OT: Conventional v alternative medicine

[Interdasting]

All of what I've advocated for is simple legislation changes. I don't have the expertise to go into any detail or even figure out a plan for how to go about such changes... but as I mentioned, the NCCAM has quite a bit of funding that I think they could be using better, and using that to provide scholarships for the best of the alt med community to transition them into better, science-based medicine could be one way to try to account for job losses in the alt med community and help address the problem of a lack of doctors.

Fair enough, I won't push further for specific regulatory and changes to the law to follow suit with your suggestions.

If you want to talk specific procedures, I can name a few, and already have named a few:
(most of) Chiropractic, (most of) Acupuncture and Homeopathy are some of the biggest things that should be addressed.

This is essentially what I've wanted all along from you. Whilst not as specific as I want, there is no way to "fix" anything about what you propose without actually stating that which you want to be changed; like theories of nonexistent reactions from cells because of water. That type of stuff is a little strange...but would your regulations extend to all "non-science based" procedures, or those that are dangerous? What type of line would you draw between what is acceptable and what isn't? Though you've said all "non-science based" medicine shouldn't be considered before so I think the same response is the answer I will receive.

I'm willing to concede that I can't present a plan for such a change. I'm not aware of any plans, either, but I would be surprised if there were any long-term plans published for the kind of change that I want, because it's not a popular opinion.

I've seen papers from a few years back of wanting regulation over the less-regulated practices like homeopathy, but what change do you want exactly? And it's strange, as kestegs pointed out, to hear that despite the perpetual debate over this, that your opinion isn't mainstream? What does that mean?

 

[pharphis]

Everything in your post makes sense. Not that I agree with you, but it makes sense.


I found this statement very interesting. The way you (and others) are presenting things had led me to believe that your views were more mainstream. What percentage of people do you think agree with you? What percentage of the scientific community agree with you? I'm not asking for hard numbers, unless you have them handy, just what you think.

Hm, good question. TBH I feel like most people in medicine probably agree with my position (at the very least that things should be better regulated so that patients can have a better standard of care). I feel like most scientists* would not agree with me but probably don't even hold more than a superficial position on the topic. I know that there are some articles written about science-based medicine vs. evidence-based medicine (this is by the authors/editors of the blog I've referenced a few times, SBM), and articles about CAM in general and some of the problems it presents. I remember finding some linked in the wikipedia page, if you want to check there, when I skimmed it a few weeks ago.

I think outside of the scientific community, that the vast majority of people would disagree with me - at least on face value. I think almost no one is informed about typical alt med treatments and are mislead into believing "natural" is better, and other very simple things that lay people should be better taught about in high school, tbh. I mean, just look at all the diet fads that come out every year, because of a lack of science literacy and unwillingness to fact check things that sound believable
Homeopathy is the easiest example, ofc, and I've heard people say that they believe it is
1) "natural"
2) "herbal"
3) "holistic"
in order to describe it. I don't talk to many people about this, ofc, but those are some examples I can remember, and have read about. Homeopathy is none of those things, but if it's in a bottle and says something nice, and advertising says it is nice, and your local naturopath recommends it, then you're probably going to take it/consider it/recommend it). I hate having to bring up homeopathy over and over but it really is the easiest example of pervasive pseudoscience... The FDA had a recent hearing about it, reported covered in some detail here (this is the same author, David Gorski, as the article I linked above).

*the rest of the scientists that aren't in medicine

 

[pharphis]

Fair enough, I won't push further for specific regulatory and changes to the law to follow suit with your suggestions.


This is essentially what I've wanted all along from you. Whilst not as specific as I want, there is no way to "fix" anything about what you propose without actually stating that which you want to be changed; like theories of nonexistent reactions from cells because of water. That type of stuff is a little strange...but would your regulations extend to all "non-science based" procedures, or those that are dangerous? What type of line would you draw between what is acceptable and what isn't? Though you've said all "non-science based" medicine shouldn't be considered before so I think the same response is the answer I will receive.


I've seen papers from a few years back of wanting regulation over the less-regulated practices like homeopathy, but what change do you want exactly? And it's strange, as kestegs pointed out, to hear that despite the perpetual debate over this, that your opinion isn't mainstream? What does that mean?

Ideally, I think NDs and DCs simply wouldn't exist, but in order to be more reasonable, we would have to first focus on what is most dangerous (here I would put insane dietary suggestions, chiropractic treatment of newborns (yes, this is seriously a thing that happens - although I believe relatively rare) and the young in general.
Eventually, I would want regulations to limit or completely prevent the use of anything that is unscientific in medicine. As for the cutoff, you're right that my answer isn't really any different than before. I'd look to see what the medical community at large agrees is ground in good science and evidence, and accept nothing further than that.*

*Do recall that I think more experimental things could take place with proper consent and strict study design

I think I answered the question of how mainstream my views are to kegs, but if it's unclear let me know. I will add something further based on today's SBM article that is more closely related to the OP and what state legislators think is an acceptable scope of practice for NDs (mostly the first half of this fairly long article). It's pretty hit or miss by state in the US, but some organizations listed in this article express negative views towards naturopathy include the American Cancer Society, Immunization Action Coalition, and even the NCCAM (when it comes to efficacy - check out their quote in the article).


This is more general in that it goes outside of medicine entirely, but I think products and services that make entirely unsubstantiated claims should be illegal. Ofc, it's difficult to regulate everything and the degree to which it is feasible or cost-effective is a different question, but things like homeopathy or "healing crystals" which aren't likely to actively harm people (outside of money and time) simply should not be allowed to be sold imo. Sure, you can have warnings like "not approved for use by the FDA" on drugs that aren't regulated at all or very loosely, but imo that's not enough. People simply don't read these warnings or take them seriously, and although I respect that everyone should have quite the variety of personal freedom, I think it's better to crack down on fraudulent claims then let people be convinced to try something... especially in medicine.

 

[pharphis]

For anyone still interested in the discussion regarding alternative medicine and its role in medicine in general, here is an article not directly related based on prior-plausibility and why it is best to put our research resources towards treatments with higher prior plausiblity than others. This is, quite frankly, why homeopathy (and many other parts in alt med) should be discontinued in research entirely. There is no reason to believe it to even be possible, because you have to overturn much of physics, chemistry and biology to do so. The prior probability is essentially zero.

http://theness.com/neurologicablog/index.php/in-defense-of-prior-probability/

 

[pharphis]

Wanted to link to another related video (by Steven Novella- same author as in the above post...) for those who are interested. ~22 min talk that covers a few reviews on the medical literature and lots of overlap with what has been said in this thread (and especially above) of the superiority of science-based medicine vs evidence-based medicine.