CAM practitioners versus preventive medicine

If there’s one claim that practitioners of “holistic” medicine frequently make, it’s that “complementary and alternative medicine” (CAM) or “integrative medicine” or whatever the term du jour for the combining of quackery with science-based medicine is these days is allegedly so much better than “conventional” or “allopathic” medicine (or whatever disparaging term “holistic practitioners” prefer) at preventing disease and keeping people healthy. The claim is a load of fetid nonsense, of course, but it sounds convincing on the surface. After all, CAM practitioners have been disturbingly successful at claiming what are science-based modalities (diet and exercise, for example) as somehow being “alternative” or “integrative,” a task they accomplish by adding a dash (or sometimes an enormous dollop) of pseudoscience to them. Such co-opted science-based modalities then serve as the thin edge of the wedge behind which the real quackery follows into medicine.

But are CAMsters really so much better at prevention? As I’ve suggested time and time again, they really are not. For example, they routinely disparage screening tests designed to detect disease before it manifests itself in a more severe form. I realize that for many screening tests, there is a problem with overdiagnosis, and not all tests are as useful as others, but that’s not the sort of criticism based on science that advocates of CAM and integrative medicine make. Rather, what they do tends to be more of a reflexive dismissal of anything resembling screening. We see it when quacks attack mammography, although frequently they attack mammography on the one hand and promote the useless modality of thermography on the other hand. We see it when they attack statins. And we see it when they attack screening for hepatitis C:

The Centers for Disease Control and Prevention recently issued notice that all “baby boomers” – that segment of the population born between 1945 and 1965 – should be tested for Hepatitis C. That would include me. The virus is considered a leading cause of liver cancer, claiming 15,000 lives each year due to related illnesses. The agency suggests that 2 million boomers have the virus and don’t know it. Their recommendation would be for one to come in for testing/screening, and where the virus is found, begin a 48-week round of interferon alpha-2b or Ribavirin treatments.

At $50 to $100 each, the testing process alone could add a $150 million stimulus to the medical industry, but getting 800,000 people on the prescribed Standard of Care, which costs from $50,000 to $150,000, could generate $60 billion in billings (averaged out at $75,000 each), if fully acted upon just once.

Of course, this all amounts to horse hockey, because following the Standard of Care will not restore the natural balance that actually defines, creates, or restores, a state of health. As such, if the Hepatitis condition goes away, you can pretty much count on something else eventually showing up to take its place.

Now, leaving aside the question of scientific merit of screening everyone between 47 and 67 years of age for hepatitis C, notice the pure hostility to the very concept of screening. I know, I know, it’s the Phaelosopher again, a guy who promotes the use of bleach (i.e., MMS) as a miracle treatment for many things and has held a “genome healing” workshop of pure quackery. What would one expect? That he’d be down with a mass screening program of any kind? But the hostility above is very telling. The “Fail”-osopher can’t imagine that the CDC is actually proposing such a screening program at an enormous expense because it has examined the evidence and thinks that detecting previously undetected subclinical hepatitis C in hundreds of thousands of people could save lives. Oh, no. He thinks that the only reason the CDC is proposing these guidelines is because it wants to provide a massive “stimulus” to testing companies and big pharma that provides the drugs designed to prevent subclinical hepatitis C from becoming clinical hepatitis C and frying hundreds of thousands of livers.

Fail-y even goes on to to say:

This story of the Hepatitis C concern comes out at a time when the Obama administration is trying to heighten the appeal of its health care reform law, called Obamacare. This program calls for mandatory enrollment into a health care plan, even suggesting penalties for non-compliance. However, it doesn’t call for mandatory use of methods by healthcare providers, that are known to help restore health. As such, this is a great windfall for the health insurance industry, which still only pays for methods that the policy makers approve. The medical policy makers continue to look askance at anything that isn’t inexpensive, adversarial, destabilizing, or toxifying in its metabolic effect on the body.

In making this story public, the Standard of Care for Hepatitis C is the only option that can be discussed in the mainstream media. As such, the entire population is led to believe that if they have Hepatitis C, irrespective of how they got it, the Medical Autocracy’s solution is the “best” and “most reliable” way to resolve it.

That too is a fiction.

The only “fiction,” of course, is pretty much every word that flows from the keyboard of the Phaelosopher, but let’s take a look at this. What is prevention in medicine? Obviously in general it involves two things: (1) taking actions that optimize health and (2) taking options that prevent disease and treat it while it is still treatable. Determining whether a screening program achieves this goal is a complicated scientific question, but arguably in the passages I’ve cited what we find is far more a reflexive resistance to screening in which it is viewed as a tool of control more than anything else. All of this is of a piece with the false claim that CAM is “personalized.” As I’ve pointed out time and time again, in CAMworld, “personalizing medicine” usually means “making it up as you go along. Quacks like the Phaelosopher are opposed to the very concept of a standard of care, particularly one based on science, because a real standard of care limits what they can do. If there is a standard of care, the can no longer individualize treatments make it up as they go along.

Which brings us full circle. Remember how I discussed how the Phaelospher is a big proponent of using the Miracle Mineral Solution (MMS) to treat what ails you, denying that it is, in fact a form of bleach and claiming that it is some sort of miracle treatment? it looks as though he thinks that MMS would be a great way of preventing subclinical hepatitis C from progressing to harm people’s livers. He mentions WF10, which is based on chlorite and might have some activity against amyotropic lateral sclerosis but for which there is little or no convincing evidence as a treatment for hepatitis C.

We see this time and time again. CAM practitioners try to claim the mantle of promoting prevention, but their claims are not grounded in evidence or science. They will provide you with diet recommendations not based in science claiming that they will reduce your chances of getting cancer to near zero or tell you to take a boatload of supplements to prevent every disease under the sun. All the while, they disparage science-based preventative measures that don’t fit within whatever mystical paradigm they believe in as being products of big pharma designed to enslave you.

It’s a lie, of course. A real primary care doctor practicing science-based medicine is a holistic doctor treating the whole patient. A real primary care doctor practicing science-based medicine is practicing real preventive medicine. A real primary care doctor practicing science-based medicine doesn’t fear and attack the concept of a standard of care.