I am about to exit at minute 10. While perhaps well-educated and knowledgeable, it is difficult for the "average" (non scientific) listener/viewer to know what they are referring to. I would advise the next scientific blogging heads to please tie your conversation to something specific and reference it frequently. It seems they are speaking extremely generally. There are tons of people interested in (sorry) alternative medicine. They would say "alternative to the prescribe first mentality" in American doctors. Alternative to becoming over chemicalized. Alternative because we listen to the body. Maybe that is what American doctors are supposed to be about, but in the main, they are not.

http://scienceblogs.com/denialism/20...ong_agency.php and also sciencebasedmedicine.com The National Center for Complementary and Alternative Medicine.

These links may be of interest: From CFI: http://www.youtube.com/watch?v=lEngMoCJEtc http://www.youtube.com/watch?v=yl_hK...eature=related From Dartmouth: http://www.howsyourhealth.org/ Complete the check-up, print it (nothing is stored on the Web!) and take it to your Physician

I certainly can't disagree with the Peter's demand that medicine be science-based, and I'm certainly not defending any of the forms of quackitude he scoffs at, but it's interesting how in here he seems to assume that the interests of scientists or of physicians is entirely a matter of good science. But physicians and scientists are full-fledged human beings whose interests far exceed their interest in scientific method, and will sometimes conflict with that method. Teachers as a class have an interest in teaching, yet teachers' unions may still be an obstacle to better teaching. This story in Slate about why the American Heart Association doesn't back universal EKG screening for American high school athletes. The article notes that the AHA offered a "baffling, non-evidence-based" justification for breaking with their European colleagues on the issue.
Here is the article's explanation of this unscientific behavior:

Why does the AHA really oppose screening tests, even though their statement plainly asserts that the tests "would have benefit?" Though not stated explicitly, widespread screening with EKGs, or even echocardiograms, threatens traditional, lucrative fee-for-service norms for expensive cardiac testing. According to Medicare reimbursements, an EKG scores about $50, though it takes only

Quoting Bloggin' Noggin: I certainly can't disagree with the Peter's demand that medicine be science-based, and I'm certainly not defending any of the forms of quackitude he scoffs at, but it's interesting how in here he seems to assume that the interests of scientists or of physicians is entirely a matter of good science.

But physicians and scientists are full-fledged human beings whose interests far exceed their interest in scientific method, and will sometimes conflict with that method. Teachers as a class have an interest in teaching, yet teachers' unions may still be an obstacle to better teaching.

This story in Slate about why the American Heart Association doesn't back universal EKG screening for American high school athletes. The article notes that the AHA offered a "baffling, non-evidence-based" justification for breaking with their European colleagues on the issue.
Here is the article's explanation of this unscientific behavior:

Peter too readily conflates physician's interests and the interests of Scientific Medicine in the abstract -- or at least he certainly seems to in the snippet of conversation I linked to above.
Perhaps this is the place where a little humility would be in order

I agree. We

Couldn't help seeing these quotes from Sen Harkin (no relation): "One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving." and "It is time to end the discrimination against alternative health care practices." and seeing the similarities to both creation science and global warming cw. But.......I'm not sure if you can call it 'unscientific' but medicine is one of those sciences where psychological factors (e.g. the uses of placebos) can have a huge impact. I've often thought that 'alternative medicine' had as much to do with attitude as science. Since attitude adjustment can have a profound impact on health, there will always be a place for AM. I'd just as soon not be required to fund it tho. Regarding scientists getting political, I'm all for it as long as the scientist is ethical enough to avoid letting the science be unvarnished by politics, which for many

NCCAM is part of NIH. I don’t know the details of its creation, but it has always seemed to me that it was at least in part a response to the increasing use of alternative medicine by the U.S. population. It seemed reasonable that if a large segment of the population is using this kind of medicine, it would be worth studying it to be able to inform the public about its validity (or lack of). If a physician wants to make a statement discrediting this kind of medicine, it’s helpful to have studies that back up that opinion. At least in the 90’s I recall that many of the large studies in this area were being conducted by large, reputable academic centers. I will infer that at least the methodology for those studies was legitimate. I find there is a contradiction between dismissing the study of what is “improbable”, as if this could be accurately determined a priori, and at the same time acknowledge the validity of the placebo effect. The “placebo effect” has become so integral to our medical knowledge that we don’t seem to be able to

Quoting harkin: One of the best speeches ever about consensus v science is Michael Crichton's 'Aliens Cause Global Warming' at Cal tech in 2003:

"the work of science has nothing whatever to do with consensus. Consensus is the business of politics. Science, on the contrary, requires only one investigator who happens to be right, which means that he or she has results that are verifiable by reference to the real world. In science consensus is irrelevant. What is relevant is reproducible results. The greatest scientists in history are great precisely because they broke with the consensus."

That's almost as dumb as his last half dozen books. Working backwards: the greatest scientists in history aren't great because they broke with the consensus (and they didn't), it's because they created new theoretical frameworks that were able to handle stuff there was no established consensus on. Second, judging "reproducible results" requires consensus. If you just write up some crap and tell people it's reproducible that doesn't mean anything. Third, "verifiable by reference to the real world" sounds nice but there is literally zero intellectual content. He could have just said "buh fuh gag du" and saved some syllables. He

Quoting harkin: Couldn't help seeing these quotes from Sen Harkin (no relation):

"One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving."

and

"It is time to end the discrimination against alternative health care practices."

and seeing the similarities to both creation science and global warming cw.

But.......I'm not sure if you can call it 'unscientific' but medicine is one of those sciences where psychological factors (e.g. the uses of placebos) can have a huge impact. I've often thought that 'alternative medicine' had as much to do with attitude as science. Since attitude adjustment can have a profound impact on health, there will always be a place for AM. I'd just as soon not be required to fund it tho.

Regarding scientists getting political, I'm all for it as long as the scientist is ethical enough to avoid letting the science be unvarnished by politics, which for many

Quoting Ocean: I find there is a contradiction between dismissing the study of what is “improbable”, as if this could be accurately determined a priori, and at the same time acknowledge the validity of the placebo effect.

Wasn't his point there simply about the need for a reasonable sieve? I mean you can construct an infinite number of assertions proposing all sorts of relationships between some aspect of the world and human health. How do you decide what's worthy of an investment in significant study?

Or as Robin Hanson would say, You Signal that you are Altruistic.

Quoting AemJeff: Wasn't his point there simply about the need for a reasonable sieve? I mean you can construct an infinite number of assertions proposing all sorts of relationships between some aspect of the world and human health. How do you decide what's worthy of an investment in significant study?

Yes, I understand that's most likely the general principle Peter implied. However, his statement would make more sense if, for example, he was to show that the studies that have been funded by NCCAM have been predominantly about highly "improbable "alternative medicine" modalities. Still, the statement implies that we possess some ability to know a priori what isn't worth studying. If that's the case, what's the criteria to be used? Would you favor studies that concern the ingestion of chemical substances (herbs, foods, other non-conventional remedies) over "action at a distance" claims such as "energy manipulation" or prayer? I'm not clear about what Peter's rationale would be for one of the other, (although I'm not saying there isn't one).

Quoting Ocean: Yes, I understand that's most likely the general principle Peter implied. However, his statement would make more sense if, for example, he was to show that the studies that have been funded by NCCAM have been predominantly about highly "improbable "alternative medicine" modalities. Still, the statement implies that we possess some ability to know a priori what isn't worth studying. If that's the case, what's the criteria to be used?

Would you favor studies that concern the ingestion of chemical substances (herbs, foods, other non-conventional remedies) over "action at a distance" claims such as "energy manipulation" or prayer? I'm not clear about what Peter's rationale would be for one of the other, (although I'm not saying there isn't one).

I think the logic has to be, of necessity, assertive. Given finite resources and potentially infinite subjects of study, the question really isn't about what we think is unworthy. Rather: for what topics does there exist evidence indicating the possibility of an interesting result? I suspect that logic is less likely to lead to major reiki studies than it is to the study of herbals, e.g., but I don't think that's an indication of an a priori bias.

How should we classify marijuana?
Alternative, experimental, illegal, all of the above? Most of the "Scientific Studies" are funded by Big Pharma, and then sometimes the results are released only when it is to the benefit of the sponsor. When a treatment is proven effective it is not alternative or complementary.

Quoting SkepticDoc: How should we classify marijuana?
Alternative, experimental, illegal, all of the above?

Most of the "Scientific Studies" are funded by Big Pharma, and then sometimes the results are released only when it is to the benefit of the sponsor.

When a treatment is proven effective it is not alternative or complementary.

Doc, that last statement is a tautology, I think. As to the rest, I don't understand how it relates to my reply to Ocean.

Quoting AemJeff: I think the logic has to be, of necessity, assertive. Given finite resources and potentially infinite subjects of study, the question really isn't about what we think is unworthy. Rather: for what topics does there exist evidence indicating the possibility of an interesting result? I suspect that logic is less likely to lead to major reiki studies than it is to the study of herbals, e.g., but I don't think that's an indication of an a priori bias.

Jeff, I agree with what you are saying above in the sense that in practice, you have to set priorities for funding. I'm sure that there are many ways to establish those priorities. In medicine, studies are generally funded when they are linked to previous lines of research. The good thing is that you are in relatively speaking solid ground when you do that. The disadvantage is that it may pre-empt innovative research. But the above are practical considerations. My initial comment was mostly a response to a dismissive attitude about research in non-traditional areas of study.

Quoting AemJeff: Doc, that last statement is a tautology, I think. As to the rest, I don't understand how it relates to my reply to Ocean.

Although it does sound like a tautology, it is relevant to some of the statements made in this diavlog. Peter asked "what is alternative medicine? Alternative to what works?" The problem with that is, that the only way to know what "works" is by studying it. The most distinctive feature of "alternative medicine" is that it is not part of traditional Western medicine. If we study it and it works, then it becomes incorporated to "traditional" medicine. The general impression seems to be though, that most of the studies show that many of these alternative approaches don't work. I don't know that is accurate. Also, if the studies "debunk" something that people are paying for with no verifiable benefit, it would still be helpful. However, I don't know whether people that use alternative medicine care about what these studies show.

How can we prove marijuana (or another herbal) is truly effective when the legal system has made it illegal? Several points were made in the diavlog about publishing negative findings, those are lacking for marijuana. Helycobacter pylori and peptic ulcers is one of the best recent examples of a medical theory that eventually was proven effective, in that case, the treatment (antibiotics, Pepto-Bismol, acid suppressants, in various protocols) was readily available and people were able to test it, it is now mainstream therapy... Meditation is another issue, definitely it is harmless, but how can we demonstrate the individual is "meditating", what "level" can they reach? If we cannot measure a practice, it would remain forever "alternative"...

Quoting Ocean: ...
My initial comment was mostly a response to a dismissive attitude about research in non-traditional areas of study.

Ok. I didn't really sense dismissiveness when I was listening to the diavlog, but I can easily understand somebody else feeling that way. I'm more sensitive to the necessity of a skeptical filter than I am to what that filter might reject.

Quoting AemJeff: Ok. I didn't really sense dismissiveness when I was listening to the diavlog, but I can easily understand somebody else feeling that way. I'm more sensitive to the necessity of a skeptical filter than I am to what that filter might reject.

Yep. This pretty much captures the different perspective. I tend to look at what we may be missing to study due to the use of exclusionary criteria.

Quoting SkepticDoc: How can we prove marijuana (or another herbal) is truly effective when the legal system has made it illegal?

Several points were made in the diavlog about publishing negative findings, those are lacking for marijuana.

Helycobacter pylori and peptic ulcers is one of the best recent examples of a medical theory that eventually was proven effective, in that case, the treatment (antibiotics, Pepto-Bismol, acid suppressants, in various protocols) was readily available and people were able to test it, it is now mainstream therapy...
........

If we cannot measure a practice, it would remain forever "alternative"...

We are saying sort of the same thing...

Meditation is another issue, definitely it is harmless, but how can we demonstrate the individual is "meditating", what "level" can they reach?

Where did this come from??? Free associating...?

Must also add that for some reason this was also the first time I clicked (albeit accidentally) on one of the ads -- Judy's Wrinkle Discovery - - and was amused to see not only Barbara Walters but Harvard touting the most recent scientific breakthrough!

Quoting pampl: If you just write up some crap and tell people it's reproducible that doesn't mean anything.

You misunderstand the basic english of Crichton's point. Telling people something is reproducable is valid only when other scientists verify your claims in their own controlled experiments.

Nevertheless, folks like harkin feel the need to dump on the work product by the guys who haven't published papers consistent with what the bribers and the obviously political think-tankers openly want to see - implying somehow that the vast majority of the people working in this field are in fact on the corrupt side of the argument.

I myself have no opinion on global warming because I have not read enough nor am I learned enough in the science to venture any sort of valid judgement. I do however wish to hear all sides to a discussion, something that

Janet mentioned meditation...

http://jama.ama-assn.org/cgi/content/full/296/13/1593

Quoting Ocean: Peter asked "what is alternative medicine? Alternative to what works?" The problem with that is, that the only way to know what "works" is by studying it.

That's one problem. Another is that so much medicine doesn't work. Yes; if you need your arm sewn back on, modern medicine will treat you right, but half the goddamn pills they give out have no effect. Ailments remain ailments. Docs take pride in the humility on display in their scientific work, and rightly so, but, Christ, fix my father's arthritis already. The real humility should come from the confession that, neither alternative, nor conventional medicine gets the job done.

My sense is Peter is somewhat delusional about how robustly what he calls medicine is backed up by "science." They might go through the motions in their drug testing regimes but, in many (I'll bet most) cases, the system is too complex to possibly validate anything scientifically without an unlimited budget. The result is gross simplifications are made, the results are dressed up in science, drug companies are able to profit from their "scientific" results, but there is no science. I'll postulate that we've passed 'Peak Drug.' The result of this would manifest either in less drugs overall coming on the market or an increasing percentage of ineffective drugs coming on the market. Given the motivations of the pharmaceutical companies to keep growing, my bet is what we're seeing is the latter phenomenon.

Quoting Ray: That's one problem. Another is that so much medicine doesn't work.

Yes; if you need your arm sewn back on, modern medicine will treat you right, but half the goddamn pills they give out have no effect. Ailments remain ailments.

Docs take pride in the humility on display in their scientific work, and rightly so, but, Christ, fix my father's arthritis already. The real humility should come from the confession that, neither alternative, nor conventional medicine gets the job done.

If you have diabetes or heart disease then the benefits granted by pharmaceuticals is concrete and measurable. Believe me, modern medicine does some jobs very well indeed.

Quoting willmybasilgrow: I am about to exit at minute 10.

While perhaps well-educated and knowledgeable, it is difficult for the "average" (non scientific) listener/viewer to know what they are referring to.

I completely disagree. I am not medically-educated (or particularly knowledgeable) and found it extremely easy to follow. Not only that, I found it extremely interesting.

Quoting Bloggin' Noggin: I certainly can't disagree with the Peter's demand that medicine be science-based, and I'm certainly not defending any of the forms of quackitude he scoffs at, but it's interesting how in here he seems to assume that the interests of scientists or of physicians is entirely a matter of good science.

I completely agree, b.n (altho I think your dingalink might be wrong). They both seem a little naive about the pressures under which scientists work. Galileo, after all, recanted his support for the Copernican / heliocentric solar system when he was pressured by the Catholic Church. I also remember all of the "science" that the tobacco companies used to prove that cigarettes weren't harmful, studies which they had bought and paid for. All drug clinical trials are organized and overseen by the pharmaceutical companies themselves. They have an enormous financial incentive to "cook the books", so to speak. That is, to remove people from trials who don't respond as desired. How many times have we learned of serious, often fatal, problems with drugs, not from the clinicals, but from anecdotal evidence uncovered during law suits, suits which the pharma companies were defending with all of their

Like in so many things in Life, it depends... Microbiology is very scientific and replicated across the spectrum, some bacteria respond only to some antibiotics (which are manufactured scientifically!), unfortunately, some people cannot tolerate some antibiotics, some antibiotics are too toxic for human use, and on, and on... Vaccination saves lives... Blood pressure control saves lives, but there is a myriad of medications that have to be tailored to the patient's individual condition, and Cardiac, Pulmonary and Renal profile (again scientific tests- sodium, potassium, BUN, Cr, etc...) Surgery and Anesthesia are also very scientific medical disciplines. Physicians and their patients, have to understand the limits, we all are going to die someday, nobody likes to think about that ugly fact and we all try to extend existence, sometimes by patient request, sometimes it's the family that asks, Physicians sometimes pressure for all interventions because it can be done, most of the time it is a combination of all, in various percentages. Throw in the concept of "Quality of Life", and everything is in a shade of gray, that is why Medicine is both a Science and an Art that can depend on the performer.

Thanks Bokonon. I've fixed the dingalink. Strange that the little dingalink maker put in the wrong values when I copied the url -- maybe it was because I was taking the link from one of the short pre-set segments? Anyway, my link should lead to the right spot now.

This reveals one of the great powers of diavlogs. You could imagine an alternative medicine militant dismissing an article with the same information as propaganda. I see this video as being more convincing for the conspiracy theorist, because one can look into the eyes of the diavloggers, and see them genuinely thinking about these issues and making rational arguments. It is no longer a faceless machine that wants you to take bad chemicals and prints articles in newspapers for political control. A good point in the video is that scientists are not against practices like yoga and meditation. But yoga can not make you levitate, and meditation can not dissolve a brain tumor. They are against the replacement of "alternative" from "scientifically proven." Something that I wonder about: Health studies are forced to subtract the effects of a placebo from the observable result. This is different from a normal control group in non-human studies, since that would simply entail an absence of an affect. Does the placebo effect itself reveal the existence of something about the power of belief or... I don't know... "Mysical"? By mystical I would mean it challenged the objectivity

Quoting Bloggin' Noggin: ...maybe it was because I was taking the link from one of the short pre-set segments?

I don't know. I'm a little paranoid about the technology. I hand-craft my dingalinks and I always test them in the preview window before I hit the "Submit Reply" button. Call me old fashioned....

Quoting SkepticDoc: Janet mentioned meditation...

Didn't notice that... sorry...

Quoting harkin: Must also add that for some reason this was also the first time I clicked (albeit accidentally) on one of the ads -- Judy's Wrinkle Discovery - - and was amused to see not only Barbara Walters but Harvard touting the most recent scientific breakthrough!

Heh. I've been wondering what the prevalence of those wrinkle ads says about Bob's view of the demographics of the BH.tv audience.

I myself have no opinion on global warming because I have not read enough nor am I learned enough in the science to venture any sort of valid judgement. I do however wish to hear all sides to a discussion, ...

This is a reasonable -- even healthy -- attitude, stated as a general principle. However, there does get to be a point where it's just a way to make denialism sound respectable. There are countless topics that one cannot take the time to learn all about, where if one cares about a given topic, there is no choice but to accept the consensus view of those who do spend their time on that topic as the best possible information. It is also true that in the

For those that are interested, Peter Lipson has a blog on scienceblogs.com (search for PalMed). Occasionally I read it, and have been impressed by what I have seen so far. No matter what field of science you are interested in I would highly recommend checking scienceblogs.com out, they are probably the most diverse collection of science blogs out there. P.S.
"Built on Facts" is one of my favorite. It centers on everyday math and physics, so if your in to that kind of stuff, its a must read.

I went back and listened to most of it. Here's what I objected to:
Was NCAM ever spelled out - what it stands for? Not knowing the context of things like this at first was a bit difficult. For that matter, did they ever define alternative medicine? What their viewers think of AM might be really different than what they think. They ought to clarify that, at least a little bit. Interesting that she would say people might sacrifice good food (to pay for the cost) for Reiki therapy. When it seems to me that people who eat poorly and don't exercise are the very ones who are consumers of regular/traditional medicine (diabetes care, bypass surgeries). It is - it seems to me - precisely the consumers of acupuncture and Reiki who take care of themselves, take care of where they live, take care of what they eat, take the time to exercise, and so on. I do not mean to come to any conclusions about who eats a poor diet, I just thought it was a poor example for her. They don't even acknowledge the horror that current medicine has become (for both patient and practitioner) - that was just

I just finished watching this diavlog, and I have to say, I was a little disappointed. It took 15 minutes for Peter to say:
"Since we have a finite amount of funding, we should stick to funding the things that are many orders of magnitude more likely to accrue some positive benefit then quackery like homeopathy or psychic healing."
and
"The scientific method good, faith based medicine bad!" On whether NCCAM should be funded or not issue, I do not think it is a binary question like it is being portrayed. I think PalMD would change his position if NCCAM shied away from the more outlandish stuff and instead focused on stuff like Coley's Concoction (for non-bladder cancers). On whether we should fund studys on obvious quackery issues, I can't seem to make my mind up. On one hand, I tend to agree with PalMD that we should not, because when one thing is falsified the voodoo people will just move onto something else, and they can come up with crap much faster then we can falsify it. On the other hand, if we keep disproving quackery over and over, we might be able to get us the public to be a

I have a very close friend who is a holistic medicine chiropractor. We frequently discuss patients (without violating confidentiality), practices, ethics and the tensions between mainstream (science-based) and "alternative" healthcare. Here are a couple of observations I think the scientific community should pay close attention to: 1) Virtually all the chiropractor's patients have already tried mainstream medicine. For one reason or another, they have fled their science-based physcians and become disenchanted, resentful, angry or hopeless. They didn't start out with witchdoctors; they started out with science that they believe short-changed or otherwise failed them. These patients almost always have legitimate gripes about doctors who have behaved badly (and Big Pharma, the insurance companies and the system in general). 2) Patients object to mainstream medicine often on the grounds that doctors are over-specialized, clinical, overpaid elitists. They don't see the whole person. The patient is not sufficiently respected. The doctor doesn't "care." The doctor doesn't really listen. He has only 15 minutes to talk about my liver and then out the door with a free sample of the latest drug I can't afford. She thinks her fancy grad school degree and her BMW make her smarter than the rest of us. (These are

Quoting willmybasilgrow: I went back and listened to most of it.

Here's what I objected to:
Was NCAM ever spelled out - what it stands for? Not knowing the context of things like this at first was a bit difficult.

I thought you were joking about that when you mentioned it. Of course they defined it (several times):
http://bloggingheads.tv/diavlogs/184...1:10&out=01:30
http://bloggingheads.tv/diavlogs/184...2:40&out=02:56
...among other times...

Quoting willmybasilgrow: For that matter, did they ever define alternative medicine? What their viewers think of AM might be really different than what they think. They ought to clarify that, at least a little bit.

Sure, they did that too. (as well as giving things to look out for and whatnot) In the "links mentioned" area (to the right of the video screen) there are some links that will provide further information on their stances, if you are interested.

Quoting willmybasilgrow: Interesting that she would say people might sacrifice good food (to pay for the cost) for Reiki therapy. When it seems to me that people who eat poorly and don't exercise are the very ones who are consumers of regular/traditional medicine (diabetes care, bypass surgeries). It is - it seems to me - precisely the consumers of acupuncture and Reiki who take care of themselves, take

Not only is the physical resemblance striking (and disturbing): Peter Lipson really is the Michael Goldfarb of Science Saturday. That is to say: unfair and unable to question his own assumptions. Take, for example, his definition of "alternative medicine." Look here: http://bloggingheads.tv/diavlogs/184...0:25&out=30:35 So, basically, his defintion of alternative medicine is "that which doesn't work." But of course everyone is against healing practices that aren't efficacious. The tautoligcal way in which he defines "alternative" medicine allows him to heap scorn on practices that allegedly aren't "science based." But of course "science based" practices (based on observation, the scientific method etc.) are to no small degree influenced by cultural and historical practices. I'm not a complete post-modern relativist (quel horreur), but it's silly to pit "objective science" against its enemies.

I think the overarching point is that "alternative medicine" is only "alternative" because it has not been proven. If studies are performed that demonstrate the efficacy of an "alternative medicine", then it ceases to be "alternative", and is then just medicine. Science in general has a number of checks and balances built into the system which purges non-factual claims from it. Sure, there are historical and cultural influences, but overall the current system we call science is self-correcting in nature.

Quoting Bokonon: I don't know. I'm a little paranoid about the technology. I hand-craft my dingalinks and I always test them in the preview window before I hit the "Submit Reply" button. Call me old fashioned....

I love "hand-crafted" dingalinks! Dingalinks like grandma made....yum!

Wow, you had your answers cocked and loaded it appears! Good condescending note you struck - very effective, sire. Re: Reiki, my point was that people who do this are probably also people who are very aware of their dietary choices, and therefore her example was a poor one - because she said people who do Reiki probably sacrifice food and where they live. When I heard that, I thought yeah, right. She seemed out of touch on that one. Congrats on your very enlightened doctors. My most recent experience was going to an eye doctor for blephitius (spelling) and him completely discounting the role of stress in it. Later that week, I heard him on the radio, doing an ad for his practice. The definition the blogging head guy gave of AM was somewhat vague and according to it, we are probably on the same page. I think there's just an element left out of this discussion that had it not been, would have gone a long way to amplify the discussion, and include people like me who are fed up with a certain kind of physician and a certain kind of arrogance. Fire away, sire.

Quoting willmybasilgrow: Wow, you had your answers cocked and loaded it appears! Good condescending note you struck - very effective, sire.

Sire? Wow, I am really moving up in the world.

Quoting willmybasilgrow: Re: Reiki, my point was that people who do this are probably also people who are very aware of their dietary choices, and therefore her example was a poor one - because she said people who do Reiki probably sacrifice food and where they live. When I heard that, I thought yeah, right. She seemed out of touch on that one.

I'll admit I don't remember the entire Reiki exchange, and I don't feel like rewatching it at the moment. If that is what she said, I will agree with you that that is an unfounded logical leap to make. There is likely some cost to believing in things that are scientifically unfounded (not speaking specifically about Reike here, but anything), but to try to quantify it off the top of your head like that with no evidence one way or the other probably shouldn't be done.

Quoting willmybasilgrow: Congrats on your very enlightened doctors. My most recent experience was going to an eye doctor for blephitius (spelling) and him completely discounting the role of

Quoting nikkibong: So, basically, his defintion of alternative medicine is "that which doesn't work." But of course everyone is against healing practices that aren't efficacious. The tautoligcal way in which he defines "alternative" medicine allows him to heap scorn on practices that allegedly aren't "science based."

I'd say it's more accurate to say that he defines AM as "that which has been shown not to work," or at least, "that which has not been shown to work." There's also an element of "no plausible mechanism" involved, when considering the various hypotheses underlying specific AM "treatments."

But of course "science based" practices (based on observation, the scientific method etc.) are to no small degree influenced by cultural and historical practices. I'm not a complete post-modern relativist (quel horreur), but it's silly to pit "objective science" against its enemies.

No it isn't. There is the potential for harm in substituting AM for evidence-based medicine, both because the AM treatments may be harmful in and of themselves, and more usually, because they cause proper treatment to be postponed or omitted. There is also a larger problem inherent in allowing wishful thinking to be equated with rigorous study and analysis. I would also say that Peter

Quoting bjkeefe: I'd say it's more accurate to say that he defines AM as "that which has been shown not to work," or at least, "that which has not been shown to work." There's also an element of "no plausible mechanism" involved, when considering the various hypotheses underlying specific AM "treatments."

I had made a comment very similar to Nikkibong´s based on this segment of the diavlog. I think the point is that unless you study the so called "alternative medicine" therapies you wouldn't really know whether they work or not. Of course, there has to be some screening to determine which of these have some chance of actually being effective (via case reports, clinical observation, etc.). NCCAM does exactly that. It funds studies to determine whether some of those treatments are effective.

Quoting Ocean: I had made a comment very similar to Nikkibong´s based on this segment of the diavlog. I think the point is that unless you study the so called "alternative medicine" therapies you wouldn't really know whether they work or not. Of course, there has to be some screening to determine which of these have some chance of actually being effective (via case reports, clinical observation, etc.). NCCAM does exactly that. It funds studies to determine whether some of those treatments are effective.

I agree with you, in general, that one has to study something to say with confidence "this doesn't work." I also agree with the idea that it may be worth studying some AM proposals, given how little we really understand about treating human ailments. However, when it comes to spending public monies to fund such research, which almost inevitably means that something else isn't going to be funded, I'm pretty dubious. It seems to me that with the amount of people out there believing in woo, it would not be unreasonable to ask that private funding pay at least for pilot studies that would have to pass proper peer review before government grants are given.

Quoting bjkeefe: I agree with you, in general, that one has to study something to say with confidence "this doesn't work."

I also agree with the idea that it may be worth studying some AM proposals, given how little we really understand about treating human ailments.

However, when it comes to spending public monies to fund such research, which almost inevitably means that something else isn't going to be funded, I'm pretty dubious. It seems to me that with the amount of people out there believing in woo, it would not be unreasonable to ask that private funding pay at least for pilot studies that would have to pass proper peer review before government grants are given.

I'm not sure what private funding would be available for this kind of research. I think it would be helpful to see what has come out of this kind of research in the last several years and make a decision based on that. Anything else may be biased one way or the other.

Quoting Ocean: I'm not sure what private funding would be available for this kind of research.

There are plenty of people who have become millionaires, and many more than that who have made comfortable livings, by peddling woo. By implication, there are plenty more people still who are willing to contribute. Seems to me it's just a matter of allocating some of what people pay for when they pay for the various AM "treatments." The problem, of course, is that most of those receiving the money have no interest in messing with what is for them a sweet set-up.

Quoting bjkeefe: There are plenty of people who have become millionaires, and many more than that who have made comfortable livings, by peddling woo. By implication, there are plenty more people still who are willing to contribute. Seems to me it's just a matter of allocating some of what people pay for when they pay for the various AM "treatments." The problem, of course, is that most of those receiving the money have no interest in messing with what is for them a sweet set-up.

You are assuming these people you refer to are crooks. I'm sure there are many, like in any other occupation or business. But, I would be careful about not generalizing. I do agree with the fact that the AM crowd, both providers of treatments and recipients, operate separate from science. There is in many of them a certain disdain for what they consider to be the corrupt "pharma-science" conspiracy. I find this phenomenon very interesting. But aside from all that, and going back to the initial topic, the best way to evaluate whether these studies are worth funding is to look at what has come out of the many that have been conducted in

Quoting Ocean: You are assuming these people you refer to are crooks. I'm sure there are many, like in any other occupation or business. But, I would be careful about not generalizing. I do agree with the fact that the AM crowd, both providers of treatments and recipients, operate separate from science. There is in many of them a certain disdain for what they consider to be the corrupt "pharma-science" conspiracy. I find this phenomenon very interesting.

I'll concede that there may be less of a general conscious intent to defraud than I implied. I don't doubt that many peddlers of snake oil believe in its efficacy. Still, most of them are unwilling to put their beliefs to the test, if the test means a proper scientific experiment, and their carping about Big Pharma strikes me mostly as a convenient excuse. (This is not to say that there aren't countless problems associated with Big Pharma -- I could go on for pages about that, too.) So, I consider such people fundamentally dishonest. I'll stick with my original main claim, though, that there is money available in the private sector to at least begin proper studies, and that what's missing is the desire to spend the

Quoting bjkeefe: To the extent that I know about this, I believe that efforts have been made along these lines, and the conclusion is that not many of the existing studies are all that worthwhile. Most tend to suffer from obvious methodological flaws, and there are also problems such as dishonest reporting of the data.

I'd also say that, logically, there cannot be that many useful studies available that stand up to scrutiny, or else proponents of AM would be holding them up as evidence when they ask for funding.

Are you familiar with this literature? My comments were based on a faint recollection of the studies conducted at Harvard, John Hopkins, and other academic centers. There may be some methodological difficulties inherent to some the alternative treatments, but I would assume that their methodology is similar to that used for other "traditional medicine" studies. Again, my recollection is perhaps more about the negative findings. I consider those very meaningful if they inform the public about what doesn't work.

Quoting Ocean: Are you familiar with this literature? My comments were based on a faint recollection of the studies conducted at Harvard, John Hopkins, and other academic centers. There may be some methodological difficulties inherent to some the alternative treatments, but I would assume that their methodology is similar to that used for other "traditional medicine" studies.

No, I can't claim to be familiar with the literature. My impressions about the existing AM studies comes from hearing interviews of, and reading articles by, people who have done these sorts of reviews, including some who are AM proponents.

Again, my recollection is perhaps more about the negative findings. I consider those very meaningful if they inform the public about what doesn't work.

There is something to that, to be sure, but as Peter observed in the diavlog and countless others have pointed out, there is no end to this process. Some people will reject the negative findings of a given study, saying there was bias involved or it's all part of the conspiracy to suppress or not enough trials were done or whatever. Some will reject the notion that their own pet "treatment" is amenable to being tested under controlled conditions

Quoting bjkeefe: No, I can't claim to be familiar with the literature. My impressions about the existing AM studies comes from hearing interviews of, and reading articles by, people who have done these sorts of reviews, including some who are AM proponents.

Yes, I'm not very familiar either. I have the fantasy that SkepticDoc will show up with some amazing links...

There is something to that, to be sure, but as Peter observed in the diavlog and countless others have pointed out, there is no end to this process. Some people will reject the negative findings of a given study, saying there was bias involved or it's all part of the conspiracy to suppress or not enough trials were done or whatever. Some will reject the notion that their own pet "treatment" is amenable to being tested under controlled conditions in the first place. And in general, studies showing, convincingly, that treatments X, Y, and Z have no effect seem to matter not at all to those who believe in treatment W.

There are people who don't care about AM. For them the studies don't make much of a difference. There are people who are totally into AM. They don't trust traditional medicine

Quoting Ocean: There are people who don't care about AM. For them the studies don't make much of a difference.

There are people who are totally into AM. They don't trust traditional medicine or science. It doesn't matter what the studies show they'll believe whatever they choose to.

And then there's everybody else in between. Those are the people for whom it may be important to know whether these treatments "work".

Perhaps, but this takes a more optimistic view of "everybody else" than I tend to hold. People do not, in general, go looking for the results of solid research when they hear from their friends, say, "Ever since I started wearing this copper bracelet, my tennis elbow hasn't bothered me at all!" or "Ever since I started taking these pills that I got from that Herbalife salesman, I've never felt better!"

Therefore, I'd say that studies that are believed highly likely to result in negative findings in this field are not very worthwhile, and that a better attitude to adopt is to place the burden of proof on those making the claims.

That's is only true if you don't really care about what the people who

I grew up with a mother who is a thorough modernist and who just as thoroughly rejected traditional Asian medicine. She detested it. She thought it primitive, shady, and taught us kids that it was only for the unwashed masses who were either too poor or too uneducated to know about real medicine. I also suspect that she had some sort of a traumatizing experience with it when she was a child. Anyway, even though it’s a big part of Korean culture I grew up in this context convinced that anything like traditional Chinese medicine or acupuncture was hocus pocus, and I had a semi-contempt for it (and fear) as I did for anyone who even had an inkling of interest in the subject, which to my surprise was a fairly large number of “ordinary” people. The first time that I thought to rethink all of this was when my friend’s mother had some sort of a swelling problem in her ankle that doctors could not treat. I forget the details of the problem because it as a long time ago, but the swelling grew humongous and scary and she eventually

Quoting Lemon Sorbet: Lemon Sorbet writes [...]

That’s what happens when you get older and start to have problems that doctor after doctor cannot help at all (or makes worse) but a good Naturopath does.
.
Yes, I want money to be spent on this.

My understanding is, Naturopathy is based on Vitalism. From the Webster dictionary: Vitalism,
1. a doctrine that the functions of a living organism are due to a vital principle distinct from biochemical reactions
2. a doctrine that the processes of life are not explicable by the laws of physics and chemistry alone and that life is in some part self-determining Seems implausible to me. Now I am not saying the field has not stumbled across some novel treatments by accident (As more mainstream medicine often does), but after thinking on this, I am going to have to agree with PalMD. If some treatment is at odds with some basic level of a more conventional field of science (Like how Homeopathy and Iridology is at odds with physics/chemistry) and there is no plausible mechanism to explain it, we are better off funding something else that is about 10000 times more likely to have

Quoting Lemon Sorbet: Lemon Sorbet writes [...]
Anyway, even though it’s a big part of Korean culture I grew up in this context convinced that anything like traditional Chinese medicine or acupuncture was hocus pocus, and I had a semi-contempt for it (and fear) as I did for anyone who even had an inkling of interest in the subject, which to my surprise was a fairly large number of “ordinary” people.
Lemon Sorbet writes [...]

Well, I am not sure why you would be surprised that so many of "ordinary people" have a type of contempt for many Alternative Medicines. Let me give you a timeline to clarify my statement. A)Some AM is tested in a scientific way
B)The AM is shown to not help in any statistically meaningful way (No more likely to cure whatever then "hitting someone with a hammer" will cure whatever) or the AM is shown to work and it ceases to be considered an AM and the timeline ends.
C)The proponents of that particular AM say that the scientific method is flawed in some way and their particular AM is above such petty things like experiment and observation
D)The people who performed the experiment say

http://www.samefacts.com/archives/sc...h_the_pope.php Was it Seneca that searched for an honest man with an oil lamp?

EBM
http://www.tripdatabase.com/index.html
http://www.jr2.ox.ac.uk/bandolier/index.html
http://www.cochrane.org/docs/ebm.htm
http://www.infopoems.com/inforetriever/
http://medlineplus.gov/
http://www.nih.gov/
http://www.guideline.gov/
http://www.emedicine.com/
http://www.bmj.com/cgi/content/full/327/7429/1459
http://www.essentialevidenceplus.com/
http://www.bmj.com/cgi/content/full/327/7409/266
http://quackwatch.org/
https://www.healthsystem.virginia.ed...fo_mastery.cfm
https://www.healthsystem.virginia.ed...ery_course.cfm
http://whitecoatunderground.com/
http://brainblogger.com/2009/01/10/s...-drug-samples/
http://www.ncbi.nlm.nih.gov/pubmed/18999188
http://www.informedmedicaldecisions.org/
http://highwire.stanford.edu/
http://www.pubmedcentral.nih.gov/art...i?artid=139053
http://www.ncbi.nlm.nih.gov/books/bv....section.46056
http://scienceblogs.com/denialism/
http://scienceblogs.com/insolence/ Some of my links...

Very nicely written. I find myself nodding in agreement a lot. Well done.

Stumble brought me this: http://www.pubmedcentral.nih.gov/art...?artid=2077351 Would it be AM?

Very interesting links! Thanks!

Quoting SkepticDoc: Stumble brought me this:

http://www.pubmedcentral.nih.gov/art...?artid=2077351

Would it be AM?

I will have to go look at it more closely when I have some free time, but to my Layman's eyes it appears to be falsifiable while providing a plausible mechanism for how the proposed treatments bring about a higher level of health. I personally would have no problem with funding studys about ways to increase serotonin without pharmaceuticals, and by the various studys mentioned in the paper, it appears the experts are of a similar mind. I have never heard of a doctor saying that exercise and a lack of stress (being happy) are not beneficial to your overall level of health, so, why is it you think people would consider it to be an AM?

Quoting Lemon Sorbet: Lemon Sorbet writes [...]
I could go on and give a first hand account of over a dozen incidents involving close friends and family who went through a gamut of diagnoses, medications, and suffering only to be helped tremondously by alternative methods, but to save time I will just say that I am now completely convinced that there are many valuable alternatives to modern medicine as we know it
Lemon Sorbet [...]

Among the AM spectrum, there is a wide variability of the likelihood of some particular AM being worthwhile. I do not know where on the spectrum the particular AM treatments you witnessed are, but I am sure we can agree guess even the totally fraudulent stuff should have some benefit to it (having something to believe in should help reduce those pesky CRF's). I do think that humans confirmation bias is a big reason why AMs have flourished to the degree they have. Which is why I am so adamant about something having to be shown to work in a controlled experiment before we give it some particular AM any credence at all.

How about these links: http://www.google.com/search?q=uk+pr...L_enUS227US240

Prisoners will be given vitamins and mineral supplements in an attempt to improve their behaviour and cut down on violence behind bars, The Daily Telegraph has learned.

The Ministry of Justice will fund pioneering research into the connection between the diet of young offenders and their behaviour.

The pilot scheme comes as a cross-party group of MPs and peers prepares to publish a study showing how greater use of nutritional supplements could improve the education and criminal justice systems.

Some scientists believe that a diet low in important nutrients encourages violent and disruptive behaviour in children and young adults.

The MoJ is planning to test that theory using vitamin and mineral supplements.

Tests will be conducted at two young offenders' institutions later this year.

Inmates at one will be given pills containing vitamins, minerals and essential fatty acids. Subjects at the other will get placebos.

The study will be led by scientists from Oxford University's Laboratory of Physiology.

Bernard Gesch, an Oxford scientist who is expected to lead the Government-funded trials, argues that the modern diet, heavy in sugars and additives but poor

Quoting SkepticDoc: How about these links:
Nobody profits from different doses of available generic resources, there is money to be made if you can make a pill with a patent, simvastatin for cholesterol used to cost between $4-5 a pill branded as Zocor, the generic is available for $9-10 for 30 pills...

Yes, sometimes corruption and financial incentives undermines the scientific process (Or in this case, its not the science that is corrupted, but the policymaking). In my mind, your examples do not tell me we should be easier on AMs because the current system has corruption, what it does tell me, is that maybe we should increase funding for medicine research by the gov't so "Big Pharmacy" does not have as much control over research as it currently does. In any case, you can't have it both ways. You can't nitpick the problems of our current mainstream systems and then pretend the massive corruption and dis-information in many if not most of the AM fields does not exist. No one is arguing our current system is perfect, just that our current system is the best out there.

Quoting Starwatcher162536: Well, I am not sure why you would be surprised that so many of "ordinary people" have a type of contempt for many Alternative Medicines.

Starwatcher, I said that I was stunned that so many ordinary people would actually believe in alternative medicine, which I initially believed was ineffective at best and dangerous at worst. I had contempt for those who actually believe in it.

we are better off funding something else that is about 10000 times more likely to have some worth behind it.

The argument that we should go with the known might sound reasonable, but to me it seems to go against the scientific (and Star Trek) ethos of exploring the unknown. I’m sure there are things in alternative medicine that collide directly with known science, but in my view the vast majority of things in it do not fall into that category. Rather, most are just unknown. That is, they are treatment options and methods which have never really had the kinds of research and analysis that would help the public to make a meaningful decision.

I do think that humans confirmation bias is a big reason why AMs have

Quoting Starwatcher162536: Yes, sometimes corruption and financial incentives undermines the scientific process (Or in this case, its not the science that is corrupted, but the policymaking). In my mind, your examples do not tell me we should be easier on AMs because the current system has corruption, what it does tell me, is that maybe we should increase funding for medicine research by the gov't so "Big Pharmacy" does not have as much control over research as it currently does.

In any case, you can't have it both ways. You can't nitpick the problems of our current mainstream systems and then pretend the massive corruption and dis-information in many if not most of the AM fields does not exist.

No one is arguing our current system is perfect, just that our current system is the best out there.

Are you a speech writer/policy maker for the Republicans? Our current system is the most profitable in the world, not the most effective or efficient. how else do you explain all the Indian doctors that come from the sub-continent, at the same time that the system overseas promotes "Medical Tourism" claiming that their doctors

Quoting SkepticDoc: Are you a speech writer/policy maker for the Republicans?

Our current system is the most profitable in the world, not the most effective or efficient. how else do you explain all the Indian doctors that come from the sub-continent, at the same time that the system overseas promotes "Medical Tourism" claiming that their doctors are just as good as the Americans.

I am far from advocating nilly-willy support for AM, the pharmaceutical market is full of me-too medications, our system would be very different if new medications were directly compared to the existing medication in the same class to get approved by the FDA. It is shameful that direct comparisons between medications are done years after they have been on the market and many of them are available as generics.

I live among new-agey, Neo-Wiccan, Reiki-sharing, AM-loving, perfectly sincere, but somewhat-at-a-deficit-rationally folks. My confidence in what they bring to the table is affected by my observation that magical thinking, selection bias, and a general aversion to bad news - not to mention a tendency to think aphoristically - sharply affects their ability to think critically. I have had an acupuncture treatment from a friend

try to listen to: http://www.pointofinquiry.org/simon_..._or_treatment/ There will never be support for true herbal research because anybody can grow plants. Some industry microbiologists collect soil samples from wherever they go to try to find new fungi that may be the source of new antibiotics, that can be refined and then marketed as new, expensive medications. Doctors are blamed for overuse of antibiotics at the same time that the bulk of antibiotic production goes into the Farming Industry, I am scared of MRSA...

Quoting SkepticDoc: try to listen to: http://www.pointofinquiry.org/simon_..._or_treatment/

There will never be support for true herbal research because anybody can grow plants.

Some industry microbiologists collect soil samples from wherever they go to try to find new fungi that may be the source of new antibiotics, that can be refined and then marketed as new, expensive medications.

Doctors are blamed for overuse of antibiotics at the same time that the bulk of antibiotic production goes into the Farming Industry, I am scared of MRSA...

Singh expresses what I would consider exactly the right tone in this regard. BTW, we just had a MRSA scare in my family. New antibiotics are probably not going to be the full answer - research in bacteriophages seems to be likely to provide the next step on that ladder.

Looks like Peter Lipson (aka PalMD) was on "Atheist Talk" (based in Minnesota) on Sunday. The podcast of the show is available online for anyone interested in listening to it:
http://mnatheists.org/content/view/300/1/ He goes into much more detail about his skepticism, and there is even an uninformed caller near the end who tries to take him to task about vaccinations.

Quoting SkepticDoc: Are you a speech writer/policy maker for the Republicans?
Our current system is the most profitable in the world, not the most effective or efficient. how else do you explain all the Indian doctors that come from the sub-continent, at the same time that the system overseas promotes "Medical Tourism" claiming that their doctors are just as good as the Americans.

When I said that our system is the best out there I was not referring to a particular geographical area as having the best system, I meant that what many have traditionally refereed to as "Western Medicine" (I.e. using controlled experiments to determine the efficacy of some procedure) as being better then faith based medicine (At this point, I consider an AM like Homeopathy to be no less faith based then prayer healing). I suspect we actually have similar viewpoints on this, but are getting derailed by us having different definitions for alternative medicine. My definition is "Some procedure that has been shown in a controlled experiment to have no statistical meaningful impact on some arbitrary condition, and/or some procedure that while untested, proposes that the procedure works by a mechanism

Quoting SkepticDoc: SkepticDoc writes [...]

I am far from advocating nilly-willy support for AM, the pharmaceutical market is full of me-too medications, our system would be very different if new medications were directly compared to the existing medication in the same class to get approved by the FDA. It is shameful that direct comparisons between medications are done years after they have been on the market and many of them are available as generics.

Wasn't there money set aside in the stimulus bill to do exactly this? The only downside I can think of for doing direct comparative studys on different brands of medicine is that may result in a one size fit all approach will will not be able to cope with biological variability in humans. Overall, there is probably more to be gained then lost in doing the studys, but I am no expert, so I reserve judgment.

They promised to end the Iraq war too...

On antibiotics and livestock: http://news.yahoo.com/s/nm/20090324/...tibiotics_bill

I could go on and give a first hand account of over a dozen incidents involving close friends and family who went through a gamut of diagnoses, medications, and suffering only to be helped tremondously by alternative methods, but to save time I will just say that I am now completely convinced that there are many valuable alternatives to modern medicine as we know it. Is there quackery? Yes, I’m sure there is, but I’m just as sure that there are incredibly beneficial treatment options that have never been explored by the establishment out of economic reasons or just sheer bias towards modernity.

...

Yes, I want money to be spent on this.

No one is saying that money shouldn't be spent on investigating certain treatments for certain diseases, treatments which are currently classified as alternative. The question is, instead, why is there a problem with investigating these treatments through the conventional means of peer-reviewed studies? Why create a separate institution? I think Lipson said it well:

The whole idea of setting up such an agency is a bit quixotic---after all, the National Institutes of Health already study health science. .... Many, many studies have been funded

Quoting jwdink: No one is saying that money shouldn't be spent on investigating certain treatments for certain diseases, treatments which are currently classified as alternative. The question is, instead, why is there a problem with investigating these treatments through the conventional means of peer-reviewed studies? Why create a separate institution?

Just a clarification: there is no problem investigating these treatments through conventional peer reviewed studies. NCCAM is the NIH center dedicated to do exactly that.