Putting it All Together

It took several separate posts, but a comment from Dr. Val (apologies for not linking to her sooner; oversight rectified) on "What could be wrong with Positive Thinking" finally put it all together:

People desperately want to control their illnesses and will resort to any number of evidenceless therapies for psychological comfort.

That was the essence of what I was trying to say in "The Real Issue with CAM". When we as physicians fail to meet our patients psychological needs -- or more precisely, their expectations -- patients will resort to other means. CAM modalities (and their practitioners) often present themselves to patients as capable of meeting those needs.

Another comment, from MSILF:

We all need to remember that the question most often underlying the patient's words, "Why did this happen to me?"... I've seen answers that range from wonderful, where you see that a great burden of guilt is lifted, to horrible, where the doctor spiels off a list of risk factors.

When we as physicians are able to answer that real question the patient is asking us, we do them a great service. Failure to meet the needs expressed by this question, and others, is what drives them to CAM. Even a treatment without rational evidence can provide comfort, albeit by buying into magical thinking.

Note: This post is not intended to regenerate a discussion on the efficacy of CAM. I'm trying to address the physician who may unintentionally be alienating his patients by simultaneously failing to meet their needs while belittling their attempts to have them met via CAM.