To talk about effectiveness

[Guest guest]

In our favor, according to the U.S. Office of Technology Assessment,

only 20% of treatments in Western clinical practice are proven

effective. The entire source article follows.

 

Jim

 

 

 

 

FSMB developing guidelines for complementary care

Medical regulators explore the sometimes fine line between fraud,

complementary and alternative medicine, integrative medicine and

treatments that are not acceptable medical practices.

By Jay Greene, AMNews staff. May 8, 2000.

 

 

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As an increasing number of physicians practice acupuncture,

naturopathy, traditional Chinese medicine and mind/body therapies,

and even more physicians integrate their practices with complementary

and alternative medicine practitioners, state medical boards are

looking at appropriate standards of medical care.

 

More than 20 states have approved laws allowing the practice of

complementary and alternative medicine, according to a survey by the

Federation of State Medical Boards. But only three medical boards --

Illinois, Kentucky and Texas -- have written guidelines to help

protect the public from inappropriate or fraudulent medical

practices.

 

To help other medical boards deal with the issue of acceptable

medicine in integrative practices, the FSMB is developing model

guidelines. The guidelines also will outline physician

responsibilities when co-managing patients with licensed alternative

health care practitioners.

 

" There are many fraudulent practices out there that need to be

stamped out, " said Tracy Gaudet, MD, executive director of the

program in integrative medicine at the University of Arizona Health

Sciences Center, Tucson.

 

Although she acknowledged there is little evidence to confirm the

safety or efficacy of most alternative therapies, Dr. Gaudet pointed

out that the majority of medical treatments are also not clinically

proven through closely controlled double-blind studies.

 

" The U.S. Office of Technology Assessment said 20% of treatments in

clinical practice are proven effective, " she said. " I hope physicians

keep an open mind as research begins to explore alternative

medicine. "

 

Dozens of clinical studies funded by the federal government are under

way on many alternative medicine treatments, Dr. Gaudet said. In

fact, Congress has increased funding for the National Institutes of

Health's Center for Complementary and Alternative Medicine from $2

million in 1992 to $70 million this year.

 

Increased interest in acupuncture

One example of growing physician interest in alternative medicine is

medical acupuncture. An estimated 3,000 to 5,000 doctors practice

acupuncture.

 

" About 20% of my patients are referred to me by doctors for chronic

pain problems, mostly in the lower back, " said Sewell Dixon, MD, a

former surgeon turned acupuncturist in Charlotte, N.C.

 

A retired cardiologist and thoracic surgeon, Dr. Dixon opened an

acupuncture clinic in 1997. He wanted to help patients suffering with

bone and muscle problems for which medical care offers little relief.

 

Although Dr. Dixon thinks that some patients improve their conditions

with proven alternative therapies, he said people should first see

their primary care physician to rule out medical problems.

 

" In this field, there are charlatans to serious tree huggers. I worry

people may delay necessary medical treatment by going to unqualified

or improper practitioners, " Dr. Dixon said.

 

Some accepted therapies

Mostly in an effort to ferret out fraud, Illinois and Kentucky have

listed accepted complementary and alternative medicine therapies.

Validated therapies include: acupuncture, aromatherapy, art therapy,

biofeedback, body work/manual therapy, botanicals/herbs, homeopathy,

hypnosis, light therapy, magnetic stimulation, massage, music

therapy, reflexotherapy, traditional Chinese medicine and yoga.

 

" Complementary medicine is here to stay. Some treatments have

potential benefits to patients and the public we protect. Some

treatments can cause harm, " said Janet Tornelli-Mitchell, MD, a

member of the Texas State Board of Medical Examiners.

 

Dr. Tornelli-Mitchell called on state boards to approve guidelines to

regulate the types of alternative treatments available to the public.

 

" State and federal laws are allowing alternative medicine and are

overriding our ability to regulate medicine, " she said. " Unregulated

practice is an endangerment to the public. "

 

Regardless of the treatment, Dr. Tornelli-Mitchell said alternative

medicine providers and physicians must keep accurate medical records,

document treatment plans carefully and provide patients with informed

consent.

 

Kentucky was the first

In becoming the first state, in 1998, to acknowledge that physicians

are integrating complementary and alternative medicine into their

practices, the Kentucky Board of Medical Licensure issued this

statement:

 

" Abusive criticism of alternative practitioners and threats to their

licensure solely because they offer their patients an integrated

practice will not be tolerated. "

 

On the other hand, Kentucky recognizes the danger of consumer fraud.

 

" If consumer protection means anything, it should protect people

weakened by illness from the dangers attendant to unsound or

invalidated health practices, " the Kentucky board said. " Physicians

and providers should never accede to invalidated treatments. "

 

The Kentucky board went on to say: " Physicians may incorporate

nonvalidated treatments if research results are very promising, if

the physician believes that a particular patient may benefit, if the

risk of harm is very low and if the physician adheres to the

conventions that govern the doctrine of informed consent for

nonvalidated treatment. "

 

But what are validated and nonvalidated treatments?

 

In Illinois, the state medical board adopted general guidelines to

assess whether a particular medical treatment falls within the

Medical Practice Act:

 

Invalidated treatments are those that have neither a proven nor

scientific basis for any health benefit. They include therapies that

are implausible because the effects contradict " well-established

laws, principles or empirical findings in physics, chemistry or

biology " ; lack scientific rationale; or have insufficient evidence

from clinical studies or trials.

Nonvalidated treatments are those that may have a basis in scientific

theory, but are unproven, innovative or experimental. These include

drugs as well as medical and surgical interventions.

Validated, or conventional, treatments are those that are generally

accepted.