Guest Blogger: Ryan Iwasiw
I am a graduate student in my last year of studies. At the end of the year I will have completed my Masters of Nursing/Nurse Practitioner. I recently attended a scheduled lecture, and was rather upset to enter the lecture hall and learn of topic to be discussed: Complementary and Alternative Medicine (CAM).
I found the topic for this lecture rather disturbing as the faculty which I attend prides itself on the utilization of evidence based practice and research.
As is common knowledge to most skeptically minded individuals, CAM treatment modalities are not based on evidence based practice. If fact one could easily argue that CAM treatment modalities are the exact opposite. Despite a growing body of research that demonstrates the lack of efficacy or plausible mechanism of action of said treatments, the practices of CAM practitioners remain largely unchanged. On the opposite end of the spectrum, the practices of evidence based medicine/healthcare change and evolve as new information/data/research becomes available.
CAM therapies, as a general rule of thumb, do not change and evolve. Instead they cling to treatments that have long been outdated and proven ineffective. Instead of accepting this fact, and either altering their treatment patterns, changing the claims made for various treatment modalities, or discarding un-useful treatments entirely, CAM practitioners and researchers attempt to find new ways to explain how their treatment modalities work. Additionally, much effort seems to be made attempting to explain why CAM therapies cannot be measured by “scientific standards” and are “beyond the scope of understanding of Western Medicine”. Instead of participating in research to advance healthcare and the understanding of the human body, CAM practitioners/researchers instead propagate, in my humble opinion, an assault against logic, reason and rationale thought.
This brings me to my next point.
Evidence based medicine/healthcare begins with a hypothesis (regarding a treatment modality) and then works to either prove or disprove that hypothesis. Upon completely this process, practitioners/researchers make decisions regarding the mechanisms of action/efficacy of a treatment modality and that make appropriate alterations to the standard practice as required. CAM on the other hand, starts with a conclusion, and then works backward from this conclusion. The CAM practitioner/researcher has already decided that a treatment modality is effective and is attempting to prove it. When a study concludes and shows the opposite, instead of questioning the efficacy or mechanism of a treatment modality, the CAM practitioner/researcher simply deems the study as flawed and discards the information. Again, this does not to advance healthcare or the understanding of the human body.
Sadly, the majority of my classmates did not share the above views. I should clarify that, when I say majority of my classmates I mean “all”. Not a single person in the class, besides myself, questioned the information that was being presented. Not a single student questioned the presenter about the information that was being put forth. No questions were asked regarding possible mechanisms of action or actual efficacy of treatment. Upon asking such questions myself, I was met with much disdain and hostility towards my comments (despite my best efforts to come across in a non-inflammatory manner). Reflecting back, I am not sure what is more disheartening, the fact that a faculty founded on evidence-based practice/research allowed such a lecture into the curriculum or that none of my fellow students felt the need to question the information being presented.
Despite the frustrations of the day and being bombarded with statements such as “there are simply some things which we cannot understand” and “maybe there are simply some things that cannot be measured” I did manage to learn something…
Healthcare professionals (and really all skeptics) must educate themselves about various pseudo-scientific topics. Furthermore, healthcare professionals (and again, all skeptics) must be willing to discuss these topics with patients (or individuals) and be willing to educate people. Not simply tell patients (individuals) what to think, but present these individuals with relevant information in order to facilitate the making of rationale decisions using critical thinking skills.
Additionally, healthcare professionals (and again, skeptics) cannot assume that “someone else” is always going to “set-up” and “say something” in the face of pseudo-science. We must assume that we are the only one in the room who can and will say something. We must stand up for science and reason and not allow individuals such as CAM practitioners/researchers to make bogus claims that are, again in my humble opinion, an assault on science and reason.
Ryan blogs regularly at: http://theskepticalsamurai.wordpress.com/