About a month ago, I discussed a rather disturbing development, namely the initiative by Dr. Andrew Weil to set up something he was going to call the American Board of Integrative Medicine, all for the purpose of creating a system of board certification for physicians practicing "integrative medicine" (IM), or, as I prefer to call them, physicians who like to integrate pseudoscience with their science, quackery with their medicine. At the time, I referred to it as a board certification in woo. Was I harsh? Yes. Accurate? Also yes. Unfortunately, many medical centers, both academic and community, are hopping on the IM bandwagon while more and more medical schools are "integrating" pseudoscience into their curricula. While one might expect Josephine Briggs of the National Center for Complementary and Alternative Medicine (NCCAM) to be cozy with IM, depressingly, even the current director of the National Institutes of Health, Francis Collins, seems to have fallen into the trap.
As was admitted by Dr. Weil and his colleagues, this decision to create a board certification in IM was a huge about-face in that Weil had always argued that IM should be infused into all specialties of medicine. What happened, of course, is that once again marketing won out over idealism. Dr. Weil was concerned that there were lots of physicians and practitioners out there claiming to practice "integrative" medicine, many of whom had no qualifications in the field. At this point, the wag in me can't resist pointing out that, given that IM "integrates" pseudoscience with science and that there really are no standards, scientific or otherwise, to guide IM practitioners (mainly because so much of IM is rank pseudoscience), why would this matter? The answer, again, comes down to branding and turf protection.
All of this is why seeing the reactions to Dr. Weil's initiative from members of the "complementary and alternative medicine" (CAM) and IM community is very instructive. Fortunately, John Weeks of the Integrator Blog has come through again, quoting over twenty different people, including physicians, naturopaths, chiropractors, journalists, and other IM practitioners in an article entitled, appropriately enough, Integrator Forum: 20 Voices on Weil/U. Arizona and the American Board of Integrative Medicine.
Uncharacteristically (for Orac, of course), I'll cut to the chase and tell you the results before I show you some of the quotes (with, of course, my own translation of what the IM-speak really means). I predict that these quotes will amuse you to no end; so I'll save them for a little bit. To cut to the chase, I'll simply tell you that physicians practicing IM appear (mostly) to love what Dr. Weil is doing. All other practitioners (chiropractors, naturopaths, etc.) appear to hate it. Of course, that's not a big surprise given that Weil's plan would in essence cut out all non-physician IM practitioners from being able to call themselves "integrative physicians" or, at the very least, to relegate them to a lower, non-board-certified rung in the practice hierarchy, which, I suspect, was the point all along. Andrew Weil wants IM to be "respectable," and to him it will only become so if the riff-raff (i.e., to him, the non-physicians) are excluded.
A typical reaction from MDs can be found from doctors like Patrick Massey, MD, PhD, the medical director for complementary and alternative medicine for the Alexian Brothers Hospital Network. (Remind me never to use an Alexian Brothers-affiliated hospital; I had no idea they were so woo-infused.) Dr. Massey, a graduate of Dr. Weil's IM residency, is very happy:
Certification is a topic that is long overdue.
Integrative medicine is a complex area of medicine that incorporates many aspects of traditional and nontraditional medicine: formal education is important. Considering how many people are blending medicine on their own, it is important for them to have qualified physicians to make sure they are not doing anything dangerous.
It cannot be done by primary care physicians. They are barely able to keep abreast of the recommendations for diabetes, HTN and CAD. Integrative medicine is not remotely in their sphere of expertise, nor the expertise of PAs and NPs, unless specifically trained in integrative medicine.
Again, one wonders what science-based standards exist to guide IM practitioners. I've asked the question before many times: When do you choose acupuncture versus, say, homeopathy? Or will IM practitioners who are MDs finally admit that homeopathy is nothing more than pure quackery with no basis in basic or clinical science but a huge basis in prescientific magical beliefs? Or how do you know what herb you should use? Or when is chiropractic more appropriate than other therapies? They don't know. There's no real science behind many of the modalities that fall under the rubric of IM. As I've pointed out before, they make it up as they go along.
One physician, Richard "Buz" Cooper, MD, pointed out something that, quite frankly, hadn't occurred to me before but should have:
This is just one more of example of Weil's entrepreneurial reach. It will enhance his 1,000 hour costly and profitable training program. He is pursuing it through a rump group, the American Board of PHYSICIAN Specialties [ABPS], which "certifies" a few marginal specialties (e.g., urgent care), rather than through the American Board of MEDICAL Specialties [ABMS], the recognized authority, which certifies legitimate specialties and which apparently has turned down the idea of certifying Weil's Integrative Medicine. Tainting the emerging discipline of Integrative Medicine with 'Weil's Entrepreneurism' will push it in the wrong direction and be a disservice to generations of patients.
You know, I really should have thought of this one myself when I wrote my first post on this issue. Dr. Cooper makes a devastatingly accurate point about how Dr. Weil has chosen to seek board certification for IM through a less-than-respected board, namely the American Board of Physician Specialties. It's very obvious that the ABMS wouldn't be interested in Dr. Weil's plan; so he looked elsewhere. Weeks, ever the Weil apologist, criticizes Dr. Cooper for "personalizing" his commentary against Dr. Weil. While this is to some extent a legitimate point, it's also legitimate to point out that Dr. Weil's residency program in IM would become a whole lot more desirable, both to graduating medical students and, more importantly, to the medical schools and residency programs to which Weil franchises his program, if IM became more respected as a specialty and especially if there were a real board certification in the specialty. (The two, of course, often go together.) Moreover, there's more to personal interest than just money. Weil is an ideologue who wants to spread his "faith" of IM to as many people as possible. Indeed, Weeks basically admits this in response to Dr. Cooper when he points out, "He is investing in something that may swell the historic importance of his work. Big egos are often associated with good things. Who isn't seeking to have more rather than less positive impact?" And IM is lucrative, as are Weil's many, many other business interests related to IM.
Interestingly, and perhaps not surprisingly, those most vociferously opposed to Dr. Weil's program were all chiropractors. I say "not surprisingly" because of the history of battles between chiropractic and the American Medical Association. For example. chiropractor Lou Sportelli comments:
Look at the Medical board of this proposed group, I care not who they are, but what they know. It will take a lot of convincing to get me to believe that this is nothing more than the old medical model at work in three stages.
- Condemn
- Investigate
- Take over
The AMA was notorious for doing this to any thing that was not allopathic. This is their modus operandi and they had been successful with it until folks got wise.
Dr. Weil and his new idea are not so novel, but are highly suspect. Sounds like a lot of hype and no substance
Chiropractor James Winterstein:
[This is] an interesting move on their part. Down deep, I fear it is more of the same - dominance at all costs - in a circumstance over which they have had little control (the interest by the public in alternative medicine). Now, they form a specialty and take it [over]. I hate to say it, but I think that is a likely probability. We have already seen them work toward usurping our 'tools.' I don't like the sound of this, John.
Chiropractor and homeopath Nancy Gahles:
You KNOW [the MDs] will get the juice because they are the REAL doctors. The ones you can trust. What do they even study to make them 'integrative'? Homeopathy? NO. Functional medicine...betcha! Little nutraceutical is now the new Big Pharma. Please tell me I am dead off base here, please!
My comment is that this looks like a duck, walks like a duck and acts like a duck: co-opting integrative healthcare, calling it integrative MEDICINE and creating a Board Specialty will identify integrative healthcare with medical doctors and they will own it, be reimbursed for it and thereby drive consumers to use them only as they will get insurance for it.
One notes that Gahles is described as someone who "has been the modern leader in pushing the field of homeopathy into the nation's health policy dialogue" as the president of the National Center for Homeopathy. I never thought I'd be in partial agreement with a homeopath, but what Gahles says is more or less what I said in my previous post when I pointed out that Weil's desire to infuse all medical specialties with his woo apparently can't stand up to the cold, hard reality of how medicine is really practiced in this country. I've also pointed out that excluding the real woo, such as homeopathy, from IM is but a tiny first step in trying to make the specialty into something respectable.
Perhaps the most amusing retort from a chiropractor comes from Stephen Marini. Unfortunately, it's not amusing because it's a devastating criticism of Andrew Weil and the concept of board certification for IM. It's unintentionally hilarious because...well, just read for yourself how he describes himself as "a vitalist trained in classical science and conventional medicine" who appreciates "the role of energy/information on an individual's health and healing processes." Also note that the link to information on Marini used by Weeks comes from an entry on that repository of all pseudoscience and conspiracy theories Whale.to and that Marini is on the board of directors for the International Chiropractic Pediatric Association (ICPA). With that background, you can truly appreciate Marini's criticism of Dr. Weil after putting it into its proper context:
The concept of a medical specialty in integrative medicine is inherently contradictory. The paradigm of conventional medicine is reductionistic, hierarchical, & mutually exclusive to other paradigms of health and healing. So to ponder the concept of such a medical doctor would require drastic changes on a medical, anthropologic, sociologic, political levels etc.....
What is needed within a complementary system is a new species of health care provider that can appropriately triage a patient with regard to Era 1, Era 2 & Era 3 health care components.
If Era III reminds you of this, you will be forgiven. So what does Marini mean by "Era 3"? Apparently this:
- Era I Medicine: Allopathic Therapies. Paradigm: CHEMISTRY - STRUCTURE - FUNCTION
- ERA II Medicine: Holistic/Holoenergetic Therapies. Paradigm: ENERGY - CHEMISTRY - STRUCTURE - FUNCTION
- ERA III Medicine: Intercessory Therapies. Paradigm: UNIFIED - ENERGY - CHEMISTRY - STRUCTURE - FUNCTION FIELDS
I say this in particular because following another link from the Whale.to entry on Marini leads to a statement that Marini provided to Jochim Shafer, who apparently wrote a book entitled The Trial of the Medical Mafia, in which Marini states bluntly that there " is no credible scientific evidence to negate the hypothesis that vaccines cause immediate or delayed damage to the immune and nervous systems of children resulting in a rise in auto-immune and neurological disorders including asthma, learning disabilities, hyperactivity, autism, chronic fatigue syndrome, lupus, diabetes, epilepsy, multiple sclerosis, Guillain-Barre Syndrome, and other diseases." He concludes that the "universal compulsory vaccination of all healthy children should be halted."
You know, I think I'll stick with Era 1 medicine, thank you very much, particularly if in Era 3 medicine I have to rely in intercessory therapies and am not allowed to vaccinate children against infectious disease. After all, intercessory prayer has been shown more than once not to work, and vaccines have arguably saved more lives than all other science-based medical interventions combined. Say what you will about Andrew Weil (and we at SBM have certainly said a lot), I've never perceived him as being anti-vaccine. Marini clearly is.
In the five weeks or so since I wrote the first installment about Dr. Weil's initiative to develop a board certification for IM, I've thought a bit about what the intent might be and what the consequences might come to be. The more I think about this, the more I think that the chiropractors and naturopaths who don't like the plan are probably perceiving it quite correctly. It is a dagger aimed right at their hearts, and it is MDs who are holding the hilt. Dr. Weil's denials notwithstanding, led by Dr. Weil, the pro-woo physician contingent is trying to make sure that no non-physician specialty can claim to be "integrative physicians." It's a big deal, too. If you don't believe just how much it matters to non-physician CAM/IM practitioners to be able to claim the title "physician," read this revealing article by John Weeks himself.
As I said before, this in and of itself might not be that bad a thing in that many of the practitioners being targeted base their practices on nothing more than prescientific vitalism tarted up with science-y-sounding language. Certainly acupuncturists, chiropractors, homeopaths, and, yes, naturopaths do this. Making it harder for them to practice their non-science-based placebo medicine is probably a good thing, as would be increasing the scientific rigor of what passes for "integrative medicine" now.
Unfortunately, I don't see that happening. What I do see happening is that, like the Thing in John Carpenter's famous 1982 movie of the same name, Weil will try to kill off the non-physician "integrative" practitioners but after doing so he will take on their appearance, just as the monster in The Thing took on the appearance of the people it killed. (Hey, it's Halloween; I had to pick a horror movie metaphor.) In doing so, he will then permanently infect the entire body of academic medicine with the virus that is IM. At least, that is his plan. He has, after all, said as much.
- Log in to post comments
There's a lesson here and it is about what health care is and isn't. There's money in woo and lots of it. I expect virtually every training and research institution will eventually have their faculties of woo. It never was about science.
At least Weil's certification might enable us to separate the sheep from the goats and the goats from the jackals..
But could he in fact be setting up the War of the Woos? Ofttimes real woo-meisters cite the integration of quackery into medical schools and hospitals as evidence of the much balleyhooed paradigm shift in medicine and naturally *congratulate* doctors like Weil, Oz, Ornish, and Chopra for their invaluable ground-seizing efforts in the expeditionary forces.
Weil now says,"Doctors only!" Holistic non-MDs/ DOs need not apply. If we were to imagine a scale** with True Woo at one end and SBM at the other Weil's newly certified doctors would sit firmly in the middle. Real woo-meisters, who usually support the almalgamation of reality- and whimsy-based*** medicine might become miffed because they are being excluded from the mix and would need to shift their allegances. They might envision the new group as being "establishment" types, sell-outs to BigPharma and BigInsurance. Supporters of SBM would ( I think correctly) label the new group as woo-tainted.
DCs, NDs, nutritionists, homeopaths,and herbalists might take up arms against the traitors. I imagine that Mike Adams might scree effusively against certified holistics who are horning in on his turf. "That's not the 'People's Medicine', it's the 'Man's Medicine'... no wait, that's SBM, it's the '*Other* Man's Medicine'"...
** + or - scores on Woo Standard
*** which defies reality testing.
I think Weil should get a Pigasus award.
Not a woo fan, but you can't be too careful about what you postulate. Nothing is 100%.
Just to stir things up a bit, maybe vaccines aren't all that after all (and not because of the Wakefield woo either). Vaccines should be given on an individual basis of risk. If a patient is immunocompromised you might not want to give an attenuated vaccine for example at least according to the CDC. However, if that is not a factor vaccines can be lifesaving for some.
Just sayin'
Osterholm MT, Kelley NS, Sommer A, & Belongia EA (2011). Efficacy and effectiveness of influenza vaccines: a systematic review and meta-analysis. The Lancet infectious diseases PMID: 22032844
I love it when there is a heated civil war in woo-land and their energy fields get all tangled up. Whatever the talk about "control" and "standards", the bottom line is money. Based on what we always hear about how alternative/integrative/woo medicine is taking over, you'd think there's enough pie for everybody, but I guess not.
"I've asked the question before many times: When do you choose acupuncture versus, say, homeopathy? Or will IM practitioners who are MDs finally admit that homeopathy is nothing more than pure quackery with no basis in basic or clinical science but a huge basis in prescientific magical beliefs? Or how do you know what herb you should use? Or when is chiropractic more appropriate than other therapies? They don't know. There's no real science behind many of the modalities that fall under the rubric of IM. As I've pointed out before, they make it up as they go along."
Really now Orac, haven't you realized yet that we are all unique individuals and there are no reductionist paradigms for diagnosing and treating any disease? You use your experience and intuition and try one modality, and if that doesn't work you keep trying others until something does work or the limb turns black and falls off, in which case it's the patient's fault for trying allopathic medicine first, not following all your advice, doing it wrong or failing to have a positive attitude.
I would love to have a shiny new board certification in Holistic Pathology if the price is right.
Kelly,
I didn't know that anyone would seriously recommend attenuated vaccines for immune compromised patients. Likewise, people with certain allergies are advised not to have certain vaccines. I know there are vaccines (like Yellow Fever or plague) that aren't routinely given because the risk of catching the disease is low.
So when you say that "Vaccines should be given on an individual basis of risk", how is this different from common practice? How does tailoring the use of vaccines to individual risk make "vaccines [not] all that"?
Well I, for one, am looking forward to a change to earn my BS-MD in Alt-Woo. I plan on doing my residency at Whole Foods with a specialization in Gluten-Induced Hysteric Generalized Soreness.
Even if it is a "dagger" aimed at the hearts of chiropractors, naturopaths and the others: if Weil gets through with this, he'll have another mark on his belt of legitimizing "integrative medicine" as a respected and scientific practice - while selling vitamin supplements for around $60/month per "patient".
It simply infuriates me that members of the medical community can't respect scientific principles when judging attempts as these and actually support them.
*snerk*
I am a yoga instructor/therapist and a physician-in-training, and I am very much looking forward to weaving elements of yoga, meditation and relaxation techniques into the lifestyle interventions I recommend to my patients. I also look forward to prescribing the necessary pharmaceutical drugs, diagnostic tests, surgical procedures and specialist referrals according to my patients' needs.
I appreciate your skepticism, but I wish you wouldn't dismiss this movement in medicine so quickly. I know there is some chaff to be sifted out, but there's also some really exciting potential. Just a different perspective. Thanks.
if the wooer's become "official" in some sort of way say by being able to call themselves a physician and Dr would that leave them open to huge malpractice suits and as a result have to carry the same sort of very expensive insurance as real Dr's??..i recall that some years ago..1980's?..a member of congress who was also a Dr somehow won a lawsuit from a wife who lost her husband as a result of his quack/woo treatments.she denounced the system as being rigged in favor of the rich over the little people.i have no idea what the details were it was so long ago.
I am a yoga instructor/therapist and a physician-in-training, and I am very much looking forward to weaving elements of yoga, meditation and relaxation techniques into the lifestyle interventions I recommend to my patients.
I hate to be repetitive in the short-response category, but given the big "OM" in "mOMmy," define "yoga" as you would look forward to pitching it as a physician.
(Gratuitously, but specifically: Who's the Swami, drmOMmy?)
Given that your beloved "scientific" medicine is producing more and more side effects and being exposed as being beholden to the big pharmaceutical companies that pay doctors and the FDA to tell us what is OK and what isn't, I'd say that the big shift to CAM is justified.
People are getting tired of cancer "success" being defined as extending the patient's painful existence for another few days or weeks before they finally wither away under chemotherapy. They're getting a little tired of the drugs being pimped to them to "fix" problems that have thirty side-effects listed in tiny print on the package insert. People are a little leery of the latest "study" showing that item X causes cancer only to have that study be destroyed by another study next month that shows that item X is fine, but items Y and Z will cause cancer.
Nevermind the sellout that is "peer review" (aka "publication of the most popular").
With drug companies getting caught writing studies and paying researchers and doctors to put their name on it, with the revolving door from the FDA to Big Pharma becoming openly obvious, and with the complete hyped up stupidity that was the Swine Flu "epidemic" and the patently obvious pimping of pharmaceuticals that went with it..
People are fast losing faith in your "scientific medicine." You can call names all you want, but it's the truth. Science has been sold up the river and medical "science" especially so.
If people are loosing their trust in scientific medicine, it might be because modern medicine doesn't have, nor promise a 100% success-rate, while the woo-salespeople promise not only 100% success, but also with no side-effects. But promissing something is one thing, keeping it is something else and there you have the problem with woo. If the patient isn't cured, he is to blame.
Alerternative medicine is either medicine that hasn't been proven to work, or has been proven not to work. If it has proven to work, it's called medicine.
And how about the profit for big-woo?
"Era I Medicine: Allopathic Therapies. Paradigm: CHEMISTRY - STRUCTURE - FUNCTION
ERA II Medicine: Holistic/Holoenergetic Therapies. Paradigm: ENERGY - CHEMISTRY - STRUCTURE - FUNCTION
ERA III Medicine: Intercessory Therapies. Paradigm: UNIFIED - ENERGY - CHEMISTRY - STRUCTURE - FUNCTION FIELDS"
This sounds like exactly like what you'd expect to get if you asked L. Ron Hubbard to make up his own novel system of "medicine".
The influenza vaccine review that Kelly linked to found effectiveness of 69%, but she writes, "maybe vaccines aren't all that after all".
If someone developed a drug that had to be taken once a year that was 69% effective at preventing any disease and had hardly any side effects it would be hailed, rightly, as a miracle. Why do vaccines get such a rough ride?
Because some people consider every bad thing that happens after getting the vaccin being a side-effect of the vaccination.
@aaron
Citation please for you unfounded asserions, or you are just another ignorant troll.
If you mean by "who's the swami" to ask about my training, I am trained in Kripalu and Sivananda yoga, as well as certified in yoga therapy with additional training in yoga for cardiac and cancer care. The latter in particular deals in large part with managing the side effects of treatments, and the stress that often accompanies illness.
My greatest interest is in the stress-reduction component of these techniques. There is also a fitness component, and many of the physical exercises improve strength and flexibility, and can help reduce tension and improve posture. There are preliminary studies out showing some of the benefits of yoga already. The claims are nothing outlandish, the interventions are cost effective and they have virtually no risks associated with them. And these interventions are not meant to substitute for medical treatment, at least not as I intend to use them.
As we find out more about the physiological effects of stress on the body (inflammatory response, telomeres, visceral fat deposition, etc), I think we'll begin to have more and more refined scientific explanations of the benefits of yogic practices. For now, my major interest is in improving quality of life, not selling alternative quick fixes.
Dr. Mommy? Really? Do you ever read this blog?!? You know that that moniker belongs to Jenny McCarthy, right? And you know how we feel about her, right? Remember, the rule on the internetz is Lurk Before You Leap. The precious, and ever so twee OM part is right out . . .
Holoenergetic Therapies - What the ever loving %& is that supposed to be? And Intercessory Therapies?
I think I need another headache pill, on second thought make that a whole box of headache pills.
No one with half a brain is going to be going into integrative medicine out of med school. I see this as a failure speciality, something akin to prev med or occ med -> i.e. places where you end up if something went dreadfully wrong, either at med school or during internship (this does not count people who went into these specialities due to disability or family reasons). I have never understood people who waste their time getting into and then slogging through med school to do a job that only really requires a 2 yr MPH or masters, or in the case of this integrative crap, some online or weekend course.
My cynical view on why real physicians are not going to go into this: 1. you are immediately putting yourself into competition with the legion of quack oriental medicine "doctors," chiropractors, and naturopaths that already bottom feed on the detritus of scientific medicine. 2. If you are already kind of quacky, why not get board certified in a real specialty so you can bill and get privleges in a place other than Arizona. Then get certificated on the weekend --> less risk, reap the exact rewards (whatever those are). 3. Despite the hype, the vast majority of people run for the hills (or the ivory tower) to actual medicine when the shit hits the fan. In an environment where nurses and PA's are on the way up in algorithm based primary care, physicians need to be in a place where they are equipped to handle 1% incidence diagnoses.
ps. please let us not get into the habit of referring to this BS as "IM"
This acronym is reserved for the actual medical specialty of internal medicine.
I agree with this previous comment "Given that your beloved "scientific" medicine is producing more and more side effects and being exposed as being beholden to the big pharmaceutical companies that pay doctors and the FDA to tell us what is OK and what isn't, I'd say that the big shift to CAM is justified."
There is mounting evidence to suggest that we are having the wool pulled over our eyes by the FDA and it is not the best science that gets approved... rather he who pays the most money.
So just as there is evidence that some 'quacks' should be kept as far away from sick people as possible - the other side of the equation are not squeaky clean either - which leads me to think there is a place for both sides - perhaps we need to be more diligent, both with the quacks AND the FDA. Somehow I think that may be wishful thinking
Steve SUP:
[citation required]
"There is mounting evidence to suggest that we are having the wool pulled over our eyes by the FDA and it is not the best science that gets approved... rather he who pays the most money."
The witch hunt against Dr. Burzynski is the first instance that springs to mind.
Given that Burzynski was a quack selling treatments of unproven safety and efficacy, his prosecution was hardly a "witch hunt." Note that the prosecution was in 1993; a review of PubMed indicates that the science has never gotten beyond phase 2 trials (and that many years later). If that's what you claim is the "best science," you need to recheck your standards.
Where was this witch hunt? Obviously there was Mr Burzynski's conviction for insurance fraud, but no-one seems to be contesting that on the facts. He remains free, continuing to use a loophole in drug-safety regulations to take money from desperate and credulous patients.
I see, Steve SUP, you don't have any real evidence. By the way you might want to read this:
Dr. Burzynski? Seriously?
Ok - let me have another go... Doctors continue to prescribe acid reflux medications willy nilly but the FDA released a press release last year (you can find the press release here http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm213377.htm) which indicates that acid reflux medications (Proton Pump Inhibitors) should not be used long term (12 months) because they increase the risk of bone fractures.
This makes sense because we normally produce stomach acid and part of the reason we need stomach acid is to break down our food to allow our body to absorb minerals and nutrients including calcium.
Now big Pharma produces a medication that blocks the production stomach acid and doctors prescribe it for years on end. My cousin was prescribed PPI medication for over 8 years - think of how hard his body has had to work to get enough minerals and nutrients over that period....
The thing about blocking stomach acid is that you never get rid of the cause of your acid reflux and therefore come to rely on these medications - great for big pharma but not great for the long term health of those taking them.
Doesn't make a lot of sense to block the production of stomach acid long term.
Now I know that there will be those that will bang on that proton pump inhibitors (PPI) as beign the best option we have, but I am sure there are better options.
I know there are some alternative medicines that have very good success with acid reflux - alternative medications that some would describe as quackery, but if it assists in eliminating acid reflux and doesn't cause your bones to become brittle then perhaps they are smart quacks.
The point I am trying to convey is that there are some quacks that are out and out quacks but there are some alternative medications that work perfectly well and are of great benefit.
On the other side of the coin Big Pharma also produce some medications that have huge benefits but they also have a 'questionable' side to them where they are dictated by profits rather than the well being of the general population.
I think we need to meet somewhere in the middle. Not accept everything that Big Pharma push at us and also be a little open minded to alternatives.