Should Alternative Medicine be taught in Med School?

  • Yes

    Votes: 12 25.0%
  • No

    Votes: 30 62.5%
  • Unsure

    Votes: 6 12.5%

  • Total voters
    48
Mar 8, 2015
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The problem is who gets to define what "alternative" means? If you are not allowed to objectively investigate a particular realm of treatment options because they have all been preemptively labeled, then you can never discover if they actually work.
 
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Lawper

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The problem is who gets to define what "alternative" means? If you are not allowed to objectively investigate a particular realm of treatment options because they have all been preemptively labeled, then you can never discover if they actually work.
Pretty sure alternative medicine refers to treatment options that were dismissed to be pseudoscience. Of course, that doesn't mean we should just blindly dismiss them to be fraudulent, but rather assess its shortcomings and pinpoint its claimed benefits.
 

Lawper

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Why is the Bohr model of the atom taught in chemistry? Same reason.
That reminds me of a joke i posted previously in the Funny Quotes Thread.

A Short History of Medicine

I have a headache:

2000 BCE: Here, eat this root.
1000 AD: That root is heathen. Here, say this prayer.
1850 AD: That prayer is superstition. Here, drink this potion.
1940 AD: That potion is snake oil. Here, swallow this pill.
1985 AD: That pill is ineffective. Here, take this antibiotic.
2011 AD: That antibiotic is artificial. Here, eat this root.
 
OP
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Also, I don't believe Insurance should cover any sort of "alternative" medicine.

The problem is who gets to define what "alternative" means? If you are not allowed to objectively investigate a particular realm of treatment options because they have all been preemptively labeled, then you can never discover if they actually work.
Perhaps it should be proven to work before becoming approved practice?

Pretty sure alternative medicine refers to treatment options that were dismissed to be pseudoscience. Of course, that doesn't mean we should just blindly dismiss them to be fraudulent, but rather assess its shortcomings and pinpoint its claimed benefits.
To be fair, would you want a doctor to tell you, "Son I think St. Johns wort can make you feel better."

Why is the Bohr model of the atom taught in chemistry? Same reason.
Err, no that is taught to help understand... It is not presented as actual logic.
 
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Spirit of the Student Doc

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Why bring politics into this? The anti-science attitude in this country can be found in both liberal and conservative camps. The question was whether we should be promoting it by teaching it in medical schools.
Perhaps, a resident Adcom could tell us what is taught and to what extent it's tested. Seems like a complete waste of very precious time to me.
 

NotASerialKiller

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Why is the Bohr model of the atom taught in chemistry? Same reason.
It's a little different. A lot of "alternative" medicine is nonsense that comes out of nowhere, not just old remedies. Also the Bohr model is a really convenient way of getting students familiar with electrons and bonds in a way that made sense to early chemists, even if ultimately false. Don't think there's a redeeming quality like that in giving people a cyanide solution so dilute there's no cyanide in it and saying that it cures... whatever those morons say that it cures.
 
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Haha touche, that may not have been the best analogy. The point I wanted to convey was that learning (in this case, alternative medicine) is done to gain knowledge, and learning about something doesn't necessarily mean you have to (or should) actually believe in it.
Gain knowledge of the symptoms of quackery gone wrong and how to best treat it? /jk I'll quit giving you a hard time
 

NotASerialKiller

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If it was just a way of getting medical students to be aware of these practices that would be fine, but I feel like more often than not it's actually an attempt to get them to "broaden their horizons" and consider it legitimate. When my brother was in med school (~3 years ago) his class attended a mandatory conference on this nonsense claiming that it was effective. Pretty weird if you ask me, don't know why we should be "open" to practices that don't undergo the same rigorous scientific testing that everything else does.
 
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Pretty sure alternative medicine refers to treatment options that were dismissed to be pseudoscience. Of course, that doesn't mean we should just blindly dismiss them to be fraudulent, but rather assess its shortcomings and pinpoint its claimed benefits.
Sure, but the question was "should alternative medicine be taught in medical school." I'm not a fan of authoritative institutions controlling what is or is not worth investigating. I'm not talking about actually using unproven or disproven treatments on people, I'm talking about the preemptive shutdown of intellectual pathways of inquiry.
 
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If it was just a way of getting medical students to be aware of these practices that would be fine, but I feel like more often than not it's actually an attempt to get them to "broaden their horizons" and consider it legitimate. When my brother was in med school (~3 years ago) his class attended a mandatory conference on this nonsense claiming that it was effective. Pretty weird if you ask me, don't know why we should be "open" to practices that don't undergo the same rigorous scientific testing that everything else does.
I think doctors should be aware of these people and their "medicine." But as I eluded to above only when these people end up going to a real doctor because their illness never got better or as a result of natural medicine.

Here's an interesting excerpt:
Ruth Conrad, an Idaho woman, had a horrible experience as a result of consulting one of the state's many unlicensed naturopaths. While seeking treatment for a sore shoulder, she also complained of a bump on her nose. The naturopath stated that it was cancer and gave her a black herbal salve to apply directly. Within a few days, her face became very painful and she developed red streaks that ran down her cheeks. Her worried phone call to the naturopath brought the explanation that the presence of the lines was a good sign because they "resemble a crab, and cancer is a crab." He also advised her to apply more of the black salve. Within a week, a large part of her face, including her nose, sloughed off. It took three years and 17 plastic surgical operations to reconstruct her face.

Mrs. Conrad's experience illustrates another aspect of cancer quackery—fake diagnosis. She never had cancer in the first place. In addition to suffering direct harm from a caustic treatment, she also suffered the mental anguish of thinking she had a dread disease.

http://www.quackwatch.com/01QuackeryRelatedTopics/harmquack.html

-Deaths after acupuncture: A systematic review

-Deaths after chiropractic: a review of published cases

-Aristolochic acid-associated urothelial cancer in Taiwan

-What's the harm
368,379 people killed, 306,096 injured and over $2,815,931,000 in economic damages
http://whatstheharm.net/alternativemedicine.html
 
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NotASerialKiller

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Sure, but the question was "should alternative medicine be taught in medical school." I'm not a fan of authoritative institutions controlling what is or is not worth investigating. I'm not talking about actually using unproven or disproven treatments on people, I'm talking about the preemptive shutdown of intellectual pathways of inquiry.
Why would med schools be obligated to teach everything that anyone on the planet has ever claimed has a medicinal purpose? The "authoritative institutions" you're talking about are already deciding what you learn in med school, it's called a curriculum. You certainly can't cover all medical knowledge in a few years, so why would you bump something that we know is legitimate to teach some crap that a guy in an herbal supplement store wearing a white coat is selling?
 

LizzyM

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There is a ton of money being spent by the feds to acquire evidence for or against these alternatives. There is also a ton of money being spent to acquire evidence showing that new drugs and devices devices work. Medical schools are going to be pretty much agnostic as long as someone is pumping money to them to determine if there is evidence on which to base treatment decisions. In medical school you are going to learn how to assess the evidence and how to make treatment decisions based on the strength of the evidence. Your faculty may be conducting research to obtain this evidence.
 
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Why would med schools be obligated to teach everything that anyone on the planet has ever claimed has a medicinal purpose? The "authoritative institutions" you're talking about are already deciding what you learn in med school, it's called a curriculum. You certainly can't cover all medical knowledge in a few years, so why would you bump something that we know is legitimate to teach some crap that a guy in an herbal supplement store wearing a white coat is selling?
That's fine, nor is it what I'm talking about.
 
OP
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Sure, but the question was "should alternative medicine be taught in medical school." I'm not a fan of authoritative institutions controlling what is or is not worth investigating. I'm not talking about actually using unproven or disproven treatments on people, I'm talking about the preemptive shutdown of intellectual pathways of inquiry.
How would you teach it then? Hey, this exists keep an open mind........ Everyone, already knows that.
As for research a lot of this exists outside medicine and science, if you can't apply the scientific method then how do you prove it to be true?

-Also, it's "Medical" School. Not undergrad let's get to know ourselves better.

There is a ton of money being spent by the feds to acquire evidence for or against these alternatives. There is also a ton of money being spent to acquire evidence showing that new drugs and devices devices work. Medical schools are going to be pretty much agnostic as long as someone is pumping money to them to determine if there is evidence on which to base treatment decisions. In medical school you are going to learn how to assess the evidence and how to make treatment decisions based on the strength of the evidence. Your faculty may be conducting research to obtain this evidence.
-So, for the most part general awareness? Wouldn't you agree the answer is to usually stay away from alternative medicine? Is the placebo effect considered? What if a patient tells you they love to juice and believe man should only eat like the stone age people did.... shouldn't that set off alarm bells?

Just curious I can't think of any situation alternative medicine is okay.
 

Spector1

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I think there is a difference between recognizing and dismissing complete hogwash and recognizing that treatments like acupuncture may have very real palliative effects
 
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Oh? You brought up the "should alternative medicine be taught in medical school?" question. My answer was no, for the above reasons.
"...to teach some crap that a guy in an herbal supplement store wearing a white coat is selling?"

That is what I am not talking about.
 
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I think there is a difference between recognizing and dismissing complete hogwash and recognizing that treatments like acupuncture may have very real palliative effects
At best it treats the symptom and done incorrectly can harm someone.

As cited earlier.
Reports of 86 deaths after acupuncture were found. Many are incomplete and causality may therefore be occasionally uncertain. Due to under-reporting, these reports are likely to merely describe the tip of a larger iceberg. Conclusion: Acupuncture has been associated with numerous deaths. These fatalities are avoidable and a reminder of the need to insist on adequate training for all acupuncturists.

http://content.iospress.com/articles/international-journal-of-risk-and-safety-in-medicine/jrs503


To be fair, I agree acupuncture does seem to have actual benefits but how does it compare w/ painkillers? Why should a doctor prescribe/ recommend/ suggest/ not stop a patient from continuing it?
 

Lawper

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Sure, but the question was "should alternative medicine be taught in medical school." I'm not a fan of authoritative institutions controlling what is or is not worth investigating. I'm not talking about actually using unproven or disproven treatments on people, I'm talking about the preemptive shutdown of intellectual pathways of inquiry.
Yeah and I oppose that as well. Sure, these alternative medicine pathways may be pseudoscientific, "too natural" etc., but finding out why people pursue alternative medicine for lethal illnesses, as well as understanding how and where each pathway suffers a shortcoming are helpful in improving the quality of traditional/mainstream medicine.
 

LizzyM

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-So, for the most part general awareness? Wouldn't you agree the answer is to usually stay away from alternative medicine? Is the placebo effect considered? What if a patient tells you they love to juice and believe man should only eat like the stone age people did.... shouldn't that set off alarm bells?

Just curious I can't think of any situation alternative medicine is okay.
What is the evidence for this treatment? Were the studies well designed? Were there placebo controlled to rule out a placebo effect? Is the data generalizable to the patients you're treating?
 
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futuredoc331

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I think doctors should be aware of these people and their "medicine." But as I eluded to above only when these people end up going to a real doctor because their illness never got better or as a result of natural medicine.

Here's an interesting excerpt:
Ruth Conrad, an Idaho woman, had a horrible experience as a result of consulting one of the state's many unlicensed naturopaths. While seeking treatment for a sore shoulder, she also complained of a bump on her nose. The naturopath stated that it was cancer and gave her a black herbal salve to apply directly. Within a few days, her face became very painful and she developed red streaks that ran down her cheeks. Her worried phone call to the naturopath brought the explanation that the presence of the lines was a good sign because they "resemble a crab, and cancer is a crab." He also advised her to apply more of the black salve. Within a week, a large part of her face, including her nose, sloughed off. It took three years and 17 plastic surgical operations to reconstruct her face.

Mrs. Conrad's experience illustrates another aspect of cancer quackery—fake diagnosis. She never had cancer in the first place. In addition to suffering direct harm from a caustic treatment, she also suffered the mental anguish of thinking she had a dread disease.

http://www.quackwatch.com/01QuackeryRelatedTopics/harmquack.html

-Deaths after acupuncture: A systematic review

-Deaths after chiropractic: a review of published cases

-Aristolochic acid-associated urothelial cancer in Taiwan

-What's the harm
368,379 people killed, 306,096 injured and over $2,815,931,000 in economic damages
http://whatstheharm.net/alternativemedicine.html
To play devil's advocate here, one could post an almost identical passage regarding licensed physicians who have fraudulently diagnosed people and charged them for treatments they never actually needed.

http://www.11alive.com/story/news/nation-now/2015/07/10/fata-sentence-handed-down/29993873/
 
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I think doctors should be aware of these people and their "medicine." But as I eluded to above only when these people end up going to a real doctor because their illness never got better or as a result of natural medicine.

Here's an interesting excerpt:
Ruth Conrad, an Idaho woman, had a horrible experience as a result of consulting one of the state's many unlicensed naturopaths. While seeking treatment for a sore shoulder, she also complained of a bump on her nose. The naturopath stated that it was cancer and gave her a black herbal salve to apply directly. Within a few days, her face became very painful and she developed red streaks that ran down her cheeks. Her worried phone call to the naturopath brought the explanation that the presence of the lines was a good sign because they "resemble a crab, and cancer is a crab." He also advised her to apply more of the black salve. Within a week, a large part of her face, including her nose, sloughed off. It took three years and 17 plastic surgical operations to reconstruct her face.

Mrs. Conrad's experience illustrates another aspect of cancer quackery—fake diagnosis. She never had cancer in the first place. In addition to suffering direct harm from a caustic treatment, she also suffered the mental anguish of thinking she had a dread disease.

http://www.quackwatch.com/01QuackeryRelatedTopics/harmquack.html

-Deaths after acupuncture: A systematic review

-Deaths after chiropractic: a review of published cases

-Aristolochic acid-associated urothelial cancer in Taiwan

-What's the harm
368,379 people killed, 306,096 injured and over $2,815,931,000 in economic damages
http://whatstheharm.net/alternativemedicine.html
Medicine all together needs to be put to an immediate stop. These numbers are ridiculous. Why do med schools teach anything at all if about 200,000 people die from Doctors Mistakes?
http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals
 
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What is the evidence for this treatment? Were the studies well designed? Were there placebo controlled to rule out a placebo effect. Is the data generalizable to the patients you're treating?
Ah, case studies. I can see the benefit in that. Thanks :)

To play devil's advocate here, one could post an almost identical passage regarding licensed physicians who have fraudulently diagnosed people and charged them for treatments they never actually needed.

http://www.11alive.com/story/news/nation-now/2015/07/10/fata-sentence-handed-down/29993873/
That man knowingly did harm to patients for monetary gains. Is that what you're comparing alternative medicine to? Because in that case, things are far worse and instead of merely lost & misguided the people giving these treatments out are criminals.

Medicine all together needs to be put to an immediate stop. These numbers are ridiculous. Why do med schools teach anything at all if about 200,000 people die from Doctors Mistakes?
http://www.propublica.org/article/how-many-die-from-medical-mistakes-in-us-hospitals

Mistakes happen and clearly this is an area in need of improvement.

However, unlike alt. med. Actual medicine (as I prefer to call it in this comparison) is proven to have an actual benefit. It is proven many people would die, would have shorter lives, would have lives w/ pointless suffering, essentially would be harmed by not going to an actual doctor.

Therefore, I don't view the shortcoming of traditional medicine to be equivalent to the systematic failures of alternative medicine, which result in physical or even just monetary harm by going to one who treats in alternative "medicine."
 
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nhnative

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I think this is actually such an interesting topic, for a variety of reasons (apologies for this post, it ended up long!)

One of the areas of modern medical practice with which I have the hardest time personally is over treatment. I have been working as a scribe for the past 18 months or so, and always feel frustrated with the excess of medications, tests and imaging studies that are done for questionable reasons (because the pt requests them, or the provider is afraid of litigation if they don't order them etc). I'm always mindful that I am currently an entirely untrained observer, but I have done a good bit of reading and research regarding the many adverse effects (financial, medical, social) of over treatment, as well as the many reasons this trend has developed.

My mother raised my sisters and I with almost exclusively herbal and homeopathic remedies, but she used these in a very thoughtful way. The vast majority of childhood illnesses are either preventable by vaccination, or viral. By treating these illnesses at home, my mother showed us that illness, in itself, is not something that has to feared and always avoided. She nurtured us when we had viral illnesses, made us rest, let the illness run it's course, and taught us that overall health is not necessarily compromised by minor illnesses (if every American took 3 days off work, slept, and drank chamomile tea when they had a cold, I would be interested to see if there would be a subsequent decrease in anxiety/depression). However, she utilized modern medicine whenever necessary (antibiotics for pneumonia, appendectomy for my sister etc). As a result, we avoided the many side effects of unnecessary antibiotics, and learned how to triage our own health, to a certain extent.

My point is that alternative medicine, although without direct physiologic benefit, can contribute to overall health, when used intelligently. I think the dangers come when people treat it as dogma and do not understand it's obvious limitations.

Also, I think the placebo effect is pretty fascinating in itself, although with it's own myriad of ethical challenges in terms of utilizing it as a therapy.....

As physicians, I really do think it's necessary to have at least a basic understanding of alternative practices, at the very least so you can intelligently explain to patient's when these treatments are inappropriate (and also when they might be harmless). Many patient's who hold these beliefs are not dogmatic and ignorant, and if we are not adequately educated, and are ourselves close-minded, I think we risk our patients' health by not being able to connect and communicate effectively with them.
 
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People tend to forget that a lot of modern medications came from the the chemical analysis of different plants around the world. I had this discussion with my organic professor. He was telling me about how many projects he had going on back in the day where the goal was just to isolate the different compounds in all kinds of plants so their effect on the body could be studied.

I don't believe that anything should be taught that hasn't been researched well enough.
 
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People die from mistakes, but how many people are treated properly after those mistakes? Amusing that the physician learned from his mistake. We're humans, we learn from our mistakes. Needless to say, we all make them.
 
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People tend to forget that a lot of modern medications came from the the chemical analysis of different plants around the world. I had this discussion with my organic professor. He was telling me about how many projects he had going on back in the day where the goal was just to isolate the different compounds in all kinds of plants so their effect on the body could be studied.

I don't believe that anything should be taught that hasn't been researched well enough.
Aspirin, for example, is just an isolated chemical from white willow bark I believe.
 
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People die from mistakes, but how many people are treated properly after those mistakes? Amusing that the physician learned from his mistake. We're humans, we learn from our mistakes. Needless to say, we all make them.
The point of my post was not to bash traditional medicine and doctors for mistakes. It was sarcastic.

I was just demonstrating that people don't die from just alternative medicine, but traditional too.
 
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The point of my post was not to bash traditional medicine and doctors for mistakes. It was sarcastic.

I was just demonstrating that people don't die from just alternative medicine, but traditional too.
Ah, my apologies. I misinterpreted your post.
 

LizzyM

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Aspirin, for example, is just an isolated chemical from white willow bark I believe.
I am also reminded of a guy who's sister was a close friend of my sister. He was treated for testicular cancer about 35 years ago and to the doctors' surprise, he had no nausea and vomiting from the chemo Was it the marijuana he smoked for fun?

Some herbs and folk traditions are complimentary to mainstream clinical care.
My point is that alternative medicine, although without direct physiologic benefit,
I wouldn't be so sure that many of these treatments are without direct physiologic benefit. You need evidence from clinical trials before making such a statement.

Ah, case studies. I can see the benefit in that. Thanks :)
A case study reports a case (sometimes more than one case). It is poor evidence but it can be a starting point for establishing the need for a randomized clinical trial.
check out clinicaltrials.gov for reported trials. There are over 600 clinical trials underway or completed testing acupuncture.
 

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Are most common alternative medicines just lacking research support or is there research saying they are ineffective/harmful?
 

StudyLater

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Anything that's been shown to work through clinical trials should be used. Anything questionable should be further researched. We done here?
 
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el_duderino

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If it can be shown to work using actual verifiable evidence, then it should be part of the physician's toolkit.

If it works, it's simply called medicine. Physicians should be, and generally are, open to any treatment that can be shown to be effective.
 

Holmwood

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I don't want to go back to the dark ages where we're drilling holes in people's heads to relieve migraines. . . . But I think medical students should at least be introduced to the topic of alternative medicine, especially in research-heavy schools.

If it works, we should understand why it works. Doesn't matter if it's a drug or an incense. You never know if what you find through alternative medicine research will revolutionize our understanding of the body and lead to novel treatments either.

Though my memory is fuzzy, I did read a study that showed incense helping rats with artificially-induced stroke improve in cognitive tasks. We need more studies like that, I think.
 
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I don't really think alternative medicine should be taught, unless it actually has some scientific support.

To quote the great Tim Minchin, "Alternative medicine has either not been proved to work, or been proved not to work. Do you know what they call alternative medicine thats been proved to work? Medicine."
 

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Taught? As in: "If you aren't comfortable giving your patient digoxin, suggest they add a little foxglove to their chamomile tea each night..."

Uh, no.

Taught, as in: "You may find that some of your patients have questions about these things they have read about or heard about or heard about or which have been used in their family for years, and you want to be able to speak intelligently on the topic?"

Yes. That sounds great. As enrichment or a couple of one-off lectures worked in somewhere into all that free time we are swimming in.
 

Biochemistry2014

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We should absolutely at least be given an introduction to the theories and uses of some alternative medicine treatments. There are quite a few that have growing scientific backing, and so it is wrong and completely ignorant for us to label all of them based on their "snake oil" stereotypes. We become physicians for our patients, not to push our views on them. We must be open minded in our education. After all, many of our current treatments have been derived from what used to be called "alternative."

I have had many opportunities to witness the huge barrier in mistrust between alternative medicine supporters and physicians, strongly contributed by the fact that some physicians IMMEDIATELY dismiss any and all alternative treatments without any knowledge of the current research. That mistrust often weakens the patient's plan of care and often polarizes their already strong attraction to alternative medicine.

I'm not saying we should learn the inside outs of alternative medicine, as none of us are going to med school for the sake of being a naturopathic "doctor." However, we should at the very least be receptive to dissecting current research on some of these treatments and weighing their validity, as LizzyM pointed out, rather than allowing our opinions to immediately dismiss them.
 

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Considering the scale of dilution that homeopathy teaches, some people don't realize that it is equivalent to the scale of ~1 atom in the galaxy. You might as well drink plain water to cure your illness - same thing :laugh:

my all-time favorite:

 
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. In medical school you are going to learn how to assess the evidence and how to make treatment decisions based on the strength of the evidence. Your faculty may be conducting research to obtain this evidence.
If this is the case, medical schools can have a course called "scientific literature evaluation skills" or something like that. There have been studies proving that homeopathy and naturopathy and the likes are nonsense. No need to spread pseudoscience further.
 
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A lot of the antivaxers are well educated upper middle class liberals
I've seen about equal of both. About equal parts granola-eating liberal yoga-doers, and nutball libertarians who believe that Obama is only days away from confiscating their guns.
 
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el_duderino

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If this is the case, medical schools can have a course called "scientific literature evaluation skills" or something like that. There have been studies proving that homeopathy and naturopathy and the likes are nonsense. No need to spread pseudoscience further.
We have that at my school. It's a 4-year longitudinal course called Evidence-based Healthcare. It's largely about biostats and critically evaluating scientific literature.

Homeopathy is of course nonsense. It's literally based on magic. Not all things alternative or natural, though, can be summarily dismissed.
 

Holmwood

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Well, the principles behind homeopathy is pure pseudoscience. Ideas like fire kills fire come from a gross misunderstanding of how vaccinations work...

Even so, studies show that some of those concoctions worked for both animals and people in the past. I don't think there are many reliability studies on the area either (which Im sure will debunk many of these studies)...But under the assumption that some concoctions worked reliably, it is important to try and understand what it contains and why it works from a molecular standpoint. During the dilution process, other contaminants may be introduced which produces the therapeutic effect. Maybe there's some bacterial growth feeding on whatever you're diluting that produces novel effects.
 
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