Drinking the KoolAid

Complementary and alternative medicine gets brought up a lot at my school, usually not in an overly positive manner.

There's reason for that animosity. Every physician has a story of a patient that had a less-than-ideal outcome because they opted for care that either diminished the effectiveness of conventional medicine or replaced it entirely. In some instances, deaths have occurred. When there are people promoting and even profiting of those outcomes, it's hard not to get angry.

When you listen to the people providing these alternative medicine services, however, they believe strongly that they're helping. Many of these practitioners go through extensive training before they practice, training which reinforced the theories underlying their practice. When you're told over and over again that something is right, and most of the people you interact with believe in it as well, it's hard to accept or even contemplate that it might be wrong. So, these alternative medicine practitioners continue to believe they're helping in spite of contradictory evidence because it's simply inconceivable that that contradictory evidence could be right. They drank the KoolAid.

Here's the thing - every field has their own KoolAid, including medicine. For those who like to go back to the evidence, some of the KoolAid is easy to point out. There are many procedures or approaches in medicine that lack supporting evidence or have even been shown to be ineffective. Yet they are still a part of our practice. Traditional medicine does tend to be more responsive to evidence - clearly unhelpful procedures do work their way out of the system, over time, but it takes far longer than it should. I have had physicians, in front of a full class of medical students, discuss a procedure, admit that the available evidence shows that it works no better than a placebo, and then insist that it still has a role in medicine.

More importantly, there are certainly some things that we're doing that are ineffective or unhelpful and we have no idea that they are ineffective or unhelpful.

Complementary and alternative medicine should be scrutinized, but so should conventional medicine. I think conventional medicine holds up much better under that scrutiny - that's why I'm getting an MD and not an ND - but we should always be willing to hold conventional medicine to the higher standards we'd like to see applied to complementary and alternative medical practices.