A Defense Of Alternative Medicine

When Dr. Tara Coles suggested I read Do You Believe In Magic? The Sense And Nonsense Of Alternative Medicine, I expected to disagree with most of Dr. Paul Offit’s book. I’d heard it was a broad-sweeping takedown of alternative medicine, lashing out against everything from vitamins to acupuncture to alternative cancer cures.

As a supporter of many alternative medicine practices, and the author of Mind Over Medicine, which examines the science behind why many alternative techniques work, I braced myself to hate Dr. Offit’s book.

Unsurprisingly, he is so impassioned in his diatribe against alternative medicine that one wonders why he included a promise to mention the “sense” in alternative medicine, when clearly he thinks it’s all “nonsense.”

With a loaded gun and an apparent chip on his shoulder, he goes after Dr. Oz, Dr. Christiane Northrup, Dr. Mercola, Dr. Deepak Chopra, Dr. Andrew Weil, Linus Pauling, Suzanne Somers, Jenny McCarthy, even Oprah. He paints them as either ignorant, money-hungry quacks who don’t have a clue what real medicine is, or dismisses them as vapid celebrities who should do their homework before influencing the public by endorsing medical treatments.

With ruthless precision, Dr. Offit unpacks the science (or apparent lack thereof) behind the supplement industry, the vitamin craze, chiropractors, the risks of vaccines (apparently none), the treatment of Chronic Lyme (a disease he says doesn’t exist), the madness of alternative cancer cures (which don’t work), and the tragedy of treatments aimed at desperate parents whose kids are autistic (which also don’t work). He says alternative medicine practitioners are nothing more than charismatic charlatans with impressive sales tactics. As for acupuncture and homeopathy, well, they’re no better than placebo.

With such a venomous critique of so many beloved celebrities and widely-used treatments (even multi-vitamins don’t make the cut), one can only imagine that Dr. Offit isn’t making the rounds on a traditional book tour, where angry mobs of chiropractors, homeopaths, Chinese medicine practitioners, and integrative medicine doctors would likely try to lynch him.

Perhaps for reasons of self-preservation, he also fails to disclose his close ties to Big Pharma, including his patent on the rotavirus vaccine he co-invented.

Vitamins Could Kill You

While I was prepared to hate this book, I applaud Dr. Offit for a thoroughly researched, persuasive argument against anything that doesn’t pass the rigors of evidence-based medicine. The book is quite compelling and more than a bit frightening. (If you’ve put all your eggs in an alternative health care basket, this will give you hives.)

According to his research, people who take multivitamins have a higher risk of heart disease and cancer, the top two causes of death in this country. Not only does the average person not need a multivitamin, says Dr. Offit, taking one could shorten his life. (This article refutes this statement.)

Dr. Offit also states that, among the 51,000 supplements on the market, only a handful provide any real value: (1) omega-3 fatty acids to prevent heart disease, (2) calcium and vitamin D to prevent osteoporosis in postmenopausal women, and (3) folic acid during pregnancy to prevent spinal-cord defects in newborns. Everything else is no better than placebo.

So what’s my take?

While Dr. Offit’s book is very well researched and well referenced, it misses the bigger point: People are flocking to alternative medicine treatments for a reason.

While Western medicine excels at acute and trauma care, it’s failing miserably in the treatment of most chronic health conditions. People are finding it lacking, not only in results, but in actual care from the health care provider.

Unsurprisingly, many are seeking out alternative care from providers who offer them love, nurturing, hope, a positive bedside manner, and more time than the average 13 minute doctor’s visit.

And when they seek care from these practitioners, a good percentage of the time, they get better. I like what Harvard professor and Chinese medicine practitioner Ted Kaptchuk said in a New Yorker article when questioned about how he could practice acupuncture when it has been scientifically proven to be no better than sham acupuncture.

He said, “Because I am a damn good healer. That is the difficult truth. If you needed help and you came to me, you would get better. Thousands of people have. Because, in the end, it isn’t really about the needles. It’s about the man.”

Amen.

But It’s No Better Than Placebo

Although Dr. Offit acknowledges the placebo effect and includes a concise, well-researched review of the placebo effect, never once does he cite how powerful that placebo effect can be. His conclusion always seems to be: If it’s no better than placebo, it doesn’t work.

My hesitant response to his diatribe (hesitant because I know this statement flies in the face of everything I was taught during my medical training) is, Who cares if alternative medicine is no better than placebo? If it’s working as much as 70% of the time and we have no better treatment in our Western medical arsenal, what’s wrong with that?

Yes, I acknowledge that there are ethical dilemmas around how much we should be charging patients for treatments that Western medicine has deemed “ineffective” by the standards of evidence-based medicine. Yes, it’s potentially dangerous to withhold conventional treatments when other options are known to be more effective than placebo. Yes, there are charlatans out there. And yes, some alternative treatments can be risky, especially given that the supplement industry is completely unregulated by the FDA.

But there are also healers out there like Ted Kaptchuk, who get results, perhaps not so much because of the needles or the homeopathic remedy or the chiropractic manipulation as for the love they offer, the way they calm the amygdala in the patient’s brain, the powerful activating effect on the body’s natural self-healing mechanisms, and the efficacy with which the practitioner IS the medicine.

I would offer that we need not dismiss any treatment as “just the placebo effect.” Instead, we must sit in awe at the body’s power to heal itself and the practitioner’s capacity to activate this power, especially when Western medicine lacks treatment proven to be more effective than placebo.

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