An Alternative-Medicine Believer’s Journey Back to Science

http://www.wired.com/2015/04/alternative-medicine-believers-journey-back-science/?Src=longreads

After celebrity doctor Andrew Weil pioneered the idea at the University of Arizona in the late ’90s, 23 medical schools now offer residencies in integrative medicine. There are now integrative medicine centers and programs in many of the nation’s top hospitals and universities, including the Cleveland Clinic, the Mayo Clinic, Duke, and Johns Hopkins.

In 2013, the American Board of Physician Specialties added integrative medicine alongside more traditional board certifications such as surgery and dermatology (there were so many applicants that the first certification exam had to be delayed). And last year, the National Center for Complementary and Alternative Medicine—a publicly funded research agency that is part of the National Institute for Health—changed its name to the National Center for Complementary and Integrative Health…

Loosely categorized as “alternative medicine,” the approaches include nutritional supplements, dietary regimens, detoxification protocols, acupuncture, energy healing, homeopathy, chiropractic, traditional Indian medicine, and whatever else has anecdotal support yet remains unaccepted by the larger scientific community…

At Yale, physician and prominent health advocate David Katz practices integrative medicine… Besides, he says, practices like reiki and homeopathy are relatively harmless. Reiki involves nothing more than laying hands on—or, often, just above—a patient’s body. Homeopathy is essentially the prescription of sugar pills. Even if these treatments really are just theatrical placebos—e.g. real acupuncture works no better than fake acupuncture—why not offer them as an option if patients want them?  …

Reflecting on his experience, Jim Laidler concluded that false hope was like a drug. Perhaps that’s part of the reason Dr. Oz’s defenders are as fervent as the parents who threatened Jim’s life: some of them can’t face the pangs of withdrawal.

And false hope isn’t just for patients. Doctors—traditional and integrative alike—also can become dependent…

Jim Laidler is an anesthesiologist, and his work involves the same kind of expectation management. “My chronic-pain patients are often referrals,” he says, “and they’ve been led to believe that they can live a life free from pain. The first thing I do is explain that our goal is to manage pain, not eliminate it.” …

By the time a pain patient gets to an anesthesiologist, she’s been through the ringer.  So I have to wonder how many patients actually arrive at Dr. Laidler’s office with the expectation that “they can live a life free from pain.”

What percentage of chronic pain patients have false hope? Should pain patients learn acceptance as soon as possible, or should they continue to hope?  How do you know when your hope is false?

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