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Gotta have more woo in my medical school, 2011 edition

Four years ago, I wrote a post that I called Gotta have more woo in my medical school! In it, I discussed how UCSF had put out a woo-ful, non-science-based booklet about “complementary and alternative medicine” (CAM), full of references to qi, acupuncture, and all manner of woo. Since then I’ve been sounding the alarm bells about the creeping infiltration of pseudoscience into medical school, even so much that it’s becoming part of the mandatory medical school curriculum. Now, four years later, I see that the creeping infiltration has ceased to creep. Rather, it’s turned into a torrent of woo pouring into medical school curricula. that’s now being recognized by the U.S. News and World Report in a disturbingly entitled article Medical Schools Embrace Alternative Medicine. Its contents are even more disturbing, and, unfortunately, it’s written chock full of alt-med tropes that concede the language war to the side of pseudoscience. That much is obvious right from the beginning when the article is subtitled “Patients’ desire for alternative therapies is driving changes in medical education,” which leads right into this:

Now that nearly 40 percent of American adults swear by some form of complementary and alternative medicine, or CAM–from nutrition and mental relaxation to acupuncture, magnet therapy, and foreign healing systems like traditional Chinese medicine and Indian ayurveda–a growing number of medical schools, too, are supplementing medication with meditation.

Interest in teaching alternative approaches “has exploded, especially this last year,” says Laurie Hofmann, executive director of the Institute for Functional Medicine, which is based in Gig Harbor, Wash. The nonprofit institute educates healthcare professionals to look for underlying systemic imbalances as a cause of illness rather than focus on treating symptoms and, when possible, to correct with lifestyle changes and mind-body techniques.

As you can see, the journalist who wrote this, Meryl Davids Landau, falls prey to common CAM framing mechanisms, beginning with the claim that CAM is so popular. Of course, that 40% figure so beloved of CAMsters and woo-meisters of all stripes is deceptive, as it includes massage, chiropractic, and yoga. If you look at the “hard” woo, such as homeopathy and energy healing, the numbers are much lower. Then there are exercise, diet, and other modalities that aren’t really “alternative” at all, but rightly should be included as part of science-based medicine. These are often subsumed into the “CAM” brand, even though they don’t really belong there. Whittle that stuff out, and the very same surveys support a figure more on the order of 5% of people using truly “alternative” medical modalities, such as homeopathy, acupuncture, reiki, and others.

Also, as I’ve pointed out before in my criticisms of its most famous practitioner Mark Hyman, Functional medicine, as we have seen before, is a collection of various quackeries that represents itself as somehow having greater insight into human physiology when in reality it’s based largely on the extrapolation of early science beyond any scientific justification and the misinterpretation of existing science. And apparently this woo is finding its way into a medical school near you.

As an academic surgeon, this does not give me a lot of confidence in our next generation of medical students. For example, we have a first year resident who is quoted in the article named Carson Brown:

“I could already see the limitations of Western medicine, especially when treating recurrent pain or other chronic conditions. I thought other healing traditions could fill in some gaps,” says Carson Brown, a first year resident at San Mateo Medical Center in California. Spurred in part by the relief that acupuncture had offered her for hip pain induced by a sports injury, she took a two-week elective offered to fourth-year UCSF students last year that covered topics from acupuncture to mind-body medicine to herbs.

Once again, whenever you see someone use the term “Western medicine” as a synonym for science-based medicine, you should know you’re dealing with someone who has at the very minimum taken a sip of the Kool Aid of CAM quackery and at the very maximum drunk deeply to the point of wanting to be a homeopath. As far as I’m concerned, it can’t be emphasized enough. There is no such thing as “Western” medicine. There is no such thing as “Eastern” medicine. There is only medicine that is science based versus medicine that is not. The East/West dichotomy beloved of CAMsters is a false one. In fact, not only is it a false dichotomy, but it contains within it a bit of racism as well.

One also can’t help but notice the irony as well that, while the CAM advocates are claiming that they are all about the science, the best they can come up with to support going into CAM is anecdotes and feelings. Well, not quite. Landau mostly uncritically parrots favorite CAM tropes like the “growing body of evidence” that allegedly supports CAM. Of course, what they mention is not really CAM, like nutrition. The “bait and switch” of CAM is alive and well and being bought into by credulous reporters. Well, not completely. I will give Landau credit for citing a 2009 review that

found a bias “in favor of CAM,” noting recommendations of acupuncture for conditions like asthma where there is “no credible evidence” and instances of ignoring research–for example, studies associating chiropractic neck manipulation with stroke.

I’ll also give him credit for noting a major problem with all this insinuation of CAM into the medical school curriculum, namely that something’s got to give. Time is limited, and the medical school curriculum is in essence a zero-sum game. If time is made for CAM, then something else has to go. What will it be? Maybe anatomy won’t be covered in as much detail so that medical students have some time to study the fantastical anatomy that is, for example, the meridian system in acupuncture through which qi is claimed to flow. Or maybe histology won’t be covered in as much detail so that students can learn a bit of faith healing in the form of reiki?. Who knows. What I do know is that every minute of pseudoscience that insinuates its way into the medical school curriculm means that some bit of real science will have to be pushed aside. It’s that simple, and that stark.

Even here, the bait and switch is alive and well. Once again, nutrition is co-opted and represented as being part of CAM, leading to a frame in which it is lamented that medical students aren’t getting enough education in nutrition–as though CAM education could remedy that situation or CAM is equated with nutrition:

Medical schools that can’t find the resources or the space in their packed curricula to add CAM–a recent Institute for Functional Medicine (IFM) survey indicated that time, not lack of interest, is the prime impediment–may find that online education can fill the gap. Next year, the University of Arizona will launch a 16-hour Internet-based holistic course on prevention and wellness, open to medical students from other schools.

The IFM will debut Web-based modules later this year on gastrointestinal health, the principles of functional medicine, and nutrition. (Time constraints are no doubt the reason a recent study in Academic Medicine found that only 27 percent of medical schools currently meet the minimum target, set by the National Academy of Sciences, of 25 hours for class time about nutrition.)

Note the framing. Gastrointestinal health, functional medicine, and nutrition are treated as a module, and then it is pointed out that most medical schools don’t reach the currently recommended minimum class time teaching about nutrition, as if science-based nutrition has anything to do with the woo that is functional medicine! This is the sort of thing that irritates the crap out of me time and time again. Unfortunately, physicians should really know better. Equally unfortunately, these same physicians uncritically buy into the “bait and switch,” whereby nutrition and other modalities that should be science-based are co-opted as somehow “alternative” and then used as a means of implying that all the other baggage that comes with CAM is just as reasonable and effective as nutritional interventions for some chronic health disorders.

It’s depressing to see an article like this for a couple of reasons. First, it shows just how thoroughly the terminology of CAM has embedded itself into medicine and, from there, has metastasized into the language used to report on CAM. Worse, the woo in medical school is not just proliferating, but becoming more intense. Gotta have more woo in my medical school, indeed.

And here I am, rapidly approaching the age where I’m likely to need more medical care. These medical students will be the ones to give it to me. All I can say is that when I’m 80+ years old and in the hospital, if some young punk comes into my room offering to realign my flow of qi or adjust my chakras I just hope I have enough strength and presence of mind left to show him how really to rearrange the flow of qi.

Either that, or I at least want to be that cantankerous old man who selectively makes the lives of any hospital physician, nurse, or staff member proposing to treat him with quackery miserable.

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]

40 replies on “Gotta have more woo in my medical school, 2011 edition”

At 60, I’ve already reached that stage–“cantankerous old (wo)man who selectively makes the lives of any hospital physician, nurse, or staff member proposing to treat him with quackery miserable.”

I have had to dump a number of female (and sort out one male) gyn’s over this issue. Also, an increasing number of “friends”, sadly. I especially tire of “science is YOUR belief”, and “science doesn’t know everything”. The most difficult one is” “you need to respect my beliefs”, because in our culture, this is true–but I don’t!

I hear you, Anthro, I don’t have respect for beliefs that convince people to refuse real medical interventions and put their children or themselves at risk.
I feel it is morally irresponsible to respect belief in homeopathy, acupuncture, magic cures,auras, psychics, naturpathy, ‘natural’ = good, detox, toxins, big pharma, and a multitude of other interesting by impossible ‘beliefs’. I am not 60, but I’ m already a cantankerous and vocal gal. 🙂

Great post Orac, I wish there was a way to just stop all such quackery from being lent a veil of legitimacy in it’s acceptance as part of medical training.
Letter writing doesn’t seem to be making a difference.

How many of the people who say “you need to respect my beliefs” are willing to respect our beliefs and lack of belief? Too often, I’m supposed to be “polite” when people push woo, meaning not arguing, but they aren’t respectful in return when I talk about what modern medicine can do for me. Where is the respect in claiming that my doctor must be lying, selfish, or a dupe of the pharmaceutical companies? Where is the respect for a person’s choice to take medicines prescribed by her doctor?

Hmmmm… Is woo a substitute for coping skills? Possibly a way to forestall- or deal with- the harsh reality of a diagnosis and its subsequent consequences (for the *really* entrenched, to *avoid* the diagnosis entirely) rather than *getting on with it*?

I’ve noticed the following**: several of my much older cousins and same-aged/ somewhat older friends have been using me as a sounding board when they suspect that there is something amiss. A few weeks ago, my friend asks me (in her lilting Irish accent)to “take a look” near her eye- where she has a tiny sore that isn’t healing. Uh-oh. Right now I have a few situations like this ongoing- *most* of them *do* go to doctors… eventually ( BTW, she did).

“Coping” includes seeking out help for what you can’t take care of adequately alone- both technically and emotionally: doctors, nurses, friends with brains (who relate to your issue but say, “See a doctor!”)

What if instead you sought aid and comfort from the ministrations of a website to soothe fears,”answer” your questions, and promise cures without any basis in reality other than *earnings*? While the hospital situation is abysmally bad, there are real professionals involved- wouldn’t it just be easier- and more reality-based- to address patients’ *coping* needs, rather than gussied-up mysticism and ersatz spirituality? Isn’t it a giant waste of money in hard times.

** a hint for the youngsters out there: when you hit 50, even if you are remarkably untouched by age ( as I am- crosses fingers)- your best buds may not be!

Luckily, in my country, there’s a growing movement against the inclusion of CAM in schools and hospitals. It’s very muched viewed as something different from “real” medicine, which I think is most definitely a good thing. You do get your woo-meisters (and our government recently appointed a woo-meister to a high-ranking government position in control of medicine, sadly), but I don’t think they’re as vitriolic or as powerful as those South of the border.

Which doesn’t mean that we should be complacent. Movements up here usually gain momentum about 5 years or so after they gain momentum in the States (case in point: a growing religious right leaning to our Conservative party, trailing the Teaparty types in the States by about 5 years), so it’s about time for them to make some unfortunate inroads into our schools.

I just had an argument last night about table salt. My acquaintance was telling me that table salt (NaCl) made in a lab is different than table salt (NaCl) from “natural” sources. I conceded that sea salt doesn’t have as high of a sodium content because it contains other salts, like KCl, but I told her that NaCl is NaCl NO MATTER WHERE IT COMES FROM. She argued this!

She is also diagnosed with stage 1 breast cancer but is seeing an alternative medicine doctor instead of accepting traditional treatments like surgery or chemo. He told her that her body’s pH is off and that is why she has cancer. It is actually very, very sad. Luckily her cancer is in an early and slow-growing stage so I hope she gets a grip on reality before it gets worse, but the whole situation is just ridiculous to me. And it is ridiculous that her alternative medicine “doctor” (who supposedly actually has an MD) allowing this quackery that could kill her. He is technically not allowed to treat the cancer – she has told me many times – but he still has her thinking that the other stuff he is doing is going to cure her cancer.

She also “doesn’t eat sugar.” To cure cancer. Even though she does eat sugar since she eats fruit and carbs and practically everything. She just doesn’t eat cupcakes. Frustrating.

The most frustrating part, again, is legit sources are condoning these practices. Eating healthier and exercising? Yes! Meditation, relaxation, and other mental health-improving measures? Sure. Changing your body’s pH? What? Anyone who knows anything about physiology knows that the pH of our body is held in a VERY tight range or else you die. Quickly. Ugh.

The most difficult one is” “you need to respect my beliefs”, because in our culture, this is true–but I don’t!

They have a right to their own opinion. They do not have a right to their own facts. If and when they publish a study showing the scientific efficacy of a given CAM therapy, I’ll listen. Until then, I prefer medicine which has been proven effective.

Also right on about the East vs. West false dichotomy. How many of these allegedly ancient Eastern medical practices are in fact of more recent (as in the last 200 years or so) provenance? And heavily influenced by Western philosophy?

I’ve managed to get onto my school’s CAM vertical integration subcommittee; not sure when we meet, but based on the composition of the subcommittee, it seems integration of CAM into the required curriculum is already a foregone conclusion; the only question left to be answered is how to do it.

Pretty sure I can hold it up, but for how long and at what cost?

My daughter, a senior in a program that feeds quite a few students into medical schools, has commented on several occasions that most of the prospective medical students she encounters display very little regard for science. They sincerely seem to want to do good and often have first-rate intellects, but tend to regard the scientific method as largely unrelated to medical professionalism. Those individuals will likely be easy targets for CAM peddlers.

@Anthro

The most difficult one is” “you need to respect my beliefs”, because in our culture, this is true–but I don’t!

To me, that’s the easy one. “No, I don’t. I respect your right to hold those beliefs, but I have no obligation to respect the beliefs themselves. They’re ridiculous/wrong headed/dangerous. This is what I believe — if you require me to respect your beliefs, then you have to respect mine as well.”

This business that says in our culture that we’re required to respect ridiculous beliefs is… ridiculous.

“Equally unfortunately, these same physicians uncritically buy into the “bait and switch,”

To me that says that schools (Med and other) need to spend more time on critical thinking skills. We’re being overwhelmed by nonsensical claims and idiocy in almost every realm of knowledge.

I don’t blame CAM proponents – I blame mainstream society and the media, who encourage low-level lying and cheating because it’s a normal part of how we do business.

Well, there is another way of looking at this that might help. Nutrition, exercise, relaxation techniques — it’s relatively easy for the bait and switchers to label these as CAM because, although there is plenty of science that says they are important and physicians will agree if asked, medicine as actually practiced tends to give them short shrift. Doctors will give people a bit of advice about eating right and getting exercise, but they pretty much assume it won’t do much good and they’ll very quickly prescribe a statin and an ACE inhibitor. Ditto for stress, depressed mood (I’ll leave major depression for another occasion) and pain — counseling, CBT, meditation, whatever, aren’t available, so the doctor will just write a prescription.

The quacks may or may not give good nutritional advice — ayurvedic dietary prescriptions are nonsensical — but they will spend plenty of time with people talking about it, give them help and support to follow it, and take it seriously. Primary care providers need to be able to spend more time with patients, and they need to have resources for nutritional counseling, mental health counseling, programs that can give people meaningful support for better nutrition and physical activity, etc.

Yes we all agree that there’s plenty of scientific information about, for example, nutrition in many important aspects of physical health, or for counseling modalities in depression, but how big of a role do those really play in medicine as it is actually practiced? A very small one, I would venture to say. And that’s what gives the woomeisters an opening. It’s not enough just to protest — medicine needs to back it up with action.

“science doesn’t know everything”

Dara ÓBriain’s rejoinder remains the perfect one – “Science knows it doesn’t know everything. Otherwise, it’d stop.”

Ugh for the first-year resident quoted – I live in San Mateo county. 🙁 The UCSF sports medicine department has given excellent science-based treatments to my husband that have done marvels for the osteoarthritis a moto accident some years back left him with. I hope they don’t replace those treatments (including PT) with acupuncture and sugar pills.

@cervantes

… medicine as actually practiced tends to give them short shrift. Doctors will give people a bit of advice about eating right and getting exercise, but they pretty much assume it won’t do much good and they’ll very quickly prescribe a statin and an ACE inhibitor. Ditto for stress, depressed mood (I’ll leave major depression for another occasion) and pain — counseling, CBT, meditation, whatever, aren’t available, so the doctor will just write a prescription.

Got any figures to back up that “usually”? It’s not data, but my personal experience, and that of my family, has been exactly the opposite. Doctors reluctant to prescribe medications before other methods have been tried.

The only exceptions to that have been situations, such as depression, where a medication can bring the patient to the point where talk therapy can be effective. It’s really hard to do CBT when you’ve got depression preventing you from doing much at all. But even then, the alternatives and approaches were discussed and the doctor didn’t just reach for the ‘scrip pad.

@ Roadstergal:

And don’t forget the indispensable rest of the rejoinder. “Just because science doesn’t know everything doesn’t mean you can fill in the gaps with whatever fairy tale most appeals to you.”

How about “the thing that has to give/go” is alumni donations back to the universities?

Part of it is probably a desire to attract donations from wealthy fools. Apparently Morgan Stanley’s John Mack’s wife Christy is big on woo, is trained in reiki herself, and likes to donate money for alternative medicine causes from the family charitable fund.

Shayna: I conceded that sea salt doesn’t have as high of a sodium content because it contains other salts, like KCl

…and chlorides, iodides, bromides, carbonates, sulfites, and sulfates of calcium, magnesium, iron, chromium, manganese, uranium, cadmium, mercury, lead, and everything else dissolved in the ocean. Yum.

(Most in traces only, but if you’re going woo, surely those would be even more dangerous because they’re in homeopathically-active dosages.)

Besides the serious amount of bullshit concerning CAM in education (I graduated as a Nurse in Holland, don’t get me started), there is also some positive stuff! Almost homeopathetically diluted as it may be: The Medical departmens of Universities in Brussels and Gent (Belgium) has just recently kicked out the woo! Hopefully more Belgian universities will follow as they are preparing their statements on this.

… medicine as actually practiced tends to give them short shrift. Doctors will give people a bit of advice about eating right and getting exercise, but they pretty much assume it won’t do much good and they’ll very quickly prescribe a statin and an ACE inhibitor. Ditto for stress, depressed mood (I’ll leave major depression for another occasion) and pain — counseling, CBT, meditation, whatever, aren’t available, so the doctor will just write a prescription.

And in many cases, when people have had very longstanding hypertension (for example) waiting the months to years before diet, exercise, and lifestyle will make the change is simply not a good idea. I have pretty bad HTN – I have since I was about 21 or so – and was extremely overweight. I fought against drugs because I was doing a degree in medical anthropology at the time and felt like medicines were bad and I didn’t want to be on them. Finally I gave in and needed pretty high doses to keep my BP under control. I lost the weight and became very fit – from 255lbs to 175, from never having run a mile in my life to running half marathons at 8 minute miles paces and doing 100 mile cycling races, working out 5-7 days a week, eating well. That was 4 years ago that I began getting fit like that. I lost the weight in a mere 5 months and have kept it off since then. And it wasn’t until THIS YEAR that my HTN finally abated. I am still running a little high, but I don’t need to take medication every day. If I had waited for 4 years for my lifestyle and exercise to kick in, I would be pretty bad off. An extra 4 years of 170/95 BP is very much not good. So I am glad my doctors kept pushing the meds on me…. while SIMULTANEOUSLY pushing diet and exercise.

@nybgrus 7:06 — Good for you! It sure feels good to be fit, doesn’t it? I was fortunate enough never to have had HTN or be overweight, but old age is just around the corner and I’m finding that staying fit is a wonderful antidote to the creeping decline. My Dad was walking 2 miles a day at age 89, before the Bad Disease killed him relatively quickly. May you live long and stay healthy!

Curious that CAM hasn’t made any inroads into acute care for things like gunshot wounds and car accidents. I’d like to know insights what “Eastern medicine” can offer in these areas.

“He’s bleeding out! Recharge his qi!”

Thanks to all who made suggestions. I am aware of most of them, but find that they just don’t work (fall on deaf ears) or only serve to make the person feel insulted. These things make sense to US, but not to my acquaintances. Surely, I am cursed though, because I run into these people constantly.

I have tried to make the case that I can respect the right to believe, but that doesn’t mean that our differing “views” are equal–this never works; they just don’t get it. I am actually becoming socially isolated because I just cannot re-educate all these people.

Asking them to present evidence doesn’t work either–they always say that there are “loads” of studies supporting CAM. Then they send you links to the Health Ranger! Most people have no clue what constitutes a proper study.

By the way, Mark Bittman’s food column in the NY Times today has a longish tribute to Dean Ornish, calling him a huge expert in heart disease and praising his diet. Many of the commenters praised Gary Taubes (a journalist with no science background that I know of) and many, many of them harped on the “big pharma” and “docs are shills” and “it’s always pills with docs” and “it’s the HFCS” memes. The column was about saving money on health care by achieving a better national diet. It was a good column in general; I’m just making the point that this stuff creeps in everywhere and is often presented as (and seen as, very mainstream.

We are not winning this battle.

RE: the table salt argument

I had a similar argument with an anti-vaxer about formaldehyde. She contended that “natural” formaldehyde (ie made as a by-product in your body) is safer/ better than the (lab-made) formaldehyde in vaccines. But isn’t CH2O, well, CH2O?

palindrom: thanks! it does feel good and I hope to stay this way for a long time.

enkidu: yes, formaldehyde is formaldehyde. Period.

Cervantes: wow. Over here (UK) trying to get a new prescription for antidepressants is like getting blood out of a stone. I only got mine (in a major depression, my fourth episode in five years) after I’d sat on a counselling waiting list for months, and I couldn’t cope unsupported any more: I sat on the floor of the doctor’s office in floods of tears, and told him I was only leaving in police custody, on an ambulance headed for the local psychiatric hospital, or with a prescription. Seriously, I had to ask to be committed before he considered medication.

On the other hand, our surgery has an information screen in the waiting room, and one of the messages flashing up yesterday was inviting you, if you’re worried about weight or other health problems, to set up a diet and exercise regimen with your GP and then get referred to the nurse for on-going support.

We were treated to “alternative medicine week” this year, a week of brown-bag lunches with a chiropractor, a practitioner of the “Nambudripad Allergy Elimination Technique,” etc. Pretty disheartening, but luckily not mandatory. And given that there were no sandwiches provided, attendance was sparse.

I do think there’s some value in learning *about* this kind of stuff, since people do use it and we might need to talk with them about it. Having some familiarity with what other beliefs people have about their health allows for clear communication. I’d rather be familiar with even the craziest stuff and explain what’s wrong with it, rather than be blindsided (which is one reason I love this blog). That doesn’t mean it should be presented uncritically, though..

Hello

I came across your website by accident recently, and although I’ve only read a tiny fraction of the content so far, find it fascinating. One thing though infuriates me about it to the point of literal out-loud screaming. Nowhere can I find a definition or explanation of a word that you pepper your topics with like a typical illiterate peppers their conversation with “you know”s – and that word is “woo”. What on earth do you mean by “woo”? I can guess with fair certainty what you mean by it, but nowhere can I find it defined. I’ve tried searching your site for a definition, I’ve tried looking it up at acronymattic.com, and God help me I’ve even tried Googling it, but I’ve found nothing! So please, post haste, stick a big fat definition at the top of your home page & put me out of my misery!

Thank you!

I would love for you to weigh in on Georgetown University’s masters program in which you can get a Masters in CAM (I believe it is in physiology too)! For example, here is a course description for a course called “Survey of Complementary and Alternative Medicine”.

(PBIO-600, 3 credits; fall): Students will have an overview of the most commonly used CAM modalities in the US centered around the five domains of Complementary and Alternative Medicine (CAM). These include the Alternative Medical Systems (traditional Chinese medicine, Unani medicine, Ayurveda, homeopathy, naturopathy); Mind-Body Medicine (techniques designed to facilitate the mind’s capacity to affect the physical body’s functions in health and illness, such as meditation, yoga, and MBSR); Manual Therapies (osteopathy, massage, and chiropractic); Energy-Based Therapies (bio-feedback, acupuncture); and Biologically-based therapies (herbal medicine and dietary supplements). This course is designed for graduate students in biomedical disciplines. It will present theory and principles of CAM practices and train students to critically evaluate evidence of their efficacy and safety. Instructor: Dr. Hakima Amri

Page can be found at: http://camprogram.georgetown.edu/curriculum.html

Alternative medicine is sometimes actually anti-nutrition. A doctor once recommended a low-carb diet to me. For my allergies! I couldn’t believe he wanted me to eat a super high fat diet, and long term, as it would have to be as an allergy treatment.
Maybe it would actually help, but if it did, that would probably be because people would be eating less gluten or some other food that interacted with their inhalant allergies. Not from less carbohydrates.

stripey cat – I hear you on that. QOF is to blame for that. My bloody father in law, 76 and worried well (apart from very minor COPD) can somehow get 4 appts a week to discuss his ‘health worries’ as encouraged by those posters, yet I have a condition that requires monitoring, have just been diagnosed with a potentially fatal autoimmune disease that they’ve missed for SIX years, and I have to wait a fortnight to see a doctor, because they’re busy offering diet advice and nicorette patches.

I was told something very important, but embarassing, so that more mainstream doctors hadn’t told me, by a “holistic” kind of doctor. There’s a tendency for mainstream doctors to just slap a prescription at you and ignore the more personal, embarassing, conflict-causing area of personal lifestyle and habits.

@stripey_cat Anyone who has psychiatric problems ought to find out whether food sensitivities are contributing, especially if they have unexplained physical symptoms too. Like get blood tests for celiac disease – many celiacs get over depression on a gluten-free diet – if the blood test is negative, try an elimination diet, explained on http://camoo.freeshell.org/elimination.html
I was depressed for twenty years. I would go on despairing crying jags where I felt “nothing is ever going to get any better”, but it seemed to be explained by my circumstances. I was blown away when I found out from an elimination diet that I had virulent food sensitivities, probably celiac disease. And my depression went away. I no longer get suicidal, even though my circumstances are worse than they were.

As a graduating med student, I gotta say that most med students don’t really instill confidence in me about the future of medicine. They can’t or just aren’t interested in thinking for themselves (and end up believing all the woo that their patients demand). A lot of it is due to med school administrators. They generally aren’t very smart (sad to say). They are pretty far removed from science-based medicine and pretty much forbid anyone to questions the status quo (or question why something is being taught a certain way). If someone does bring up a tough question, they get labeled as “unprofessional” and are given no chance to explain themselves. This gives med students the attitude that they should just accept what is presented to them (and you end up getting people like Dr. Brown (the first-year resident). The followers get A’s, the transcripts of those that think for themselves are mediocre at best. Med school has left a sour taste in my mouth and makes me fear for the future of many patients.

@ Narad: * Merci beaucoup!* Holy crap! It reminds me of those Chakra-based formulae that use different-hued gemstones to treat various Chakra imbalances. *Comment dit-on _rubbish_ en francais?*

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