There is no Alternative Medicine.
Thus sprach Phil Fontanarosa and me in a 1998 JAMA editorial in the famous theme issue dedicated to Complementary and Alternative Medicine.
So I went to Mr. Google in 2010 and entered … Alternative Medicine … and clicked — 41,200,000 results; entered Complementary and Alternative Medicine, click — 3,210,000 results; entered CAM, click — 191,000,000 results, but that’s not fair; CAM can stand for many unrelated topics.
Let’s try quackery on Mr. Google, click — “only” 818,000 results.
Meanwhile, back to that 1998 JAMA editorial. “There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking.”
But actually there are three piles:
- You have a test or treatment that has itself been tested and found to be safe and effective. Use it; pay for it.
- You have a test or treatment that has been found to be unsafe or ineffective. Don’t use it; don’t pay for it.
- You have a test or treatment that is scientifically plausible, meaning not preposterous. Test it and then put it into one of the other two piles.
This 1998 JAMA theme issue is credited or blamed by many with opening the door for conversation, study, and serious research. It even promoted respectful consideration of the practices of patients and practitioners of complementary and alternative medicine, since the practices were common, communication almost nonexistent, and understanding veiled at best.
What has happened since 1998?
A large amount of serious research into previously unstudied practices, largely funded by the NIH, has resulted in many articles in mainstream journals. And, guess what, almost all of the long-term traditional CAM practices have been found to be safe but ineffective.
And what has happened in practice? The American Medical Marketing Machine (AMMM) has done its thing.
As the published scientific studies have one by one found CAM practices to be ineffective, more Americans are using CAM than ever. And, such use often is now in mainstream institutions, sterilized, and sold as “Integrative Medicine,” which Mr. Google numbers at 1,230,000 results.
Looks like there will always be snake oil sellers as long as there are snake oil buyers.
George Lundberg is a MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association.