SAN FRANCISCOPatients use of alternative (or
complementary) medicine poses real difficulty for many physicians
today. Patients often query their doctors about alternative medicine,
asking for evaluations of different therapies, such as acupuncture.
The problem is that its very difficult to be truthful and
factual while at the same time honoring the patients feelings
and beliefs, said Robert Buckman, MD, medical oncologist at the
University of Toronto. Dr. Buckman spoke at a seminar on alternative
medicine at the Society of Gynecologic Oncologists meeting.
Most alternative therapies are not based on scientific hypotheses or
even collected data, but on anecdotal observation, Dr. Buckman said.
And only a few have been proven to be even mildly effective in
scientific studies. But that does not mean that conventional medicine
might not embrace some of these therapies in the futureif they
are studied in a scientific manner.
Conventional medicine like alternative medicine is an ever-changing
field, Dr. Buckman said. But unlike alternative medicine,
conventional medicine operates on clear didactic principles. We
try to test hypotheses in conventional medicine by disproving them.
But alternative medicine adherents have used no scientific methods.
They just claim that their treatments cure cancer, for instance.
Yet if alternative medicine is unproven, why is it so popular? Dr.
Buckman said that a 1998 JAMA study offers some clues. In this study,
the most common reason people gave for seeking out alternative
medicine is that they think they get relief from their symptoms.
Other patients believe that alternative medicine is better for their
health than conventional treatments. Some also said they like
alternative medicine because it promotes health rather than focusing
Any scientist evaluating alternative medicine, however, has to
conclude that most of these therapies are not effective, Dr. Buckman
said. In his view, only four such treatments have been proven in
double-blind, placebo-controlled studies. These include traditional
Chinese medicinal tea for childhood eczema, chiropractic therapy for
low back pain, acupuncture for analgesia, and St. Johns wort
for mild to moderate depression.
The problem is that factual information about alternative therapies
has not filtered down to the public at large, he said. The
reason that so many people believe in alternative medicine is
suspension of disbelief. Theres no way to prove that these
therapies do or dont work because no one collects data,
theres insufficient follow-up, concurrent use of conventional
therapy, and misinterpretation of information.
He pointed out that many consumers of alternative medicine say they
feel better rather than that they are getting
better through alternative medicine use. And theres
an enormous difference between these two judgments, he said.
Dr. Buckman believes that alternative medicine practitioners should
stop telling liessaying that their therapies cure
cancer, for instance. These claims can have devastating
consequences, he said.
Yet conventional physicians can learn from alternative practitioners.
Many patients, for instance, say they go to alternative practitioners
because they get more attention and care than from conventional
We need to develop the skills of person-doctoring to the same
level as our skills of disease-doctoring, Dr. Buckman said.
We need to put more emphasis on magicnot just medicine.
We need to give the same kind of support thats contained in
mothers chicken soup. Its a matter of giving our patients
more emotional support.