Informed Consent and CAM: Truth Not Optional
In three recent posts, Drs. Novella, Gorski and Atwood took the Bravewell Collaborative to task over a report on its recent survey of U.S. “integrative medicine” centers. As Dr. Novella noted, So what is integrative medicine? When you strip away the rebranding and co-opting of features and treatments of mainstream medicine, you are left with the usual list of pseudoscientific practices that...
Antipodean CAM
It is one of the pleasures of travel to read the local newspapers of places I visit. I wholly agree with In a Sunburned Country author Bill Bryson, who observed, It always amazes me how seldom visitors bother with local papers. Personally I can think of nothing more exciting – certainly nothing you could do in a public place with a cup...
Legislative Alchemy: The New Year
A new year brings new opportunities for practicing the magic of legislative alchemy, the process by which state legislatures transform implausible and unproven diagnostic methods and treatments into perfectly legal health care practices, such as naturopathy, chiropractic and acupuncture. Different states have different legislative calendars, but many begin a new session soon after the first of the year. This gives “complementary and...
Strains, sprains and pains
What do you think would happen if you gave a bunch of “complementary and alternative medicine” practitioners access to a big pot of money — say, up to $10,000 per patient — and let them treat patients virtually without restriction, hampered only by a fee schedule. No utilization review, no refusal based on a treatment being “experimental” — none of the usual...
Vaccination mandate exemptions: gimme that ol’ time philosophy
Each of the 50 states and the District of Columbia require vaccination against certain diseases as a prerequisite to public and private school attendance, most commonly polio, mumps, measles, diphtheria, rubella, chicken pox, Heamophilus influenza type b, pertussis, tetanus, pneumococcal disease and hepatitis B. Unfortunately, mandatory vaccination for home-schooled children is rare. (1) All states provide medical exemptions to vaccination mandates for...
Pediatrics & “CAM” II: just wrong
In November, the journal Pediatrics published an entire supplement devoted to Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical and Clinical Issues in Decision-Making. The authors purport to have “examined current legal, ethical, and clinical issues that arise when considering CAM use for children and identified where gaps remain in law and policy.” (S150) Their aim is to “illustrate the relevance...
Pediatrics & “CAM” I: the wrong solution
Oh no! Not again! The venerable medical journal Pediatrics devotes an entire supplement this month to Pediatric Use of Complementary and Alternative Medicine: Legal, Ethical, and Clinical Issues in Decision-Making. We sense from the very first sentence that we are in familiar territory: Rapid increases the use of complementary and alternative medicine (CAM) raise important legal, ethical, clinical, and policy issues. (S150)...
Spinal Fusion: Chiropractic and Subluxation
A spirited exchange about chiropractic arose in response to a recent post proposing “The Cure” for the legalization of implausible and unproven diagnostic methods and treatments. Some comments pointed to the implausibility of the chiropractic “subluxation” and the lack of robust evidence of efficacy/effectiveness for spinal manipulation, as well as the difficulty of understanding what exactly “chiropractic” is, or does, that distinguishes...
The Cure
Legislative Alchemy In Legislative Alchemy I: Naturopathy, II: Chiropractic and III: Acupuncture, we learned how state legislatures transform scientifically implausible and unproven diagnostic methods and treatments into legal health care practices. Examples typical of the sheer nonsense found in both proposed and actual legislation include: Naturopathic health care [is] a system of health care practices for the prevention, diagnosis, evaluation and treatment...
Legislative Alchemy III: Acupuncture
Acupuncture is typically depicted as sticking needles at various points on the body prescribed (inconsistently, it turns out) by charts indicating purported “meridians” through which “qi” flows in the human, or animal, body. However, from one of the many SBM posts on acupuncture, this one by Dr. Novella , we in fact know that: the consensus of the best clinical studies on...