One Last Time: Alternative Medicine

There are certain subjects that have come up time and again over the last 9 years. The main benefit of a behavioral approach is that so many seemingly diverse behaviors can be grouped into categories or dimensions to make sense of the consequences that arise from the resulting choices. 

About five weeks ago, in August, I wrapped up the subject of unfounded fears over GMOs with a One Last Time entry. Today the subject is the very broad area of alternative medicine, which I have described as magic pills and miracle cures. Just typing “magic pill” in the search box at the top left corner of the screen will reveal about 20 entries on this subject from vitamins to caffeinated underwear. In these and several other cases I pointed out the fallacies in their advertising and directed attention to the legally required disclaimer: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease."

Recently, I found this informative site with an excellent summary.

First they list the various aliases used instead of alternative including: esoteric, complementary, holistic, integrative or natural medicine. It includes such a variety of treatments that “generally accepted definitions do not exist.” 

An incomplete list includes: acupuncture, anthroposophical medicine, applied kinesiology, aromatherapy, autologous blood therapy, Ayurvedic medicine, Bach flower remedies, bioresonance, chelation therapy, chiropractic, colonic irrigation, detox therapies, dietary supplements, energy healing, herbal medicine, homeopathy, iridology, Kampo medicine, macrobiotic, magnet therapy, mind-body therapies, music therapy, neural therapy, ozone therapy, reflexology, Reiki, shiatsu and Traditional Chinese Medicine. I have discussed many of these elsewhere, here and here, for example, but some I’ve never heard of. 

Since they have no scientific backing, how do they lure in customers? “The realm of EM (Esoteric Medicine) is riddled with fallacies which confuse patients and consumers and are used regularly to undermine critical thinking.” In other words, they trick people. The most prevalent and important of these fallacies from the site are summarized below.

The “appeal to popularity” or “appeal to authority” tries to substitute popularity or the opinion of respected people for scientific evidence. But “medicine is no popularity contest” and “even people of high standing make mistakes.”

The post hoc fallacy wrongly assumes “an event ‘X’ that is preceded by another event ‘Y’ must be caused by ‘Y’. If the rooster didn’t crow, the sun would not come up. If the child skipped vaccinations, he would not have autism. (No and no.) It is not true for individuals or for groups.

Many of these interventions rely on the placebo effect. Scientists are just beginning to understand the power of the mind to heal the body. This effect is present whether the medicine is real or not. Likewise, sometimes people just get better on their own. These alternative treatments take advantage of these facts to gather supporters and celebrity endorsements without bothering with scientific evidence.

Using an appeal to tradition, citing a long history is another fallacy, assuming that if it has passed the test of time, it must be effective and safe. This may be good reason to conduct research, and if the argument is valid, the results will be favorable. But long history is no substitute for evidence. Many treatments were applied in the past that would be unconscionable today. Contrary to some popular opinion, ancient Chinese is not a code for safe and effective.

The article gives a long explanation of why EM is unethical by medical standards. “Informed consent is rarely possible in the realm of EM.” Often there is not a professional diagnosis.

“Another fallacy holds that EM defies science or extends beyond the boundaries of science as it is currently understood. Therefore, proponents claim, it cannot be tested in the same way as one would test conventional treatments.” 

Finally, because it is natural, it is assumed to be harmless. “Nature is pictured as benign and natural remedies are therefore not just intrinsically superior but also safer.” This shows a limited viewpoint and a basic misunderstanding of nature. Hurricanes, tornados and blizzards are natural. No one would argue that tobacco is safe because it is natural. To be enamored with words like “natural” and “non-chemical” or the phrase “available without a prescription” is to succumb to deceptive advertising.

These tools are used to “mislead the public such that even the most extravagant absurdities of EM might appear more plausible. Collectively they help foster and perpetuate a culture of unreason that is essential for EM to thrive.”

Ads for a vast number of bogus alternative medical products and services have cropped up since the advent of the COVID-19, faster than the authorities can alert the public or warn the purveyors about their illegal activity. The best defense is: Don’t be a sucker!

The truth is there is no such thing as alternative medicine (no matter what name it goes by); there is only medicine that works and medicine that doesn’t work. All these tricks, alluring words and excuses do not change that fact. Lack of critical thinking in this area can lead to a waste of money, but worse, real harm to you or your family.

Testing Our Critical Thinking

At least once a day, though we may not even realize it, our critical thinking is tested.  I received this in an email from a friend who participates in a weekly walking group at a local nature center.  It’s good exercise and a pleasant time, but one of the participants wanted to let us know about additional benefits.

The article attached to the email was about something called forest bathing, and it tells how walking in the woods can be healthy, in fact, healthier than walking down a city sidewalk.  The headline tells us:  “A Retreat To Nature Can Boost Immunity And Mood.”

But forest bathing is more than just walking in the woods and enjoying the natural surroundings.  The outing in the article was led by a Certified Forest Therapy Guide.  It is the guide’s job to encourage participants to “slow down and become immersed in the natural environment” and to help them “tune in to the smells, textures, tastes and sights of the forest.”  The guide leads them through exercises to help them isolate each of these senses to take in the unique sights, sounds and smells.

It’s clearly not like hiking, because the forest bathers have no particular destination.  It’s a slow, mindful walk, akin to walking meditation practiced at some yoga retreats.  The emphasis is on the present moment, rather than on plans or worries.

After describing the experience, they list the health benefits.  The practice began in Japan where one study showed that walking in a forest environment “led to more significant reductions in blood pressure and certain stress hormones” than walking the same distance in the city.  I followed the link and found that this study had only 16 participants – was that 8 in each group (a test group and a control group)?  If so, that is an extremely small sample size; if not, it's not really an experiment. (And always remember that linked does not mean causes.)

They cite other “preliminary” studies as well.  One referred to as a “small study” and another with no mention of sample size or the experimental design, but both touting benefits of being in close proximity to trees or enjoying certain scents of the forest.

Now comes the worrisome part.  Apparently we are not able to get these benefits on our own.  The Association of Nature & Forest Therapy is training and certifying Forest Therapy guides to help.  Using this rather sparse scientific justification and an unsupported assertion that “work-related stress accounts for up to $190 billion in health care costs each [year],” their representative makes a leap of faith that forest bathing should be part of every doctor’s toolkit and covered by health insurance – "It's my hope that the health care system will include [forest therapy] into the range of services they reimburse for.”

Now I don’t doubt that taking a nice quiet leisurely walk in the woods, being sensitive to and appreciating the natural surroundings is surely healthier and more relaxing than walking down a crowded city sidewalk.  That’s a no-brainer.  But do you need a coach to benefit from it, do you need to pay and should insurance be involved?

The whole thing begins to sound like the case of therapeutic touch, which has no scientific basis, but for which insurance companies reimburse hospitals.  It reminds me of the company that sells scooters to the elderly with the sales pitch, “if Medicare doesn’t pay for yours, it’s free.”  The forest bathing business (and it is a business) wants to slide into that category enjoyed by some other health-related businesses – “your insurance will cover most or all of the cost.”  We’ve heard the sales pitches over and over and should know deep down that when no one is paying, no one is caring how much it cost and no one is concerned about abuse or true quality.  Patients get placebo benefits and the therapists get insurance money.  Our health costs rise and everyone wonders why.