Last updated on February 7th, 2023 at 02:46 pm
As I’ve mentioned before, I often hang out on Quora answering questions about medicine with science-based answers. But I reached the breaking point after the 347th question that uses “allopathic,” “Western,” or “conventional” medicine as a pejorative term trying to show that it is somehow less safe and less effective than alternative “medicine” like homeopathy or Arvuyedic or traditional Chinese.
Minchin’s Law, which is quoted frequently by those of us who utilized science-based medicine in either practice or writing, makes it clear what is real medicine and what is alternative “medicine”:
“By definition”, I begin
“Alternative Medicine”, I continue
“Has either not been proved to work,
Or been proved not to work.
You know what they call “alternative medicine”
That’s been proved to work?
Medicine.”
So, let’s take a look at what is and isn’t science-based medicine. And spoiler alert, alternative medicine is not even close to being science-based.
What is alternative medicine?
Alternative medicine is any treatment not supported by robust scientific evidence in the form of a large clinical trial that would be incorporated into evidence-based medicine. Most alternative medicines have no clinical effects beyond a placebo (see Note 1), and they cannot treat any serious medical condition. Mostly, alternative medicine is pure pseudoscience.
Complementary and alternative medicine (as it is sometimes described) is known by its other names – quackery, quackademic medicine, snake oil, woo, or junk medicine. Alternative “medicine” quacks invent absurd pejorative names for evidence-based medicine just to create a ridiculous false balance – terms like allopathy, conventional medicine, or Western medicine. You science-based readers will see through this nonsense, and understand what they really mean is “evidence-based medicine, but we prefer our pseudoscientific medicine.”
In fact, the term “allopathy” is an archaic term invented by Samuel Hahnemann who invented homeopathy over 200 years ago. Homeopathic potions are nothing more than water. They have no clinical effect beyond treating thirst, and there are cheaper ways to do that. Medicine in the early 1800s was not even close to what we have now — a derogatory term for the medicine of that time probably was deserved. But it has zero meaning today. It’s just a pejorative meant to imply that science-based medicine is the same as alternative medicine. It isn’t.
Alternative medicine includes traditional Native American remedies, traditional Chinese medicine (like acupuncture), chiropractic, homeopathy, New Age nonsense, Aryuvedic, and many other kinds of pseudoscience. Of course, many alternative medicine scammers push their cancer cures, none of which have been shown to work.
Alternative medicine is popular because it provides false hope for people looking for a cure for their diseases or conditions. Alternative medicine quacks can make outrageous claims about cancer cures because they can play to the fears of cancer patients about surgery, chemotherapy, or radiation therapy. The scammers make the treatment of cancer easy and simple while relying on myths about cancer like Big Pharma pushes chemotherapy because they’d make more money than from a cure — in fact, if there were a miraculous cure that cured all cancer, the company that made it would make billions, if not trillions, of dollars.
But alternative medicine gets to make claims the easy way — they rely upon testimonials and anecdotes while ignoring real science.
What is science-based medicine?
Lucky for us, there’s one of my favorite websites (to which I often link, since I write about science-based medicine), Science-Based Medicine, that provides us with the best definition:
Good science is the best and only way to determine which treatments and products are truly safe and effective.
A lot of people use “evidence-based” and “science-based” medicine interchangeably. The differences are small, and “evidence-based” medicine probably overlaps with “science-based” medicine over 95% of the time. According to the gang at Science-Based Medicine, evidence-based medicine tends to have an over-reliance on clinical trials.
For example, I generally say that “allopathic, Western, or conventional” medicine is just medicine whereby drugs, devices, and procedures are supported by evidence from large, randomized, double-blind clinical trials that have been published in peer-reviewed medical journals. But I’m actually more strict with this definition — I want to see results in systematic reviews or meta-analyses, which are the gold standard of biomedical research.
Science-based medicine doesn’t just depend on clinical trials, which can be poorly designed and poorly analyzed, it depends on the totality of science.
Some could argue, for example, that acupuncture meets the standards of evidence-based medicine because clinical trials seem to show it works. Science-based medicine takes a totally different approach — it critiques the clinical trials, especially since you can’t create a decent placebo in clinical trials, the systematic reviews that are filled with bias and poor analyses, and the basic principles of acupuncture which are pure pseudoscience. Science-based medicine examines the totality of evidence and science behind something like acupuncture to conclude that it is useless. Yes, I know there are people, who reject alternative medicine, but who love acupuncture, and will be mad at this analysis. But the evidence really does not support any clinical effects of acupuncture.
Science-based medicine works
While I am cruising around Quora, a lot of the questions and answers try to make it appear that science-based medicine is closed-minded about ancient therapies or whatever is being pushed by alternative medicine grifters. But as Tim Minchin said, bring evidence that it works, and science-based medicine will incorporate it.
Here’s an example of where that happens. Traditional Chinese Medicine contains a lot of treatments for lots of diseases, almost all of which have not been shown to do anything for anything.
Dr. Youyou Tu, a Chinese scientist, was examining traditional Chinese remedies for malaria to see if any worked to actually treat the disease. I wrote about her efforts, in which she examined 640 different prescriptions, 2000 recipes, and 380 herbal extracts that were claimed to treat malaria to determine if they actually worked. Well, she found one, which led to her being awarded the 2015 Nobel Prize for Medicine.
She discovered artemisinin (also known as qinghaosu) and dihydroartemisinin, which are now used to treat malaria worldwide. Yes, the basis of this treatment is from someone, long ago, writing about making a qinghaosu tea. But she discovered that boiling the tea destroyed most of the two active ingredients that were effective in attacking malaria. So she used real science to isolate those ingredients and then purify them without destroying their activity.
In other words, Dr. Tu found evidence that one of over 3000 claimed Traditional Chinese Medicine treatments for malaria actually worked. She provided evidence that it worked. And now, artemisinin is used worldwide to treat malaria.
Once again, if something in alternative medicine is shown to work, it’s just called medicine. And her discovery is just plain medicine, only a handful know it was an obscure treatment for malaria.
Dr. Tu’s discovery did not mean that Traditional Chinese Medicine works, it just means one treatment written about centuries ago did work. It took science to establish its safety and effectiveness, not some magical claim that it worked. Artemisinin is science-based medicine!
Some people will try to throw this in the face of proponents of science-based medicine — they’ll use the argument from ignorance to try to claim that their favorite alternative medicine treatment must work because it hasn’t been proven to not work. That’s not how science-based medicine works — it requires evidence.
Alternative “medicine” is not medicine, period, end-of-story. There is not a great conspiracy by Big Pharma to quash alternative medicine, they’d laugh at anyone who made that claim. But if they are shown something may work, like artemisinin, then they will isolate it, put it into clinical trials, and then sell it.
Again, we are open-minded to the potential that some alternative medicine might work. We know a lot doesn’t work — chiropractic, acupuncture, most Traditional Chinese Medicine, and homeopathy come to mind — but if we see that it works in real scientific studies, then science-based medicine will embrace it. But testimonials, anecdotes, and logical fallacies are probably not going to be very convincing.
One last thing — the term “Western medicine” is completely false. Physicians in Japan, China, Vietnam, Thailand, India, and many other countries practice science-based medicine. Most of them reject the term “Western medicine,” since it doesn’t actually describe what they’re practicing, which is medicine based on scientific evidence.
Notes
- Many people overstate the value of placebos — officially, a placebo means that the effect is nothing more than can be found by giving the patient a sugar pill. The effect is almost always psychosomatic, so placebos effects are more prevalent with neurological conditions like pain, although the evidence that alternative medicine can treat pain is exceptionally inconsistent. However, placebos have never been shown to treat cancer, mend a broken bone, cure infectious disease, save a trauma victim, or do anything for other serious medical conditions. In medical research, anything with a “placebo effect” is considered a failure and would never receive FDA approval. The placebo effect, outside of pain and a few neurological conditions, cannot treat any disease or condition.
