Quackwatch revisited....

[WillowRose]

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I know we've discussed this guy on these boards before, but I was reading on Quackwatch again last night and I feel that I'm going to have to send him my comments! LOL

For those that aren't familiar...
http://www.quackwatch.org/04ConsumerEducation/QA/osteo.html

Quackwatch was founded by an MD psychiatrist who's made it his life mission to point out quackery in all its forms. An admirable goal, for the most part. But, naturally I have issues with his article on osteopathy.

I noticed last night that he mentions several questionable practices that he says DO's engage in more often than MD's. Now, I doubt his statistics to start with because it's based on pure percentages and the number of DO's is significantly less than MD's. But what concerns me most is that all of these practices are fully discussed in separate articles. The essay specifically on osteopathy offers nothing new except a diatribe against the AOA (not that I'm defending them).

I found the overall tone of the article to be more condescending than anything else. If craniosacral therapy, chelation therapy, and ayurvedic medicine are quackery, then does it matter what degree the practitioner has? No. So why write an article to show that osteopathy has "cultist roots" and they're more likely to use quack ideas? I guess his justification is that modalities like craniosacral manipulation are taught at all of the schools and thus, deeply ingrained in the profession.

Is it just me? Or does anyone else get the impression that the article does little more than imply that DO's are just "not as good" as MD's? If you're looking for a DO, his suggestion is to look for one who:
"(a) has undergone residency training at a medical hospital; (b) does not assert that osteopaths have a unique philosophy or that manipulation offers general health benefits; (c) either does not use manipulation or uses it primarily to treat back pain; and (d) does not practice cranial therapy."

Now, I'm a skeptic at heart and I'm certainly not worshipping at the grave of A.T. Still, but it seems a little extreme to me that I should go out and find a D.O. who looks as much like an M.D. as possible! And personally, I think OMT is a great thing on more musculoskeletal problems than just the back. I'm still undecided on any other benefits.

Ok...vent over......

Willow

 

[stoic]

Yea, that site has a thinnly veiled anti-DO tone. It's not outright DO bashing, and he does say that most DO's are legit doctors.... but still, you can definately tell that he holds osteopathy in a lower light than allopathy.

 

[adennis]

"The percentages of DOs involved in chelation therapy, clinical ecology, orthomolecular therapy, homeopathy, ayurvedic medicine, and several other dubious practices appear to be higher among osteopaths than among medical doctors. "

Ok.. will someone explain to me why these are such dubious practices?
Granted, some are taken to the extreme.. but many "accepted" practices are super similar to all of these listed above.

Simplified analogies.
Chelation therapy is simply the taking in of nutrients/supplements to help rid the body of excess heavy metals.
Clinical ecology.. well, has your allergist ever told you that you should really keep your cat out of your bedroom? or put a dust proof cover on your bed? anybody heard of black mold?

Orthomolecular therapy: it's called proper nutrition boys and girls.. it's also called not mixing your calcium with your iron and definitely mixing your calcium with vitamin C.
Homeopathy. Anybody ever taken allergy shots?
Aryuvedic medicine... well, it's been practiced in India for nigh near a really really really long time.. I guess like any non-Westernized medicine, people are going to be skeptical.. but when it comes down to it.. Deepak Chopra is the big man on campus for STRESS REDUCTION... and how is that a bad thing...?

now, I'm not saying I agree with all of these things (practices or philosophies).. but I certainly don't see how they're quackery...

I do see some practices as unhealthy... say... the overprescription of oh, I don't know.. antidepressants or antibiotics... or the in and out philosophy that has become the business of medicine...

For as many DOs that practice craniosacral massage or any of these other "dubious practices", my guess is there are many times more alternative, non-licensed practitioners or chiropractors, or MDs that also do these things.

What it comes down to is.. caring for the patient, and helping the patient care for him/herself..

Can't we all just get along?

 

[stoic]

"The percentages of DOs involved in chelation therapy, clinical ecology, orthomolecular therapy, homeopathy, ayurvedic medicine, and several other dubious practices appear to be higher among osteopaths than among medical doctors. "

Ok.. will someone explain to me why these are such dubious practices?
Granted, some are taken to the extreme.. but many "accepted" practices are super similar to all of these listed above.

Simplified analogies.
Chelation therapy is simply the taking in of nutrients/supplements to help rid the body of excess heavy metals.
Clinical ecology.. well, has your allergist ever told you that you should really keep your cat out of your bedroom? or put a dust proof cover on your bed? anybody heard of black mold?

Orthomolecular therapy: it's called proper nutrition boys and girls.. it's also called not mixing your calcium with your iron and definitely mixing your calcium with vitamin C.
Homeopathy. Anybody ever taken allergy shots?
Aryuvedic medicine... well, it's been practiced in India for nigh near a really really really long time.. I guess like any non-Westernized medicine, people are going to be skeptical.. but when it comes down to it.. Deepak Chopra is the big man on campus for STRESS REDUCTION... and how is that a bad thing...?

now, I'm not saying I agree with all of these things (practices or philosophies).. but I certainly don't see how they're quackery...

I do see some practices as unhealthy... say... the overprescription of oh, I don't know.. antidepressants or antibiotics... or the in and out philosophy that has become the business of medicine...

For as many DOs that practice craniosacral massage or any of these other "dubious practices", my guess is there are many times more alternative, non-licensed practitioners or chiropractors, or MDs that also do these things.

What it comes down to is.. caring for the patient, and helping the patient care for him/herself..

Can't we all just get along?

You can't be serious.

Chelation therapy is useful in treating acute exposure to heavy metals. That's it. There has been no research, clinical or basic science, showing otherewise. Here's what the American Heart Association says about chelation therapy:

"EDTA isn?t totally safe as a drug. There?s a real danger of kidney failure. (renal tubular necrosis). EDTA can also cause bone marrow depression, shock, low blood pressure (hypotension), convulsions, disturbances of regular heart rhythm (cardiac arrhythmias), allergic-type reactions and respiratory arrest.

In fact, a number of deaths in the United States have been linked with chelation therapy. Also, some people are on dialysis because of kidney failure caused, at least in part, by chelation therapy.

The American Heart Association is concerned that some people who rely on this therapy may delay undergoing proven therapies like drugs or surgery until it?s too late. This is the added danger of relying on an unproven ?miracle cure.?

Clearly, people who choose chelation therapy are risking more than money."

Hmmmm... risk with no proven benifits... that sounds like, oh what's the word, oh yea. QUACKARY. I feel the same way about the forms of OMT that have not been proven in efficacy trials (read cranio-sacral), but that's another thread.

As for homeopathy, well, it kind terms it's crap. People take these herbs and spices and think it's ok because it's "natural." I got news for you people, if those herbs do anything it's because of a pharmacologically active chemical in them - it just hasn't been concentrated and put in a pill yet (one implication of which is very poor dosage control). Hyperforin (the active ingredient in St. Johns Wort) is one of the most potent activates of the human CYP3A system known to science. So go ahead and take that St. Johns Wort without telling your doctor. But don't be suprised when it ends up altering your ability to properly metabolize/absorb drugs that have been been perscribed.

In the end, there are likely alternative therapies out there that work. But efficacy needs to be shown through clinical trials before these practices can be accepted. Here's the take home point: Just being alternative doesn't make something quackary. Quackary results when unproven methods are pushed on patients as effective and safe, when either one or both of those assumptions could easily be false.

It's called evidence based medicine, and you're going to be hearing a lot about it in the next few years....

 

[adennis]

I think you may be misinformed.. not to start a huge debate or anything over this.. but EDTA isn't the only form of chelation available.. in fact, to be honest, that was one until recently that I hadn't even heard of. It may be the all the forms of chelation that I've become familiar with are naturopathic, as opposed to chemical based. They are a mixture of nutrients/substances that are supposed to help clear the heavy metals out of the body.. again, I didn't say that I agree with it..

It's hard to say what evidence based medicine is... There have been thousands of drugs that through evidence and studies showed some benefit for people.. and then those same drugs turned out to be extremely harmful... The vast majority of our drugs on the market are either based on plants or synthesized from a plant origin (ie technology copied a plant original)... many of these drugs were used naturopathically long before the pharmaceutical industry ever patented them...

I think evidence is entirely subjective.. and that I am totally serious about...

There are a multitude of studies on herbal preparations out there.. not just St. Johns Wort, but others... They're not as readily available as drug studies, but they do exist.. look for them..

I think the difference between our definitions of quackery is this... My definition is something to the effect of magical elixirs touted to cure every ill with no basis whatsoever toward even treating the ill... it seems as if yours is non-accepted practices with or without medical basis.

My definition expands toward the blanket treatment of people with "depression" with anti-depressants, regardless of chemical imbalance.. this, IMHO is quackery. My definition also expands toward the unnecessary use of any medication (licensed and regulated or otherwise) for a purpose in which it was not intended (investigate which medications are regulated by the FDA for use during labor).

Many of the herbal preparations and methods that are being used out there are effective.. if for anything than the placebo effect... Many of them are dangerous (as are MANY MANY pharmaceutically produced substances).

Of course we're always going to be skeptical of things that we're not educated on or familiar with (this was not meant to sound like an insult.. we fear that which we do not know and this goes for everybody)... and to an extent this is extremely healthy.. cautious... but to label and condemn something that hasn't been fully explored, well, it's wrong....see Galileo, Christopher Columbus, Marie Curie, Jonas Salk, Albert Einstein, etc etc.


I digress...
Andrea

 

[dancote]

I try and stay off the quackwatch site because he seems to mix in some good practices with the rest of the quackery. For example, he includes Weston A. Price one of the greatest contributers to nutritional information. His works are one of the reasons I got into medicine. And to include osteopathic medicine in his quack site really gets to me.
Anyway, I read the person's research or books before I take someone else's opinion. If I told you some of the stuff the D.O. I shadowed with last summer does in his practice (he also visits the Amazon each summer to work with healers there) you'd probably think it sounded like quackery. But, he was certainlly one of the most effective and reknown doctors in our city. His patients would rave about his work to me whenever he stepped out of the room. At the local hospital they (acedemics) told me I'd better be a sponge when I was with him because he was so well respected.

-dan