CAMLAW: Complementary and Alternative Medicine Law Blog

March of the alternative meds

If you liked "March of the Falsettos," you'll like this post on march, march, march of the alternative meds.

So sayeth the US News & World Report in a piece called, The March of Alternative Medicine:

Another year, another report on the ostensibly growing embrace by hospitals of complementary and alternative medicine--or integrative medicine, as many practitioners prefer to call CAM because "alternative" has dubious vibes. The American Hospital Association has just released a new survey showing that about 37 percent of the hospitals that responded offer one or more CAM therapies such as acupuncture, massage therapy, and guided imagery, up from about 26 percent in an AHA survey in 2005.

I requested the survey and looked it over. I've walked the CAM beat for more than three decades, and my antennae are always sniffing for data true and false. Early this year, a cover story I wrote about CAM's spread into academic medical centers took heat from CAM detractors (for buying into a passel of woo-woo nonsense) and supporters (for mindlessly rejecting effective treatments just because they haven't passed conventional standards of evidence) alike. There's no middle ground with these folks.

For what it's worth, my position hasn't changed in the three-plus decades I've walked the CAM beat: I won't reject anything out of hand, but please don't feed me success stories from grateful patients and results from poorly designed or executed studies. There is no substitute for good clinical trials.

There's also no substitute for good surveys, and I'm not sure this one qualifies. The claim of CAM growth is based on a paltry survey response of 12 percent--748 hospitals out of 6,439 surveyed. And while 748 may seem high enough, such a low response rate all but guarantees that hospitals offering CAM were likelier to respond. The AHA staff member who ran the survey (he didn't design it) agrees that such a "positive bias" is unquestionable.

Yes, indeed, biases never change. There's always quacking (not quaking) about quackery too.

One of my friends is a skeptic. A BIG time skeptic. We have begun an email-pal relationship where he shares some of his resources with me. This began as a result of some of the articles I wrote about complementary and alternative medicine. It continues on other topics, too.

He points out to me -- and he's right -- that gullibility is the underlying reason people get sucked into promises made by those who are in no position to make them. Of course, the reason those snake oil salesmen (and women) are out there is because they want to separate us from our money.

There is more to the gullibility, of course. When we are fearful of disease or treatment, we just want to believe there is any simple and painless cure. Once we know there is no simple or painless cure, then we go in pursuit of one that may be not so simple, but will still cure us. Fear plays tricks on us and forces us to make choices that are foolish. And those foolish choices mean we give our money to someone who has pretended they have a way to fix us.

Meanwhile, JAMA reviews CAM in "Integrative Pain Medicine: The Science and Practice of Complementary and Alternative." And from the CDC, "This Quick Stat report from the CDC MMWR reports 38% of adults reported use of complementary and alternative (CAM) practices in the preceding 12 months. The most common use of CAM was for the treatment of low back pain. Complementary and alternative medicine is a collection of diverse medical and health care systems, practices, and products that are used by millions of Americans to treat or lessen disease."

Here is a program using complementary therapies for cancer care:

The Gawler Foundation's lifestyle programs can help people with cancer, MS or other serious illness to improve quality of life and increase their chances of survival. Since 1983, this world-leading not for profit organisation has helped thousands of people to activate the body's own mechanisms for healing. "The Gawler Foundation presents a lifestyle program which focuses on how people can be helped to work with the medical treatments they are having to actively play a part in improving their quality of life and to ncrease their chances of survival," said The Foundation's Therapeutic Director Dr Ian Gawler. "We believe that a lifestyle program is an essential part of best practice management of cancer and needs to be available and encouraged for everyone from the point of first diagnosis, just as in heart disease and type 2 diabetes."

He said it was important to distinguish and be very clear about the wide range of different programs and treatments available when making a decision about how to tackle serious illness.

"There are significant differences between what is on offer from conventional medicine, lifestyle programs, complementary and alternative medicine," said Dr Gawler.

"It is important to define and then differentiate these services in terms of what they offer, what validity they have and how they are regulated.

"One of the reasons The Gawler Foundation is very supportive of conventional medicine and its allied health professions is that they have a strong commitment to research and are well regulated by the medical board and other professions," Dr Gawler said.

"We are also supportive of many of the practitioners of complementary medicine. Such practitioners commonly include doctors and Allied Health Professionals who are already registered by a recognised regulatory body.

"It is important that lifestyle programs offered by The Gawler Foundation be differentiated from the practice of complementary and alternative medicine.

"A lifestyle program focuses on what a person can do for themselves and includes the support of family and friends," Dr Gawler said.
"Complementary and alternative medicine involves going to a practitioner for help or taking herbs, supplements and the like. A lifestyle program is self-empowering while complementary and alternative medicine requires outside help. "The Gawler Foundation is fully committed to making its lifestyle program available to all people affected by cancer in Australia."

For more information, phone The Gawler Foundation on (03) 59671730 or visit www.gawler.org

Many readers are familiar with the AHA's latest report on CAM use:

The percentage of U.S. hospitals that offer the following complementary and alternative therapies for their patients (Note: Services offered for inpatients):

Acupunture
2005: 12%
2007: 18%

Massage therapy
2005: 37%
2007: 40%

Music/art therapy
2005: 26%
2007: 31%

Reiki
2005: NA
2007: 15%

Source: The American Hospital Association

My own group had studied CAM use in hospitals some years ago and found a very high rate of use--interestingly, it was spread across numerous departments from pediatrics to geriatrics, neurology, oncology, pain management, and others.

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COMPLEMENTARY & ALTERNATIVE MEDICINE LAW BLOG

Michael H. Cohen, Esq.; 468 North Camden Dr. | Beverly Hills, California 90210 | 310-844-3173