This is a question I'm sure comes up often. What is the best way to treat an illness? We hear a lot about how science and modern medicine have made astounding breakthroughs in curing potentially fatal disease. We also hear about all these great things about Alternative Medicine, how it's “All natural”, how it's “Ancient Chinese Medicine”, or how it's so much safer than modern medicine. With so much information around on both of these it might seem like an enormous task to figure what will work the best. Hopefully in this article I can simplify things and hopefully make the choice seem a little bit easier.
The Placebo Effect
While I'm sure most of the people reading this have heard of the placebo effect, this is an important issue to understand in making choices for treatment. The placebo effect was discovered in the 18th century and is essentially a pill or procedure that does nothing, but tricks your mind into relieving the symptoms of a disease or illness. The most common form of a placebo used is a sugar pill, which is just a pill made of sugar. While modern science still doesn't understand a lot about how it works, they have discovered a lot about the effect. Research shows that 2 sugar pills are more effective than 1, and that an injection is more effective than a pill. The more invasive a procedure the more of a placebo effect it has. There are other things, such as blue sugar pills work better as a sleeping pill placebo than red sugar pills. Or a doctor in a lab coat gives out more effective sugar pills than a doctor in jeans and a T-shirt.
So why is understanding the placebo effect important in making medical decisions? It's because sometimes, a treatment can seem like it's working even though all it's doing is creating this placebo effect.
Modern Medicine, or western medicine as it's sometimes called is more properly known as Evidence Based Medicine. This is the medicine your doctor practices. Any drug your doctor prescribes, or recommends has been tested against a placebo and shown to work better. A lot of procedures and treatments come from a good understanding of human physiology. All of the treatments and procedures are based on scientifically sound evidence. A doctor should be able to tell you the benefits and risks of a particular treatment and what options are available.
So how is medicine tested? A good test to see if a particular treatment is better than a placebo begins with a double blinded, randomized, placebo controlled trial. So what does all that mean? In a properly conducted trial, both the patients and the doctors are blinded, that means that the doctors giving out the medication, and the patients receiving the medication have no idea whether it's real or a placebo. The patients should be randomized using a computer algorithm or some other blinded method. A researcher selecting patients for the groups could unconsciously bias the trail in one direction. So during the trial, no one knows who is getting a placebo, and who is getting real medication, this should even extend to the statisticians doing the final tally on the numbers. Only at the end of the trial, after all the results are in should the blinding be taken off, and which group is which be revealed. In a well conducted trial, with lots of participants, we get a really good idea of the effectiveness of a treatment.
If modern medicine is evidence based, where does that leave alternative medicine? Well, alternative medicine is either unproven, or dis proven So either it hasn't been tested, or is difficult to test properly, or it has been tested and shown to work no better than a placebo. There are a lot of alternative therapies out there that have been tested and shown no better results than a placebo. I realize at this point my view of alternative medicine is looking pretty grim, as I am making the claim that none of it has passed a test and shown to be effective. So what happened to the alternative medicine that was tested and shown to work? Modern medicine, being evidence based, adopts any treatment shown to work, and as it's adopted, it becomes mainstream, and no longer “Alternative”.
I'm not going to get into a description of every alternative medicine out there. That might be a topic for a later post. However be wary of any medical claims that rely on an abundance of anecdotal evidence. If I haven't made it clear yet, anecdotal evidence is completely worthless. How can you be sure that the anecdotal evidence in these claims, is simply not the placebo effect? The other effect that dis proven medicine relies on is called “Return to the mean”. This effect is best shown by your bodies natural ability to heal itself. How do you know if the anecdotal claims for these alternative therapies are not just the person getting better on their own? Truth is, we can't know, that is why we have such controlled and rigorous testing, to control for variables like this.
One of the other claims of alternative medicine followers I hear quite often is “Big Pharma doesn't want you to know, because it's not profitable”. This claim is simply wrong. “Big Pharma” is mandated and regulated to prove that their drugs work better than a placebo, in order to bring them to market. The other part of this is that the alternative medicine industry is now making over 100 billion dollars a year. I don't know about you, but last time I checked, that seemed like a decent profit. Please don't take this paragraph as my endorsement of the pharmaceutical companies, they are definitely guilty of some shady practices for profit. Dr. Ben Goldacre is working hard to bring this shady practices to light and stop them.
While there are several topics I didn't discuss in this article like the ethics of selling a placebo, or particular alternative treatments, I hope there was enough information to help you make a better decision. My thoughts are this, why would you spend your hard earned money on a treatment that is either dis proven or unproven when we have a good system of evidence based medicine available. For further reading if you're interested I recommend Trick or Treatment by Edzard Ernst and Simon Singh and also Bad Science by Ben Goldacre.