Medicine Health

Let's be honest... If you're like most people you get a little twitchy, roll your eyes or furrow your brow at the mere mention of terms like "Natural Medicine" or "Complementary and Alternative Medicine". You envision lotions, potions, chanting and rubbing stones or crystals. I swear that half my new patients are shocked to come see me and find that I don't have a bone through my nose. If you aren't part of the medical mainstream then you have likely had to endure labels like "voodoo doctor", "witch doctor", "pseudoscience", or "quack". C'mon... Admit it. You have had those thoughts. I know because even though I'm a chiropractor I've had them too. So what gives then? Why the stigma around natural healing arts? There are some definite reasons which may be surprising why you feel the way you do.

First let's talk about your upbringing. Since the 70s medical dramas have always been big on TV. Actually some of the most successful series of all time are about medical doctors. Quincy, General Hospital, E.R., M.A.S.H., Scrubs, Grey's Anatomy, House, Dougie Houser, MD, Chicago Hope, and the list goes on. The doctors are witty, beautiful, smart and usually manage to produce a life saving conclusion within 30-60 minutes. You and I were raised learning that we could trust the doctor, especially if he or she had a white coat, stethoscope, scalpel and a prescription pad. These doctors never say sorry, they rarely lose and heaven knows they have never told anybody their problem could be fixed with a vitamin. They are the difference between life and death with beautiful tans and lavish sex lives.

What about other practitioners? Usually a Chiropractor, Acupuncturist, or Massage Therapist is a punch line. The Simpsons aired an episode where chiropractors pulled up in a truck one night and demolished Homer's spinal alignment tool (a trash can) using model spines. Of course they all had ponytails. Phoebe on Friends was a massage therapist and was the odd one of the bunch, famous only for her ditzy remarks. One of the main characters on Two and a Half Men is a chiropractor but is portrayed as a nerdy loser. People who use acupuncture or similar techniques in movies or TV are typically perceived as desperate or eccentric.

Why do networks want a successful medical drama? You only need to look at commercials to find the answer. Pharmaceutical firms pay big bucks to advertise their drugs and products during these shows. Believe me... Networks are eager to receive them.

All this is not to say that the media is the only reason you have trouble trusting natural medicine. "Science" is to blame as well. Maybe you noted the quotes I just used there. Medicine would have us believe that all of their practices are based on cold, hard, unbiased, emotionless science. In fact they call just about everything else pseudoscience or unscientific. The truth is that many of the practices in medicine (conventional, alternative or otherwise) are not based on hard science. There are various reasons for this. For example, we may not have the technology to evaluate claims made by chiropractic or acupuncture to our satisfaction therefore we don't have hard science to validate some theories. For medicine the biggest obstacle is the dominance of pharmaceuticals over the profession. Most health research studies are funded by pharmaceutical corporations either directly or indirectly. This is a problem because it introduces multibillion dollar bias into the body of research. Studies are designed to make the drugs being developed or tested look good. Maybe they exclude test subjects who are more typical patients but might not respond as well to the treatment. Other times they will test it against treatments that are administered in the wrong way such as a low dose of vitamins or the wrong chemical form of a mineral. What ever the tactic may be these studies are usually set up to give drugs the best chance of prevailing. That is not science. Science is about disproving and the burden is always on the treatment being tested. It is not science when the deck is stacked so that we can sell a drug. According to Robert K. Merton's "norms" which help us identify "real" science the party conducting the research must be detached meaning they have no other reason for conducting the study other than the expansion of knowledge; other reasons liiiiiiike... $100s of millions. Also drug companies often bury studies that have negative results making it look like all available studies show a working drug with few or no side effects.

I'm not trying to say that you can't trust science when it comes to healthcare. It helps us move away from treatments that are dangerous and ineffective (real science that is). However, its value in a clinical setting is limited. Scientific research tends to apply to a narrow group of specifically selected people and it might have greater implications for the rest of the world. That is why doctors of all disciplines are moving toward practicing Evidence Based Medicine and not Science Based Medicine. Science Based Medicine would only work on lab rats or monkeys or a select group of people trying to make some extra cash by being test subjects. Evidence Based Medicine takes into account the best and worst designed studies to help guide decisions. Guess what? There is evidence out there that medicine works! But guess what else?! There is evidence out there that Medical medicine isn't the only thing that works or even the best thing in some situations.

Why else might you not trust Natural Medicine? How about the way it is categorized? Alternative? Complementary? What do these name suggest? Non-Medical approaches are for eccentrics and people who are on the fringe? We only fix weird problems that hippies get? Or if I am a Complimentary care provider is it only OK for me to treat people as long as they are taking their pills? Why don't we just call Medical care "Medicine" and call everything else "Health care"? Whaaaaat? That would make people think that Medicine doesn't help people get healthy? Of course that isn't true but see the value of a label?

How about the government? Do they teach us anything about Natural Medicine? While most of the research that actually shows the efficacy of more natural approaches are funded by governments, there is another edge to the sword. Take for example the Food and Drug Administration (FDA). Their labeling policies prohibit any natural supplement and even vitamins from indicating to the average consumer the proven benefits of these products. For example Vitamin D can only be labeled as being important for contributing to bone health. REALLY? Vitamin D (according to Science) treats and/or prevents Cardiovascular Disease, Hypertension, Type 1 and Type 2 Diabetes, Osteoarthritis, Multiple Sclerosis, Depression, Epilepsy, Migraine Headaches, Polycystic Ovary Syndrome, Muscle and Joint Pain, Autoimmune disease, Chronic Inflammatory Conditions, and even Cancer. The research is out there and the evidence is clear but the FDA only says we can make bone health claims. Why? Because they said so (read: bureaucracy). Basically, here is how it works... if they think that your product can save lives then it is a drug. That is unless it occurs in nature and can't be patented by a pharmaceutical company thereby making billions, in which case it should be discredited and ignored.

Finally, there are the Natural Medicine providers themselves. I have to admit we have some crazies. We have every type of quack that Medicine has. We have people who burn candles in your ear to cure ear aches. Medicine has quacks who prescribe prophylactic anti-biotics for ear aches. We have chiropractors who tell people they need to be adjusted 5 times a week for months in order to be healthy. Medicine has quacks who tell people to take ibuprofen every day to fix their arthritis. The difference between our quacks and their quacks is the stakes. Our quacks cost you money. Their quacks can cost you your life. There are about 20,000 deaths per year from prescription drug overdose. (CDC 2008). Ok... Ok.. To be fair that is probably from drug abuse. What about adverse reactions to drugs properly prescribed and administered? The estimates are that about 5-9x more people die this way (Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA . 1998 Apr 15;279(15):1200-5.). What about drugs like Ibuprofen, Advil and Aleve? About 16,500 deaths per year from internal bleeding (Byron Cryer MD. NSAID-Associated Deaths: The Rise and Fall of NSAID-Associated GI Mortality. The American Journal of Gastroenterology (2005) 100, 1694-1695). In fairness we should look at the deaths that Natural Medicine is causing. There are 2.68 deaths per 10,000,000 adjustments. (Gouveia LO, Castanho P, Ferreira JJ (2009). "Safety of chiropractic interventions: a systematic review". Spine 34 (11): E405-13) That means after about 61.5 billion adjustments we would just be catching up to Ibuprofen. Most years there are 0 deaths reported from Vitamins and Supplement use.

So what's the point here? Am I just trying to crack on Medical Doctors? NO! They aren't villains. They save more lives than they cost. They entered the health care arena for the same reason I did, to improve the quality of people's lives. Heck! I go see a Medical Doctor! The fact is that here are many, many brilliant practitioners (some of them even have MD after their name) of what we call Natural Medicine. Our species has thrived on nature for thousands and thousands of years. Our disdain for it is only recent. It is our synthetic world that has made us sick with additives, pesticides, pollution and even pills. A return to the natural may be the best thing for us.

In conclusion, consider the work of another great doctor: Dr. Seuss, to drive my point home in his classic tale: Green Eggs and Ham. (Paraphrasing of course)

Say!
I like [Natural Medicine].
I do! I like [it] Sam-I-Am.
And I would [try it] in a boat.
And I would [try it] with a goat.

And I will [try it] in the rain.
And in the dark. And on a train.
And in a car. And in a tree.
[It is] so good so good you see!

So I will [try it] in a box.
And I will [try it] with a fox.
And I will [try it] in a house.
And I will [try it] with a mouse.
And I will [try it] here and there.
Say! I will [try it] ANYWHERE!

I do so like
[Natural Medicine]!
Thank you!
Thank you,
Sam-I-am