My medical school is hosting Reiki sessions for students....

[Tots]

For the second time this year my medical school will be hosting Reiki sessions sponsored by our Wellness Dean and our student interest group in CAM. They are actually having a practitioner come out and perform healing energy sessions on interested students(no idea if this is costing the administration anything). The claim being that this is a "safe way to alleviate stress, reduce physical pain, improve sleep patterns..." Does anyone else think this is ridiculous? I would understand if the goal was simply to educate students on the practice but to actively promote pseudoscience seems naive. I guess I should be thankful this not a mandatory part of the curriculum...yet. Is this common at many medical schools?

I am slightly embarrassed to be affiliated with this. Maybe I just need some healing of my energies.

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[Ismet]

You'll find a lot of patients swear by certain forms of CAM. And stuff works. Whether it's placebo or actually doing something, it works for some people. And some of those people might be evidence-based science people like your classmates. If you think it's ridiculous, it's probably not for you, but I'm sure there are people interested in checking it out. I'd give it a go, can't hurt.

 

[Psai]

i'm not saying that there's nothing at all to every kind of cam. i've met patients that got better with yellow mustard for lower extremity claudication or vinegar for gerd. but have you ever seen a reiki session? it's basically a massage except they almost never touch you. it's the most ridiculous thing i've ever seen in my life. modern medicine doesn't have all the answers but that doesn't mean stupid answers are the solution.

 

[Ismet]

i'm not saying that there's nothing at all to every kind of cam. i've met patients that got better with yellow mustard for lower extremity claudication or vinegar for gerd. but have you ever seen a reiki session? it's basically a massage except they almost never touch you. it's the most ridiculous thing i've ever seen in my life. modern medicine doesn't have all the answers but that doesn't mean stupid answers are the solution.

So worst case it's a placebo that makes the patient feel better in their mind. Doesn't sound horrible to me.

 

[s5260205]

I would much prefer an actual massage than some bullsh*t energy thingy that does absolutely nothing.

 

[wholeheartedly]

I think our wellness center has classes and stuff like this. Yeah....

 

[Psai]

So worst case it's a placebo that makes the patient feel better in their mind. Doesn't sound horrible to me.

Watch a YouTube video of it before you start opining

 

[Ismet]

Watch a YouTube video of it before you start opining

I know what Reiki is, thanks. If a patient thinks it relieves their stress or helps with their chronic pain, I'm all for it. And I do think it can relieve stress, although I'd much prefer a massage. Heck, I feel amazing and stress-free just by lying in savasana at the end of a yoga session. Throw in someone applying light pressure to your head/torso? Sure. It's essentially guided meditation.

 

[NickNaylor]

Can't explain this: http://www.ncbi.nlm.nih.gov/pubmed/25682383

REIKI IS REAL

 

[chipwhitley]

Our school also offers reiki sessions, and we had a reiki lesson as well. The reiki person demonstrated in front of the class how she could make someone lose their arm strength without even touching them. Pretty sure that person just played along.

 

[Frazier]

IMO, CAM practices have value no matter what they are (reiki, acupuncture, massage, magnets, aromatherapy, music therapy, art therapy, whatever).

As alluded to earlier, placebo effect can be a beneficial thing for a patient.

Surely, anyone can appreciate the benefit to a patient that is able to gain a further sense of active control in their health/treatment when otherwise rendered pretty useless/passive... say receiving chemotherapy.

They show up at the clinic, then they are somewhat passive: the meds are chosen by the doc, the IV started by the nurse. Sit and wait. Go home and feel like pure crap. Repeat x10.

If gaining a sense of power and therapeutic benefit (even if just psychological) can be had by supplementing with reiki, by god, go get some reiki.

Who is the physician to look down their nose at such circumstances?

That said, the CAM practitioners that recommend folks turn away from medical treatment (ie "chemo is poison, heal yourself with reiki exclusively")...yeah, that's not good.

It is a valuable supplement for those that choose to believe in it.

EDIT: looking back at the original post, it says the reiki is framed as: "a safe way to alleviate stress, reduce physical pain, improve sleep patterns..." To me that sounds completely reasonable and likely very true -- STRESS is a real SOB on mind/body AND sleep.

 

[PreMedBeauty]

Why are people so against anything that is not strictly science? Not everything can show proof or be explained fully.

 

[chipwhitley]

Why are people so against anything that is not strictly science? Not everything can show proof or be explained fully.

Because if you go down that path, you literally have to believe in everything.

 

[Frazier]

Why are people so against anything that is not strictly science? Not everything can show proof or be explained fully.

Because if you go down that path, you literally have to believe in everything.

Well, there's a subtle difference going on here.

A physician doesn't have to "believe" in the "power" of reiki (or XYZ CAM modality) to believe that it might have the power to benefit the patient.

A physician shouldn't feel obligated to practice reiki on a patient anymore than they should be obligated to offer the patient holy communion. That said, going out of their way to degrade either of those things to the patient based on the enlightening fact that they "aren't science-based" is a poor choice by the physician, IMO.

I don't believe those in the medical community need to put on their gloves until the CAM is [purposefully] impinging on medical progress and thereby harming the patient.

 

[Ismet]

Because if you go down that path, you literally have to believe in everything.

No not really. The thing is, YOU don't have to believe in it. Do I believe that positive energy is actually flowing from the Reiki person to the patient? No. The person receiving the treatment/therapy/whatever believes that it helps, and that's what matters.

 

[Tots]

You'll find a lot of patients swear by certain forms of CAM. And stuff works. Whether it's placebo or actually doing something, it works for some people. And some of those people might be evidence-based science people like your classmates. If you think it's ridiculous, it's probably not for you, but I'm sure there are people interested in checking it out. I'd give it a go, can't hurt.

So worst case it's a placebo that makes the patient feel better in their mind. Doesn't sound horrible to me.

I understand. I have less a problem with patients partaking in Reiki, then of the promotion of the practice. In regards to it doing something, is a placebo treatment really justified if its effect is only a placebo? Real treatments have the same placebo in addition to therapeutic benefit. For example take this Reiki RCT(http://www.ncbi.nlm.nih.gov/pubmed/21531671). Reiki had a modifiable effect greater than then no intervention but the effect was no different than the sham Reiki. Yet there is evidence(who knew) that massage has a similar effects on people's wellbeing plus additional therapeutic benefit(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168862/, http://www.ncbi.nlm.nih.gov/pubmed/19148685). So by accepting and promoting Reiki are we not denying people the therapeutic benefit of actual treatments? If people are turning to Reiki to gain a sense of power or psychological benefit then maybe we should enable that sense of power and psychological benefit through therapy that has been shown to work instead of allowing our patients to be subjected a delusion?

Either way, I appreciate the different takes on the issue - I definitely sit with some bias in the anti-CAM pool and that certainly clouds my reaction to things like this.

Can't explain this: http://www.ncbi.nlm.nih.gov/pubmed/25682383

REIKI IS REAL

Ah man. /Thread

 

[Frazier]

I understand. I have less a problem with patients partaking in Reiki, then of the promotion of the practice. In regards to it doing something, is a placebo treatment really justified if its effect is only a placebo? Real treatments have the same placebo in addition to therapeutic benefit. For example take this Reiki RCT(http://www.ncbi.nlm.nih.gov/pubmed/21531671). Reiki had a modifiable effect greater than then no intervention but the effect was no different than the sham Reiki. Yet there is evidence(who knew) that massage has a similar effects on people's wellbeing plus additional therapeutic benefit(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168862/, http://www.ncbi.nlm.nih.gov/pubmed/19148685). So by accepting and promoting Reiki are we not denying people the therapeutic benefit of actual treatments? If people are turning to Reiki to gain a sense of power or psychological benefit then maybe we should enable that sense of power and psychological benefit through therapy that has been shown to work instead of allowing our patients to be subjected a delusion?

We aren't supposed to be paternalistic anymore.

Who are you (generally-speaking) to impinge on a patient's beliefs outside of medical treatment and things that pertain to it?

Should the pediatricians tell the kiddies that Easter bunny is fake and Santa was a hoax?

I can see the scenario now. Pediatric CA patient. Resilient young lad. Has taken a beating. Has been wearing down. A few days before Christmas he comes in and has a new glow about him. Turns out he is really excited about Santa coming.
"Look Jimmy, your belief that a 350 pound man sneaks down your chimney on christmas to bring you toys...and then leaves on a sleigh with flying reindeer. Yeah, that is kind of delusional."

How about the religious patients?

"Last Rights for your dying father? No, sir, I need to talk to him before he goes about that delusion."

The articles you posted I assume say that there was "something" to be gained from the "experience" of Reiki (Reiki had a modifiable effect greater than then no intervention but the effect was no different than the sham Reiki.)

Then you say:

"... is a placebo treatment really justified if its effect is only a placebo? Real treatments have the same placebo in addition to therapeutic benefit. "

My question:

Placebo on placebo on medical therapeutic benefit.

 

[Tots]

We aren't supposed to be paternalistic anymore.

Who are you to impinge on their beliefs outside of medical treatment and things that pertain to it?

Should the pediatricians tell the kiddies that Easter bunny is fake and Santa was a hoax?
"Look Jimmy, your believe that a 350 pound man sneaks down your chimney on christmas to bring you toys...and then leaves on a sleigh with flying reindeer. Yeah, that is kind of delusional."

How about the religious patients?

"Last Rights for your dying father? No, sir, I need to talk to him before he goes about that delusion."

The articles you posted I assume say that there was "something" to be gained from the "experience" of Reiki (Reiki had a modifiable effect greater than then no intervention but the effect was no different than the sham Reiki.)

Then you say:

"Real treatments have the same placebo in addition to therapeutic benefit. "

My question:

Eh, I don't believe doctors should impinge on their personal beliefs, I was particularly against the promotion of the practice. I get your points.

In re: to why not both: My point was that a placebo provides a placebo effect. A therapy provides the same placebo effect + therapeutic benefit (So you don't need both). Ie take a sugar pill vs. aspirin for your headache. When you take the aspirin you get the same placebo effect of taking a pill + the aspirin.

 

[Frazier]

Eh, I don't believe doctors should impinge on their personal beliefs, I was particularly against the promotion of the practice. I get your points.

In re: to why not both: My point was that a placebo provides a placebo effect. A therapy provides the same placebo effect + therapeutic benefit (So you don't need both). Ie take a sugar pill vs. aspirin for your headache. When you take the aspirin you get the same placebo effect of taking a pill + the aspirin.

We will need a study that looks at the incremental utility gained from stacking multiple CAM modailities on medical therapeutic treatment and seeing if there is something extra to be gained for those that believe in them.

 

[NickNaylor]

From a general perspective I agree that if something that is inherently a sham treatment results in improvement for individual people then they should certainly be entitled to undergo those things. Thinking otherwise is little more than allowing one's own biases to influence others' decisions. Note that this is at the level of the individual and not the general population.

That said, I think it's important to draw a line at the point of actively encouraging people to get these sham interventions (and yes, I'm calling Reiki a sham intervention) if there isn't, at a minimum, a theoretical basis for believing an unproven treatment might be helpful and is otherwise not harmful. I'm not a big fan of explicitly promoting nonsense pseudoscience. That said, I understand people buy into the pseudoscience, and if it works for them, hey, more power to them. You won't see me at the Reiki master's house, though.

 

[Stagg737]

Our head athletic trainer in college believed believed in Qi Gong (similar to reiki) and would 'brush the bad energy' away from all the athletes before they would start their treatments. She'd also get pissed off at any of the students that didn't want her to do it before their rehab. I really don't understand how some people can think it works, but to each their own...

IMO, CAM practices have value no matter what they are (reiki, acupuncture, massage, magnets, aromatherapy, music therapy, art therapy, whatever).

Not sure about some of those. There've been studies showing acupuncture like techniques can have an actual positive physiological effect on patients with low back pain. They showed that the whole opening 'meridians' and chi had nothing to do with it, but that simply putting X number of needles into the lower back actually lead to pain relief in a number of people significant enough to rule out the placebo effect. Most of those studies also involved electro-stimulation of the needles, so I'm sure that played some role too.

I would still never recommend something like that as a primary treatment unless there were strong evidence-based studies to back it up, but some of those treatments can lead to physiological effects that could potentially be used as legitimate therapies. I'd like to see more studies on some of the CAM practices you mentioned, though reiki is definitely not one of them.

 

[chipwhitley]

If reiki is OK as long as it works, can we start giving placebo pills too as long as they work?

 

[alpinism]

For the second time this year my medical school will be hosting Reiki sessions sponsored by our Wellness Dean and our student interest group in CAM. They are actually having a practitioner come out and perform healing energy sessions on interested students(no idea if this is costing the administration anything). The claim being that this is a "safe way to alleviate stress, reduce physical pain, improve sleep patterns..." Does anyone else think this is ridiculous? I would understand if the goal was simply to educate students on the practice but to actively promote pseudoscience seems naive. I guess I should be thankful this not a mandatory part of the curriculum...yet. Is this common at many medical schools?

I am slightly embarrassed to be affiliated with this. Maybe I just need some healing of my energies.

My school tries to pull this crap every once and a while too. Its embarrassing to say the least.

We're going to medical school, not Hogwarts school of witchcraft and wizardry.

I know what Reiki is, thanks. If a patient thinks it relieves their stress or helps with their chronic pain, I'm all for it. And I do think it can relieve stress, although I'd much prefer a massage. Heck, I feel amazing and stress-free just by lying in savasana at the end of a yoga session. Throw in someone applying light pressure to your head/torso? Sure. It's essentially guided meditation.

IMO, CAM practices have value no matter what they are (reiki, acupuncture, massage, magnets, aromatherapy, music therapy, art therapy, whatever).

As alluded to earlier, placebo effect can be a beneficial thing for a patient.

Surely, anyone can appreciate the benefit to a patient that is able to gain a further sense of active control in their health/treatment when otherwise rendered pretty useless/passive... say receiving chemotherapy.

They show up at the clinic, then they are somewhat passive: the meds are chosen by the doc, the IV started by the nurse. Sit and wait. Go home and feel like pure crap. Repeat x10.

If gaining a sense of power and therapeutic benefit (even if just psychological) can be had by supplementing with reiki, by god, go get some reiki.

Who is the physician to look down their nose at such circumstances?

That said, the CAM practitioners that recommend folks turn away from medical treatment (ie "chemo is poison, heal yourself with reiki exclusively")...yeah, that's not good.

It is a valuable supplement for those that choose to believe in it.

EDIT: looking back at the original post, it says the reiki is framed as: "a safe way to alleviate stress, reduce physical pain, improve sleep patterns..." To me that sounds completely reasonable and likely very true -- STRESS is a real SOB on mind/body AND sleep.

Yeaaah just wait till your cancer patient spends all their money on alternative therapies and now has no money to feed their family or pay for further treatment. Or when you see your first patient with a stroke caused by chiropractic manipulation or infection due to acupuncture.

Sadly i've seen it happen multiple times already.

But at least they got their placebo effect, right?

These faith healers or whatever they’re calling themselves aren’t doing it for free and certainly not out of the goodness of their hearts.

You know who else offers Reiki therapy? Cancer Treatment Centers of America.

http://www.forbes.com/sites/stevens...ing-ineffective-therapies-to-cancer-patients/

 

[Frazier]

Yeaaah just wait till your cancer patient spends all their money on alternative therapies and now has no money to feed their family or pay for further treatment. Or when you see your first patient with a stroke caused by chiropractic manipulation or infection due to acupuncture.

Sadly i've seen it happen multiple times already.

But at least they got their placebo effect, right?

These faith healers or whatever they’re calling themselves aren’t doing it for free and certainly not out of the goodness of their hearts.

You know who else offers Reiki therapy? Cancer Treatment Centers of America.

http://www.forbes.com/sites/stevens...ing-ineffective-therapies-to-cancer-patients/

These things you mentioned specifically had nothing to do with what I wrote about.

Notice how I repeatedly emphasized "as long as they do not harm the patient" or "impinge on medical progress" (I think your example: "cancer patient spends all their money on alternative therapies and now has no money to feed their family or pay for further treatment" would be exactly what I was describing).

Also note, I never mentioned chiropractic once. Not a coincidence. The dissected arteries/risks are no secret on these boards.

Also, your line: the "healers or whatever they’re calling themselves aren’t doing it for free and certainly not out of the goodness of their hearts" makes little sense... majority of physicians would fit in that mold as well, no? So what was the point?

It was like you picked out the opposite of what was said (and least relevant points) to highlight.

 

[ERK123]

If reiki is OK as long as it works, can we start giving placebo pills too as long as they work?

I wish. I know some old school doctors who are upset that they can no longer use placebos for certain complaints and disorders because they are sometimes more effective and have less side effects than the traditional medication. I have seen studies for disorders like insomnia where placebos are more effective than traditional medications.

 

[chipwhitley]

I wish. I know some old school doctors who are upset that they can no longer use placebos for certain complaints and disorders because they are sometimes more effective and have less side effects than the traditional medication. I have seen studies for disorders like insomnia where placebos are more effective than traditional medications.

Why can't we use them if they're more effective?

 

[s5260205]

I wish. I know some old school doctors who are upset that they can no longer use placebos for certain complaints and disorders because they are sometimes more effective and have less side effects than the traditional medication. I have seen studies for disorders like insomnia where placebos are more effective than traditional medications.

Would be an interesting interview question. "So, do you think it's ethical to prescribe placebo pills?"

 

[chipwhitley]

No not really. The thing is, YOU don't have to believe in it. Do I believe that positive energy is actually flowing from the Reiki person to the patient? No. The person receiving the treatment/therapy/whatever believes that it helps, and that's what matters.

I was responding to her question which was why I'm against treatments that are not science based. I don't believe in them. I cannot recommend a treatment I don't believe in. If it works for you and you believe in it, great, but if you ask my opinion I'm going to be honest and tell you I don't think it is a valid treatment modality.

 

[PreMedBeauty]

After comparing science vs. the unknown now religion gets involved. lol These topics can get messy. Anyway, maybe it needs to happen.

 

[PreMedBeauty]

Would be an interesting interview question. "So, do you think it's ethical to prescribe placebo pills?"

That can be said about medicine, which can cause side effects etc.

 

[chipwhitley]

After comparing science vs. the unknown now religion gets involved. lol These topics can get messy. Anyway, maybe it needs to happen.

I mean I'm an atheist so it doesn't really get messy for me...

 

[ERK123]

Why can't we use them if they're more effective?

As far as I can understand new regulations concerning patient disclosure forbid the direct use of medication designed to be used as a placebo. I also wonder if using a placebo like obecalp would be as effective now that patients might google the name of their prescriptions.

 

[ERK123]

I was responding to her question which was why I'm against treatments that are not science based. I don't believe in them. I cannot recommend a treatment I don't believe in. If it works for you and you believe in it, great, but if you ask my opinion I'm going to be honest and tell you I don't think it is a valid treatment modality.

What if the CAM therapy does improve patient outcomes when combined with traditional treatments even if the mechanism for the CAM therapy is thought to only stimulate well being or perhaps adherence to the traditional treatment?

 

[NontradCA]

My school does something similar, except it's every week and mandatory. I go to a DO school. 😵

 

[MrChance2]

My question is how do they choose which placebo treatment provider to come in?

Why hire the reiki guy over the magic dance guy or whoever if a magic dance guy is just as helpful? I'd guess it's just whoever advertised better. It does open the door to literally anything.

 

[PL198]

We aren't supposed to be paternalistic anymore.

Who are you (generally-speaking) to impinge on a patient's beliefs outside of medical treatment and things that pertain to it?

Should the pediatricians tell the kiddies that Easter bunny is fake and Santa was a hoax?

I can see the scenario now. Pediatric CA patient. Resilient young lad. Has taken a beating. Has been wearing down. A few days before Christmas he comes in and has a new glow about him. Turns out he is really excited about Santa coming.
"Look Jimmy, your belief that a 350 pound man sneaks down your chimney on christmas to bring you toys...and then leaves on a sleigh with flying reindeer. Yeah, that is kind of delusional."

How about the religious patients?

"Last Rights for your dying father? No, sir, I need to talk to him before he goes about that delusion."

The articles you posted I assume say that there was "something" to be gained from the "experience" of Reiki (Reiki had a modifiable effect greater than then no intervention but the effect was no different than the sham Reiki.)

Then you say:

"... is a placebo treatment really justified if its effect is only a placebo? Real treatments have the same placebo in addition to therapeutic benefit. "

My question:

Placebo on placebo on medical therapeutic benefit.

huh? we're not supposed to be paternalistic? What do you think the purpose of 4 years of medical school + residency and fellowship. To be on the same level of knowledge as the patient? No, by definition, I will be aware of what is likely best for the patient, which I will inform them of, along with their other options. Then they get to decide what to do. That's still paternalism.

The whole anti paternalism movement is so stupid. To be a physician you have to be paternalistic. Its just another idiotic thing the social progressive med school machine says.

 

[PL198]

My question is how do they choose which placebo treatment provider to come in?

Why hire the reiki guy over the magic dance guy or whoever if a magic dance guy is just as helpful? I'd guess it's just whoever advertised better. It does open the door to literally anything.

exactly. if you're willing to believe one thing without proof, you are more likely to believe others. you can't arbitrarily throw out the existence of proof or not. either you use evidence to make decisions, or you don't.

 

[Cytarabine]

huh? we're not supposed to be paternalistic? What do you think the purpose of 4 years of medical school + residency and fellowship. To be on the same level of knowledge as the patient? No, by definition, I will be aware of what is likely best for the patient, which I will inform them of, along with their other options. Then they get to decide what to do. That's still paternalism.

The whole anti paternalism movement is so stupid. To be a physician you have to be paternalistic. Its just another idiotic thing the social progressive med school machine says.

Fully informing and involving the patient in shared decision making is not paternalistic medicine

 

[Thought Crime Spree]

One thing I learned from suffering through a mandatory OMM rotation - patients with nothing really wrong with them seem to benefit greatly from treatment modalities that do nothing real for them.

 

[alpinism]

These things you mentioned specifically had nothing to do with what I wrote about.

Notice how I repeatedly emphasized "as long as they do not harm the patient" or "impinge on medical progress" (I think your example: "cancer patient spends all their money on alternative therapies and now has no money to feed their family or pay for further treatment" would be exactly what I was describing).

Also note, I never mentioned chiropractic once. Not a coincidence. The dissected arteries/risks are no secret on these boards.

Also, your line: the "healers or whatever they’re calling themselves aren’t doing it for free and certainly not out of the goodness of their hearts" makes little sense... majority of physicians would fit in that mold as well, no? So what was the point?

It was like you picked out the opposite of what was said (and least relevant points) to highlight.

The problem is that with any CAM therapy (like any medication) there is the potential to harm the patient. This includes financial harm. By your own criteria then no one should use CAM unless it's free and requires no training or resources. If this were the case you wouldn't need a hospital or clinic for training sessions anyway.

In addition there's also the issue of opportunity cost. We live in a world with finite time, money, and resources. The more time you spend on promoting and practicing CAM, the less is available for real medicine that provides an actual therapeutic benefit. Instead of spending time/money on reiki sessions the school could have been spending it on medical research or patient education.

 

[Ismet]

huh? we're not supposed to be paternalistic? What do you think the purpose of 4 years of medical school + residency and fellowship. To be on the same level of knowledge as the patient? No, by definition, I will be aware of what is likely best for the patient, which I will inform them of, along with their other options. Then they get to decide what to do. That's still paternalism.

The whole anti paternalism movement is so stupid. To be a physician you have to be paternalistic. Its just another idiotic thing the social progressive med school machine says.

That's not what paternalism is. What you described is exactly the "anti-paternalism" thing you call stupid. Informed consent is not paternalism. It's the opposite.

Try to stop raging against the machine sometime. 😛 it's not all stupid like you say it is.

 

[MatCauthon]

CAM bashing-- a circular argument that no one can ever win.

A lot of the conditions that people seek CAM for don't have great treatment options in conventional medicine. If nothing else, reiki can promote a sense of relaxation. There are plenty of patients out there that need outside help to relax. I'd rather see someone get a massage or a reiki session than start downing ativan.

 

[05silvergt]

I go to a DO school, I can't feel too sorry for some MD students having to deal with something that seems made up. Sorry not sorry.

 

[QuantumFlame]

It seems to me that the problem with CAM is in the claims of efficacy being made, not the actual modality itself. For example, if a oncology group wants to offer massages to patients, to help them relax throughout the stressful course of their illness, then more power to them. If they then claim that massages (or reiki, or acupuncture or whatever) are somehow healing their cancer through mysterious energy mechanisms, then we have a problem. The problem as I see it is that many CAM modalities are making unjustified, unsubstantiated claims, giving patients false hope and diverting limited resources to interventions that are not useful and in fact may be harmful. A lot of the "evidence" behind CAM (the positive results in some Acupuncture trials for instance) are built on shoddy science (insufficient or non-existent control groups, small sample size, non-blinded etc.) when these concerns are addressed, the purported therapeutic benefit evaporates. Again, these are issues only if practitioners of these arts want to make claims of efficacy or therapeutic benefit beyond placebo. As physicians (or future physicians), I think we can all agree that we want to give patients the best information, in a fashion they can process and act upon in a semi-rational way. Limiting claims of efficacy to that which can be proved, and vigorously fighting attempts to manipulate patients by giving them false hope based on fanciful pseudoscience is one good way to do that.

 

[Irish Luck]

I volunteered for hospice and as a part of the training they had one of the Reiki therapists do a shortened session on each of us. It felt great physically. Light touch feels wonderful on your skin and I could definetly see how sitting quietly for a half hour+ with someone lightly touching your skin would be relaxing. I certainly don't buy into the idea that it can cure physical illness but I would be thrilled to have a free, stress relieving activity available on campus.

 

[chipwhitley]

What if the CAM therapy does improve patient outcomes when combined with traditional treatments even if the mechanism for the CAM therapy is thought to only stimulate well being or perhaps adherence to the traditional treatment?

Then the CAM therapy is basically a placebo. I wouldn't give out placebos, even if they do improve patient outcomes, because I consider that to be unethical (and I think most doctors agree).

 

[PreMedBeauty]

As a doctor the patient is in control too. If it does no harm, why it is your choice to dictate what they should do?

 

[Tired]

As a doctor the patient is in control too. If it does no harm, why it is your choice to dictate what they should do?

Our profession aspires to scientific excellence. All treatments (even seemingly benign treatments) have potential risks that must be weighed against the benefits. We utilize scientific evidence to advise patients on whether the potential benefits outweigh the potential risks. That is our fundamental role.

You are correct: it is not our position to dictate to patients what they must do.

However, it is also our responsibility to not associate ourselves and our profession with pseudo-science. When we attach our name, however peripherally, to practices like this, our reputation is being used to give respectability to an otherwise unscientific practice. This is why there is constant pressure to incorporate CAM into hospitals and medical schools; they are trying to use our reputation to improve their own. If they actually had anything real to offer patients, they would not need to use us to promote themselves. I promise you that this Reiki "practitioner" prominently advertises that he "teaches" his techniques at the local medical school.

Remember that CAM practitioners collect real money from real patients for the "treatments" they provide. People who go to work, who could spend that money on fixing their car, or taking out their families for a nice dinner, instead hand over their cash to have needles poked in their skin or crystals waved over their heads. It is exploitation, pure and simple. People may "choose" to be exploited, but we shouldn't pretend that's okay. The victims of Bernie Madoff may have been dumb, but I still feel bad for them, and I wouldn't refer anyone who needed investment help to his office (when he still had one).

When patients ask me about CAM therapies, I tell them that it is not science and not medicine, and I can't offer an opinion on it at all. When they press me on what I "really" think (and most do), I just keep telling them that I am trained in science and medicine, and I don't know much about things that don't fall in those categories.

 

[ERK123]

Our profession aspires to scientific excellence. All treatments (even seemingly benign treatments) have potential risks that must be weighed against the benefits. We utilize scientific evidence to advise patients on whether the potential benefits outweigh the potential risks. That is our fundamental role.

You are correct: it is not our position to dictate to patients what they must do.

However, it is also our responsibility to not associate ourselves and our profession with pseudo-science. When we attach our name, however peripherally, to practices like this, our reputation is being used to give respectability to an otherwise unscientific practice. This is why there is constant pressure to incorporate CAM into hospitals and medical schools; they are trying to use our reputation to improve their own. If they actually had anything real to offer patients, they would not need to use us to promote themselves. I promise you that this Reiki "practitioner" prominently advertises that he "teaches" his techniques at the local medical school.

Remember that CAM practitioners collect real money from real patients for the "treatments" they provide. People who go to work, who could spend that money on fixing their car, or taking out their families for a nice dinner, instead hand over their cash to have needles poked in their skin or crystals waved over their heads. It is exploitation, pure and simple. People may "choose" to be exploited, but we shouldn't pretend that's okay. The victims of Bernie Madoff may have been dumb, but I still feel bad for them, and I wouldn't refer anyone who needed investment help to his office (when he still had one).

When patients ask me about CAM therapies, I tell them that it is not science and not medicine, and I can't offer an opinion on it at all. When they press me on what I "really" think (and most do), I just keep telling them that I am trained in science and medicine, and I don't know much about things that don't fall in those categories.

Have you evaluated the scientific literature for all of the treatments that you prescribe?

 

[Tired]

Have you evaluated the scientific literature for all of the treatments that you prescribe?

Yes. I am a senior surgical resident. I would never perform a procedure or prescribe a medication unless I had a working knowledge of the rationale for the treatment and the potential risks/benefits based on available evidence. Where there is uncertainty or disagreement in our field, I clearly spell that out to the patient, so that they can make a fully informed decision.

Those are the fundamentals of "informed consent."

Or, as some of my older staff would put it, "being a doctor".