No approved therapeutic claim #PetPeeveStories

I have nothing against complementary alternative medicine. Let that be my disclaimer before you go on to reading this post. After all, there is a scientific basis for herbal products. I understand the general public that wants to use “herbal supplements” and other forms of complementary alternative treatment modalities (acupuncture, Ayurvedic Medicine, massage, etc) for either prevention or treatment of an underlying disease.

For the understanding of the reader, CAM or complementary and alternative medicine is the general term for health and wellness therapies not part of conventional Western Medicine. Complementary refers to treatment used alongside conventional medicine. Alternative refers to treatment in place of conventional therapy.

The focus of CAM is the person as a whole – emotional, physical, spiritual, and mental health. Natural products, also known as naturopathy, include herbs and dietary supplements.

With increasing use of CAM worldwide, the term Integrative Medicine has been preferred to describe the best of conventional care with the best of alternative medicines.

Sadly, while not a lot of patients understand what CAM is, the lack of knowledge and information by many doctors limits the integration into best clinical practice of CAM with conventional medicine. It is important in this equation that BOTH parties understand each other when using CAM as part of, or as a substitute for, conventional medicine.

The peeve in this issue is the misunderstanding of either parties about CAM.

Complementary therapies used alongside may help in the management of certain diseases. For example, marijuana in patients undergoing chemotherapy has beneficial properties on the nausea and vomiting side effects of chemotherapeutic agents. Instead of having to administer an anti-emetic agent, minimising more drugs which can result in drug to drug interaction may benefit select patients.

Like many other things in life, what may be good for the goose may not necessarily be applicable for the gander. Which means, that just because it works for someone, it is applicable to all.

Many alternative therapies lack controlled clinical trials. Clinical trials is the road taken by conventional medicines in order to support the claim of efficacy over placebo or other standard therapy. It is thereby encouraged that when looking for the evidence of efficacy and safety, clinical trials over testimonials are the rule rather than the exception.

Physicians are encouraged to learn about the benefits and risks of CAM, the science behind their development, and their uses and contraindications as well as potential drug interactions with conventional medicine so that when discussing it with patients who inquire about this issue, they can discuss on a cerebral level, its potential use and misuse with the patient.

Two important points should be cited here:

1. Physicians should not base their recommendation of CAM on financial gains by selling a product in their clinics, without appropriate information on the supplement.

2. Some doctors refuse to use it because they say the patient will not benefit from its complementary, alternative or integrative use not because there is truly no “approved therapeutic claim”, but because the doctor does not know what the product and the question is.

As physicians, the prime objective is to do no harm to patients. This includes assisting them in the various levels of care of their illness. Patients rely highly on recommendations of doctors. When the doctor shuns away information (valid or not) brought to his/her attention by patients who pick up a variety of information on the Internet, it is their responsibility to keep updated and assist the patient in arriving at a consensus in the management of the patient’s illness.

No one deserves anything less.

A friendly advice to patients, don’t believe everything on the Internet. It takes very little effort to sell something that can bring you harm. Discuss CAM with your physician or someone knowledgable in this first.

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