Trick or Treatment

[August 2009] Is alternative medicine bad? Well, the authors of this book certainly think so. And they have a strong belief that scientific reasoning will prove it is bad. Unfortunately, while they spend a lot of time explaining "science", they spend very little time using it to back up their arguments.

The book focuses on four alternative medicines: Homeopathy, Acupuncture, Chiropractors and herbal remedies. Homeopathy is viewed as purely bogus, while the others are seen as having some very limited value. Significant space is devoted to the history of each of these alternatives (as well as a history of modern scientific medicine.) These histories are easily the best part of the book. Their biggest fault is the writing style, which comes across as juvenile and condescending.

The analysis of alternative medicine is where the book really falls apart. A typical analysis will provide some anecdotes that appeared to show it worked. Those will be brushed off as "anecdotes", and then some studies showing success. Those will then be brushed of as "invalid" and a "metastudy" will then show that the "alternative" is of very little value. Finally anecdotes will be used to show that harm can occur when using the alternative remedy. Very little data is given to back up the statements given (not even a footnote with a paper citation!) Do the metastudies include studies by alternative medicine practitioners? Or are these studies filtered out in favor of studies by conventional doctors? How would a more conventional treatment stand up to similar scrutiny? (Is a study with a doctor performing "fake" acupuncture any more reliable than one with an acupuncturist performing "fake" surgery?) The over-reliance on anecdotes is also problematic, as it could just as easily be switched to provide negative anecdotes for conventional medicine, with positive ones for the alternatives.

It is obvious that the authors have a distaste for much of alternative medicine and have produced this book in an attempt to persuade a large audience of their belief. Unfortunately, by using the "snake oil" arguments that they claim to be fighting, they provide very little of value to the debate.

After reading it, I came away with much less respect for traditional "evidence-based" medicine. Is it really all that good if they have to do so much to twist the data to fit their model?