Opening up a CAM of worms

According to this article on Yahoo News, most people who use complementary and alternative medicine (CAM) don’t mention it to their doctors.

Sixty-nine percent of those who reported using CAM had not discussed it with a doctor. Why? Forty-two percent said because their doctor never asked; 30 percent said they did not know they should; 19 percent felt there was not enough time during the office visit; 17 percent didn’t think the doctor would know about the topic; and 12 percent thought the doctor would be dismissive or tell them not to use CAM.

I suppose it’s the doctor’s responsibility to ask the patient what alternative therapies they are using, but what are doctors supposed to say after that? What if a patient is using a treatment that clearly has no scientific basis (e.g. homeopathy) or may be harmful (e.g. certain herbal remedies)? Of course a doctor would be dismissive and even strongly urge the patient to stop the therapy — thus confirming the patient’s fears that discussing this with his doctor was a bad idea.

This is a very real dilemma. Just the other day I was hanging out at a friend’s apartment, and his girlfriend was asking me about a water filter from Japan that supposedly filters out the water (and adds something to it?) into two portions, one that you can drink, and the other that you can’t drink, but can be used for washing your hair, face, etc. Supposedly drinking and cooking with this water can dramatically improve health, and she was talking about people whose cancer went into remission, or whose diabetes was cured, who looked tens of years younger than they really were, etc etc etc. And I raised some gentle objections (”I don’t know exactly how it works, but I’m not sure about their claims about cancer.”), but that only made her try harder to convince me it worked. I mean, I’m not going to tell someone I know that this is utter crap (and expensive, too, at $4000), but I’m not going to endorse it, either, so there was no way out.

And today my sister-in-law and brother went out to buy some Chinese herbal medicine for my mother. They had taken her to a traditional Chinese doctor in their apartment complex, and he had felt her pulse and diagnosed a variety of problems (which, to be fair, were pretty accurate — but my mom is skeptical). My sister-in-law said, “After all, she’s tried Western medicine for so long, why not try this?” My mom asked me in private whether or not to take the medicine. I said, it probably wouldn’t hurt, but we can look it up online and get more information. She said, but these aren’t real medicines, there’s probably no information on them, and besides, I don’t know what they are in English. I don’t want to cause problems with my brother and sister-in-law, but again I don’t want to have my mom take something that could hurt her. So what do I say?

What’s infuriating about a lot of products and books out there is the pseudo-medical jargon they throw out: vague terms like “cleanse the body,” “strengthen the immune system,” “promote well-being,” and “detoxify the body.” Like this alkaline ionized water nonsense. But people soak it in as if it were accurate descriptions of bodily function (and they shell out good money for it, too). I guess physicians have to keep an open mind and all, but we are trained to be scientists. And if there is no scientific basis behind something touted as beneficial for health, and especially if there is a purported scientific basis that is pure nonsense, we are obligated to say so. But 12% of people won’t discuss CAM with their doctors because they are afraid the doctor would be dismissive or tell them not to use it. So what are doctors supposed to say? How do we ask the patient to look at things more critically, without implying that they are gullible or that their beliefs are unfounded?