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.
40 Responses to So-called alternative medicine (SCAM) causes harm in multiple ways – here are 10 dangers that come to my mind. Do you know more?
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Nice one… can you support your claim of “potential harm” with some Risk Management data? For example how many lawsuits were claimed against such medical centers for introducing Chiropractic or alternative medicine?
I have yet to come across any medical study using lawsuits as a measure of iatrogenic morbidity.
Not just a concern about homeopathy (although I understood them to be very diluted), but cytochrome p450 interactions with cannabinoids isn’t well understood. There is predicted to be significant interactions, and would at least be akin to grapefruit juice and Warfarin. in addition, THC and CBD have sex dependent differences as well as strong dosage variance by the circadian clock.
Patient self reporting is unreliable, but it has been protocol to ask about all supplements and over the counter as well as prescriptions.
The actual number of homeopathy related medication problems likely pale next to the FDA statement about prescription errors.
1.3 Million injured a year.
https://www.aarp.org/health/drugs-supplements/info-2017/medication-errors-rise-fd.html
The number of direct harm caused by homeopathy is obviously going to be zero because there is nothing in homeopathic remedies, I use the term loosely, that does anything. Mainly because there isn’t anything in them apart fro water and occasionally sugar!
It isn’t a contest to see which is worse. Both are bad. Both should be stamped out. SCAM and Rx errors.
Homeopathy isn’t medicine. It is at absolute best a placebo.
A placebo that can (and has) delayed actual medical treatment to the point of no return.
Psychological/emotional harms?
Some belief systems associated with SCAM posit that “dis-ease” is the result of moral failure. In the case of disabled children, that moral failure may be on the part of the parents. These belief systems probably contribute to the social stigma associated with certain conditions.
Raising false hopes about “cure” is cruel to say the least.
It’s difficult to generalise though.
good points
thanks
harm done by dodgy anrcdotal evidence by non critical thinkers being spread to the health illiterate
Another example of harm cause by SCAM is the additional student debt incurred by medical students enticed and lured and preyed upon being convinced to spend massive amounts of cash learning an ineffectual medical modality. Just look at how many medical and veterinary schools now have offerings in scam….Wouldn’t training in critical thinking serve the next generation better ?
EE….stroke after chiropractic manipulation
To state it as such implies that a stroke would only occur if a chiropractor did the manipulation.
if you say so!
Actually, you said so by phrasing it that way.
if you say so.
So if my osteopath scripts me an antibiotic i suppose that’s an osteopathic antibiotic.
… and as if it happens on a daily basis 🙂
You can argue effectiveness and financial sense, you can even argue appropriateness… but to argue the case for harm being caused to the patient is nonsense. Speak with every Risk Manager in every large hospital employing such techniques and they will tell you this is the least of their worries.
but the least of his worries are still worries
true
And of course the unbridled anger set off in the non-SCAMMERs trying to come to grips with why so many reprobates can so easily and without remorse screw over their fellow man/woman at their most vulnerable.
Damage done to animals due to vitalistic beliefs in powers of rhino horn, bear gall, etc.
Financial harm to practitioners who paid for expensive trainings in the belief that they could help people and have a useful career, and then find they have learned a skill that is not only useless but can’t improve or undergo any progress. (Pseudo-science, by definition, doesn’t progress.)
yakaru, I am with you… selling shamanism is bullshit!
Gosh yes. How many pangolins are being killed?
Your second point is so, so relevant. Britt Marie Hermes has mentioned this. SCAM practitioners are victims as well. We need to drill down on this.
check out this tuition….heavily marketed to graduates of traditional veterinary programs….If the material in course of TCVM was such vital important medical information, why isn’t it taught as part of the core curriculum at the veterinary college?
http://www.tcvm.com/MastersDegree/TuitionandPayment.aspx
What does an unbridled attack on alternative treatments based on the arrogance that only what one was taught in medical school is not “quackery”?
1. Conveying a lack of empathy for those with chronic conditions seeking relief.
2. By directly targeting with frontal attacks of ridicule one causes a counter intuitive further entrenchment of those beliefs rather than dispelling them.
3. Making patients feel like it is a ” either/or” scenario causes lack of engagement and delays seeking traditional treatment, or, causes failure to disclose treatments they feel will offend the doctor leading to drug interactions or not getting accurate information about treatments that are not effective.
4. Prescribing placebos is a treatment that makes patients feel better.
5. Effective or not, a person has a right to be stupid. There are those that pray for themselves and others and believe it works. Just as helping at these people that “medical care is proven and praying is not” would create a negative view, then this would too.
6. Diluting the power of medical advice. By going full force against what is said by medicine itself to be “placebo-effect” it places that minimal concern on the same level of importance as vaccine concerns. It isn’t.
7. “Streetlight Effect” if a cure can be found, or more effective treatment, it likely won’t be found in the same place that science has been looking for decades.
8. The public knows that most medical prescriptions are, in some manner, derived from phytochemicals. Focussing on product safety of heavy metals, arsenic, etc would have a good public safety endpoint and further the reputation of traditional medicine.
9. There are many, or at least some treatments (nontraditional or off-label use of an FDA approved medication) that a doctor uses or recommends because it works and it decreases the doctors ability to do so.
10. “Eggs are good. Eggs are bad. Salt is bad. Salt doesn’t matter.” When the time comes, as it inevitably will, that blueberries health benefits, or strawberries for arthritis, or some alternative “treatment” is funded to go through the expensive and restrictive processes and, (this will be very few) turns out to be backed by scientific evidence to be effective, again authority is lost. Unless one is decidedly dangerous, a neutral position might be best.
I don’t defend or endorse homeopathy, but in my experience, “pick your battles” is always good advise.
SO SORRY THAT YOU ARE UNABLE TO UNDERSTAND MY POST!
“only what one was taught in medical school is not “quackery”
where did I say or imply that?
this blog is about SCAM; that’s not a difficult message!
but evidently too difficult for you.
Wow! What a tempest in a teapot. The harms due to CONventional MEdiciNe (CONMEN) is so much greater by several orders of magnitude. Ever hear of ViOXX or the opioid epidemic or fraudulent research by big pharma or … Its endless. Why waste our time with this drivel? Evidently Baseless Medicine (EBM) is the great fraud of our time. You could probably put the total number of people harmed by CAM over the last decade in a small auditorium. The numbers killed by CONMEN Each Year in the USA alone number in the hundreds of thousands by various estimates.
you are like a broken record playing the wrong tune.
THIS BLOG IS ABOUT SCAM!!!
Roger
Failures in aircraft do not validate the use of magic carpets.
And who is it who finds out the dodgy research, the Vioxx problems, the opioid crisis. AltMed types? No. Doctors. Medicine tries to rectify its problems in view of the evidence.
Show me where AltMed does this.
It doesn’t.
Lenny, State of Oklahoma is taking CONMED to court for perpetrating the opioid crisis.
Wake up please.
WAKE UP, said the man who has been fast asleep, dreaming of homeopathy
Edzard, I would be fine with you writing whatever you like about about if only CONMED would warn patients that they kill and maim millions of patients around the world, day in and day out, year after year. Many people that seek alternative treatments do so because they prefer to take their chances with this route rather than die or be maimed by CONMED. Those who don’t know better, are those that go to the slaughter.
I see!
that must mean that soon there will be only SCAM enthusiasts left.
I am pleased for you; you then can relax.
Oh, the number one reason in my opinion is that these guys will never give up and admit failure. It’s always the patient’s fault if it doesn’t work and always the remedy’s success if the disease abates.
If someone is suffering people (not just providers) will always be after them to try this stuff.
“Have you tried acupuncture?”
“No, it’s scientifically implausible, potentially dangerous, and there’s no data supporting its use for XYZ.”
“That’s your problem! Just take my advice!”
“No.”
“I guess you don’t want to get better. You have Munchausen’s syndrome.”
It’s incredibly cruel.
This list is quite exhaustive. The only other risk that I see is “Harm by lobbying/pressuring government into approving bogus interventions and therapists”. But it could be encompassed within # 8 to 10.
Thank you for this post!
BMJ took down their post but I saved it at Wayback Machine. It shows the proportion of experiemtnal medicine in relation to medicine as a whole. Patients are the guinea pigs.
https://web.archive.org/web/20170818042535/http://clinicalevidence.bmj.com/x/set/static/cms/efficacy-categorisations.html
https://edzardernst.com/2017/05/is-conventional-medicine-based-on-good-evidence/
It looks like patients are caught between SCAM and CONMED.
to you perhaps
in reality they have a choice between medicine and quackery
A generation of young people are being led astray by the widespread acceptance and government promotion of BS. Instead of doing real science graduate students are going off on wild goose chases pursuing delusions and frauds. These minds are a terrible thing to waste.
hear, hear!!!