As medical professionals, a primary function of our job is to educate our patients on topics related to their health. So what do you do when a patient is using products or remedies that have unsubstantiated health benefits? Examples would include pomegranate juice, magnetic bracelets and homeopathy. Do you try to explain that the product claims are not scientifically or medically accurate, or do you let it slide and let them spend their money on products that at best provide a placebo effect?  Sometimes I find myself in stunned silence when I hearing the anecdotal "evidence" patients provide. What do you think is the right thing to do?

Tags: medicine, placebo, skeptic, woo

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I have noticed that trying to explain that alternative medicine in general doesn't work is most often a waste of time.  But if the patient asks my opinion I explain as best as I can why the particular treatment is not effective.  I also do it when I think the alternative treatment can be dangerous or the patient is inclined to abandon conventional medicine.

Does it "do harm" to your patient?? I guess I would say that we follow an alternative diet- that does have a significant body of scientific evidence in its use for patients with IBD/colitis and other conditions. Our docs thought it was not warranted when begun in our household BUT for my children, there have been remarkable improvements with no other known cause... had I listened to nay-sayers, we would NOT be where we are now with regard to my children's health status. I am not the typical patient tho. Had the data not supported continuing the diet, we would have gone back to our prior regimen.

I guess it might not matter what you tell the patient if they BELIEVE it is helping them and your role might well be only to guide them away from things which will cause harm. Magnets without a pace-maker seem pretty harmless. Pomegranate juice might be ok for hydration and is probably cheaper than other beverages they might consider. 

I absolutely want my doc/ my kids' docs to provide an opinion on things known to be harmful- to give medically sound advice. I also don't expect them to make a decision FOR me short of clear medical decisions. I have worked in the field of autism for years and find the BEST way to help families is to provide them a framework for evaluating information/intervention strategies. TEACHING them to look for scientific evidence, to assess risk/benefit for them/their child - it's much more about teaching someone to fish, than providing all the fish for them. 

 We have about ten minutes to educate, evaluate and answer questions.  If there is a subsequent visit, then we do it all over again.  Balance that ten minute visit with their having listened to Aunt Sally or Uncle Googie for the last 40 years about whichever brand of snake oil they are using.  

I educate the patient on the specific benefit the med provides (decreases ankle swelling, improves your breathing) and have them focus there.

If they want to take something that 'detoxifies the liver' , that's OK, as long as there is no interaction, it causes no additional problems  and they're not skimping on the prescribed med to buy the snake oil.

And I insist on having a list of EVERY medication, prescribed and woo, they're taking.

 

 

 

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