I missed this article by Canadian vascular surgeons when it came out in 2018. It is well-argued, and I think you should read it in full, if you can get access (it’s behind a pay wall). It contains interesting details about the anti-vax attitude of doctors of integrative medicine (something we discussed before), as well as the most dubious things that go on in the ‘Cleveland Clinic’. Here is at least the abstract of the article:
Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) 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 CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries.
Those who have been following this blog a little know how much I agree with these authors. In fact, in the peer-reviewed literature, I have been publishing similar arguments for almost 20 years, e.g:
- Integrative medicine: not a carte blanche for untested nonsense. Ernst E. Arch Intern Med 2002. PMID 12153386
- Disentangling integrative medicine Ernst E. Mayo Clin Proc 2004 – Review. PMID 15065622
- Integrated medicine. Ernst E. J Intern Med 2012. PMID 21682782 Free article.
- Integrative medicine: more than the promotion of unproven treatments? Ernst E. Med J Aust 2016. PMID 26985838
Gotta love those Canadians! 🙂
Something I’ve been wondering about. . . So, we have two sides, science-based medicine and fantasy fixes. Those who peddle the latter seem to have the time to push their wacky agenda. (Is my bias showing?)
Why are we not getting serious pushback from SBM proponents? Granted, there are a few people fighting the good fight but why aren’t ALL SBM docs making noise? Serious question. Are they just too busy? It can’t be because they don’t care. What is it?
in my experience, they
are too busy,
don’t take it seriously,
don’t realise the problem,
are afraid to be ‘politically incorrect’,
see a financial opportunity.
AND SOME MIGHT EVEN BE CONVINCED IT’S FINE.
[critical thinking has never been a forte of the medical profession]
With all the fraud and dangerous practices of EBM (Evidently Baseless Medicine) or SBM (Scientitiously Based Medicine) you have an uphill battle on your hands. Why dont you clean up your own house first. A carrot is always better than a stick.
Whenever I raise this question I am told that it is unethical for one profession to call out another? They can do it at a general level like this thread but cannot do it on an individual level. So patients suffer and quacks and charlatans continue to make money. Other professions like law are more regulated and customers vote with their feet more. Health care is so different because its customers are vulnerable to start with and feel like victims who have to accept what is offered even if they are directly paying for it. Something needs to change!
it is certainly not unethical for a doctor to call out a colleague; it can be unethical not to do it.
It is unlawful, in most (all?) civilised societies, not to report unethical or unlawful practices. Not only in your own profession but also other health care services.
difference between illegai,unlawful and unethical. The HCCP do not allow professions to call each other out in UK and will investigate if they do ?
A barrister friend once explained to me that if something is unlawful this means it is against the law. Illegal, however, refers to a sick bird.
For some reason, it’s not considered unethical for MD’s to prescribe meds that do harm, without doing much good.
Why is this not unethical ??…. oh yeah, because it’s a state sanctioned business.
Bjorn, tell us how it went when you reported cupping and gua sha practitioners. ?
I see that I need to clarify.
I am talking about healthcare legislation regulafing registered and accredited health care professionals. Other HC professionals are required to report unethical and unlawful practices. Cases of serious injury from playing doctor by members of the general public are reported to the police, not authorities regulating healthcare.
Bjorn, tell us how it went when you reported cupping and gua sha practitioners to the police. ?
Just as a reminder, here’s how you describe gua sha (after citing your extensive expertise on the subject): injurious assault, BODILY ASSAULT! (your caps), etc. – and that practitioners “are a threat to their fellow humans”.
You said “I have seen more patients extensively bruised by ignorants, sometimes family members, sometimes “professional” quacks.”
Your solution: “My suggestion is that anyone who comes across a victim of cupping, Gua Sha, bloodletting or other antiquated nonsense that in effect constitutes bodily assault, consider submitting a complaint to the police or whatever suitable authority as any citizen should who observes a fellow human being attacked under any circumstances.”
If you aren’t willing to go to the police after witnessing the effects of bodily assault on your patients…why do you think doctors would report their colleagues for offering or recommending CAM services?
The “jm” seems to keep records of my comments. I must have made an impression on the poor troll’s ego as it starts trying to sling mudpies as soon as I step on its Gua-Sha scraped toes ? Would be more fun if it posessed better logical skills.
Edzard is keeping a handy-dandy archive here:
You certainly did make an impression! It’s truly stunning how hard you cling to your fantasy, even after Edzard posted video…
All that aside, you didn’t answer the question. You’ve seen patients that in your professional opinion were victims of assault – yet didn’t call the police. That’s pretty extreme. Why would a doctor report their colleagues for offering or recommending CAM services – a minor issue, compared to “bodily assault”?