In general, the global multi-billion-pound alternative medicine industry is failing to deliver the sort of health benefits it claims to offer. Therefore millions of patients are wasting their money and risking their health by turning towards a snake-oil industry. [Page 219]
Alternative medicine or therapies are hot right now. The surprising thing is that this is not a new trend in any way shape or form and some of the latest “trends” are really recycled from our past. Separating what is truly medically beneficial from what is pure quackery or worse has always been the issue bedeviling both providers and consumers of health care.
This conundrum alone is why I found Simon Singh’s Trick or Treatment: The Undeniable Facts about Alternative Medicine so interesting. The book was written in partnership with Edzard Ernst, M.D. who is an academic physician and researcher who specializes in alternative and complementary medicine.
The approach taken by the author is to present four major alternative therapies—acupuncture, homeopathy, chiropractic, herbal—for examination. In addition to the examination of the aforementioned therapies there is a lengthy discussion throughout the book about the methodologies used to determine the efficacy of any particular treatment. This was critical to my recommendation of the book because the more we understand about the rigor behind accepted medical practice the better equipped we are to critically judge the claims of anyone offering “miracle” therapies.
The strand throughout is a stout defense of evidence based medicine. Singh states it elegantly:
No amount of anecdote can stand in place of firm evidence, or, as scientists like to say, “The plural of anecdote is not data” [Page 129]
With evidence of efficacy through rigorous trial being the benchmark none of the four therapies comes out looking very good. Each therapy suffers from somewhat hokey or mystical origins promoted by hucksters and quacks just a step removed from the people trying to sell you a product on television at 3 AM.
The one surprise was just how bad the profession of chiropractic care came out. Spend any time driving around a mid-size or larger American city and you will be surprised at the number of clinics specializing in such care. Signs abound offering $20 walk-in “adjustments.” Color me skeptical, but I do not see the potential benefit in letting a stranger spend a few minutes adjusting my spine with little or no examination. Granted, chiropractic care is split into several camps with some providers following a more complementary approach with traditional medicine—so called mixers—versus those that adhere to the more stringent guidelines of the discipline—so called straights. Nonetheless, the author is pretty damning:
Partly, they are blindly following a corrupt methodology and a bankrupt philosophy that has been passed down through the decades, while ignoring the latest advice from experts. [Page 173]
Ouch. The pain you feel, however, might be your own as there are real risks to the types of movements that chiropractors employ to adjust their clients’ necks. This is particularly true when sudden, sharp movements are used in the area around the neck where there is a cluster of circulatory and nerve pathways that may be damaged by such movements. I have never heard anyone discuss these types of ricks when talking about getting their “back cracked.” Caveat emptor indeed.
A common complaint hurled by the supporters of alternative medicine at critics is that traditional medicine is defending a lucrative industry by breaking down a competitor. Ignoring the billions of dollars spent on alternative therapies, which would provide plenty of incentive for practitioners to create false hope, all of the doctors that I have known would gladly accept a proven treatment if it could benefit the patient. I know of no competent doctor who would deny an efficacious treatment because it was “alternative” or what not. This is the trope of conspiracy theorists and message board trolls.