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Once More Unto the Breach, Dear Friends, Once More... PDF Print E-mail
Swift
Written by James Randi   

Please forgive me if I hammer once again at this theme, but I see that just this month, the prestigious Mayo Clinic has issued a lengthy report that stresses the importance of not accepting "alternative medicine treatments ranging from herbal remedies to acupuncture" simply because they have become more popular and offer more options, cautioning that these treatments aren't always proven safe or effective. The report asks that people "Be open-minded yet skeptical of medical claims." While I certainly agree with this advice, and it's stated in an appropriately caring, polite, and skeptical fashion, I'm somewhat alarmed to see that the report also contains:

With any alternative treatment you consider, find out if the potential benefits outweigh the risks. It's a good idea to talk to your doctor and do research on your own before trying any treatment.

With due deference to the authority of the Mayo Clinic, I will state that I have met - quite recently - fully-qualified, licensed, practicing physicians who have endorsed or at least tolerated various aspects of quackery - especially acupuncture. Though innocently presented, such professional opinions originate in benign ignorance. Never assume malice when incompetence will do.

One of the references at the end of the report - at tinyurl.com/mqsfgs - bearing the same respected imprimatur of the Mayo Clinic, repeats the same ragged almost-endorsements of acupuncture that I've found all through the "orthodox" outlets of the medical profession, a seeming reluctance to call nonsense by its proper name for fear of being rude. Duh. These deluded quacks don't deserve any courtesy, consideration, or sympathy, and no matter whether they devoutly follow medieval Chinese or Indian mythology, or have developed their own cute variations of the idiocy, they are dangerous people.

What irritates me most about this situation, is that endless tests of acupuncture have been done, all over the globe, and the notion has failed, and failed again, to pass those tests. It seems to me that the Mayo Clinic - and Sloan Kettering, Cancer Treatment Centers of America, National Institutes of Health - have the financial and technical means to conduct a proper, thorough, extensive, definitive, comprehensive, test to determine whether acupuncture actually works, or not. It can be done, and though it could add the quacks to the ranks of the unemployed, it would provide rational people with a standard to which they could refer. Hey, it was done with the practice of blood-letting, so why can't it be done with this variety of wrong thinking?

This is the 21st Century, not the 14th...

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written by ConTester, September 06, 2009
Hmm, maybe acupuncture is blood-letting, but done to homoeopathic standards.
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written by garyg, September 07, 2009
Some tests of acupuncture that I've seen in the press are allegedly positive, thus adding to the confusion.

Weighing the "benefits vs. risks" may lead people to think "What's the harm?" (as a skeptical website is named) because
placebos DON'T harm (or materially help).
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Medicos & Skepticism
written by Michael K Gray, September 07, 2009
Steven Novella has observed that even properly trained medical doctors do not receive adequate formal training in the scientific method.
This can result in doctors who's bullshit detectors are turned down to near zero.
They spend more time learning Latin than critical thinking.

And as for the advice: "...do research on your own...";
we all know what that research will entail for the average consumer:
The University of Google

And we all know that every ounce of medical advice on the intertubes is 100% accurate, science-based, and up-to-date!
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written by Otara, September 07, 2009
While Im sure its partly lack of the scientific method, its mostly just avoidance of conflict in my experience as someone who works in a multidisciplinary setting. As long as its seen as 'fairly harmless' it tends to be avoided unless theres a majority of anti woo types, and only the really 'in your face' stuff tends to get challenged.
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written by Paulhoff, September 07, 2009
“This is the 21st Century, not the 14th”
Randi, many times I have said over the years, that I would like to drop the first three digits of the year that is on the calendar, so it would be the 1st Century. You can’t take the “Human” out of “Human Beings”, as you can’t take the Magic out of many people’s “Thinking”.

Paul

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Issues with Mayo Clinic Health Letter
written by Rustylizard, September 07, 2009
I have had issues with Mayo too - with their health letter. On more than one occasion, the publication had touted the involvement of clergy in medical settings. If a clergyman came into my hospital room uninvited, it would only send my blood pressure soaring—very unhealthy for me. The letter also printed an article recommending Alcoholics Anonymous as a treatment for alcoholism. That organization may or may not be effective—there is plenty of doubt. But I wrote a letter to the editor complaining that a patient’s personal faith or lack thereof was none of the Mayo Clinic’s business. I also suggested that if they were going to endorse an organization to help alcoholics they should give equal space to the Secular Organizations for Sobriety.

I received a reply from the then-current editor—a condescending lecture, of sorts. I assume he was a devout protestant because he referred to Martin Luther. I, in turn, replied with a quote from Luther: “I confess that mankind has a free will, but it is to milk kine, to build houses, etc., and no further,” hardly an endorsement to become a physician. I requested that my subscription be canceled. I must have pissed the editor off badly. I never received a refund.
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written by bosshog, September 07, 2009
The world is full of "authoritative voices" willing to say what their audience wants to hear in order to retain their authority. I listen to them all with a presumption of their duplicity.
On the other hand, the individual physician working in the trenches has to work with what he's got. If he tries too hard to wean his patient off a belief in woo the patient will most likely hold onto his beliefs and turn away from the physician. So the physician shrugs off CAM the way he shrugs off alcoholism or poor dietary habits in his patients and does what he can in spite of it.
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@Paulhoff
written by CasaRojo, September 07, 2009
But you can help people to be humans being smart. Which in turn will help to keep magical thinking in the theater. smilies/smiley.gif
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written by Captain Al, September 07, 2009
Doctors are subject to falling for woo as much as the next guy. Personally, I have never met a doctor that I would trust my life to; I've seen and experienced too much of their incompetence. This is why I avoid modern medical treatment like the plague (pun intended). However this does not mean I would consider these so-called alternative treatments. If I won't trust a person who went through 10 years of modern medical training there's no way I'm going to trust someone who has no medical training at all. I'll take my chances with no treatment thank you very much.
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written by Skeptigirl, September 07, 2009
written by Otara, September 07, 2009
While Im sure its partly lack of the scientific method, its mostly just avoidance of conflict in my experience as someone who works in a multidisciplinary setting. As long as its seen as 'fairly harmless' it tends to be avoided unless theres a majority of anti woo types, and only the really 'in your face' stuff tends to get challenged.
It would be interesting to discover how much was about not wanting conflict with patients' beliefs and how much was lack of applied critical thinking. I can see that in an individual patient encounter one would approach patient beliefs in a specific way. But a lot of the buying into sCAM by the medical profession is not occurring in patient encounters. Acceptance of sCAM as if there were actual value in it is reflected continually in medical opinions outside of the patient encounter.
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written by Skeptigirl, September 07, 2009
written by Captain Al, September 07, 2009
...I'll take my chances with no treatment thank you very much.
Really? So if a tumor were to begin growing somewhere on your body you could see it, or you started having significant chest pain walking up stairs, you'd opt for no treatment?

Something tells me that's BS.
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written by Paulhoff, September 07, 2009
There are three main conditions that people have, one is being smart another is being dumb and the third is being ignorant.
We all are ignorant about something, one cannot begin to know everything.
But being smart and ignorant is a good combination, because with being smart we have the ability learn.
Being dumb and ignorant is a bad combination, because no matter what you do, people that are dumb will always be dumb no matter what you do, and the best thing you can do is to run away from them.

Paul

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written by Otara, September 07, 2009
"Acceptance of sCAM as if there were actual value in it is reflected continually in medical opinions outside of the patient encounter."

Im talking about avoidance of conflict between professionals as well as between professionals and patients.

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@Captain Al
written by CasaRojo, September 07, 2009
"I'll take my chances with no treatment thank you very much."

I think you should seek out a good GP that you can trust. That may be difficult depending on your circumstances. I can understand where you're coming from though. I've many personal anecdotes regarding health-care. I was told by my GP that I had squamish cell carcinoma and was referred to a dermatologist. The specialist confirmed this and said I would need facial reconstructive surgery after the surgery to remove the cancer. My GP and the specialist were confident of their Dx. BTW before the specialist would do the biopsy, I had to pay up front as I have no insurance. Then there was the botched Lasik eye surgery where they doubled my astigmatism instead of eliminating it. And the doctor that gave me a script for nitro glycerin for chest pains without one single test. It goes on...... BTW, the biopsy was negative for cancer. An uneasy ten days.
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Redundancies?
written by Liveliest Crib, September 07, 2009
Be open-minded yet skeptical of medical claims.


At the risk of being pedantic, "skeptical" is "open-minded." Oh, I know they mean that we should be "willing to believe, but not gullible," but skeptics are -- by definition -- willing to believe. Contrary to popular [ahem] beliefs, which apparently define "open minded" as virtuously non-judgmental about even the most ridiculous of claims and "skeptical" as rigid, mean-spirited disbelief, a skeptic's mind is always open. We just have evidentiary standards for the beliefs we will adopt, and place the burden of proof upon anyone making a claim. Often, those who demand an "open mind" to their claims, really mean that we should stop pestering them about proof, and just believe as they do.

With any alternative treatment you consider, find out if the potential benefits outweigh the risks.


With any alternative treatment? Uh, weighing benefits against risks is the proper approach for any medical treatment. The problem is that laypeople are not sufficiently educated (at least in my home country of the USA) to know how to evaluate whatever information they get. If we're lucky, we'll be taught what to think, but rarely will learn how to think.

It's a good idea to talk to your doctor and do research on your own before trying any treatment.


All well and good if we're armed with a method for evaluating the avalanche of medical claims we'll encounter. Perhaps the Mayo Clinic would do well not just to conduct an authoritative study on such alternative treatments, but to teach patients how to think about medical truth claims in general.
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Annnnnnd.......
written by CasaRojo, September 07, 2009
After I received the good news that my "cancer" was benign, I picked up a copy of the biopsy report from the dermatologist's office. There were but a couple of sentences that said the growth was simply a certain type of wart. A few weeks later I received a bill in the mail for about $100.00 for the dermatologist reading the report. I had asked them, when they demanded payment up front of over $300.00, if that was to be the entire fee for the biopsy procedure and they had said "yes". I politely refused to pay the bill on those grounds. They were insistent, I don't care. Perhaps I didn't ask the exact right question. I tried and someone should have known that there would be more fees and should have told me so. IMHO. I'm sure that *I showed them*, ha ha right. It's a sad state........
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patient research
written by jer, September 08, 2009
This reminds me of my friendly neighborhood sCAM doctor. He encourages people that when they do their own research and bring it to their appointments, he will be open-minded and willing to make use of what they've found. Can you imagine the crap load of nonsense that invites into his practice? The thing is, he deals mainly in placebos, so this invitation serves two purposes: 1) it makes him sound open-minded, and 2) it lets him tailor his fake cures to something they are predisposed to believe in, making "success" more likely.

Is there any other reason for such a nonsense offer? Medicine in our society is so advanced and so complicated, there's no actual constructive reason to turn untrained people loose on the internet to dredge up every idiotic rumor they can find. I don't tell my mechanic how to fix my car, I don't tell my electrician how to fix my wiring, and I don't tell my doctor how to fix my body.
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Regarding patient research
written by Rustylizard, September 09, 2009
@jer
I certainly understand your concerns. Some MDs will exploit the use of alternative garbage for financial gain. But as skeptics, we shouldn’t throw out the baby with the bathwater. Some internet sites provide excellent information, and certain university health letters (that do not accept advertising) provide detailed up-to-date information on many medical subjects from renowned experts in various fields. Over the years, I’ve discussed many issues based on these sources with my doctors. Let me give you three examples:

1. For years, I suffered from excruciating headaches. Both an emergency room physician and my own general practitioner diagnosed them as tension headaches. They were not. An article in one of my health letters suggested headaches are frequently related to diet, and after keeping a diary of what I had eaten, I found the culprit turned out to be cheese.

2. My father was dying of cancer and had just been given a transfusion due to internal bleeding. His doctor prescribed percodan which contained aspirin. I had learned from an article that the drug was entirely inappropriate for his condition. When I contacted the doctor, she quickly changed the prescription to percocet.

3. After reading about recent studies on blood pressure medications, I changed to one with similar benefits and fewer side effects after discussing it with my current family doctor.

Doctors are often extremely busy, and they don’t always know everything. It is advantageous to know as much as you can. Like yourself, I am willing to question certain doctors’ motives, but I am also willing to question their diagnosis if I have a sound basis for doing so. A GOOD doctor will welcome your input if you offer quality evidence.


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@Rustylizard
written by jer, September 09, 2009
Thank you - you're certainly right. I'm not against the idea of patients looking things up themselves. I myself do my own research when a medical issue comes up. However, I know how to look up reputable sources and know how to feel out viable options within the body of legitimate medical knowledge. I then can figure out how to ask doctors for different opinions. My statement "I don't tell my doctor how to fix my body" was probably worded more strongly than I intended. I do believe in asking and checking around.

However, I am highly suspicious of the results of turning a mostly illiterate public loose on Google. Sounds elitist, but really - do most people know good scientific sources from random crap they find on a random site?
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written by heinz333, September 09, 2009
Wow, another place with no army i guess Costa rica is the paradise in the south and Iceland in the north
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written by Steve Packard, September 10, 2009
It's a complex subject. I know doctors will sometimes respond with at least indifference to treatments they know won't work but see as harmless or think could potentially benefit the patient in a placebo type of role. When people say something to a doctor like "What about acupuncture? Should I try that? I've heard good things." they may very well give a response like "Some people seem to think it works well" or something else that is not a full endorsement but does not in any way put it down either.

There are a lot of reasons for this. They may not want people to feel they can't do anything or they may think it would be less well received if they seemed dismissive. I don't know, but I do know that many have told me this is the nature of the response they get. Of course in the long run, sanctioning this BS can cause a lot of harm.

The thing about alternative treatments is that they are alternative because they failed to be proven safe and effective. As soon as they are, they become incorporated into mainstream medicine and are no longer alternative. One thing that irritates me is hearing people say that they want more than one option and that's bull, as many times a condition can be treated by different methods that are proven. For example clogged artery can be treated with a balloon angioplasty or a bypass - it is up to the doctor and patient which has the best risk/benefit. What they are really saying is that "I want to be able to choose the treatments that don't work." Of course, nobody actually goes for treatments they know don't work, they just have bought into the PR.
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written by ciccio, September 12, 2009
One of the main reasons the Canadian health care system is so much cheaper than the American is that none of these alternative treatments, not even chiropractors are covered.
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