“In the current state of confusion that many in the general population find themselves as to what constitutes good medical practices, the last thing we need is the licensure and governmental support of more substandard (CAM) practitioners.”

Maybe:

“The public face a cacophony of discordant voices regarding what constitutes good medical practice. The last thing we need is licensure and governmental support of substandard (CAM) practitioners.”

WRT policy: keep it simple. Emphasize the non-sectarian method of rating evidence quality and of weighing risks and benefits. That way you won’t have to update the policy page very often.

Details regarding me-too drugs, HRT, vitamin D, etc., will change while the method of inquiry won’t.

For fun and to promote your site, create an award to draw attention to examples of anti-science or bad science. Might I suggest, “The Tinfoil Hat.”
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Advertising is cherry-picked info presented in a manner that takes advantage of the neurobiology of branding. It should be secondary to a systematic review published somewhere that patients can access. Adds should point to that review.

However, with regards to advertising, how I wish that direct to the consumer advertising was banned. It makes my job MUCH tougher.

If you are addressing the differences between brand names and generics , please note that generics do not exactly equal brand names. The most important difference between generic and brand name meds is that brand names have less variability between batches ( some references have suggested the number as 3-5%) as compared to generics ( which can have as much as 15% variability). Though this often is not important, it can be important when precise levels of medications are needed, such as in seizure disorders. Many variables can effect the actual pharmacokinetic effect. There is no need to add another variable when it’s important to know what exactly is being delivered.

The Pharmaceutical industry does not usually try to invent a more expensive version of a cheaper wheel. The brand names, after the patent expires, evolve to form generic medications. What the industry does to is try to grab a piece of the same pie while the going is good. That’s capitalism. It’s ok. We, the physicians, must simply make a judgement call based on the best available data.

When a class of drug becomes a major tool for medicine, in general, one company after another often will develop their own version. For example, for hypertension, the first ARB was COZAAR. Now there are four. Closely related to the ARBS are the ACES, which preceded the ARBS. There are TEN of these! However, several ACES are now generic and these are usually used first by most physicians. Are there differences between these meds within a class? Yes. Are these differences clinically relevant? Not often, but sometimes the differences do matter. Sometimes it definitely depends on the class. This is where science based medicine comes in. WHAT IS THE DATA? Then act accordingly IF the insurance company permits. Which is another story.

For those of us who blog and protest against this type of thing, I think at times, we feel like we are preaching to the choir and not really reaching our target audience – those who legislate and in effect allow these types of products and associated nonsense into medical practices.

I am looking forward to the positive changes that ISM can make worldwide in this area and will also be looking out for ways that I can, in my own small way, help the ISM achieve them.

I would love to see science-based advocacy groups that publicize alternative medicine horror stories. There is so much to choose from that supplying anecdotal evidence that “hits home” should be simple.

I know that, generally, “alternative treatments” are not dangerous unto themselves and that the true danger lies in eroding the public trust in SBM. Still, this sort of argument doesn’t gain much traction because it is just not sensational enough.

While publicizing the rare, but real, tragedies that result DIRECTLY from alternative medicine, I think we have a chance to avert the true disaster: widespread public acceptance (in both opinion and policy) of alternative treatments as comparable to SBM

Pneumothorax due to acupuncture

Hospitalization as a result of a treatable condition that was missed by an “alternative” doctor

Medical complications resulting from the active ingredients in “Chinese Herbs”

Multiple deaths and injuries at an alternative healing retreat