A new paper reminds us that so-called alternative medicine (SCAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of SCAM may cause harm to patients through interactions with prescribed medications or by patients choosing to forego evidence-based care. SCAM may also put financial strain on patients as most SCAM expenditures are paid out-of-pocket.
Despite these drawbacks, patients continue to use SCAM due to a range of reasons, e.g. media promotion of SCAM therapies, dissatisfaction with conventional healthcare, a desire for more holistic care. Given the increasing demand for SCAM, many medical institutions now offer SCAM services. Several leaders of SCAM centres based at a highly respected academic medical institution have publicly expressed anti-vaccination views, and non-evidence-based philosophies run deep within SCAM.
Although there are financial incentives for institutions to provide SCAM, it is important to recognize that this legitimizes SCAM and may cause harm to patients. The poor regulation of SCAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy.
As I have tried to point out many times, the potential for harm caused by the increasing integration of SCAM can thus be summarised as follows:
- direct harm due to adverse effects such as toxicity of an herbal remedy, stroke after chiropractic manipulation, pneumothorax after acupuncture;
- direct harm through the use of bogus diagnostic techniques;
- direct harm by using materials from endangered species;
- indirect harm through incompetent advice such as recommendation not to immunize or discontinue prescribed medications;
- neglect due to using SCAM instead of an effective therapy for a serious condition;
- harm due to medicalising trivial states of reduced well-being;
- financial harm due to the costs of SCAM;
- harm through making a mockery of evidence-based medicine;
- harm caused by undermining rational thinking in the society at large;
- harm caused by inhibiting medical progress and research.
In case you see other ways in which SCAM can cause harm, please let me know by posting a comment.