Here we go again.
As regular readers know, I've lamented long and loud the infiltration of unscientific "complementary and alternative medicine" (CAM, or what Dr. RW dubbed "quackademic medicine, a term I very much like) into medical school curricula, academic medical centers, and postgraduate medical education. A while back, in particular, I got rather worked up over how the University of Maryland's respected Shock Trauma Center. But it wasn't just any woo. Rather, it was one of the absolute woo-iest of woos, namely reiki, which is nothing more than magical faith healing based on Eastern mysticism rather than Christianity.
Yesterday, thanks to an AP story making the rounds, I got an update:
BALTIMORE - At one of the nation's top trauma hospitals, a nurse circles a patient's bed, humming and waving her arms as if shooing evil spirits. Another woman rubs a quartz bowl with a wand, making tunes that mix with the beeping monitors and hissing respirator keeping the man alive.They are doing Reiki therapy, which claims to heal through invisible energy fields. The anesthesia chief, Dr. Richard Dutton, calls it "mystical mumbo jumbo." Still, he's a fan.
"It's self-hypnosis" that can help patients relax, he said. "If you tell yourself you have less pain, you actually do have less pain."
Alternative medicine has become mainstream. It is finding wider acceptance by doctors, insurers and hospitals like the shock trauma center at the University of Maryland Medical Center.
Well, it's obvious to see that an attack of rationality and science hasn't struck the University of Maryland in the year and a half since I last paid attention to this. Why not bring in the witch doctors while they're at it? After all, reiki may not be "shooing away evil spirits," but it's not far removed from such superstitions. Wait. Strike that. it's not removed from that at all, as it is faith healing, patterned after stories about Jesus in the Bible and fused with a heapin' helpin' of Eastern woo. It's magic. Indeed, it even has chanting and spell casting that go with it, as reiki masters inscribe mystical symbols in the air and hold their hands over their patients, either not touching or only barely touching the patient in order to direct "healing energy" or qi into the patient to an allegedly therapeutic effect.
Everybody dumps on the big, bad health insurance companies. Certainly, I've done my share of it and on occasion gone to war to try to get a treatment covered for a patient, usually successfully. However if there was one thing I had always thought the insurance companies were good for, it was to put a brake on the infiltration of pseudoscientific quackery into medicine by refusing to pay for modalities that have no good science or clinical evidence to support their use. True, the refusal of insurance companies to pay for woo in a perverse way made it more attractive, mainly because woo then became all cash on the barrelhead without all that mucking about with any paperwork other than perhaps credit card receipts. At least, there was no bothering with preapprovals and the copious documentation insurance companies require. Despite that advantage, though, insurance company reimbursement is a critical step for CAM, because it signifies treatments that are truly mainstream, and refusal of third party payers to reimburse for CAM has been a major stumbling block in its never ending quest to enter the mainstream.
Perhaps not any more:
Health insurers are cutting deals to let alternative medicine providers market supplements and services directly to members. Some insurers steer patients to Internet sellers of supplements, even though patients must pay for these out of pocket.
This is depressing. Cracks are forming in one of the last lines of defense. The reason, of course, is that insurance companies are businesses. Although they are mainly hired by employers and are thus mainly responsive to them, if enough of their potential customers want woo, this desire will eventually make itself felt through by insurance companies through employers, particularly when more than one plan are offered by a single insurer. In that case, woo sells, and insurance companies may feel compelled to offer it in order to avoid losing customers to other insurance companies that do offer it.
The bummer news about insurance companies, aside, this article does get a fair amount right:
Government actions and powerful interest groups have left consumers vulnerable to flawed products and misleading marketing.
Dietary supplements do not have to be proved safe or effective before they can be sold. Some contain natural things you might not want, such as lead and arsenic. Some interfere with other things you may be taking, such as birth control pills.
"Herbals are medicines," with good and bad effects, said Bruce Silverglade of the consumer group Center for Science in the Public Interest.
Contrary to their little-guy image, many of these products are made by big businesses. Ingredients and their countries of origin are a mystery to consumers. They are marketed in ways that manipulate emotions, just like ads for hot cars and cool clothes.
Even therapies that may help certain conditions, such as acupuncture, are being touted for uses beyond their evidence.
An Associated Press review of dozens of studies and interviews with more than 100 sources found an underground medical system operating in plain sight, with a different standard than the rest of medical care, and millions of people using it on blind faith.
That's exactly right (except for the part about acupuncture possibly helping with some conditions, a claim for which the evidence is dubious at best). Herbs, if they do anything, are drugs (or contain drugs). Sometimes they're adulterated on purpose with drugs. Often, supplements are made by subsidiaries of big pharma, operating under a different name so as not to risk the reputation of the parent company and, more importantly, not to disillusion the credulous looking for "natural" cures untouched by big pharma. What amazed me about this article is that it points out things I've been talking about for a long time, particularly how the Dietary Supplement and Health Education Act of 1994 declared that supplements are food, not drugs, and therefore do not have to be shown to be safe and effective. It even cited an expert who points out that one in four supplements has a problem when actually tested. This is a good thing, and something that needs to be reemphasized again and again and again.
The article even points out other things that I've been saying here:
- Big hospitals and clinics increasingly offer alternative therapies. Many just offer stress reducers like meditation, yoga and massage. But some offer treatments with little or no scientific basis, to patients who are emotionally vulnerable and gravely ill.
- Some medical schools are teaching future doctors about alternative medicine, sometimes with federal grants. The goal is to educate them about what patients are using so they can give evidence-based, nonjudgmental care. But some schools have ties to alternative medicine practitioners and advocates.
Add to that pointing out that alternative medicine can lead to cancer patients' blowing their best shot at beating their disease and how little regulation and self-policing there is in the alternative medicine and supplement industry. If you've been reading this blog for a while, you know just how bad it is. If you haven't, either hit the archives or hang around a while, and you soon will. Still, no article is perfect, and I really hate it when I see quotes like this from Dr. Josephine Briggs, director of the National Center for Complementary and Alternative Medicine (NCCAM):
"Most patients are not treated very satisfactorily," Briggs said. "If we had highly effective, satisfactory conventional treatment we probably wouldn't have as much need for these other strategies and as much public interest in them."
While there is a grain of truth to this, it ignores one huge side of the equation, namely the massively overblown claims based on no evidence that many CAM practitioners make for "natural cures" with no side effects for a wide variety of diseases. Yes, science-based practitioners often do not meet the emotional needs of their patients. In fact, it was always very hard, but it's getting harder and harder as Medicare and third party payers relentlessly keep ratcheting reimbursement down, necessitating higher volumes just to keep incomes from plummeting. Higher volumes, unfortunately, mean less time with each patient. I don't claim that that's the main reason. Surely, we physicians do bear part of the blame, as often we aren't interested enough in doing better on that score. However, CAM practitioners have a huge advantage, namely that of time coupled with little or now accountability if things go wrong.
Perhaps the best part of this article came near the end, when it reiterated something I've said time and time again: Just how meaningless the term "natural" is and, especially, that just because something is "natural" does not make it safe or effective. As I like to say, strychnine is "natural." Tetrodotoxin is "natural." Curare is "natural." They'll all kill you quite naturally.
Unfortunately, the growth of quackademic medicine continues apace. Fortunately, I'm seeing a bit more skepticism--at least at times--in the mainstream press. I've been wondering whether any pushback would occur against the unrelenting infiltration of pseudoscience would. Certainly it exists in the blogosphere; unfortunately, very little appears to be occurring in the mainstream press. I'm happy to say that this article, despite its flaws, is better than at least 90% of what I read out there.
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I get better insurance coverage for acupuncture than I do for dental work. Seriously.
Woo costs insurance companies less than most traditional medical modalities. Hence insurance companies will push chiropractic medicine, acupuncture, and other forms of CAM so they can maximize profits. That's my speculation on it.
James, I'm afraid you're not the only one. Many (if not most) health insurance schemes in Europe provide better cover for woo than dental work, often paying out 100% for acupuncture and only 80-90% for dental work (even when medically nedessary...not cosmetic dental work). The thinking seems to be that if patients don't have to pay a proportion of the dental fee rapacious dentists will take advantage and charge higher fees for already expensive dental work, while individual woo courses tend to be cheap.
Even the health scheme of my employer, a scientific institute, has fallen prey to this particular bias against real medicine; they'll happily pay for unscientific nonsense but for some reason don't trust their staff to not go OTT on dental work. Needless to say I've complained about these rules a few times, but got nowhere.
The whole thing stinks!
a nurse circles a patient's bed, humming and waving her arms as if shooing evil spirits.
Hang on, if Reiki isn't ACTUALLY shooting evil spirits, who is taking care of the evil spirits in our hospitals?
Wouldn't insurance companies find it even cheaper to just send everyone a copy of The Secret and tell patients to wish themselves better?
Hard financial times in my hospital (as all I imagine) has taken away the treatment room for the M.D. acupuncturist and the hospital has given it to a gastric bypass doc for exams. He now has his office in the hospital and an exam room...free. But, we get loads of bypass patients and they, in fact, do go off their diabetes drugs, antihypertensives, etc. with no woo. Imagaine that.
The acupuncturist is gone. I asked her what she will do. She said she'll go back to her family practice full time.
Good. Make a legitiamte contribution. I'm tired of my health insurance premium indirectly going to you.
a nurse circles a patient's bed, humming and waving her arms as if shooing evil spirits.
If I were in the hospital and saw that, I'd request immediate discharge, believing that I had been accidentally admitted to the psych ward.
Dietary supplements are naturally occurring substances, and already part of the food supply. They should not be as strictly regulated as pharmaceuticals, which are created in the laboratory. Those who keep saying dietary supplements are not regulated are probably ignorant of the very strict GMP standards which are currently being implemented by the FDA. Companies will now be required to keep detailed records during every step of the manufacturing process. Supplement ingredients will have to be tested for purity. The FDA plans inpections of manufacturing facilities, beginning this year. Read about it here:
http://www.nutraingredients-usa.com/Regulation/GMP-inspections-could-fo…
This just chaps my butt...the only hope I have is that when a certain number of woo-using people on woo-friendly insurance hit a critical mass, insurance will stop paying for it because it doesn't work, and if used in addition to medicine, will add too much to the overhead.
80-90% coverage of dental in Europe? Oh, I'm moving there. If one can get dental insurance here in Washington State, one's lucky to get fifty percent covered on procedures other than check ups. I'm not sure what it is for anything else, that's how long I've been paying out of pocket for dental.
Meanwhile, I cannot get my insurance company to get my wheelchair fixed. It sits in my home gathering dust, because that's all it's good for now.
Granted, I am superbly lucky in that I was already working on learning to use a walker. I could stand up with the walker for 20 minutes at a stretch 2 or 3 times a day every day without overwhelming pain and on really good days I could go around the block with my walker. I'm in a lot of pain and I'm dizzy as hell and exhausted, but I'm meeting the most basic of my needs. So, yeah, I'm counting my blessings there. But I still want more.
But the insurance company is unaware that I am learning to use a walker, because I managed to score a walker that meets my complicated needs free, donated by someone who doesn't need it any more. (And to whoever did it: I know you told the PT you wanted to help someone, and you really did. I am so, so grateful.)
So now I can get acupuncture if I want it (and in fairness, I was willing to try it back when I had overwhelming uncontrollable pain every day and a placebo might have been better than what I had, but since then my evidence-based pain specialist had gotten me down to 3- or 4-out-of-10 every day when I had a working chair, which is enough for me to work), but I can't go get the mail every day.
That's the trade-off. If they're paying for woo, that money is coming from somewhere, and it's not from the richest employees' paychecks. It's from the paychecks of people who need that money to eat and/or from the benefits of people who need those benefits to function or it's coming out of the pockets of people who pay for insurance. Most of us in any of those categories can't afford that.
And I get that nondisabled people care more about their benefits than mine. I don't even think that they're wrong to do so: complete altruism is just not a reasonable expectation. But the longer we live on average the more of us are going to age into disability, and that means that a lot of nondisabled people are going to find their parents, their siblings, their spouses, or themselves in situations like mine. When that happens, they may care about whether the insurance providers are giving people the basic tools they need to live minimally satisfying lives too.
Jeff, just because a dietary supplement meets the highest GMP standards doesn't mean that it will be a safe or effective treatment for an illness. A very pure poison is still pure poison.
Paul, the FDA prohibits any dietary supplement claiming it can treat or prevent disease. However there are an increasing number of doctors who recommend supplements to their patients. Read about it here:
http://www.lifesupplemented.org/supplements/healthcare_professionals_im…
Hey, I've had good benefits out of some supplements. Potassium tablets cured an ongoing problem with muscle cramps, and magnesium (I think it was magnesium, anyway) helped with a muscle spasm problem. And when my mother was badly ill and on a heavily restricted diet, supplements of things like folic acid helped make up for some of the things she couldn't eat. (That said, mind you, she did have to go on intravenous feeding for a while in order to recover from her illness, but that was more because she'd become unable to eat anything at all.) And a friend of mine who takes epilepsy medications that leech some things from her system takes supplement tablets to make up for it, and they make a serious difference to her quality of life.
I wouldn't say they're really useful for Actual Diseases, though. And barring dietary restrictions and special medications, eating properly should do it. (I could probably have gone without the potassium tablets if I'd eaten a few bananas, but I'm allergic.)
A family friend is a new age faith healer. He's into pranotherapy and thinks very highly of his gifts. Since social cohesion demands I be polite to him, I've developed an *amazing* knack for making excuses, but have nonetheless been subjected to "pranic healing" for a chronic pain condition on several occasions.
Allegedly, the reason it didn't work is that I still had some overlooked metal on my person. And the room wasn't right. And he didn't have his proper stone for waving at me. (The trick is to draw out the negative energy and dump it in whatever's nearby and the correct colour.)
Alas, fate is cruel, and somehow I always seem to have a prior engagement when he suggests we try again.
and to point out the effectiveness flip side of Paul's argument, you can make a placebo as pure as you like, but it still won't be very useful for treating whatever might ail you.
@10
Oh, Paul, poor innocent, misguided Paul. You need to come to Sebastopol. Here in the heart of the Axis of Me-ville, all things natural cannot harm you. Why, I'm eating wildcrafted arsenic and free-range yellowcake uranium for breakfast! It's good with sugar too, but to easy on the white death, that stuff'l kill ya.
Right .... We should stop pointing out that, right now, supplements are unregulated, because after all they're about to be regulated. You still don't know for sure what the dosage is in the bottle on the shelf right now.
i think you'll find the FDA stops people from making such claims without being able to back them up.
present the FDA with decent, rigorous studies showing safety and efficacy in treating some specific condition, and they should be quite happy to let you make that claim. that, after all, is how actual medications get to make their claims.
"Perhaps not any more:
"Health insurers are cutting deals to let alternative medicine providers market supplements and services directly to members."
Insurance companies are businesses. There may be a rationale for this. If you have a patient with long term chronic condition for which regular medicine can do little, it may be cheaper to let them get some supplement, than to have them make continued visits to a doctor. In fact most people get better anyway, if they can be put off with a placebo until this happens it could save a doctors visit.
What is surprising is that they don't set up their own factories producing homeopathic cures. You just need some vials, labels and a tap.
Potassium for leg cramps and magnesium for muscle spasms are absolutely evidence-based (speaking as someone with those problems and plenty of MD support for the program.)
HOWEVER it's hard to get low on either without something else going on (in my case leaky kidneys) that you'd best know about before it gets any worse.
Oh, and potassium tablets are a waste of money. 90 mg (the strongest tablet on the market) is a whopping 3% of your RDA. If you really need more potassium, I'll point out that Morton's Lite Salt is available by the pound at 40% KCl, and you can get water-softener salt that's near enough 100% KCl in 20 bags for less than one bottle of potassium gluconate. Switch your water softener over and that may do the trick by itself.
It appears D. C. Sessions is not a shill for Big Supple.
:-)
Maybe a shill for Big Salt, though...
I take a vitamin D supplement because a lab test showed that I was deficient. I took the lab test because I had reason to believe that I was in an at-risk population for deficiency. You know--I was being all evidency about it. What's inappropriate is misleading people into believing that if a little bit of something is a good thing (vitamins and minerals), then a lot of them must be a great thing (unregulated megadoses). So far, the evidence on vitamin supplements is that they only help in the case of a deficiency. And of course, that's only one small bit of the market. There are the numerous supplements with deceiving non-claim claims: This can help you see better at night!*
*Statement not supported by the FDA
"The large print giveth; and the small print taketh away."
While the chances of me being able to express an opinion if I needed that level of trauma center, I think I now would ask to go Johns Hopkins, Washington Hospital Center or GW instead. (Yes, I realize that having a choice in trauma centers is something many people lack.)
Some of the craziest people I have ever talked to in my life called in when I worked in a Senator's office in late 1998 and every nut job in America called me to yell about my boss want to take away their vitamins and supplements. I don't even remember what the law was or the outcome. Just that I talked to more irrational crazy people than on any other topic ever.
I think there's a simple reason insurance companies provide woo. It lets them advertise to, and attract, a particular segment of the population: people who are interested in low-level treatments for low-level problems. These are likely to be healthier than average, thus lowering the "medical loss" rate for the insurer (their term for money they spend on patient care).
I admit that I don't have good evidence for my opinion. Also, I admit to being a pharma shill, seeing as I work for a pharma company (that's my disclosure).
Could any of you explain why chi or the energy that reiki is supposed to be manipulating, cannot be possible?
Electromagnetic energy is invisible and can travel through the air. So it's general properties would fit what is said to go on with Reiki or Chi.
If a human being could generate electromagnetic energy, why couldn't they project that energy into the body of another human being?
Science has proved that the human body reacts to electromagnetic fields, so if another human being was generating and projecting an electromagnetic field into the body of another human being, your own science says there would likely be some observable effect.
What I read in the comments is people saying stuff is impossible, or a study says it is impossible. But they never explain why it is impossible. They try to say it is witchcraft like it is imaginary, but witchcraft works on the same electromagnetic principles that reiki and chi do.
If those disciplines are not electromagnetic based, what other things does science know about that are invisible, that can travel through the air, and that will cause a reaction in a human body? Maybe reiki, chi, and witchcraft work on one of those things instead of electromagnetic radiation?
Don't laugh. Be a scientist and think about what could be.
Almost all the health plans that are part of the Federal Employee Health Benefits Plan have some language about covering "alternative treatments." It used to be more specific about what they meant by "alternative treaments" and specified things like accupuncture. I'm not sure if this is required or it is an optional benefit that some plans include to get you to pick them like extremely limited dental coverage or "discounts" on eye care.
If paying for a placebo effect would get people to stop using using expensive actual health care, I think insurance companies would be for it. Or if attract members who aren't likely to use the benefits anyway.
The language from the plan documents talks about "flexible benefits" and always reads something like this:
Under the flexible benefits option, we determine the most effective way to provide services.
⢠We may identify medically appropriate alternatives to traditional care and coordinate other benefits as a less costly alternative benefit. If we identify a less costly alternative, we will ask you to sign an alternative benefits agreement that will include all of the following terms. Until you sign and return the agreement, regular contract benefits will continue.
⢠Alternative benefits are will be made available for a limited time period and are subject to our ongoing review. You must cooperate with the review process.
⢠By approving an alternative benefit, we cannot guarantee you will get it in the future.
⢠The decision to offer an alternative benefit is solely ours, and except as expressly provided in the agreement, we may withdraw it at any time and resume regular contract benefits.
⢠If you sign the agreement, we will provide the agreed-upon alternative benefits for the stated time period (unless circumstances change). You may request an extension of the time period, but regular benefits will resume if we do not approve your request.
⢠Our decision to offer or withdraw alternative benefits is not subject to OPM review under the disputed claims process.
"BALTIMORE - At one of the nation's top trauma hospitals, a nurse circles a patient's bed, humming and waving her arms as if shooing evil spirits. Another woman rubs a quartz bowl with a wand, making tunes that mix with the beeping monitors and hissing respirator keeping the man alive."
Once again! Does she circle clockwise or counterclockwise?
Humming and waving her arms is hardly enough information either. Look if we are going to get anywhere I need specific details damit, a mans life is at stake here!!!
This story was not taken from the "Onion" or some other periodical dedicated to the proliferation of laughter? All seriousness aside, the opening is just too damn funny!
It seems that Orac poo poos the alternative therapies ... while boasting the benefits of chemicals ... (chemi_kills) ...
By the way drugs are chemi_kills right ...
Please tell me why the US has the highest vaccine rate, the highest Autism rate and the highest childhood mortality ... in the greatest nation with the best insurance? And insurance does not cover ACAM ... LOL
Then we started autism in China by sending them all the un-used mercury vaccines ... I am sure they will find some way to thanks us ...
I tell my patients .. want to get better health .. go to your MD and ask them what to do ... then just do the opposite ... and you will have better health ...
Sad by true ...
Please avoid white coats bearing prescription pads ... Otherwise known as gods ...
Spentz
Spentz,
Would you care to detail any diseases that you have successfully treated, along with the modality you used?
I just realized there's money to be made here. I want to start a woo-insurance company. People will pay me premiums and promise to only use woo-based medicines and treatments.
As they kick off well before becoming expensive senior citizens, I think I'll make a fortune.
So, Spentz, you care to tell me how long you would live without these chemicals:
Calcium
Potassium
Carbon
glycogen
Sodium Chloride
Iron
Oxygen
Hydrogen
Phosphorus
Deoxyribonucleic acid
adenosine diphosphate
aenosine triphosphate
water
Oh, and you said this lie "Then we started autism in China "... right, so you get all your information from silly places. Did you ever see this A follow-up study of infantile autism in Hong Kong.?
Happeh (#24)
Simply, there is no evidence for it.
Furthermore, who says ki/chi is electromagnetic energy? It sounds like you're making a grab for scientific legitimacy by associating the two, since the existence of electromagnetic fields is uncontroversial. However, you drag even the well known into Woo-ville by speculating on the ability of humans to consciously project electromagnetic fields. By what possible mechanism would we do that? Not to mention, we constantly encounter much stronger electromagnetic fields while walking by appliances or under power lines or talking on the cell phone, so why would these not have an effect but extremely weak fields generated by another person would?
There are testimonials aplenty which all say that reiki has particular, observable (and thus measurable) effects. However, when rigorous scientific standards are applied to measure those effects, none can be detected beyond placebo. (And all treatments include a placebo effect--true effectivness is determined by those that go beyond placebo, which reiki does not.)
By the way, actual scientists look at evidence and reject what isn't supported. If you want to put faith in woo regardless of what the evidence points to, do so--but don't pretend your credulity is anything akin to scientific inquiry.
~*~*~*~
Chris (#30)
Reminds me of when I was at a street fair a few summers ago and refused the offer to try out some woman's homemade herbal face cream, explaining politely that my skin often reacts poorly to strange chemicals. She earnestly told me that her face cream was all natural and there were no chemicals in it. :/
Just in case Spentz tries the old stuff on "no autism in China before 1999" (I remember an old debate on this years ago, it was pushed around by certain folks, until it was finally revealed it was made up by someone, I tried to find it, but some webpages from 2005 have disappeared). So I looked some more and found this paper:
Two Decades of Serving Children with Autism in the People's Republic of China: Achievements and Challenges of a State-Run Mental Health Center, which is dated 2008. Spentz, two decades equals 20 years, and twenty years before 2008 is before 1999.
John Best, you mean? That particular argument was settled by going to PubMed, typing "autism china", and clicking on the last page of the search results.
@Happeh:
They try to say it is witchcraft like it is imaginary, but witchcraft works on the same electromagnetic ...
I'm curious as to what evidence has lead you to believe that witchcraft works.
The US does not have the "highest autism rate," at least not from epi studies. That would be the UK. It also does not have the highest childhood mortality rate, not even in the industrialized world, I believe.
True, lack of universal health care might have to do with relatively poor health in the US, but there are other factors. For example, infant mortality is mostly the result of low birth weight, which in turn probably has to do with the level of income inequality and racial inequality.
CAM is absolutely irrelevant to these arguments, though.
If Reiki works then so should walking past people in the street, or hugging someone, standing on a crowded train might be very very healing or very very sick making, but according to Reiki "energy" theory it can't be neutral.
The main trouble with "Alternating Medicines" is that they crowd out useful treatments. For every Reiki handwaver a hospital funds it's not funding a rehab person to help teach people to walk again, for every acupuncturist there's some one less to help ensure that medications are appropriate and are being taken correctly.
If Reiki works then so should walking past people in the street, or hugging someone, standing on a crowded train might be very very healing or very very sick making, but according to Reiki "energy" theory it can't be neutral.
The main trouble with "Alternating Medicines" is that they crowd out useful treatments. For every Reiki handwaver a hospital funds it's not funding a rehab person to help teach people to walk again, for every acupuncturist there's some one less to help ensure that medications are appropriate and are being taken correctly.
"I'm curious as to what evidence has lead you to believe that witchcraft works."
It works exactly as well as Reiki.
@D.C. Sessions:
Except that the potassium tablets I took worked for me, so getting random about it wasn't necessary... (I can't remember what the precise amount in them was.)
In any case, it probably makes a difference that I'm in Australia, where regulations are a lot stricter on *anything* that is for human consumption.
I'm not sure what a "water softener" is.
*googles*
Okay, that looks like woo all by itself. That, or there's something wrong with your tap water.
I don't live in Adelaide, I can drink my city's tap water just fine.
I can totally see teaching young doctors about CAM practices their patients may use so that the doctors understand any potential side effects or interactions with mainstream medical therapies. I also think it's important for doctors to learn the social skills to avoid alienating patients who may choose to undergo CAM practices...once that patient decides they're done with the "arrogant allopathic doctor", who knows what kind of care they'll receive. Teaching the CAM as if it was evidence-based gives me the willies, though.
Yup -- it's loaded with calcium carbonate: "hard water." That's the nature of the supply hereabouts. Calcium really messes with the way detergents work and leads to some nasty buildup in the drains. Makes crappy coffee, too.
A "water softener" is a fairly simple ion-exchange setup where the resin releases sodium (or potassium) ions in exchange for calcium ions. Eventually the sodium is depleted, the resin fills up with calcium, and you have to reverse the process with a soak in a concentrated brine. That's where the 20-kilo bags of salt come into play.
As for the food-grade potassium chloride, it's sold here in groceries for people on sodium-restricted diets. Trade name is "Morton Lite Salt." Other countries may have different vendors, but the demand for low-sodium table salt is worldwide.
I just had a water softener put in last autumn, and it's made a HUGE difference in the effectiveness of our dishwasher. No more calcium scum! We got by okay without the water softener before (and truth be told, I actually kinda liked the flavor of the hard water), but it's worth it to not have to scrub the dishes *after* they've been washed, just to get that nasty calcium scum off of them.
Water softeners are fairly common in the US, partly because of the relatively high percentage of folks on well water, which tends to be harder. But I'm on city water; the fact that our aquifer is in a massive limestone formation means we end up with a lot of calcium in the water anyway. You can buy the bags of salt for it at any local grocery or hardware store, and even most convenience stores.
And there's your answer, Orac.
What do you think an insurance company would rather do -- shell out upwards of $30,000 for a knee replacement, or pay $50 a month for glucosamine which, even if taken for twenty years, comes to but a small fraction of the cost of a knee replacement?
The insurance companies are not on your side and never have been.
What are you allergic to? There are a number of other fruits and vegetables with high potassium content, such as apricots. beans, tomatoes, etc. (The FDA used to have a list on their web site, but somehow I can't find it right now.)
Potatoes, for one. They actually have more potassium per calorie than bananas.
The worst part of insurance companies paying for this crap is that it will raise the premiums for the rest of us. Particularly as more people start using this garbage and their easily, inexpensively treatable/curable illnesses worsen into conditions requiring expensive long-term therapies. We can only hope that those woo-loving patients' life-expectancies will decrease and they won't be parasitizing our society into deep old age. Of course, then our life insurance premiums will go up.
@Spentz
The best insurance? I've not heard that one before. I've often heard the "best medical care in the world!" line, though--which is not true.
According to the WHO, we rank 37th (out of 192) in health care in the world and 25th in life expectancy. We do, however spend more of our GDP on health care than any country save one (that being some tiny island the name of which escapes me).
Mortality and life expectancy have much more to do with lack of medical care (being uninsured or under-insured) than with quality of care.
This is pretty frightening for a patient like me who depends on real science. My type 1 diabetes doesn't respond to woo, I hope I won't be in a position of having to demand actual science-based treatment/medications someday regardless of what the ER staff says...(:-(
Orac writes:
That's exactly right (except for the part about acupuncture possibly helping with some conditions,
Acupuncture does help with one condition: excess wealth. If you've got money you want to get rid of, there's an acupuncturist who'll find something wrong with your qi that costs a couple hundred bucks to adjust.
Some feel that uncontaminated well water is actually healthier that city water because of it's high mineral content and lack of chlorine. Is that plausible?
Alternative Energy said "Some feel that uncontaminated well water is actually healthier that city water because of it's high mineral content and lack of chlorine. Is that plausible?"
How exactly is well water considered "uncontaminated"?
When we lived in Texas the well water had a high level of sulphur. It make the ice smell funky, and it really helped my teenage acne!
Many years later (after living in a municipal that provided very soft river water), when my husband and I vacationed in Carlsbad, CA before the Napa Valley was an expensive place to visit we stayed in a motel next to the tiny Police Station called "The Roman Spa". It turned out the "spa" name was do to the natural springs that provided the preheated water to the pool, hot tub... and the showers. It was quite a surprise when we turned on the shower to get sprayed with water with a definite sulphur smell! Woo--wee!
Funny. One scientist actually thinks out loud and wonders how Reiki or Chi could work. It think college must be training the imagination and independence out of scientists, and training them mainly in obedience these days.
You were robbed. You needed to grow up back in the 50's and 60's when scientists were going to change the world and they looked at every possiblity. You know. Star Trek optimism.
None of this "I need permission from a study before I can think independently and imaginatively" stuff
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Matthew Cline - "I'm curious as to what evidence has lead you to believe that witchcraft works."
Witchcraft is what primitive people called energy work.
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A Noyd - "you drag even the well known into Woo-ville by speculating on the ability of humans to consciously project electromagnetic fields. By what possible mechanism would we do that"
I feel like I am in some alternate dimension where just anyone claims to have scientific knowledge. You are as bad as Matthew Cline talking about asthma, but he doesn't even know the dictionary definition of asthma.
(Happeh puts on child like lecture cap)
"The human body generates an electrical current by changing chemical concentrations in and around the nerves."
"The electricity that comes out of every power socket has associated low frequency electromagnetic fields."
Can you see where I am going? You scientists claim that the human body produces electricity. You scientists tell us that electricity has electromagnetic fields around it.
But when we then say "Why can't a human body project the electromagnetic fields you just told us surround the electricity in the human body?", you become abusive and tell us we are woo people.
If you were really a scientist who knew something, you would answer the question. "The electromagnetic fields surrounding the electricity in the human body cannot be projected out from the body because of reason X."
But you don't do that. You just say "no" like a babysitter to a child. And then you wonder why no one listens to you.
I think it is because you can't give a reason. I think this is another case of scientists claiming to know something to gain status and power, but really they don't know squat.
Happeh: "Why can't a human body project the electromagnetic fields you just told us surround the electricity in the human body?"
The onus surely must remain on the people making the claims. If you believe that human beings can project electromagnetic fields, all you have to do is measure them and show us skeptical folk the evidence. If I claim something amazing like the fact that there is a giant cup and saucer on the dark side of the moon, I do not challenge other people to disprove it.
Just show us the evidence because elecromagnetic fields can be measured.
Wedgehead -- I would recommend you check out Happeh's website. He is not just an altie, he's batshit crazy, so don't bother even responding.
What you seem to fail to grasp, Happeh, is that a true scientist will not only consider how Reiki or Chi could work, he/she will also consider that they might not work at all. And if this is the more plausible hypothesis, this is the hypothesis that will be given strongest consideration.
This is true open mindedness. Credulity is not open mindedness at all, quite the contrary.
I am a little late to the party, but I had to contribute my own commentary on these purveyors of nonsense.
Shock Trauma Infested With Evil Spirits
Shock Trauma likes to have all of the minor trauma patients flown past the closest hospitals so that Shock Trauma can get their claws into them.
A misrepresentation? No. They have conned the people of Maryland into paying for the helicopter ride, just so there isn't any objection on the part of the patients. Everything in a helicopter is better, right? Except their helicopters only have one person in the back to provide care and the medic doubles as a State Trooper, so you know medicine is their priority.
The recent crash of one of their helicopters led to new rules that have decreased their flights by almost 70%. Dr. Scalea, the head of trauma, and Dr. Bass, the CEO of the state EMS organization, both predicted that they would run out of body bags with the delays in treatment, even though flying the patient often delayed arrival at the hospital. The result. No difference in outcome.
Science based medicine?
Not at Shock Trauma.
But if your evil spirits need to be manipulated, they have your Voodoo.
We're having a similar debate in rural Arizona. It takes almost half an hour to get a helicopter to our area, and about the same to get an ambulance. Since we often need the ambulance for backup, no strain so far. However, once the helo arrives we need to get them to definitive care, which generally means Phoenix or Flagstaff. That's an hour or more by air with the usual issues of care in the bird.
Compare with ambulance to Springerville (20 minutes) and transfer to fixed-wing for 30-minute ride to Phoenix. Only problem then is getting the patient from airport to hospital, which could be simpler but is solvable. Much better care along the way, but two patient transfers rather than continuity.
Much debate continues.
I did look up the pathophysiology of asthma before asking "Why do you think that frozen muscles have anything to do with asthma?" I thought that by "frozen muscles" you meant "muscles that either can't uncontract or can't contract" and thought that this doesn't describe bronchial spasms (and still don't think so), so I asked you why you thought there was a connection.
The electromagnetic fields generated by nerves extend outside the body, but presumably more is meant by "projecting" than simply this, since otherwise every living organism with a nervous system would be projecting every single second of its life, and it would also mean that anyone who hovers their open palm over someone else's body would be practicing reiki. One interpretation of "projecting" might be establishing in a certain volume of space a certain 3-D pattern of magnitudes and directions of electrical and magnetic forces. For example, holding the fingers in one hand in a certain combination of positions might produce a fixed pattern of electromagnetic energy, since holding that pattern would mean certain nerves producing or not producing a current, and the positions of the fingers would cause the nerves to follow a certain pathway in 3-D space. However, from what I've been able to determine, reiki doesn't involve the practitioner contorting their hands into various shapes, but simply holding their palms over the patient and willing their ki out through their palms.
Additionally, for those who claim to practice distance reiki, electric fields fall off in intensity with the square of the distance from the source, and magnetic fields fall of with the cube of the distance, so if a distance reiki practitioner is miles away from the patient whatever electromagnetic fields they're emanating will be drowned out by the fields generated by other people closer by, and especially by the patient's own fields.
Guys... seriously... click on Happeh's website before you bother trying to rebut what he is saying. Do it, you'll see for yourself what I mean.
In Maryland, part of the problem was that they would be 10 minutes from the hospital, call a helicopter, spend 20 minutes setting up a landing zone and transferring the patient, then flying the patient to the hospital that they would have arrived at 15 minutes earlier, if they had driven.
The whole purpose of the helicopter is to make a significant difference in the transport time of the truly unstable patient to the specialty center. I am spoiled in having so many trauma centers so close by, but still there are plenty of medics who will fly patients a short distance, just because it is cool.
It's more than 20 minutes to the trauma center! We have to fly him!
Medics never learn to assess patients properly, because they learn to fly patients based on the damage to the vehicle, rather than the condition of the patient. If medics never learn how to assess patients, how do they deliver the right treatment to the patient?
Too often they don't treat appropriately.
If you need an experienced medic to point people in the right direction, Gene Gandy recently moved to Tucson and is a great medic.
Did you know there are people in this world to whom being high status is more important than the truth or anything else? People like corporate officers, or medical people, or military officers.
These people actually go to classes to be taught how to behave like a high status person, which is about convincing low status people to defer to you.
One of the things they teach at these classes, is that if you are a high status person, and you meet a low status person who knows something you do not, don't say anything. The class will teach these high status individuals that they should never open their mouth to give any indication at all that they do not know something.
High status is about seeming ominipotence. If a high status person makes any kind of comment indicating their ignorance about something, there goes their high status.
I think that is what is going on in this column. I asked a clear question, "Can a scientists who doubts the electromagnetic explanation for Reiki explain why the human body cannot project electromagnetic fields". There are one or two responses.
I don't think the remainder of you can explain why a human body cannot project an electric field. I think that you are probably medical people who would have to go get a physicist and a mathematician to prove that the human body can or cannot project electric fields.
So to preserve your high status, none of you are saying anything just like that class taught you. If you admit that it is reasonable that the human body can project electromagnetic fields, or you try to explain why the human body cannot project electromagnetic fields and the explanation is faulty, there goes your perceived omnipotence and your high status.
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I don't care about status seekers. Are there any scientists out there that are interested in a reality that you do not know about? I can tell you all kinds of things related to the health of the human body that I would bet you do not know.
All of them are based on scientific observation, and all of them are supported by theories and common sense. Most of them are nothing more than translation problems.
I need to find out how you think so I can translate what I say into something you can understand and accept, since you refuse to act as cultural anthropologists yourselves and do the translation yourselves.
James Sweet? What is it exactly about the site that you want people to see? Go ahead and spell it out.
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Matthew Cline - "Additionally, for those who claim to practice distance reiki, electric fields fall off in intensity with the square of the distance from the source, and magnetic fields fall of with the cube of the distance, so if a distance reiki practitioner is miles away from the patient whatever electromagnetic fields they're emanating will be drowned out by the fields generated by other people closer by, and especially by the patient's own fields."
Eureka! Real scientific commentary!
That is an excellent point. So now, as a thinking scientist, I need to admit defeat and admit that reiki does not work and human beings cannot project energy, or I must come up with an alternative explanation.
I choose alternative explanation.
What if human beings can project energy? And while they can and do project their energy into other human beings for various purposes, it is not necessary?
What if a Reiki or other energy worker triggers the patients own body? What if instead of taking their energy and putting it into the body of the patient, the Reiki or other energy worker triggered the body of the patient somehow to produce it's own energy?
If an energy worker triggered the body of the patient to produce it's own energy, then maybe the distance factor would make no difference for energy work. Maybe all that is needed is the absolute minutest amount of energy from the Reiki practictioner to trigger the body of the patient to produce it's own energy.
That explanation should cover all bases. In close proximity, energy workers actually put their energy into other human beings. At distances where the laws of physics say electromagnetic fields would start to drop off drastically, a very faint amount of the energy worker's energy would be used to trigger the body of the patient to produce energy.
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Can I do some of your thinking for you? As a scientist, if I was you one of my questions would be:
How would a patient know if someone else was putting their energy into the patient, or if the someone else only triggered the patient's own energy?
All the patient would feel is an influx of energy. The patient is not educated about energy so they cannot make any meaningful commentary about it. They would be limited to saying things like "I feel good".
Science is fun if you let your imagination go.
You are asking the wrong question, which is not at all surprising. The question should be, Is there any evidence that Reiki works, regardless of the mechanism?
As long as there is no evidence that there is any Reiki effect, except on the wallet, there is no reason to try to explain the Reiki effect.
Science is about learning what we do not know about. Science is not about dreaming up fantasy worlds. Show that there is something to investigate, then I will have an interest in explaining it. If Reiki is not real, and there is no evidence that Reiki is real, then explaining this imaginary condition is pointless.
RogueMedic - "The question should be, Is there any evidence that Reiki works, regardless of the mechanism?
As long as there is no evidence that there is any Reiki effect, except on the wallet, there is no reason to try to explain the Reiki effect."
This statement shows that you are interested in obfuscation and resistance, not information exchange and mind expansion.
happeh,
As long as you believe that, you will never probably learn what really works.
I am not all that interested in why something works. Show me that it works, consistently, and then it is worth thinking about why it works.
There are people who will theorize about what might work. They may design studies to test those theories, but I am not interested until after they have results to show that it works. If you cannot show me that something works, you are wasting my time.
You may try to heal people with theories. Let me know when your theories work. Until you have a well done study to show that some of your unicorn medicine works, my response will be the same - prove it.
Happeh (#53)
Yes, I said before: Woo-ville. You're making ridiculous leaps from things you barely comprehend to areas of the completely imagined and impossible. While it's great to take science places it's never been, you have to get there (or get back from there) with conventional methods.
My answer was that there is no evidence. Did you miss it because it wasn't the one you wanted? It's still my answer. There is no evidence, not for the existence of ki/chi or the efficacy of reiki.
You never answered my question on who says ki/chi is electromagnetic energy. Nor did you propose a mechanism for projection. You flat-out ignored my question as to why other, stronger electromagnetic fields that surround us would have no effect even if human-projected ones could be shown to exist and work this way.
(#62)
Well, I can certainly understand how a conspiracy theory is more appealing than recognizing you are being a moron with no understanding of science, angry that we will not legitimize your freakish fantasies for you.
It must be my high status that makes it impossible to see how your "alternative" explanation is a) an explanation or b) any different than your original blathering.
I think you're confusing "fiction" and "science."
RogueMedic - "You may try to heal people with theories."
More hate and stupidity. I have seen many people helped by these therapies. Go ahead and post some more hate and disbelief.
It will not change reality.
In 20 years or so when you grow up, remember Happeh tried to tell you about reality 20 years ago when you could have done something with the information that would have completely changed your life.
Happeh:
Regarding electromagnetic fields, there are many different electromagnetic sensors used by physicists and others. (From FM radios to our eyes) What frequency range does Reiki claim to use? Has a Reiki master ever demonstrated an ability to trigger a sensor designed for this range?
I mean, as claims by woo practitioners go, this one is relatively easy to test objectively. You can also put together studies to directly test medical benefits. For all the acupuncture is a "precise art with years of refinement" there are studies which seem to say that it works no better than randomly poking people. ( http://www.msnbc.msn.com/id/20959624/ )
As for the rest - number of people helped and so on - the placebo effect is an known phenomenon and the plural of anecdote is not data.
Happeh
Regarding electromagnetic fields, there are many different electromagnetic sensors used by physicists and others. (From FM radios to our eyes) What frequency range does Reiki claim to use? Has a Reiki master ever demonstrated an ability to trigger a sensor designed for this range?
I mean, as claims by woo practitions go, this one is relatively easy to test objectively.
As for the rest - number of people helped and so on - the placebo effect is an known phenomenon and the plural of anecdote is not data.
happeh,
You have seen people get better in spite of your unicorn medicine.
If there were any validity to your claims, there would be studies to demonstrate that there is a significant effect of your treatments.
All these treatments do is let quacks like you steal from the sick and vulnerable.
While I don't agree with tall claims of alternative medicine practitioners, I don't always agree with the scientific community either.
"Clinical Studies", a term that supposedly is a set of controlled tests conducted by high-integrity scientists is more or less woo these days. How else can you explain the thousands of studies that contradict themselves? Case in point, antioxidants.
An American heart association article clearly says "Until recently, it was thought that LDL cholesterol lipoprotein oxidation and its biological effects could be prevented by using antioxidant supplements..."
Who thought? It was the medical community themselves! Now, they say it may even be harmful (http://www.nutraceuticalsworld.com/news/2008/04/16/review_claims_antiox…)?
For what its worth, I was deeply shaken by the book "Bad Science" by Ben Goldacre. It'll show you how exactly the kind of claims where 'eating substance X will add Y years to your life' are pretty much all based on very shakey evidence. Often from studies like this; where a correlation is noticed between one factor and longer life, while ignoring other aspects of those groups, e.g. totally healthy diet, regular exercise etc. Or from poorly constructed studies. Or they have a very blinkered approach of what substance X will do.
Again, Case-in-point: antioxidants - the theory may suggest that these would help prevent cancer in high risk groups, however a properly conducted trail involving 18,000 people was stopped on ethical grounds in 1993 when the antioxidant group was found to be 46% more likely to die from cancer than the placebo control group.
When the scientific community can make all sorts of claims and get away by using scientific terms like "randomized, double-blind studies" , I don't think we are in a position to criticize others.
ConfusedSoul,
Some people make exaggerated claims of the results of their research. Some perform bad research. Eventually, the scientific method leads to the discovery of these errors.
Ignoring the scientific method does nothing to help us learn what is helpful.
How do you differentiate among many claims of effectiveness? The most effective, most reliable, most honest way is to use the scientific method.
Not everything needs to be randomized, double blinded, placebo controlled, large scale trials, but the method of study should be appropriate for what is being studied. There is a big difference between research on healthy people looking for differences in outcomes based on one variable out of hundreds and research on the treatment of sick people with strictly controlled of variables.
Fiction and Fantasy in Medical Research By James Penston is a book with an excellent look at some of the problems with the population studies you mention.
In many cases, supplements are made by subsidiaries of big pharma, operating under a different name.
Regarding electromagnetic fields, there are many different electromagnetic sensors used by physicists and others. (From FM radios to our eyes) What frequency range does Reiki claim to use? Has a Reiki master ever demonstrated an ability to trigger a sensor designed for this range?
I mean, as claims by woo practitions go, this one is relatively easy to test objectively.
As for the rest - number of people helped and so on - the placebo effect is an known phenomenon and the plural of anecdote is not data.