or remedies they have heard or read about. I usually have to respond that I have limited knowledge about the product, but I will sometimes try to help the patient research the product or its ingredients.

The business of complementary and alternative medicine or "CAM" is booming. This is largely an outgrowth of patient frustration with traditional medical practice in America. People are fed up with the high cost of medications and other treatments as well as the perceived lack of caring by medical professionals. Many are looking for less expensive "natural" ways to deal with illness and health promotion. A government survey in 2007 revealed that 83 million Americans spent $33.9 billion on CAM treatments over the preceding 12-month period. This accounted for 11.2 percent of total health care spending that year. This number has no doubt increased since that study was reported.

Traditionally, physicians trained in the U.S. have received little or no education in CAM treatments in medical school or afterwards. This is beginning to change as more medical centers are starting to integrate CAM into their treatment programs.

Physicians are trained in the scientific method from an early age and rely on carefully designed medical studies to provide convincing evidence that the likelihood of a specific treatment working is not simply due to chance. In fact, medical treatments are frequently modified or abandoned when evidence indicates they are not as effective as initially thought, or that they are doing more harm than good. Most of us are therefore very hesitant to recommend or even comment on treatments that we do not feel have been shown to offer a significant benefit based on current scientific knowledge.

Many physicians, including me, are concerned that CAM treatments are being promoted as legitimate by an increasing number of academic medical centers without any solid scientific evidence to support their use. Some have called this "quackademic medicine," the marketing of dubious treatments that have not been shown to provide significant benefit that may, in fact, be harmful in some cases. You can read an interesting blog post, with supporting hyperlinks, addressing this issue at tinyurl.com/3dckcdo.

When researching a product, I usually do an Internet search to find information about the product or its ingredients. The difficulty with Internet search engines like Google is that the majority of the web sites appearing at the top of a search are posted by manufacturers or sellers of the product. These sites frequently look very professional.

The sites often have testimonials by patients, physicians or other scientists who are being paid to endorse the product. There are frequently anecdotal stories of people who have received benefit from the product, often without any side effects. I must stress to the readers that these sites are NOT the place to go for unbiased information. You should try to look for sites from academic or clinical institutions if possible. The URLs (Internet addresses) for reputable sites often end in .edu or .org rather than .com. You should absolutely avoid any site that is selling a product alongside their advice.

Another red flag is a web site or advertisement that says physicians, scientists, the government and others (particularly pharmaceutical companies) are conspiring to suppress evidence that the product works. If a product were indeed shown to be such an incredible scientific breakthrough with no downside, think to yourself, "wouldn't that be the lead story for every news outlet on the planet?"

Conspiracy theories aside, people should be concerned about products marketed without firm scientific evidence that they produce the desired effect and that they are any safer than other treatments that do have scientific support.

It's also important to remember that most CAM treatments are not regulated by any agency that looks out for the public interest. This is particularly the case with unregulated nutritional supplements that are not required to be monitored by the FDA.

Always remember to do your research and ask lots of questions. Check things out using objective resources like Consumer Reports, The Center for Science in the Public Interest, sciencebasedmedicine.com or Quackwatch.com.

Dr. John Roberts is a local physician. His column appears in Monday's edition of the Times, and he has a daily health tip on the front page. Dr. Roberts is one of the owners of Sagamore News Media, parent company of The Times.







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