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The Mayo Clinic Supports CAM
Posted: 23 September 2009 01:17 PM   [ Ignore ]
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Apparently not all forms of CAM are highly unethical, unless this Doctor from the Mayo Clinic in Rochester, MN is a Charlatan. I highly doubt that though.NYT’s Article
Yet more proof that CAM and alternative therapies are swiftly integrating into the traditional medicine world, to treat sufferers of a wide array of maladies-and with efficacy too!!
Word has it that the 2 Billion Dollar fine for Pfizer wasn’t even a bump in the road for them. Talk about ethics!!

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Posted: 23 September 2009 03:13 PM   [ Ignore ]   [ # 1 ]
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*sigh* I know I’ll never convince you, but this sort of thing doesn’t validate CAM in any way. The doctor in the article is the “director of the complementary and integrative medicine program,” which means he’s a believer in this stuff. Unfortunately, the fact that he believes in it and has and MD doesn’t change the scientific evidence, which does not support the effectiveness or safety of many of these therapies. He doesn’t have to be a charlatan, just mistaken. And the fact that these programs are turning up in all sorts of well-respected places doesn’t mean the stuff they promote is safe or works, just that people want it and believe in it. People want and believe in religion, and that’s “integrated” into all sorts of instituition, but that doesn’t make it true either.

Fibromyalgia is the classic disorder for CAM. It is vague and hard to diagnose, it is defined by an inconsistent collection of symptoms which can only be examined through the subjective report of the patient, no consistent physical or laboratory signs to identify it have been found, and not surprisingly, given how poorly understood it is, scientific medicine doesn’t have any really effectove treatments. So people turn to CAM, which promises much and delivers a lot of placebo. Since people are really suffering and there isn’t much in the way of real therapy, it’s understandable why they would look to the magic and wild guesses that underlie CAM, but I for one still consider it unethical to sell desparate people magic and wild guesses as if they were medicine. The association with Mayo gives the appearance of legitimacy to stuff that doesn’t deserve it, and that’s not a good thing for patients.

As for the Pfizer reference, it is has nothing to do with whether CAM for fibromyalgia is a good thing or not. I realize you are unable to believe that anyone could oppose CAM on the basis that it doesn’t work without somehow being a tool of the pharmaceutical industry, but the idea that people have to choose between CAM or evil industrial medicine is a false choice that has marketing power for the CAM industry, but no real truth to it. The bad behavior of Big Pharma and the ethics of alternative medicine are separate issues.

[ Edited: 23 September 2009 03:16 PM by mckenzievmd ]
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Posted: 23 September 2009 03:51 PM   [ Ignore ]   [ # 2 ]
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So you are saying that the Mayo Clinic, and as you said, hundreds of other health care facilities, are putting profit before peoples well-being, healing, and comfort.
Never mind the burgeoning amount of studies that are beginning to support the efficacy of someof CAM.
And importantly that thousands of health care providers are discovering that these therapies, unctions, foods, rubs, and vitamins(etc) are merging with various traditional meds(I always hate calling ‘em that because actually the CAMs are more traditional really)to form a more complete, well rounded approach to healing, and health.
I’m glad to continue this debate, because it is beginning to show an abject stubbornness on the part of those Forum Participants who continue to shun these Concepts. A stubborness that reveals an idiosyncratic reaction that may not be conducive to well-rounded inquiry, or knowledge.
Of course I’m not pushing Kinoki Foot Pads, or even Electro-Shock Therapy(which was effective in it’s own right, but highlights the ups and downs of medicinal therapies and their acceptance by the Industry and the consumer as time goes on).
The debate here isn’t about Medicine really, as I said I could care less about medicine, my beef is with this abject stubborness
I mean there is a whole Forum Dept. dedicated to what is predominantly a bashing site for CAM. This has always struck me as a Peevish concept. Mostly due to what you yourself have stated above McKenz. These are products for consumers. I see nobody has posted anything about cigarettes? They are now regulated by the FDA. I would say these are real concern, far above and beyond herbs, or massages or acupuncture-wouldn’t you? They kill 300k-500k a year or so. That even overshadows Medical Malpractice, or adverse reactions to prescription meds.

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Posted: 23 September 2009 04:47 PM   [ Ignore ]   [ # 3 ]
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So you are saying that the Mayo Clinic, and as you said, hundreds of other health care facilities, are putting profit before peoples well-being, healing, and comfort

No. I think profit is one motive, and as someone concerned about the exploitation of people by uncontrolled big business, I would think you’d be concerned by the billions of dollars spent worldwide on worthless bogus treatments that make some people rich but nobody well.  However, most of the motive is about keeping people happy and avoiding the sort of bashing I get from you whenever this comes up. For some reason I will never understand, insisting that someone show some reasonable evidence that what they are selling is safe and works before welcome a therapy with open arms gets labeled as stubborness or closed-mindedness. Perhaps you prefer to just take whatever someone aellinga therapy tells you at face value, but I know enough about the history of snake oil in this coutnry before government regulation to know how dangerous that is.
Anyone interested might want to look at what I’ve written elsewhere on these topics:

What is Open-mindedness
The David and Goliath Myth—why CAM isn’t “the little guy”

Never mind the burgeoning amount of studies that are beginning to support the efficacy of someof CAM.

You’re just plain wrong here. There is no burgeoning of studies showing CAM works. The nearly $2 billion dollars of taxpayer money the NIH’s NCCAM has spent researching it has yet to validate a single significant therapy in over 10 years. In most cases, the trajectory is clear and predictable: suggestive in vitro and laboratory animal studies lead to initially positive results from small, poorly designed studies which are then overturned by larger, better-designed studies.

actually the CAMs are more traditional really

Another myth, and irrelevant even if it were true. Homeopathy and Chiropractic were invented by single individuals in the 19th century, and Naturopathy is no older. Most of the vitamins and alternative diets are 20th century inventions. And even for those methods which trace at least some of their ideas to ancient history, how does this mean anything? Acupuncture points and meridians were derived from a form of Chinese astrology. Why would we want ot continue that? And all the pre-industrial cultures that relied on “traditional” folk medicine had levels of illness, infant mortality, and life expectancy that are well below ours today. So the appeal to tradition as support for CAM is often wrong and is meaningless even when it is true.

As for stubborness, that’s just a silly ad hominem. The debate most certainly is about medicine, not about why you find my persistant criticism of unproven medicine irritating. If I continue to insist that people marketing any medical therapy, regardless of its origins, show some evidence of basic plausibility and actual clinical safety and efficacy, how does that squelch inquiry? We are, after all, talking about mostly faith-based approaches to therapy that rely on blind belief and don’t give a fig for what the evidence says. I would say my position is far more consistent with rational skepticism thatn yours here.

What is there to say about cigarettes? The overwhelming majority of the scientific medical establishment has been combating smoking for years. Science showed us how dangerous they were and the medical community accepted the evidence and took action, and here has been a marked decline in smoking-related deaths since. Once again, you bring up a totally irrelevant subject which I think hints at an underlying motive behind your posts. It certainly seems like your problem with my criticising CAM is that you think of the CAM community as a bunch of plucky and well-intentioned underdogs beset by a sinister corporate-dominated monolith. Nonsense! Most of the herbs, vitamins, glucosamine, and the like is sold by hugely profitable corporations. The chiropractors are a vigorous and powerful lobby. These groups spend millions buying legislative support just like the big pharmaceutical companies you hate so much. They’re no better ethically, and most of the time they’re not even selling stuff that works!

Here’s a great article in which one of these folks outright admits taking advantage of scientific uncertainty to make a profit before sufficient research is done to undermine the promise of a new idea:

manufacturers of neutraceuticals consider the time between the proposal of a hypothesis that a supplement might be beneficial and the accumulation of sufficient data to decide the truth as a golden time for marketing. As a recent article from the Los Angeles Times news service put it regarding one of these compounds:

“For the purveyors of vitamins, minerals and herbal remedies, that is a five- to seven-year opportunity not to be missed. Consumers’ dreams of forestalling the ravages of age have been engaged, and they will buy and swallow anything that gleams with the luster of science. While they wait for science to flesh out resveratrol’s promise, consumers’ demands for the stuff can be built, tapped and satisfied with products that offer plenty of promise but tread lightly around the preliminary state of the scientific evidence.

““There’s a watershed time for a good nutraceutical,”” says Dr. Joseph Maroon, a University of Pittsburgh neurosurgeon, author of a book titled “The Longevity Factor” and co-founder of a company, Xenomis, which rolled out a line of resveratrol-based supplements last May.

Resveratrol, in short, stands at the juncture of hope, profit and scientific promise — a social phenomenon galloping ahead of research that is undeniably intriguing but very incomplete.

[ Edited: 23 September 2009 04:49 PM by mckenzievmd ]
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Posted: 23 September 2009 07:51 PM   [ Ignore ]   [ # 4 ]
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Good evening folks. I’d like to welcome our studio audience, and thank the people at home for tuning in to Spot the Logical Fallacy!

VYAZMA - 23 September 2009 03:51 PM

Word has it that the 2 Billion Dollar fine for Pfizer wasn’t even a bump in the road for them. Talk about ethics!!

That has nothing to do with CAM. It is a red herring.

So you are saying that the Mayo Clinic, and as you said, hundreds of other health care facilities, are putting profit before peoples well-being, healing, and comfort.

Straw man.

Never mind the burgeoning amount of studies that are beginning to support the efficacy of someof CAM.

Unsupported assertion.

And importantly that thousands of health care providers are discovering that these therapies, unctions, foods, rubs, and vitamins(etc) are merging with various traditional meds…

Another unsupported assertion. In Mexico this type of reasoning is known as caca de toro.

actually the CAMs are more traditional really

So are leeching and bloodletting. What is your point?

The debate here isn’t about Medicine really, as I said I could care less about medicine, my beef is with this abject stubborness

Ding ding ding ding! He’s pegged the irony meter!

I mean there is a whole Forum Dept. dedicated to what is predominantly a bashing site for CAM.

We also have a discussion forum dedicated to bashing pseudoscience and the paranormal. Just because we enjoy bashing woo doesn’t mean we’re closed minded, it means we have the critical thinking skills and education to recognize bad science and bad medicine when we see it.

I see nobody has posted anything about cigarettes?

Another red herring.

That even overshadows Medical Malpractice, or adverse reactions to prescription meds.

How many people does Medical Malpractice (sic) kill every year? How many people die of adverse reactions to alternative meds? How many people die of adverse reactions to CAM? How many people die while being treated by CAM practitioners when conventional evidence-based medicine could have saved them? How does any of this prove CAM is acceptable medicine?

mckenzievmd - 23 September 2009 04:47 PM

I think profit is one motive, and as someone concerned about the exploitation of people by uncontrolled big business, I would think you’d be concerned by the billions of dollars spent worldwide on worthless bogus treatments that make some people rich but nobody well.

We have a winner!

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Posted: 24 September 2009 04:13 AM   [ Ignore ]   [ # 5 ]
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Brennen and fotobits have this spot on. Thanks.

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Posted: 24 September 2009 05:28 AM   [ Ignore ]   [ # 6 ]
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I noticed the National Institute of Health website has a large Directory for CAM. I just looked up acupuncture, and it stated that research has shown that acupuncture reduces nausea after chemotherapy or surgery.
Do you think the NIH has been hijacked by lobbyists? I suppose it could be. Or maybe they aren’t a reputable organization to begin with.
I see they have quite an extensive research Dept. They are involved with researching CAMs and all other Meds. Their website appears to take steps to explain the varied world of CAM. Stating that not all CAMs are researched, not all CAMs are safe, and that they should be used only as directed by a physician.(Just like the prescription kind, or the OTC kind)They do have plenty of areas in their site which
explain the benefits of all kinds of treatments-treatments that aren’t under the realm of the FDA.(and don’t need to be apparently).
So I have to ask myself, as a Consumer, what do I believe? Who do I believe? Hmnnn? What if I came down with some Croup, or some arthritis or something? What if I saw a Doctor and he prescribed some prescription meds, but also gave me some herbal ointments. What if he told me to see an acupuncturist? What if I ditch that Doctor, and I have trouble finding a Doctor that stays rigidly within the confines of FDA approved prescription meds, and OTC meds?
CAM isn’t going away. Even in the most anti-consumerism States like the former USSR, or today in Switzerland, CAMs are hugely popular. This debate is about what constitutes “medicines”, and how “medicines” can easily be determined by peoples needs and wants.
Their Comfort!! As far as the swindling you want to keep highlighting, and I’m sure that goes on, we can only address swindling in the larger context of the medicine world, not just subdivided into CAM.
Like almost 100% of ALL CONSUMERS, I’ll use what works. I’ll take what I want please. I’ll use what makes me feel good. And hospitals and doctors are beginning to realize that this IS an integral part of healing. Not that they haven’t used forms of CAM since the beginning of time.

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Posted: 24 September 2009 05:31 AM   [ Ignore ]   [ # 7 ]
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fotobits - 23 September 2009 07:51 PM

Good evening folks. I’d like to welcome our studio audience, and thank the people at home for tuning in to Spot the Logical Fallacy!

Foto, I cut this post of yours down to a few phrases, over a foot long essay mainly concerned with drama, and quirky argumentative highlights is really “tired”! None the less I see it has it’s purpose.

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Posted: 24 September 2009 05:32 AM   [ Ignore ]   [ # 8 ]
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What do you see as its purpose?

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Posted: 24 September 2009 05:52 AM   [ Ignore ]   [ # 9 ]
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fotobits - 24 September 2009 05:32 AM

What do you see as its purpose?

Laughs at my expense! Bandwagon mentality. High volume content, little expenditure.
I’m bringing up SOLID POINTS here! Your mockery only reinforces my resolve concerning the true argumentative basis here.
I’m not bothered personally by your quips, I just want to highlight them to show the value of your rebuttals. Rebuttals which are off the track of this debate. Frankly they appear a little contrived.

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Posted: 24 September 2009 07:20 AM   [ Ignore ]   [ # 10 ]
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So! I suppose reading the rebuttals of McKenz, Doug Smith, and Fotobits, combined with the numerous other thread postings, that there are NO forms of CAM that are effective, worthwhile, or ethical?
Hmnn? Come on- I dare ya. Just come out on the limb, and reiterate your position.
No forms of CAM, in any way, have any value. They are categorically unethical, woo, and require only faith to utilize.

[ Edited: 24 September 2009 07:28 AM by VYAZMA ]
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Posted: 24 September 2009 07:53 AM   [ Ignore ]   [ # 11 ]
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As far as acupuncture, there is some evidence that is reduces subjective symptoms such as pain or nausea. It doesn’t measurably affect the underlying disease, and “sham” or fake acupuncture (piercing the skin at random places rather than traditional acupuncture points or using fake retractable needles that don’t pierce the skin at all) works as well as “real” acupuncture in many studies. This suggests that the procedure is a very effective placebo. And I don’t think there’s anything wrong with that if it makes people feel better, as long as they understand it’s not making their disease any better. Unfortunately, most acupuncture promoters credit the method with many effects it doesn’t really have, and when this leads to using it instead of validated therapies then it causes harm. Here is a good resource for reviewing the evidence for and against acupuncture for specific indications. The Cochrane Reviews also have good concise reviews of the approach.

If you’re going to be fair and really listen to what I’m saying, you have to acknowledge that I have never said all CAM is evil. All I say is that methods must be evaluated individually in terms of basic plausibility and actual clinical safety and efficacy. Most of these methods either haven’t been evaluated this way (most herbs, for example) or have been and failed (homeopathy for everything, acupuncture for anything except pain and nausea, chiropractc for everything except idiopathic low back pain, etc). What is unethical is claiming more than can be demonstrated for these therapies and setting them up as alternatives to real medicine.

As for NIH’s NCCAM, it was founded under pressure from Sen. Tom Harkin, who is a believer in CAM generally because he thinks bee pollen cured his allergies. Many good articles, including this one at the Science Based Medicine Blog examine the agency and how it’s wasted billions of dollars on pseudoscience because of the irrational beliefs of a few politically powerful people. The agency has been largely filled with people who believe in CAM, and its standards for funding and conducting research are far lower than the rest of the NIH. A recent example is the debacle of a study on the Gonzalez Protocol for pancreatic cancer. Cancer patients were subjected to a ridiculous and uncomfortable regime of diet changes, supplements, coffeee enemas and the like, and after years of study and attempts to bury the results rather than publish them, the final outcome was the CAM patients lived an average of 4mos, rather than the 14mos patients on chemotherapy lived AND the CAM patients had significantly worse quality of life scores. People suffered unecessarily and died almot a year sooner than they needed to in a government-funded study of something that had no rational evidence to suggest it would be of benefit, all because a few people had faith in it anyway.

So yes, essentially the NIH has been “hijacked by lobbyists”, or more accurately this small agency within it has been created by true believers to validate their pet theories regardless of what the science says. It is certainly not a good reason to accept the claims of CAM proponents, but sadly I can see why it would make you and most other people more likely to do so.

As for things the FDA “doesn’t have to regulate,” well we can thank Sen. Harkin for that too. DSHEA (the Dietary Supplement Health and Education Act of 1994) severely limits the FDA’s authrity to regulate anything that can conceivably been identified as a food or supplement. The marketers of these products can’t claim to prevent or cure any disease without proof (though they often do, and FDA doesn’t have the resources to police this effectively), but they can sell anythig they want with no evidence and no quality control oversight and claim almost anything else about it. Consequently, herbs contaminated with toxic metals or pharmaceuticals, and all sorts of other dangerous and ineffective stuff is freely available to consumers without any safeguards. (see HERE for some examples of the dangers posed by these things. Also, try reading Natural Causes: Death, Lies and Politics in America’s Vitamin and Herbal Supplement Industry by Dan Hurley).

You seem to be arguing a sort of extreme anti-government libertarian position that suggests that consumers should be able to purchase whatever they want for their health problems and government and science has no business trying to protect them from harm if it means limiting their choices. I, for one, don’t believe such a position make sense. Prior to the creation of the FDA, such a system was effectively in place, and it did not benefit the health of the public. You say you’ll use what works, but unless you’re a lot smarter than all the rest of us, what you mean is you’ll use what you think works whether it really does or not. We didn’t invent placebo-controlled, blinded, randomized clinical trials because they’re fun but because all humans have cognitive weaknesses that lead us to believing things that aren’t true. Science is just a method to help us see past these, and it works.

[ Edited: 24 September 2009 08:42 AM by mckenzievmd ]
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Posted: 24 September 2009 08:31 AM   [ Ignore ]   [ # 12 ]
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Poof! Your post is entirely too long. Backfill away! Poof!
Debate Over!
Take the time to read the months worth of posts from your camp, read mine and others, and please, please don’t mention Fairness!!
I’m restraining myself as it is. Lengthy posts are NOT going to dilute any concessions or backfilling.
Frankly I’m amazed at this outcome- I figured you sensed you were painting yourself into a corner…Oh well.
Forgive my apparent gloating- but after the time I have expended on this matter, I do feel satisfied.

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Posted: 24 September 2009 08:46 AM   [ Ignore ]   [ # 13 ]
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As so often happens, I have no idea what you’re talking about. Backfill? Concessions?

If you don’t have the patience to read my response or to learn anything about what you clearly have so many opinions about, then you’re just trolling and wasting everybody’s time here. I’m glad you feel satisfied by avoiding actually having to think about my points and just resting smugly in your own beliefs.

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Posted: 24 September 2009 09:45 AM   [ Ignore ]   [ # 14 ]
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mckenzievmd - 24 September 2009 08:46 AM

As so often happens, I have no idea what you’re talking about. Backfill? Concessions?

If you don’t have the patience to read my response or to learn anything about what you clearly have so many opinions about, then you’re just trolling and wasting everybody’s time here. I’m glad you feel satisfied by avoiding actually having to think about my points and just resting smugly in your own beliefs.

You take the time. You re-read the volumes of debate we have had on this subject.
All along I have said I don’t favor any kind of Medicine. All along you have stated that CAM is woo, unethical, sometimes dangerous(but alas, in a debate vs, traditional meds which are also dangerous this is moot)
You continue to spew forth your opinions, but the worst part which is evident just above, but also throughout this ENTIRE Forum, you continually put words in folks mouths, and try to force words into the other parties debate. You try and steer the argument so that it will go along with your opinions.
A few posts above, I asked you to reiterate what you have said countless times before- That there is no room for CAM, and CAM is woo. It is Akin to religion. You stated a short while ago CAM is akin to RELIGION!!!
So there are currently hundreds, if not thousands of ACTUAL SCIENTISTS doing ACTUAL RESEARCH into the ACTUAL BENEFITS of some forms of CAM….but this is just a religious phenomenom??
GIVE ME A BREAK!! Start erasing all your old posts concerning this topic. Start Erasing!!!
I put the bait out-you bit!! You are Debated Sir!

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Posted: 24 September 2009 09:52 AM   [ Ignore ]   [ # 15 ]
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Also, was that a hint at giving me a warning for Trolling? Is that what you are going to fall back on?
Here, I’ll use one of your favorite techniques- “SIGH”....

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