A University of Michigan Medical School alumnus confronts anthroposophic medicine at his alma mater
Anthroposophic medicine is the creation of Rudolf Steiner, who also founded Waldorf Schools. It's a form of medicine that is vitalistic and full of quackery. Unfortunately, my medical alma mater, the University of Michigan, has a program in anthroposophic medicine. It's a small program, but that it exists at all is a disturbing reminder how quackery can infiltrate even the best medical...
Triskaidekaphobia times two.
There is germaphobia, the fear of germs. Or Germans. One of the two. Oddly, I do not fear most germs, despite my daily reminders as to how destructive these wee beasties can be. I recognize their limits and my immunologic strengths and know I have more to fear from cars or unsaturated fats than E. coli or influenza. There is also a...
Is “CAM” Fraud?
During my continuing education about so-called “complementary and alternative” medicine one question presents itself in my mind over and over: Isn’t that fraud? Well, is it?
The Dark Side of Medical Globalization
You are not going to change what we do, you’re not going to change our determination to make these patients better. I see these patients, I know these patients, I value these patients, I’ve looked after them for years. I’ve seen them after the procedure, the vast majority are improved. The above quote could be a reference to just about any fringe...
Eating Placentas: Cannibalism, Recycling, or Health Food?
After giving birth, most mammals eat the afterbirth, the placenta. Most humans don’t. Several hypotheses have been suggested as to why placentophagy might have had evolutionary survival value, but are there any actual benefits for modern women? Placentophagy has been recommended for various reasons, from nutritional benefit to preventing postpartum depression to “honoring the placenta.” In other cultures, various rituals surround the...
Ethics in human experimentation in science-based medicine
Science-based medicine depends upon human experimentation. Scientists can do the most fantastic translational research in the world, starting with elegant hypotheses, tested through in vitro and biochemical experiments, after which they are tested in animals. They can understand disease mechanisms to the individual amino acid level in a protein or nucleotide in a DNA molecule. However, without human testing, they will never...
Of SBM and EBM Redux. Part IV, Continued: More Cochrane and a little Bayes
OK, I admit that I pulled a fast one. I never finished the last post as promised, so here it is. Cochrane Continued In the last post I alluded to the 2006 Cochrane Laetrile review, the conclusion of which was: This systematic review has clearly identified the need for randomised or controlled clinical trials assessing the effectiveness of Laetrile or amygdalin for...
Topical NSAIDs
I have a mental basket of drugs that I suspect may be placebos. In that basket were the topical versions of non-steroidal anti-inflammatory drugs (NSAIDs). When the first products were commercially marketed over a decade ago, I found the clinical evidence unconvincing, and I suspected that the modestly positive effects were probably due to simply rubbing the affected area, or possibly due...
Placebo Effect for Pain
It has long been recognized that there are substantial multifactorial placebo effects that create real and illusory improvements in response to even an inactive treatment. There is a tendency, however (especially in popular discussion), to oversimplify placebo effects – to treat them as one mind-over-matter effect for all outcomes. Meanwhile researchers are elucidating the many mechanisms that go into measured placebo effects,...
Questioning the Annual Pelvic Exam
A new article in the Journal of Women’s Health by Westhoff, Jones, and Guiahi asks “Do New Guidelines and Technology Make the Routine Pelvic Examination Obsolete?” The pelvic exam consists of two main components: the insertion of a speculum to visualize the cervix and the bimanual exam where the practitioner inserts two fingers into the vagina and puts the other hand on...