Dr. Ron’s Research Review – August 22, 2018

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This week’s research review focuses on quackery and alternative medicine.

“There is no alternative medicine," stated the editors (Drs. Fontanarosa and Lundberg) of the Journal of the American Medical Association in 1998. "There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. (Fontanarosa and Lundberg, 1998)

Eisenberg et al. defined alternative medicine (now often called complementary medicine) as “medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals.” That is not a very satisfactory definition, especially since many alternative remedies have recently found their way into the medical mainstream. (Angell and Kassirer, 1998)

Today’s quackery is defined by the National Council Against Health Fraud as “promoting health products, services, or practices of questionable safety, effectiveness, or validity for an intended purpose,” and further clarified as therapy that provides risk of harm without providing offsetting benefit. It often takes the form of alternative medicine. (Widder and Anderson, 2015)
In the 19th century, “Quacks concocted and hawked patent medicines”. Conventional medicine was based on three principal remedies for whatever ailed the patient: phlebotomy or bleeding, the use of purgatives, and blistering with caustic poultices.” “Faced with unresolved disease and horrific standard treatments, it is not surprising that many people sought relief by going to what might be considered quacks.” (Mehlman, 2005)
“What is striking is that so many of the conditions that gave rise to quackery in the 19th century are present today. After a half-century of major therapeutic breakthroughs in the form of antibiotics and vaccines, medical progress seems to have slowed. No cures have been found for the major killer diseases.” (Mehlman, 2005)

 

Dr. Ron

 


Articles

 

Alternative medicine--the risks of untested and unregulated remedies.
            (Angell and Kassirer, 1998) Download
Eisenberg et al. defined alternative medicine (now often called complementary medicine) as “medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals.” That is not a very satisfactory definition, especially since many alternative remedies have recently found their way into the medical mainstream.

Alternative medicine meets science.
            (Fontanarosa and Lundberg, 1998) Download
There is no alternative medicine," the editors of the Journal of the American Medical Association wrote last year. "There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.

Quackery
            (Mehlman, 2005) Download
Everyone condemns medical quackery. Government regulators seek to protect us from it. Alternative providers strive to distance themselves from it. Orthodox medicine wants to stamp it out. The question is: What constitutes “quackery”? How do we distinguish quacks from mainstream practitioners? Even more problematic, how do we distinguish between quackery, which everyone agrees is beyond the pale and therefore should be fair game for sanction, and practices that, while unorthodox, should be tolerated in the interests of promoting medical progress and patient choice? These are particularly challenging questions now, when a number of factors are combining to undermine the hegemony of mainstream medicine, when some of the same forces that spurred the growth of quackery in the 19th century are remerging, and when neo-conservatives are clamoring for greater freedom of choice for health care consumers. This article begins with a brief history of quackery in America and the factors that encourage its growth. The article then attempts to distinguish between quackery and acceptable medical practice. The article concludes by discussing how best to protect patients from quackery.


 

The appeal of medical quackery: a rhetorical analysis.
            (Widder and Anderson, 2015) Download
Medical quackery has been a pressing issue nearly from the start of the medical profession - whether the nostrums and patent medications of old or the super-foods and miracle supplements of today. Throughout history and into the modern day, the medical establishment has tried to counteract the claims of charlatans in order to protect patients from potentially harmful treatments. Countering today's pseudo-medicine begins with an examination of what makes patients susceptible to the claims of quack medicine. Understanding why patients are susceptible to dubious health claims begins with an examination of the rhetoric used to persuade a demographic toward alternative therapies. This knowledge can then be used to educate patients, and to better demonstrate the benefits of evidence-based medicine while improving patient interactions.

 

References

Angell, M and JP Kassirer (1998), ‘Alternative medicine--the risks of untested and unregulated remedies.’, N Engl J Med, 339 (12), 839-41. PubMed: 9738094
Fontanarosa, PB and GD Lundberg (1998), ‘Alternative medicine meets science.’, JAMA, 280 (18), 1618-19. PubMed: 9820267
Mehlman, MJ (2005), ‘Quackery.’, Am J Law Med, 31 (2-3), 349-63. PubMed: 16146294
Widder, RM and DC Anderson (2015), ‘The appeal of medical quackery: a rhetorical analysis.’, Res Social Adm Pharm, 11 (2), 288-96. PubMed: 25194893