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Integrating homeopathy with medicine: Not the “best of both worlds”

Advocates of “integrative medicine” argue that integrating alternative medicine with real medicine represents the “best of both worlds.” A recent study by Ben Goldacre suggests that, in reality, integrating quackery with medicine infects medicine with pseudoscience and poor practice.

After yesterday’s post about a naturopathy (a.k.a., an ND, or “Not-A-Doctor”) named Anke Zimmermann who treated a four-year-old boy with a homeopathic concoction claimed to be made from the usual dilution to nothing of saliva from a rabid dog in order to cure him of aggressive behavior, pretending to be a dog, and fear of werewolves (I kid you not), I thought more about homeopathy and just how ridiculous it is. Given that naturopathy is a form of pseudo-medicine based on prescientific vitalism and, essentially, principles of magic, it’s not surprising that naturopaths embrace homeopathy. Indeed, as I’ve said so many times before, you can’t have naturopathy without homeopathy because homeopathy is an integral part of naturopathic education and practice. However, it is surprising that a number of real doctors (i.e., MDs) actually believe in homeopathy and prescribe homeopathic remedies.

Having been born, raised, and trained in medicine in the US, I note that homeopathy isn’t as big a deal here as it appears to be in the UK and Europe, particularly Germany and France. It’s more accepted there in ways that it isn’t in the US, where seldom will you find an actual physician prescribing homeopathy, although, of course, there are a number of over-the-counter homeopathic remedies that one can buy at major pharmacy chains like CVS, Walgreens, and the like. In the US, however, most people are unaware of the magical principles of homeopathy, such as the law of similars (i.e., “like cures like,” in which to relieve a symptom a homeopath will use something that causes the symptom) and the law of infinitesimals (which claims that diluting a remedy makes it stronger, with the very highest dilutions being many orders of magnitude greater than Avogadro’s number, meaning that the remedy is in essence diluted away to nothing, sometimes by factors greater than the estimated number of atoms in the known universe). Here, most people think that homeopathy is just herbal medicine.

An interesting question arises when one considers physicians who embrace The One Quackery To Rule Them All, along with real medicine. This is not a question limited to homeopathy, but homeopathy is one of the best modalities to consider for this because it is so obviously utter bullshit. The reason is that it is an extreme version of “integrative medicine,” which “integrates” alternative medicine with real, science-based medicine. Advocates of integrative medicine claim that it represents the “best of both worlds,” while critics (like myself) point out that combining pseudoscience and quackery with science-based medicine doesn’t make medicine better, but rather dilutes the scientific basis of medicine, thus making it worse. But how can we test the hypothesis that integrating quackery with medicine? Ben Goldacre did just that in a recent study.

Here’s the basic idea. Goldacre and colleagues examined practices in the UK that prescribed homeopathic remedies and measured associations with four prescribing and two practice quality indicators. The basic question is simple: Do practices that use homeopathy do worse in standardized quality indicators. AFter noting in the introduction that homeopathy is not only incredibly implausible from a scientific standpoint but that the clinical evidence for it is also negative, Goldacre describes the rationale:

Despite the lack of evidence for homeopathy, and its lack of a plausible mechanism, some NHS doctors still prescribe it. However, there is limited evidence on clinician factors associated with choosing to use hom- eopathy, mostly based on surveys. German medical students taking elective modules in homeopathy scored lower in ‘science orientation’, but higher in ‘care orientation’ and were less motivated by ‘status’ compared to their peers. A commonly cited advantage of homeopathy is safety, and in a small survey of healthcare staff from general practice in London, 70% thought homeopathy could reduce costs for some conditions; however, 55% thought it could increase costs for others. Globally, personal use of homeopathy in doctors has a strong association with prescribing of homeopathy. There is also some evidence on patient factors associated with choosing homeopathy, again based on surveys: patients are most likely to be female, better educated, have healthier lifestyles and report lower tendency to seek medical help when their child is ill.

Using publicly available data, practices may be measured on their prescribing quality through assess- ment of the cost-effectiveness, efficacy and safety of medicines prescribed, based on national guidelines. Practices may also be judged by their quality out- comes framework score and patient recommendation rates. We hypothesised that practices that prescribe any homeopathy might differ in their prescribing in other measurable ways. We therefore set out to explore whether general practices prescribing homeo- pathic remedies also behave differently on these other measures of general practitioner behaviour.

To investigate this question, Goldacre used a retrospective cross-sectional design incorporating UK general practices that have prescribed any homeopathic remedies in the last six months versus those that did not prescribe any in the same period of time. They used both univariable and multivariable logistic regression to investigate correlation between ever using homeopathy with several measures of practice prescribing quality and behavior. The data source used was the OpenPrescribing.net project, which imports prescribing data from the monthly prescribing data files published by NHS Digital. And then:

These contain data on cost and volume prescribed for each drug, dose and preparation, for each month, for each English general practice. We extracted the most recent six months of data available (December 2016 to May 2017 inclusive). This allowed us to determine practices where homeopathy is prescribed and generate com- posite prescribing measures for practices using the various standard measures of prescribing quality already in use on the OpenPrescribing project (sum- marised below). We also merged the prescribing data with publicly available data on practices from Public Health England.15 This allowed us to adjust for sus- pected confounders at the practice level. All standard English practices labelled within the data as a ‘general practice’ were included within the analysis; this excluded prescribing in non-standard settings such as prisons. Additionally, in order to further exclude practices that are no longer active, those without a 2015/2016 quality outcomes framework score were excluded. Using inclusive criteria such as this reduced the likelihood of obtaining a biased sample.

Homeopathic prescribing practices were defined as those with at least one prescription for homeopathy within the most recent six months, and several measures were examined, including a composite measure score, aggregate potential savings from measures, composite low-value prescribing; and aggregate price-per-unit potential savings. A number of factors were considered to try to control for potential confounders and systematic differences between practices and practice populations that could influence homeopathy use.

Goldacre found 8,184 practices in the dataset labeled as “general practice,” of which 566 were excluded because they did not have a quality outcomes framework score, leaving 7,618 practices. Of these, 644 (8.5%) met the criteria of having prescribed homeopathy, although 363 of these practices only prescribed one homeopathic remedies and 38 prescribed more than 10 prescriptions and three over 100, with the maximum number of homeopathic prescriptions in any of the practices being 252. Goldacre’s findings are summarized thusly:

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blockquote>
Each of the four prescribing quality measurements was strongly associated with prescribing any hom- eopathy. Furthermore, all of the four prescribing quality measurements exhibited a strong, significant trend where practices in each category of worsening prescribing were more likely to prescribe any hom- eopathy (Table 2). Adjustment for various prespeci- fied practice factors such as demographics and index of multiple deprivation score slightly reduced the size but not significance of associations, with adjustment for prescribing volume accounting for almost all of the change in odds ratio.

In the composite measures score, those in the worst score category (>51.4) were 2.1 times more likely to prescribe any homeopathy than those in the best category (<40.3) (multivariable odds ratio: 2.1, 95% confidence interval: 1.6–2.8). The aggregate savings from the measures where a cost saving could be calculated also showed a strong, significant trend: those in categories with more available savings were more likely to have prescribed any homeopathy than those in categories with fewer available savings. Prescribing of other ‘low value’ items, as identified by NHS England, was also strongly associated with prescribing any homeopathy: only 3.9% of practices in the best category prescribed any homeopathy, compared to 12.8% in the worst category (multivari- able odds ratio: 2.6, confidence interval: 1.9–3.6). Aggregate price-per-unit savings were also strongly associated: in the category where the fewest savings are available where prescribing value has therefore been better optimised, only 3.5% of practices prescribed any homeopathy within the last six months, while for those where the most savings were available, 12.7% of practices prescribed homeopathy (multivariable odds ratio: 2.7, confidence interval: 1.9–3.9).

There was a dose-response relationship found as well:

We found that prescribing any homeopathy is asso- ciated with poorer performance at practice level on a range of standard prescribing measures. We also found a dose–response relationship, with increasing odds of prescribing any homeopathy associated with worsening categories of performance on each prescrib- ing measure: the worse a practice’s performance was on our standard prescribing measures, the more likely they were to have ever prescribed homeopathy. This finding was robust to inclusion of data into the model on a range of plausible confounders. Lower quality outcomes framework scores were not associated with increased odds of prescribing homeopathy nor were patient recommendation scores. We used a highly inclusive criteria for homeopathy prescribing (􏰀1 pre- scription over six months), and most practices that did prescribe homeopathy did so in small volumes. Given the low level of homeopathy prescribing, it is therefore remarkable that any difference was found.

I’m surprised that Goldacre could resist making the obvious joke about homeopathy, namely how dilution makes it stronger. Of course, this is a real medical journal; so humor is rarely permitted. Still, I’d have tried to sneak a joke like that into the manuscript in a way that got past the editors and peer reviewers. It’s true, though. It is rather amazing that any difference was seen at all in this sample. It’s also true that this is an association. It doesn’t demonstrate causation. However, it does suggest that there’s something about practices that use homeopathy that also leads to their using poorer prescribing practices. These could be, as Goldacre speculates, deeper underlying features of these practices, such as respect for evidence-based practice or the quality of teamwork in optimizing treatment and managing cost.

Another interesting thing about this study is that it does not show what integrative medicine advocates claim for integrative medicine, namely decreased costs. Indeed, it found the opposite. Again, the cost of quackery doesn’t generally replace the cost of evidence-based medicine (which might save money by substituting ineffective treatment). More commonly, it’s additional expense added to evidence-based treatments.

Yes, this is just one study, and it’s a retrospective study. It’s possible that there were confounders that weren’t adequately controlled for. On the other hand, doctors who prescribe homeopathy, The One Quackery To Rule Them All, have gone further down the rabbit hole of pseudoscience in having decided that science-based practice is optional than doctors who might think that the occasional herbal remedy is acceptable or that there might be something to acupuncture because it involves sticking needles into the body. It’s not unreasonable to wonder whether they do more poorly in other areas of medical prescribing. This study suggests that they do. It’s also a cautionary tale that the effects of integrating quackery into medicine could well be more insidious and deeper than even I’ve warned. Combining nonsense like homeopathy (or naturopathy or energy medicine or traditional Chinese medicine) infects medicine with pseudoscience in ways that are not always immediately apparent. There are powerful and wealthy forces promoting the integration of pseudoscience, including homeopathy, into medicine that must be opposed.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

53 replies on “Integrating homeopathy with medicine: Not the “best of both worlds””

Trying to improve rationalist medicine by adding homeopathy is like trying to improve a gallon of ice cream by adding a teaspoon of cow manure. It does not make the manure better and it ruins the ice cream.

So let me get this straight. Doctors who are incompetent / ignorant enough to prescribe homeopathic remedies, are generally the ones with practices not serving their patients very well. My shocked face seems to be missing in action. Instead let me show you my face-palm face.

And we’re running down the same path up here.

Advocates of integrative medicine claim that it represents the “best of both worlds”

There are at least anecdotal indications that it leads to the worst of both worlds: the arrogant certainty that critics of science-based medicine associate with science-based medicine, and the pseudoscience of alternative medicine. How else to explain practitioners who are convinced, despite an educational background that implies they know better, that homeopathy and other alt-med modalities work?

The people who push for integrative medicine talk about caring (in the emotional sense of the word) for their patients. Goldacre’s results are consistent with that. But do they actually implement it in their practices? I don’t have any evidence for that, and I am reluctant to take the word of anybody who routinely believes six impossible things before breakfast, as many (if not most) alt-med practitioners do.

I have more or less ruled out a dog breeder whose puppies we were thinking about, based on their stated use of homeopathic treatments for their animals (and 4X annual herbal “detoxification” treatments). Use of pseudoscience does not increase my confidence that your animals are healthy and properly reared.

Nor am I reassured by the fervent Bible-based proselytizing that another breeder included as an irrelevant aside on their website.

And these are the sort of people who want ME to fill out a questionnaire to prove I’m a decent sort of person, before they’ll consider letting me adopt one of their little angels for $$$.

I agree, that’s grounds for walking away from breeder #1. And the reason not to walk away from breeder #2 is that you should run instead–he might as well have a bright neon flashing marquee that screams, “I AM NOT TO BE TRUSTED”.

I used to buy “organic” milk (is there inorganic milk?) just to support small farms (I live in Wisconsin), until one of said small farmers informed me that she treats the cows with homeopathy instead of the evil antibiotics. I am talking about a sick cow, not the routine use of antibiotics that really is a problem. I reported this to the organic dairy that buys her milk, but had no reply.

I am talking about a sick cow

^ A bit of nicotine caused me to realize a likely motive: the cow would have to be sold. If one reads through the certification rules, failing to appropriately treat a sick cow is also prohibited, so I’m guessing that the whole operation would be screwed if reported to the USDA.

And these are the sort of people who want ME to fill out a questionnaire to prove I’m a decent sort of person, before they’ll consider letting me adopt one of their little angels for $$$.

There are these things known as “animal shelters.”

Goldacre’s so-called study is obviously quackery. The Journal of the Royal Society of Medicine is a, bottom-feeding, predatory journal, as evidenced by their rushing the article trough in only four months. They probably didn’t even charge him tuppence to do so.

On a more serious note, as touched on by a few previous comments,the study offers support for the intuitive conclusion that nominally legitimate physicians (i.e. real MDs) offering homeopathy and certain other alternative therapies may be generally suspect.

A defender of homeopathy who commented under an article about the recent BC naturopath case, was claiming that “Ben Goldacre himself recognized that homeopathy is working”.
Must have missed this published paper or must have read it too fast.

I would love to know how anyone could so misconstrue Goldacre’s views as to think he recognised that homeopathy works…

What Goldacre et al’s study doesn’t tell you is who the GPs are. I did an analysis using data from EBM DataLabs (Goldacre’s project) to identify those GP surgeries with the highest levels of prescribing of homeopathic medicines. I then looked at the surgery websites. https://ukhomeopathyregulation.blogspot.co.uk/2017/12/nhs-homeopathy-3-analysis-gp.html

It is clear that Anthroposophic medicine is being practiced on the NHS. Many aren’t aware of the bizarre beliefs behind Anthroposophic medicine. The Wikipedia article https://en.wikipedia.org/wiki/Anthroposophic_medicine is quite mild –

“For example, one anthroposophic physician claims that the heart does not pump blood but that blood propels itself along. Anthroposophic medicine also proposes that patients’ past lives may influence their illness and that the course of an illness is subject to karmic destiny.”

It’s attitude towards, say, autism is that it is an “incarnation problem”, whatever that means. The combination of Anthoposophic medicine and Steiner-Waldorf education is worrying. Supporters of Anthroposophy will tell you it’s NOT racist. But it certainly reads as if it is. It is likely ableist, especially when it to learning disabilities.

Re. UK Homeopathy Regulation, “Antroposophic medicine”: I’d like to suggest a “remedy” for that:

Set up a number of websites for things such as “Anthroposophy Airlines” and “Anthroposophy Motorcars,” using Anthroposophy memes to promote obvious absurdities such as “if the plane crashes, it must have something to do with the passengers’ past lives” and so on. Use Anthroposophy jargon wherever possible. Make the websites look “serious,” like they are real businesses. Then use every available means of publicity to spread the memes.

The point being to illustrate that nowhere else in public life would such absurdities be tolerated under present safety regulations, so, by implication, they should not be tolerated when it comes to health care.

If people wish to believe in Anthroposophy as a matter of religion, it’s a free country and they’re welcome to do that. But not to inflict those beliefs upon vulnerable innocent persons seeking actual health care.

Colour me entirely unsurprised at where most of those are to be found.

What does surprise me is that places like Glastonbury, Totnes and Hebden Bridge seem to be absent.

Somewhat related: an op-ed in today’s Wall St. Journal by Steve Salerno criticizes cancer centers for promoting false narratives about effectiveness of their cancer treatments, singling out an ad campaign by M.D. Anderson and also making note of Cancer Treatment Centers of America’s advertising.

The op-ed mentions dubious integration of alt med into cancer treatment, as well as dietary interventions that haven’t been shown to affect the course of cancer.

Worth reading if you get the paper or can get around the website paywall.

Elsewhere, bad news for promoters of quack “leaky gut” interventions: a newly released published study that seemed to back up claims of disease stemming from dietary gut permeability alterations is apparently headed for the dumpster. The authors had presented data that zinc levels in canned products including tuna and asparagus were alarmingly high, and media reports suggested the zinc could “wreak havoc” on G.I. tracts through permeability changes. It turns out that the authors’ calculations were wrong, the zinc levels were within safe limits and the paper is being retracted. Ooopsie.

https://retractionwatch.com/2018/04/20/that-study-reporting-worrisome-levels-of-zinc-in-tuna-its-being-retracted/

Worth reading if you get the paper or can get around the website paywall.

They may not paywall “opinion” entries, but the Wayback Machine has it, should there be an expiration date. The CCTA spots on NPR always get on my nerves.

NOT SURE where to put this but here goes…

Is Wikip– being infiltrated by woo-meisters? Take a look, oh skeptical (and Dangerous) ones!

Recently, I’ve reported how arrogant woo-meister Gary Null frequently snarls about how Wikip– spreads “misinformation” about him, tried to sue them unsuccessfully, had a Wikip– critic/ troll, “Rome”, explain how he tried to fix profiles for Chopra and Sheldrake and how resident scholar ( see Rational Wiki), Richard Gale, is assisting Null in exposing Wikip– as a pack of lies manufactured by Pharma to disgrace Truth tellers like themselves ( and keep customers away) to be premiered soon. Simultaneously, he smears Barrett on air

So I looked at the entry in question and there have been changes and additions as follows:
– he’s still called an aids denialist but there is mention of how he’s helped aids patients (!!!!!) That’s new.
– discussion of his bogus degrees is called a controversy
– the middle section of the page is dominated by his “accomplishments”: descriptions of prn shows, books, films, documentary awards and “athletic career” all written in the style of his promotional material

I haven’t consulted the Wayback but I think that the critical parts may be shortened although links to Barrett, DG and Kloor remain as well as the poisoning episodes as recounted by newspapers.

This may seem arcane but wikip– editors should take a look at this development.

I have three possible responses prepared for someone who proposes to “treat” me with any pseudoscience:
1) “I’m leaving now.”
2) “Please leave.”
3) “Please let me alone.”
I believe that these will suffice for any such situation.

Or maybe “I do not consent to be treated!”
Then again, if they’re trying to treat you with quackery, who knows how they feel about basic ethics like consent.

William Bromberg really now your example is at best stupid
I don’t know your health status and let me educate you, I have colon cancer stage 4 I went torugh 12 rounds of chemio you should know that it’s not a joy ride the side effects in my case permanent. After my first scan (after the chemio) my surgeon told me tat I was in remission. But I still have a opreration to look ”forward” to it’s called the CHIP operation google it.
At this point and being 61 years old Diabetis and heart problems anything that could help me is a plus, further more homeopathic as been proven to help.
One example is weed

Michel Polnicky,

While it is certainly possible to have a homeopathic preparation of weed, weed is not in and of itself homeopathic. A joint or a brownie is not a homeopathic treatment. You might want to look up homeopathy dot com to see the difference between homeopathic and herbal.

If you have evidence that homeopathy has been proven effective, please share. The only thing that would convince a skeptic is good, strong, repeatable evidence.

Mr. Polnicky, I appreciate what you have gone through. Although my cancer treatment was different, I went through an ordeal too. Furthermore, I am a retired physician assistant and in my career I saw many patients through chemotherapy regimens, and treated other serious illnesses. I wish you nothing but the best of care and of results, and many good years to follow.
But the truth is that homeopathy has nothing behind it. It was the best guess of a physician who lived over two centuries ago, when there was no such thing as scientific medicine – the word “scientist” wouldn’t even be used for another 60 or 70 years. The number of treatments from the 1700s that are still in use is very small, if any. In those days treatments included leeches, bleeding, and various compounds of mercury, lead, and arsenic. Homeopathy was probably easier to endure, but it was no more effective. I sure wouldn’t want to be treated by a physician using 18th Century methods, brutal or kind.
I hate to think of you wasting time, money, and hope on something that really is no better than a placebo.
Now marijuana is not homeopathic. Sometimes people confuse “homeopathic” with “natural”, but they really are not the same thing at all. Homeopathic marijuana would be so diluted that it is indistinguishable from a glass of water by any imaginable test. I believe there is enough evidence that pot is worth trying for a good range of conditions, but none of them will be helped by diluting it beyond all reason.
None of your doctors and nurses want you to suffer from your treatment. It makes their work harder, and it is genuinely stressful to see day in and day out. A lot of research goes into finding new and better ways to alleviate side effects. If your treatment is hard to endure and the methods used to help you tolerate it are not helping, you need to open your mouth, and ask for something else. All too often I have seen patients give up on a treatment they needed when they decided it wasn’t helping. They don’t ask if there is another alternative method, and end up suffering needlessly.
Again, I wish you only the best of everything.

But I still have a opreration to look ”forward” to it’s called the CHIP operation google it.

OK. I think that’s called “HIPEC” in English.

Advocates of integrative medicine claim that it represents the “best of both worlds,” while critics (like myself) point out that combining pseudoscience and quackery with science-based medicine doesn’t make medicine better, but rather dilutes the scientific basis of medicine, thus making it worse.

But wouldn’t homeopaths claim that diluting science makes it more potent?

A sick person is sitting in a waiting room waiting to be “cured” by the Medical Doctor (MD).

The person puts their mouth on an arm and sneezes loudly, “Achoo”

The doctor happened to be nearby and says, “Bless you”

Others in the room are comforted by this show of empathy.

The ritual of saying “Bless you” after someone sneezes relates to the idea that the devil is being sneezed out of their system. Thus, the devil is less likely to re-enter that person’s body after being blessed.

Q. Does the MD believe saying “Bless you” (i.e., pseudoscience) will help the patient.

@Orac,

Have you ever said “Bless you” to a person after they sneezed?

MJD says,

In some instances, science and pseudoscience are intertwined to such an extent that any attempt to completely separate them is pointless.

While the use of “Bless you” may have started out as a religious pseudo-health ritual it is a pretty big stretch to suggest that it is still that when it essentially now sits in the language as a polite turn of phrase. It is courtesy, nothing more. And I’m not sure what relevance that has to any discussion of the creep of homeopathy into science-based medicine?

motosubatsu asks,

And I’m not sure what relevance that has to any discussion of the creep of homeopathy into science-based medicine?

MJD says,

The last sentence in Orac’s posting states, “There are powerful and wealthy forces promoting the integration of pseudoscience, including homeopathy, into medicine that must be opposed.”

Inquisitive minds would like to know if Orac has ever used medical rituals (e.g., Bless you) and/or “appeasement medicine” (e.g., defensive medicine like antibiotics) in his practice.

Ellie, a southern friend once explained for me the meaning of “Bless your heart”, and it’s appropriate in the context of dealing with MJD, the Bear of Very Little Brain. Permit me to translate:
“Bless your heart” is a southern way of saying “Just what kind of a f***ing idiot are you?”

If an MD ever says ” Bless you” to a patient, he or she could merely be following a social convention and not advocating trust in higher/ supernatural powers . An atheist might say this..I might even say it -btw-. Empathy has been studied by psychologists.
Saying ” Bless you” has nothing to do with belief in pseudoscience and its imagined “intertwining” with SBM. Neither would saying, “Goodbye” which has similar religious roots.

Efforts to distinguish pseudoscience and science are only “pointless” to people like MJD who cannot understand the difference.

So Goodbye, MJD.

Denice Walter says,

So Goodbye, MJD.

MJD says,

Not so fast.

In my opinion, modern medical science has been guilty of “appeasment medicine” with the overuse of antibiotics.

https://www.ncbi.nlm.nih.gov/pubmed/28737082

Q. How is “defensive medicine” and “appeasement medicine” similar.

A. Both may be harmful.

@ Orac,

Have you ever prescribed the use of antibiotics (i.e., defensive medicine) when no bacterial atypicality was evident?

There are powerful and wealthy forces promoting the overuse of antibiotics, it must be opposed.

MJD, the Bear of Very Little Brain, says that MJD says: “In my opinion, modern medical science has been guilty of “appeasment [sic] medicine” with the overuse of antibiotics.”
Did you come to that opinion on your own, or did you actually encounter that idea coming from reality-based medicine? Just look at the source you quote – hardly a homeopathic one.
And there in a nutshell is the difference between your views and real medicine. You go on cherry-picking things that support your preconceived notions. The scientific endeavor questions itself and, while it sometimes takes time, corrects itself and changes over time.
Now, how did you get to this set of ideas, when, IIRC, you started out defending your view of vaccines?

Michael J. Dochniak received a degree in Psychology and Chemistry from the University of Wisconsin, River Falls, USA

Alain ask:

How did MJD manage to graduate and get the degree?

Answer:

His professors had to get scripts for LSD to finally understand his homework and thesis. After concern regarding LSD’s side effect and the resulting depressive disorder of these professors due to incessant questioning by MJD during classtime, they decided to hand him the degree along with good, deep dropkick in the bµtt.

Alain 😉

The ritual of saying “Bless you” after someone sneezes relates to the idea that the devil is being sneezed out of their system.

No, it doesn’t. You’ve got it backward, dipshit.

i NEARLY FORGOT
In other news…

CBS announced last night that NY state has issued a warning about exposure to measles from a European tourist who visited the tri-state area last weekend: it appears to be Jehovah’s Witness** related with stops at Kingdom Halls in both Brooklyn and Tuxedo and another exposure in Patterson, NY.

Oh crap, I am fairly frequently in Tuxedo BUT I already had the measles!

** IIRC, there was a similar incident involving JWs several weeks ago : they visited the Metropolitan Museum of Art amongst other popular venues.

There have also been some hepatitis A outbreaks, as I learned this morning when I went to donate blood. The Red Cross is saying that anybody who has patronized any of six listed restaurants (three in Michigan and three in Utah) in the last four months should not donate blood.

I vaguely recall Orac covering the Michigan outbreak, since at least two of those restaurants are in his neck of the woods (they are in the Grosse Pointes; I don’t recall where the third one was). That was the first I heard about anything of this kind in Utah; the affected locations were West Jordan (which I think is metro SLC) and Spanish Fork (which is some distance south of Provo).

Interestingly, I was just the other day reading about the development of the Hepatitis A vaccine: it was tested amongst children in Kiryas Joel ( see wikip—) a village established by a Hassidic rebbe in the past 40 years.
Whenever I drive past, I marvel at the size of the houses: they have many children.

DW: “If an MD ever says ” Bless you” to a patient, he or she could merely be following a social convention and not advocating trust in higher/ supernatural powers .”

I know a surgeon whose dictated patient workups include “Bless her heart” when referring to very senior citizens.

So in that case, the phrase suggests someone who is circling the drain.

*belated followup to Eric Lund: years ago when we were looking for a Lab pup, there was a newspaper ad from a person advertising puppies available to “a good Christian home”. Sadly we did not qualify, and instead raised a Labrador who, when overstimulated, would spin in circles like Linda Blair’s head in “The Exorcist”.

Since no one else has responded to MJD, I might as well.

Doctors may prescribe antibiotics without a current bacterial infection for many reasons that are neither appeasement nor superstition:
colds/flu may be followed by secondary bacterial infections such as sinusitis and pneumonia. After surgery, they may prescribe prophylactic antibiotics to prevent infections. Many elderly and other compromised individuals take antibiotics as prophylaxes as well, some long-term. Heart valve issues may call for similar actions by doctors and dentists.

All of the examples I cite are from family members- not speculation.
Patients who are aware of these potential consequences/ have a history of them, may advocate for antibiotics for themselves.

I am not a doctor or nurse and I know this.

Old Rockin’ Dave asks,

Now, how did you get to this set of ideas, when, IIRC, you started out defending your view of vaccines?

MJD says,

Many years ago, MJD researched the feasibility of producing non-leachable high MW polymers having antimicrobial properties. The results showed disruption of the phospholipid membrane of the bacterium(s) was only significant in the presence of leachable contaminants. This scientific endeavor taught me that even minute quantities of a contaminant can adversely affect a living organism.

As the story continues, describing the use of antibiotics as “appeasement medicine” in SBM reinforces the idea that medical science must correct itself and change over time.

Thanks for keeping MJD a part of your learning and discovery, Old Rockin’ Dave. 🙂

“This scientific endeavor taught me that even minute quantities of a contaminant can adversely affect a living organism.”
Hold the presses. This is the scientific revelation of the century – the 14th Century, I would guess. Medicine has a very long history, and It has very long been a maxim in medicine that “the dose makes the poison”. Just because a small amount of material can cause harm on a cellular scale does not mean that it must have a discernible effect, or any effect at all, at the macroscopic level. A very large and complex organism is not just a collection of cells.
As to the actual question I asked, maybe you haven’t noticed that you jump from topic to topic trying to score points and you have long lost sight of whatever it was you set out to proselytize in the first place.
The principal thing I have learned from you is how to conduct a long drawn-out Gish gallop.

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