More on "CAM"
Not unexpectedly, my previous post generated a measured and considered response from a true believer. [Intended to be read as respectful and not sarcastic.] That's what I get, in part, from having a clear idea of my thesis but rushing to publish its execution. Allow me to clarify, beginning with a quote from Orac*:
I reject the distinction between evidence-based medicine and "alternative medicine" as a false dichotomy. To me, the only dichotomy that matters is between medicine that has high quality scientific evidence showing that it works and medicine that does not, a category that includes plausible treatments that might work but have not yet been shown to work, implausible treatments with little or no evidence of efficacy (a category that includes the vast majority of what is lumped together as "alternative medicine"), and treatments for which the preponderance of evidence shows that they do not work.Modalities such as homeopathy, Reiki, acupuncture, etc. have not been shown to work. Over and over, mainstream researchers have tried to prove their efficacy. Hey, who wouldn't be excited about new treatments? The problem is that over and over, those experiments -- when well-designed -- have failed. Testimonials, even from initial unbelievers ("I didn't believe it would work, but I tried it and it did") do not constitute evidence.
My problem is when these "alternative" practitioners reject the idea that their modality can be subjected to scientific study. "You have to believe," or it doesn't work. That's what disqualifies it -- right there -- from being considered "medicine" at all. It's trying to claim the rights and privileges of medicine without accepting the responsibility of proving itself objectively, or at least the willingness to try.
Do they make people feel better? No doubt about it.
Many women I know claim that a trip to the beauty parlor is rejuvenating. Getting their hair washed (perhaps with a nice scalp massage), cut, styled and blown dry; maybe get a mani-pedi; it feels great! They can forget their troubles while they're there and allow themselves to be pampered. But no one would dream of calling it medicine, despite its undisputed contribution to well-being.
Perhaps that's where we can forge a compromise: If alternative therapies help, make patients feel better, enhance wellness and well-being, fine. Physicians should feel free to refer away. (In a sense, I do it all the time when I recommend chicken soup.) I'm sure there would be much greater openness from physicians to "other things that may help" as long as they're not misrepresented as "medicine." Practitioners can set themselves up in business all day long, as long as they don't call themselves "doctors." Hell, maybe I should "integrate" a hairdresser into my office. Plenty of women would surely be thrilled with the convenience!
It is by putting on airs, overreaching, and running the risk of steering their customers (not "patients") away from needed medical attention that alternative practitioners alienate doctors.
Let's reserve the term "medicine" for interventions that have either objective evidence of efficacy, scientific plausibility, or the willingness to be studied objectively (which of course runs the risk of not demonstrating efficacy, in which case includes the willingness to be discarded.)
*Actually, this entire post from Respectful Insolence about double standards says some of this more clearly.