Let’s give patients both real medicine and the placebo effect

Filed under: Ideas by Jeremy on Friday, 17th June 2011 at 10:04 am

David Freeman, the author of the book Wrong, has a new article in the The Atlantic called “The Triumph of New-Age Medicine” that Matthew Herper at Forbes aptly calls: Wrong: The Magazine Article. Herper, Dr. Steven Novella at Neurologica and Orac at Respectful Insolence have written excellent take-downs of this article pointing out that mainstream medicine is clearly not failing, as Freeman would have it, neither would alternative medicine be the right path to go down even if it was. I have just two points to add to these criticisms.

In Freeman’s article, the so-called triumph of new-age medicine isn’t the medicine, it’s how big the placebo effect can be when this ‘medicine’ is given with care. This is really not surprising. We know that placebo injections have stronger effects than placebo pills and that doctor-administered placebos are more effective than nurse-administered placebos. How placebos are administered matters and alternative medicine practioners have more time to spend with their patient and therefore more time to ‘sell’ their placebo.

Freeman’s bottom line is that mainstream medicine sometimes fails in bonding with the patient and is therefore missing one extra way of maximizing good outcomes in patients. Some doctors definitely do both bond with their patients as well as dispense proven medicines but as an overall criticism of the mainstream medicine fair enough. In the end, his suggestion is that we should use alternative medicine practitioners to plug the ‘caring’ hole in mainstream medicine.

So, wait, what? On one hand we have doctors who have medicine that actually works but who aren’t caring enough. On the other hand we have alt-med practitioners who have medicine that doesn’t work but who care. Doesn’t the obvious solution be to give patients both medicine that works from someone who cares–not just someone who cares? If we dispense medicine that works while simultaneously maximizing the placebo effect we can have the best of both words. As a patient, that’s what I would want.

My second point is something I find strange about these alt-med articles is that when they criticize mainstream medicine, they always use studies but not anecdotes, but when they turn around and praise alternative medicine, they only use anecdotes and not studies. That’s some pretty obvious cherry-picking and for a good reason. There are no well-conducted studies that show that alternative therapies like homeopathy or acupuncture work so they lose on the research front. As for the anecdote front, where are the anecdotes from people for whom alternative medicine didn’t work? Or the anecdotes from people for whom mainstream medicine did work? Why are you only giving us anecdotes that support your position? That makes me awfully suspicious…

 

One Response to “Let’s give patients both real medicine and the placebo effect”

  1. [...] smokes! I wrote a rebuttal last week about the pro-alternative medicine article David Freeman wrote recently in the Atlantic. I should [...]

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