It's ridiculous to pretend that patients aren't going to be interested in (and pursue) CAM treatments. The patient doesn't give a damn about your double-blind, randomized trial. They care that suddenly they feel better.
But no, you're right. Patients and physicians are much better off with physicians laughing at the idea of CAM and patients going to people without medical training for medical advice and treatment.
We're not laughing at our patients. When we have the time to think about CAM we are quite seriously annoyed at the con artists who take advantage of our patients' trust, low scientific literacy, and very often their desperation to scam them out of their savings. In addition to preying on the anxieties of the healthy these people are stealing from people in chronic pain, people with mental health issues, and even the dying. No one is laughing.
To be fair I'm aware that many of these CAM practicioners aren't consciously scamming their patients and sincerely believe in what they're doing. However the fact that they're sincerely trying to help does not change our obligation to protect our patients.
I mean what kind of terrible world would we be in if physicians offered CAM in reasonable instances with the admission that evidence supporting it is limited to anecdotal evidence of feeling better. It's much better that patients go give money to people who tell them CAM will cure cancer, AIDs, and the common cold.
There is no 'reasonable' instance of CAM use. Chiropractic doesn't cure spinal prblems any more than it can cure AIDS, and acupuncture doesn't promote general health any more than it can cure toxic shock syndrome. I'd love to know what you think a reasonable use of healing crystals, homeopathy, or Reiki is. Our job, with respect to CAM, is to represent science by educating our patients and helping them wade through the flood of mass marketed ignorance they are exposed to. You do not fight fire by lighting another more 'reasonable' fire, you fight a fire by putting it out.
No, I'm proud that my peers simply scoff at the notion and felate themselves over a recent and incomplete shift to actually evaluating the effectiveness of a treatment
Again, it is not our responsibility to 'evaluate' every claim that someone someone has cancer curing pixie dust. Our tests and treatmets work under a governmet mandated guilty until proven innocent philosophy and I, at least, expect CAM to confrom to the same standards.
Which is not to say that this hasn't been studies. There have been private studies, government studies, and meta studies of the studies. There's even a government deparment whose sole purpose is to evaluate CAM. Their conclusions? Just about nothing works. Chiro doesn't even work for back pain, let alone anything else. Exactly how much evaluation do we owe them?
