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Which Doctors?
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| SOURCE: Wall Street Journal Nov. 13, 1998 Review & Outlook |
POSTED: 08/31/01 22:49:10 EDT |
Clearly American doctors will never be comfortable with the idea that an expertise in crystals or in aromatherapy should be accorded the same weight that we attach to a Yale medical degree. But the just-released issue of the Journal of the American Medical Association, devoted entirely to alternative medicine, suggests that doctors are not as closed-minded as they are often assumed to be.
Traditionally, the U.S. medical establishment has tended to regard alternative treatment as quackery, and not without reason: Some of it is. This suspicion among doctors notwithstanding, JAMA reports that four out of 10 Americans sought out some form of alternative treatment in 1997, well up from just a few years ago. And the estimated out-of-pocket spending on these therapies rose to $27 million, about the same as for physician services.
In other words, alternative medicine is a booming business, and it is interesting that the more affluent and educated you are, the more likely you are to seek it. Rather than dismissing these treatments out of hand, JAMA to its credit put them to the test. And though it found dubious results in some cases (namely, acupuncture treatment for nerve pain associated with HIV and chiropractic manipulation for headaches), it did find positive results in others. Yoga, for example, was found to be effective for carpal tunnel syndrome, an ailment caused by repetitive actions such as typing. Likewise interesting was the reported success in getting breech babies to reposition themselves in their mothers' wombs after the burning of some Chinese herbs near the small toe of the pregnant women.
Not that this constitutes a blanket endorsement. In the case of the Chinese treatment for breech babies, for example, we don't know whether success has to do with some property in the herb or the sensation of heat on an acupuncture point. Studies showing that placebos -- fake treatments given to make anxious patients feel better -- sometimes work as well as real medicine further complicate the picture, implying that the power of mind over matter may be greater than we think.
What it all suggests is that the divide between "Western" and "alternative" medicine can be misleading and artificial. Western medicine, after all, has to do with process and verification and not national origin; just because something was not discovered in an American or European lab doesn't mean it is not real or effective. Equally, one test of the good faith of alternative practitioners is their willingness to submit their treatment to testing, not least to separate successful therapies from snake oil. Indeed, it is encouraging that JAMA's special issue had its genesis in letters from doctors begging the journal for information on some of the treatments their patients were asking about.
Patients, of course, are generally concerned only with whether a treatment is effective or not, and in an ideal world that would be medicine's only concern too. But the billions of dollars at stake, the dominant role played by insurance companies and the question of certification in practice mean that power and control are often more at issue than science and truth. More research on alternative medicine won't necessarily yield us definitive answers. But tests and verification will bring us much closer to what the scientific method is all about: narrowing our research down to the right questions.
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| OUR REVIEW OF THIS ARTICLE |
| REVIEWED BY: Dr. Chris Tong |
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