MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Whenever a level-headed person discloses that a specific alternative therapy is not based on good evidence, you can bet your last shirt that a proponent of the said treatment responds by claiming that conventional medicine is not much better.

There are several variations to this theme. Today I want to focus on just one of them, namely the counter-claim that, only a short while ago, conventional medicine was not much better than the said alternative therapy (the implication is that it must be unfair to demand evidence from alternative medicine, while accepting a similar state of affairs in conventional medicine). The argument has recently been formulated by one commentator on this blog as follows:

“Trepanation, leeches for UTI’s, and bloodletting are all historical treatments of medical doctors…It’s hypocritical… to impute mainstream chiropractice to the profession’s beginnings and yet not admit that medicine’s founding and evolution was inbued with consistently scientific rigor.”

Sadly, some people seem to be convinced by such words, and this is why they are being repeated ad nauseam by interested parties. Yet the argument is fallacious for a range of reasons.

  • Firstly, it is based on the classical ‘tu quoque’ fallacy (appeal to hypocrisy).
  • Secondly – unless we happen to be historians – it is not the healthcare of the past that is relevant to our discussions. The question cannot be what this or that group of clinicians used to do; the question is HOW DO THEY TREAT THEIR PATIENTS TODAY?

As soon as we focus on this issue, it is impossible to deny that conventional medicine has made lots of progress and moved light years away from treatments such as trepanation, leeches, bloodletting and many others.

Why?

Why did we make such huge progress?

Because research showed that many of the traditional treatments were ineffective, unsafe and/or implausible (thus demonstrating that hundreds of years of experience – which alternative therapists rate so very highly – is of more than dubious value), and because we consequently developed and tested new therapies and subsequently used those treatments that passed these tests and were proven to do more good than harm.

By contrast, in the last decades, centuries and millennia, homeopathy, chiropractic, acupuncture, paranormal healing etc. did make no (or very little) progress. So much so that Hahnemann, for instance, would pass any exam for  homeopathy today. (If you disagree with this statement, please post a list of those treatments that have been given up by alternative therapists in the last 100 years or so.) Come to think of it, it is a hallmark of alternative medicine that it does not progress in the way conventional medicine does. It is almost completely static, a fact, that renders it akin to a dogma or a cult.

But why? Why is there no real progress in alternative medicine?

Don’t tell me that there is no research, research funding, etc. There are now hundreds of studies of homeopathy or chiropractic, thousands of acupuncture, and dozens of paranormal healing, for instance. The trouble is not the paucity of such research but its findings! The totality of the evidence in each of these areas fails to show that the therapy in question is efficacious.

And there we have, I think, another hallmark of alternative medicine: it is an area where research is only acted upon, if its findings are in line with the preconceptions and aspirations of its proponents.

I find this interesting!

It means, amongst other things, that research into alternative medicine tends not to be used for finding the truth or establishing new knowledge; it is mainly employed for the promotion of the therapy in question, regardless of what the truth about it might be (this would disqualify this exercise from being research and qualify it as PSEUDO-RESEARCH). If the research findings are such that they cannot be used for promotion, they are simply ignored or defamed as inadequate.

23 Responses to Two hallmarks of alternative medicine

  • You have it in a nutshell: Pseudo-research.

  • “it does not progress in the way conventional medicine does. It is almost completely static, a fact, that renders it akin to a dogma or a cult.”

    I’ve been thinking about that lately — religion/spirituality as such not only does not progress, but in fact cannot. That’s not even meant to be a negative statement necessarily — art doesn’t progress either. The problem starts when fans start insisting it can progress and belongs to the realm of fact. That’s why when we read Hippocrates, we can be struck by the fact that some of his ideas are in fact more “advanced” (ie closer to modern science) than much modern alt med. Alt med doesn’t progress, although it does manage to run around in circles.

    “research is only acted upon, if its findings are in line with the preconceptions and aspirations of its proponents.”

    Yes — I also notice proponents use language like “We wanted to prove this scientifically, so we designed this experiment.” And after the experiment is deemed successful, instead of seeing if it can be replicated, they instead run with it straight to the PR department.

    • In past conversations, Edzard and other bloggers have criticized chiropractic for proffering too few research studies for SMT to be considered a scientifically valid treatment; their alleged paucity of such studies was demonstrative of chiropratic’s cultism, according to them. Paradoxically, we now read Edzard’s recent, tacit “walk-back” of previous allegations: at least for the purpose of Edzard’s current “hit piece,” chiropractic now has hundreds of studies which, according to him, testify negatively to its efficatiousness.

      Edzard claims that a hallmark of alternative medicine is that research is only acted upon if its findings are in line with preconceptions and aspirations of its alt-med proponents. Hmmmmmmmmmmmmmmm. It seems that Dr. Ioannidis has determined the same to be true in “modern medicine.”

      “So why are medical doctors—to a striking extent—still drawing upon misinformation in their everyday practice”? Dr. John Ioannidis has spent his career challenging his peers by exposing their bad science.

      Criticisms and concerns of some of this renowned health researcher and professor of medicine can be found in many of Dr. Ioannidis’ publications, for the pleasure of the readers of Edzard’s post:

      Research bias appears to be a problem in clinical healthcare studies. It’s dubious, however, that such bias in SMT research has led to more iatrogenic morbidity/mortality in patients than the bias has in “modern medicine” wherein bogus claims of efficacy and safety of drugs and devices have led to improper treatments.

      • …chiropractic now has hundreds of studies which, according to him, testify negatively to its efficatiousness….”
        WHERE DID I SAY THAT?
        [efficatiousness??? is that a term you learnt at chiro school?]

        • efficaciousness
          noun

          Synonyms and Antonyms of efficaciousness
          the power to produce a desired result
          Synonyms edge, effectiveness, effectualness, efficacy, efficacity, efficiency, productiveness
          Related Words ability, capability, capacity; potency, puissance, strength
          Near Antonyms inability, inadequacy, inadequateness, incompetence, incompetency
          Antonyms ineffectiveness, ineffectuality, ineffectualness, inefficiency

        • “Where did I say that?” asked Edzard.

          “There are now hundreds of studies of homeopathy or chiropractic…” stated Edzard.

          You’re welcome!

          Be well

    • “Yes — I also notice proponents use language like “We wanted to prove this scientifically, so we designed this experiment.” And after the experiment is deemed successful, instead of seeing if it can be replicated, they instead run with it straight to the PR department,” stated Yakaru.

      Please see my post below regarding whether any medical-research studies can be trusted.

      Be well

  • It is almost completely static, a fact, that renders it akin to a dogma or a cult.

    Well a cult, yes. But they are ephemeral.

    On the other hand, something like the Catholic Church has managed to adjust its dogma fairly well.

    One does not stay in business for 2000 years by ignoring the customers.

  • “Can any medical-research studies be trusted”? Dr. John Ioannidis

    That question has been central to Ioannidis’s career. He’s what’s known as a meta-researcher, and he’s become one of the world’s foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field’s top journals, where it is heavily cited; and he is a big draw at conferences. Given this exposure, and the fact that his work broadly targets everyone else’s work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the field of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change—or even to publicly admitting that there’s a problem.

    The Paxil/GSK debacle comes to mind when one reads these informative observations regarding biased, untrustworthy research within “modern medicine.”

  • There is one hallmark of natural medicine that Edzard did not mention: The laws of nature.

    The underlying philosophy of natural medicine is that the universe is governed by laws. Maths, physics, engineering are precise scientific disciplines. Similarly, the adherents of natural medicine believe that the human body and human being are governed by natural laws.

    This is why homeopathy, for example, still teaches the principles according to what Hahnemann postulated and that was expounded further after him, because it believes that these laws do not change over time.

    • In science, ‘laws’ are based on repeated observations of phenomena that occur reproducibly under the same conditions. The true ‘laws of nature’ conform to these requirements, in the same way as the laws of maths, physics and chemistry. Things that people postulate are not laws unless and until they conform to the conditions of repeated observation.

      “This is why homeopathy, for example, still teaches the principles according to what Hahnemann postulated and that was expounded further after him, because it believes that these laws do not change over time.” Which would be true if those principles were in any sense reproducible observations!

      • I think Greg might have taken the Mikey

      • FrankO,

        The laws of nature don’t conform to anything.

        • How about “True ‘laws of nature’ are not exempt from these requirements”?

        • Still sounds like you’re putting requirements on nature. Maybe just change the quote marks?

          “True ‘laws’ of nature are not exempt fromm these requirements.”

          • Still sounds like you are promoting your alternatives to medicine, despite not just the dire lack of evidence of efficacy for what you practise and promote, but also despite the evidence that clearly shows the risk-benefit ratio of that which you practise and promote.

            I admire you for your continuing belligerence in your despise for experts who practise 21st Century medicine. Thank you very much indeed for being such a loyal and persistent hallmark of quackery.

          • @jm regarding Pete

            Note that Pete is quick to criticize what he considers “a lack of evidence” for paramedical disciplines. Yet, Pete characteristically failed to address my 1/19 post in this thread regarding Dr. John Ioannidis’ observations of research within “modern medicine.” Sadly, even non-quack medical physicians are led to the trough of financial enrichment via their prescribing of medications whose benefits are often overstated and whose adverse effects are often under-reported. Of course medical quacks come and go(to jail!). At least three more medical quacks in California the past few months have been rightly rounded up so they can no longer prescribe their addictive poisons(opioids) to patients.

            Certainly, the prescribing of meds by doctors usually assumes that the doctors have faith in the research which led to the drug’s production. Not so fast, says Dr. Ioannidis; medical research is often tainted by financial interests within one of the pillars of “modern medicine”(drug companies). There have been countless more iatrogenic deaths/morbidity due to medical quackery with each and every medical quackery scam than there have been such adverse effects throughout the entire history of chiropractic(even the “evil, deadly” cervical manipulation).

            Perhaps you should thank Pete directly for being such a “loyal and persistent hallmark of…….” hypocrisy.

            Be well

          • Wow. That’s just….weird, Pete. The inner dialogue leading to that comment must have been interesting.

          • “Wow. That’s just….weird, Pete. The inner dialogue leading to that comment must have been interesting.”

            It was as ‘interesting’ as the ‘contents’ of your ‘comments’ and those of Logos-Bios.

          • Pete’s 1/22 post, as usual, failed to discuss specifically the taint within much of medical research. Instead he authored what he thought ws a “funny,” but it was nothing more than a deflection. Big time fail by Pete!

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