Dr. Oz's journey to the Dark Side continues apace: Bring on the bait and switch!

As I sat down to write this, I was torn. What topic to deconstruct? There appear to be so many! Certainly, the latest Huffington Post excretion by the ever-clueless (but amusing in his cluelessness, which results in posts of pure hilarity) Dana Ullman, entitled Luc Montagnier, Nobel Prize Winner, Takes Homeopathy Seriously sure looked tempting. Ullman always makes an amusing target. However, I realized that I had already discussed Montagnier, not just once but twice in the last couple of months, first for promoting autism quackery and then, more recently, for having fallen hard for homeopathy, so hard that he's trying to convince people that DNA can teleport. Then I realized that Steve Novella had already gotten to it, and my enthusiasm for taking it on diminished. True, the fact that a fellow skeptic had beat me to a woo-ful post never stopped me before, at least not in and of itself, but when I combined Steve's having beaten me to the punch with my having visited the topic a couple of times, a distinct sense of ennui hit me.

So I perused the propaganda blog of everybody's favorite band of anti-vaccine loons, Age of Autism, and what to my wondering eyes should appear but a screed by our old friend J.B. Handley entitled Paul Offit and the "Original Sin" of Autism, which is nothing more than an extended screed against the man that the anti-vaccine movement considers to be the Font of All Evil, the Dark Lord of Vaccination, living in his Barad-dûr of vaccine-derived wealth (to mix fantasy/science fiction metaphors), complete with this gem:

I think Paul Offit is a blowhard liar, a vaccine profiteer and apologist, and every time he opens his mouth he disrespects my son.

Actually, I'm hard-pressed to think of a better description of J.B. Handley himself than "blowhard liar." In my opinion, of course. Which is why my reaction was a big yawn and a question: Project much, J.B.? Add to that reruns of an old post attacking Paul Offit for actually making some money off of a vaccine he helped invent that can save the lives of children and a new post in essence saying the same thing, and all I could conclude is that it must really burn AoA that Paul Offit was on The Colbert Report last night. Really, really burn them. Good.

But not good enough to inspire me to lay some not-so-Respectful Insolence on something so idiotic. That's why I decided to revisit Dr. Oz instead.

One message that I've been trying to get my readers to understand is that much of what falls under the rubric of "alternative" medicine, "complementary and alternative medicine" (CAM), and "integrative medicine" (IM) is in reality a "bait and switch." The bait consists of various modalities that naturally fall into the bailiwick of science-based medicine (SBM). These modalities include diet, exercise, relaxation. Indeed, it irritates the hell out of me when various apologists and advocates for CAM claim that science-based physicians don't recognize the importance of diet and exercise or how they can have a profound effect on health, in particular on diseases like type II diabetes. I ranted about this not long ago when i wrote about the woo of raw "living food" diets. Diet and exercise are every bit a part of science-based medicine; yet CAMsters appropriate them as being somehow "alternative," the better to bring in the real woo along with them. The pitch is, in essence, that diet and exercise work and are "alternative." Therefore there must be something to other forms of "alternative" medicine. That's the "switch" in the bait and switch.

Nowhere is this better demonstrated in a segment from a recent episode of The Dr. Oz Show called Dr. Oz's Holistic Health Overhaul. It illustrates exactly what I mean when I describe the "bait and switch" of alternative medicine. I'll show you what I mean. Let's start with Part I.

Right from the start, Dr. Oz comes out and announces his "holistic health overhaul." First, what strikes me is that what he is supposedly "overhauling" is based on people who feel run down, who lack energy, who feel older than they are. Right from the start, he promises that he can make you feel younger and better, all within 28 days. After this, he immediately introduces a yoga instructor who calls himself Yogi Cameron Alborzian, who talks about spirituality, yoga, and how he became a yogi. There are many shots of him doing yoga poses in beautiful, natural surroundings (of course!) interspersed with shots of him talking about "mind-body" connections and how he asks people what they're feeling. The segment finishes with Yogi Cameron showing up on Dr. Oz's set for an introductory interview.

Then, in part II, Patricia from New Jersey is introduced. She is a stay-at-home mom of four boys, who describes herself as feeling "toxic, tired, and stressed-out." Her biggest problem, according to her, is that she's a junk food junkie and that she doesn't exercise. She complains of sluggishness, feeling "hung over," and wiped out. Here is the bait. In response to her complaints, Yogi Cameron and Dr. Oz show Patricia her health risks, pointing out that her body mass index qualifies her as obese and that her waist size suggests that most of her fat is in her abdomen, which is known to be a risk factor for type II diabetes and a variety of other health problems. Basically, the problem is laid out. It's (mostly) science-based. Unfortunately, the solution is a mixture of woo and science-based diet and lifestyle changes. Enter Dr. Oz and Yogi Cameron and his "holistic health overhaul" in part 3 and part 4. Here's where the switch comes in.

First, let me show why this is not a surprise at all by referring you to Yogi Cameron's own website. One thing we learn about Yogi Cameron is why he is such a fantastically good-looking man. It turns out he was a fashion model for several years and even was cast in what looks in the video like Madonna's Express Yourself video:

On his website, Yogi Cameron opines about Ayruvedic, referring to it as the "science of life":

Before Western medicine, before homeopathic medicine, and before even traditional Chinese medicine, there was Ayurveda. This is an ancient system of healing created by sages in India over five thousand years ago. While yoga was developed as a science for the practitioner to bring balance and control to the mind, Ayurveda is a sister science developed for the practitioner to bring balance to the body.

Western medicine tends to treat a patient's symptoms with different pills and medications without any attention to healing the cause of a disease that is feeding the symptom. It is like weeding a garden without taking out the roots; the weeds just grow back. Ayurveda works to define the cause of the patient's symptoms and to treat the body with various methods for the sake of restoring balance to the system as a whole. These methods include eating in a way appropriate to one's constitution, taking herbal supplements and remedies, and receiving treatments such as oil massage. Effective use of Ayurveda can help to alleviate digestive problems, allergies, insomnia, asthma, obesity, migraines, and many other bodily complaints.

The ancient sages who developed Ayurveda many centuries ago observed that our bodies are formed by three fundamental energy types or doshas. The first (Pitta) is responsible for metabolizing for the sake of processing oxygen and perpetuating life. The second (Kapha) forms our bodies, which serves as a container so that life can exist as matter. The third (Vata) shifts matter's position in space through the act of motion.

And this is how Yogi Cameron treats his clients' problems:

Through other Ayurvedic treatments such as Pancha Karma we also clean the inside of the body. Cleaning the inside of our system is fundamental to our wellbeing and without such cleanings we can never experience complete health and vitality, youth and vigor. When the inside of the body is clean we experience young skin and vibrate energy on the outside.

For those of you who don't know what Pancha Karma is, it the name for five actions that make up an Ayruvedic method to purify the body. There are three stages of treatment. First, there is the pretreatment, which consists of oil therapy, massage, and something called formentation therapy. This part actually doesn't sound too bad. Whether it cures anything or not, who knows? However, having your body oiled up and massage can't be all bad. The formentation therapy is basically heat, either steam from herbs, sitting under the sun, or using warm blankets. Of course, this latter treatment, depending on what it is used for, is a perfectly fine science-based treatment. Be that as it may it's the next part of the Pancha Karma that is supposed to do the purification. This consists of Nasya (nasal therapy), Vamana (emesis or vomiting), Virechana (purging) and two kinds of Vasti (therapeutic enema), Nirooha Vasti and Sneha Vasti.

Enemas? What is it with enemas? Truly, enemas seem to be the woo that knows no national or ethnic boundaries, the quackery that is truly world-wide. Fortunately, there does appear to be an alteration to this ancient art of purging in America:

Originally, this phase consisted of five practices: nasal cleansing, enemas, laxatives, emesis (vomiting), and blood-letting. Although the five practices are followed in India, the practice of emesis and blood-letting is omitted in North America.

Imagine my relief. But:

A cleansing fast is often used during this period.

Bummer. This does, however, set the stage for what Yogi Cameron recommends for Patricia in parts 3 and 4. This is where the switch in the bait and switch comes in. Right from the start, Dr. Oz describes week 1 of this plan as "detox," as Yogi Cameron helpfully chimes in that his methods "burn off toxins." Dr. Oz then immediately asks Yogi Cameron about tongue examination. Now, there's one thing you need to know about tongue examination. When an Ayruvedic practitioner talks about tongue examinations he is not talking bout what they teach us in medical school about tongue examinations, where we look for turgor, moistness, plaques, and a variety of other physical findings that might indicate disease. No, the Ayruvedic art of tongue diagnosis is very much like reflexology in that various organs are claimed to map to various parts of the tongue:

i-5d955485f826cd231095b2c57248e174-tongue-thumb-400x277-60836.png

To be fair, some of the tongue diagnoses actually do agree with science-based medicine, for example, a yellow tongue being indicative of jaundice. However, someone with jaundice will also usually have yellow visibile in their sclerae, which are probably more sensitive. In reality, the Ayruvedic tongue diagnoses that match science-based medicine diagnoses are actually a classic case of being right for all the wrong reasons, and most of them are wrong, wrong, wrong, particularly the mapping of various organs to different parts of the tongue. Not that that stops Yogi Cameron from proclaiming that the "head is represented by the tip of the tongue."

I will admit that there is one highly amusing part of this entire segment. Yogi Cameron has a rather strong disagreement about the amount of sex people should have. Yogi thinks that people shouldn't have sex too much; Dr. Oz is apparently a randy little bugger and thinks people should have sex all the time. I'm not sure whether I should feel sorry for Mrs. Oz or not. However, my amusement aside, one thing that strikes me about this argument is that it appears to be vitalistic in nature. Yogi Cameron claims you shouldn't have too much sex because it's about "conserving energy," in essence implying that sex somehow saps your life energy.

Basically, Dr. Oz has performed the classic "bait and switch" here. He presents the story of a typical middle class mother who works hard, doesn't eat right, is a bit obese, and as a consequence of her lack of exercise, her work, and her poor diet feels run down. A perfectly fine science-based solution to her problems would involve a change in diet, less junk food, and regular exercise (all things that I myself have a lot of problem managing to do). Instead, what Dr. Oz and his guest Yogi Cameron present is an improved diet and yoga, plus woo that includes tongue diagnosis, "detox," and "Nasya lite," given that all Yogi Cameron had Patricia do was to place some Ghee in her nose, rather than shooting water in and out of it. At least he spared her the purging and enemas, and I guess the bloodletting is too much even for the woo-full. But there's enough there, even the classic favorite of apologists for Ayruveda and traditional Chinese medicine, the appeal to ancient wisdom, the claim that, if people have been doing this for thousands of years, there must be something to it, they must know something we don't.

Is Dr. Oz's journey to the Dark Side complete? He's certainly controlled his message, but has he fully released his woo? I don't know, but I suspect we'll find out. Today's show will feature a faith healer. I might have to make this a two-parter. Oh, well. It'll be a nice distraction from the anti-vaccine movement for a couple of days.

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My favourite comedian, Tim Minchin, penned a great song in which he argues that just because an idea is tenacious, doesnt make it valid (he says it more eloguently than this) and this point fits perfectly with the above ideology by the yogi. These types always use the fact something has been around for a long time, as evidence that it must be good (like religion). Which is so inherently ridiculous yet so influential. Anything new (vaccines?) is not to be trusted, and anything old is accepted as wise as it has stood the test of time. Those of us with some critical thought processes will automatically see the error of this assessment. BUt plenty do not. Sigh!

Diet and exercise are every bit a part of science-based medicine; yet CAMsters appropriate them as being somehow "alternative," the better to bring in the real woo along with them.

I'd bet that the CAMsters view diet/excercise/etc as being things that "allopathic medicine" appropriated from CAM. Which isn't to say that they're right, just that they aren't claiming diet and such as part of CAM out of cynicism/deception/etc, and thus aren't consciously (or e even subconsciously) performing a bait and switch.

By Matthew Cline (not verified) on 01 Feb 2011 #permalink

It's a romantic notion that ancient Eastern medical modalities are somehow imbued with timeless wisdom we have forgotten or abandoned in the West. Ben Kavoussi on the Science Based Medicine blog thoroughly disabused me of that idea when he pointed out that the philosophy behind traditional Chinese medicine is functionally identical to pre-scientific Western ideas of humours. He has demonstrated that acupuncture is descended from blood-letting, and the meridians were originally based on blood vessels.

The same can be said of Ayurveda - the three doshas resemble to the four humors of Hippocratic medicine. Many of the treatments - purging, enemas, blood-letting - are the same as those used in medieval Europe.

I think that blood-letting was abandoned in the West as it is an actively dangerous practice. It was a Scottish military doctor, Alexander Hamilton, who first conducted a crude clinical trial, back in 1809 (shortly after George Washington was bled to death by his doctors in an attempt to cure a throat infection). That trial demonstrated that patients who had been bled had 10 times the mortality of those that had not. Other trials followed and the practice was mostly abandoned. There is more about this in 'Trick or Treatment' by Edzard Ernst and Simon Singh.

I was on vacation in Cuba last week (and was vaccinated before I went! Still alive!) and the only english channel my hotel room got was Dr Oz (there was also the Disney Channel, actually, but for some reason I just can't watch more than 5 minutes of Hannah Montana). What got me was the whole week before this show, the ads were all about "What your doctor won't tell you!" As if my doctor is some evil villian, cackling wildly while he doles out prescriptions and rakes in the cash. I don't understand how undermining the trust in the doctor-patient relationship is helpful to people.

I also was thinking along your lines, Orac, about the bait-and-switch. Oz keeps mixing good science in with the bad stuff, and the way he does it seems to be deliberate: he WANTS us to be confused. I hope he has trouble sleeping at night, but I kind of believe he sleeps very, very soundly.

By Quietmarc (not verified) on 01 Feb 2011 #permalink

Since Yogi Cameron is so worried about getting rid of toxins, he should pay attention to what's growing in that garden of earthly delights he poses in for the video.

Behind him to the left is a clump of plants with large, nodding yellow trumpets - unmistakeably Brugmansia, one of the most toxic plants known*. This plant (and its relative, Datura) is potentially fatal if ingested. Even casual contact with the sap causes dermatitis.

But of course it is "natural". :)

*it's also a spectacular fragrant ornamental which I grow. One of my potted Brugmansias is currently in flower and I wanted to bring it from its window into the dining room to show it off, but we have a Labrador that eats everything (plants, window curtains, my socks) and it wasn't worth the risk.

By Dangerous Bacon (not verified) on 01 Feb 2011 #permalink

I hear this more and more every day. Being a stay at home mom & 'lucky' enough to be roped into my mother-in-laws book club, I can tell you firsthand what the ladies are saying. And it is the same thing. You take women who don't exercise, they aren't eating right and they are getting older (40's - 60's). In other words, the perfect storm for feeling like crap.

Then, they get on a (gluten free, vegetarian, "cleansing") diet and rave about how they have never felt so good. Suddenly they have all had food allergies and gluten intolerance that they never knew about. Things that their doctor ignored. And it's not just the ladies - their husbands get on board and now think their doctor visits aren't accomplishing anything except fleecing them for a copay.

I don't envy MD's. If you say "You should exercise and eat a healthy diet to lose some weight and feel better," you're going directly to the doghouse for insulting the patient or you are ignoring their OBVIOUS underlying conditions that Dr. Oz can gladly bring to light in 20 minutes of his "life changing" TV show.

How much of this is the Hawthorne effect: not the specific diet or exercise, but taking any action to fix a problem, and being told it will help?

I suspect some people would improve if they were told that from now on, instead of water, they should drink seltzer, and followed that recommendation. And that some seltzer-drinkers could be helped by being told to drink non-fizzy water instead.

Certainly, drinking green tea is easier than getting to the gym regularly.

I don't envy MD's. If you say "You should exercise and eat a healthy diet to lose some weight and feel better," you're going directly to the doghouse for insulting the patient

I guess I am atypical, then. For me, I knew it was bloody obvious that I was eating crap and out of shape. The doctor telling me to eat healthier and exercise (which he did) made me feel about as stupid as you do when the dentist gets on your for not flossing.

Are overweight/out of shape people really in that much denial? Then again, perhaps it was because I wasn't in denial that I was able to lose 30 lbs by changing my diet (although it's still not the healthiest, and I don't exercise enough)

"Anything new (vaccines?) is not to be trusted, and anything old is accepted as wise as it has stood the test of time."

The problem is not that.

Anything new is not to be trusted because we don't know the consequences. So we test them.

Anything old that has been tested can be trusted provisionally because we've looked for the consequences.

Where it falls down in CAM is that anything old doesn't necessarily have to have been tested, merely used a long time.

Old vaccines are old and therefore despite your attribution, do not fit in the "Anything new" category. Lemon is old and its effects are tested and we use it in our cold remedies. Asbestos was used long ago, but we hadn't actually tested it. When we did, we stopped using it.

Well, I have to disagree with Orac on one thing. Yogi Cameron is not a fantastically good looking man. He's kind of grotesque. Now, if Brad Pitt was selling woo, I might have to consider turning to the Dark Side myself.

When I read something as loony as the stuff that yogi Cameron is saying, I laugh at first, and then I think of certain grandparents of mine who watch Dr. Oz and realize, aww hell, I'm never going to hear the end of this one.

Dangerous Bacon said:

Behind him to the left is a clump of plants with large, nodding yellow trumpets - unmistakeably Brugmansia, one of the most toxic plants known.

Mr. Cameron probably wouldn't object. Honest to goodness toxicity seems to be as much a woo magnet as exoticness or the ability to make it an enemma. I recall when I used to buy melatonin at a quack shop the shelves were full of herbal and homeopathic products sporting poisonous plant names, like belladonna, poison ivy etc.

Frankly, it often looks to me like a perverse attitude toward legitimate authority and a need to run in the exact opposite direction of whatever the legitimate authorities say is part and parcel of CAM. Which fits nicely with my very, very, very left-wing Philosophy class friends buying it wholesale.

Oh my goodness, I think I see confirmation bias in my own post!

By Scott Cunningham (not verified) on 01 Feb 2011 #permalink

I think Liz has it right. We can complain all we want about the woo invasion, but until docs get WHY people are drawn to these quakeries, they will surely continue. Now, if Oprah or Oz, et. al., would start featuring books like "Trick or Treatment" and having REAL nutrition experts, like Marion Nestle, on their shows, things might change, but still, people really, really want the attention they get from the alt practitioner. Yes, the doc gives the same basic advice, but he just states it--lose some weight. I once complained to my doctor that I "just couldn't lose weight--even though I only eat an apple a day". His response, given with a shrug and no follow up, was, "so, eat half an apple". He was right of course, but it took me twenty-five years to get that. I left that day feeling that he was an uncaring, stupid, sexist male who didn't give a crap about me. I was wrong, but what difference did that make. Had I not stumbled onto books like Trick or Treatment, I'm not sure I wouldn't be held in the thrall of CAM today.

A lot of you who post here are science professionals and it is easy for you to dismiss people who fall for CAM, but I wish more effort was spent in actually trying to introduce more real science into the mainstream. I saw a display at B&N bookstore the other day that was called "Health and Diet" or some such. It was a large display of ridiculous fad diet books, some written by people with science degrees (but often not with expertise in nutritional science). Every one of them included sample menus with (guess what?) appropriate portion sizes of whatever food plan they were touting. In spite of this, do you think anyone will praise the new gov't guidelines for saying to "eat less"?

My point is, where are the popular books about real science? They are there, but their authors aren't on TV every day. And doctors have to do more than simply declare "lose some weight". The clinics now have lots of support level staff to call people back with routine questions, etc., why not utilize this level of staff to spend more time sitting down with people and discussing practical ways they can implement the necessary changes in their lives and maybe offering massage for relaxation as a "treatment"? That would be "integrative" medicine I could "believe" in--and so could a lot of woo-people.

By turnipseed (not verified) on 01 Feb 2011 #permalink

Last evening, while I was driving to a resturant, my SO described in great detail how Bernie Madoff first "set up" his victims- I exclaimed, "Compared to some of the operators I observe, Bernie's just a piker!" While he relieved them of their money, pseudo-scientists' methods can take health and lives as well as money.

I've noticed a trend among some web woo-meisters since before the Great Recession started - they focus much of their ire on the economy and politics. If things are bad, you might also worry about your health, however I suspect a more insidious reason: they want to separate potential marks from information that comes from any other source- thus, if established medicine, doctors, pharma, journals, research, universities, governmental agencies, the government, and the media, are all corrupt, to whom then, can you turn? Well, the friendly guy who, as "investigative reporter" and "truth teller", revealed all the corruption to you! There's a reason it's call "con" ( i.e. confidence) "artist". Oz provides them with a "foot in the door".

By Denice Walter (not verified) on 01 Feb 2011 #permalink

"Before Western medicine, before homeopathic medicine, and before even traditional Chinese medicine, there was Ayurveda."

Before modern astronomy and chemistry, before astrology and alchemy, and even before the Greek and Egyptian gods, there were cave men superstitions about how the world around them worked. Obviously we must appease the fire gods to get them to beat back the snow gods and restore pleasant weather to the Midwest.

"Western medicine tends to treat a patient's symptoms with different pills and medications without any attention to healing the cause of a disease that is feeding the symptom"..."Ayurveda works to define the cause of the patient's symptoms and to treat the body with various methods for the sake of restoring balance to the system as a whole."

Even if the first part were true, making stuff up about the causes of disease and inventing ways to treat these fairy tales is not valid medicine. Just because I don't have a satisfactory answer to a question doesn't make your answer correct by default.

Considering all the different forms of CAM that claim to understand and treat the one true cause of disease, it's fascinating that there isn't more conflict in the CAM world between the various groups. Most of the different CAM philosophies are mutually exclusive in concept other than the expressed or implied underlying vitalism..

-Karl Withakay

I don't envy MD's. If you say "You should exercise and eat a healthy diet to lose some weight and feel better," you're going directly to the doghouse for insulting the patient or you are ignoring their OBVIOUS underlying conditions that Dr. Oz can gladly bring to light in 20 minutes of his "life changing" TV show.

What I seem to see more often goes like this:

MD: You should exercise and eat a healthy diet.
Patient: I don't want to do that, give me a pill.
MD: There is no pill. You need to exercise and eat a healthy diet.
[Patient goes home, buys a weight loss pill from TV]
[Patient gains more weight]
[Patient goes to a quack]
Quack: You need to take these 50 supplements a day.
Patient: What else?
Quack: You should exercise 3 hours a day and eat nothing but raw cabbage. One head a week.
[Patient ends up exercising 30 minutes a day and eating a sensible diet exactly as the MD recommended; loses weight]
Patient: That MD put me on useless pills, but the quack sure helped a lot!

Will the alt-med people and the conventional-med people ever agree on the definition of CAM? The CAM side seems to see the word "alternative" as meaning "alternative to prescriptions or surgery," which would include diet changes, exercise, relaxation, etc. but the conventional side defines alternative medicine as anything that uses the word "mystery" in its explanation, i.e. dismisses RCTs as irrelevant.

CAM says "MINE!" to exercise because it is not surgery or pills, and Medicine says "MINE!" to exercise because it has good evidence behind it. Can we just put lifestyle changes in the overlapping bit in the Venn diagram?

It's not as simple as being in denial. It seems to be a combination of how important it seems, and maybe how possible the work seems.

My partner is an ex-smoker. He didn't keep smoking because he wanted to, but because it was very hard to quit. Doctors kept pointing out that he should stop. He kept agreeing, and sometimes trying cold turkey. Eventually, he had a medical scare, and the doctors slapped a nicotine patch on him (no smoking in hospitals). Even with the nicotine, it took months, and a year and a half later, he will point out in random conversation "I'm still not smoking" because not smoking continues to be an effort.

Again, deciding to eat some more fruit--just buy a bunch of bananas or a bag of apples, and have one every day--is going to be easier for a lot of people than changing their entire diet. It may well do some good, and someone interrupting them for a nutrition lecture as they're having (say) a roast beef sandwich, potato chips, and a banana for lunch won't. Tell someone that their small but attainable change is insufficient, and they may decide that it's useless and stop, not add to it.

Your organs are mapped on your tongue? That's a good one. I'll get a giggle out of that for the rest of the day.

I have to echo what Liz said about tired mom's turning to different diets to solve their problems. That's the biggest type of woo that I deal with in my real life. The gluten free diet seems to be the big one at the moment. It will phase out and be replaced by something different in a few months, I'm sure.

What I don't understand is why so many women with small children are surprised that they are tired all of the time. Kids are exhausting! They are little balls of energy that will suck every last morsel of energy out of you. I guess I thought everyone knew that. The advice I always give when the topic comes up is to exercise. I tell them that even if the workout doesn't energize you, spending 45 minutes without anyone going, "mommy, mommy, mommy, " sure does.

Also, in response to turnipseed. I'd actually like to see it going father than just having doctors spend more time with their patients so they feel respected and listened to. One of the most demoralizing aspects of dealing with doctors is often the office staff. If it takes two days just to get through to a person to schedule an appointment, then you get snapped at by the receptionist because you didn't fill out your paper work properly, only to find yourself waiting in a cramped waiting room for half an hour, you don't feel valued as a person and a patient before you ever even get to see the doctor. A maassage would be awesome, but just being treated as more than an inconvenience by the doctor's staff might be a nice start.

I like how Ayurveda restores the balance - eat this mercury loaded dirt, and it will kill both the bacteria and you. Perfectly balanced indeed.

My view is that so called "conventional" doctors often set the "alternative" appellation, irrespective of any science based analysis, short of some national blessing or review, preferably aged like a fine Bordeaux.

If one uses a procedure/diet that conflicts with the (lack of) understanding of Dr MSM from CowTech, it's "alternative" and it doesn't matter how many more qualified doctors' signatures and journal articles you've assembled or whether the violent shaking or emesis of the last few weeks suddenly disappears overnight under the new regimes, as well as having some improved blood chemistry.

So... is there a part of the tongue that corresponds to the tongue?

Also, if you bite your tongue, to you injure the corresponding organ?

Lulu wrote:

CAM says "MINE!" to exercise because it is not surgery or pills, and Medicine says "MINE!" to exercise because it has good evidence behind it. Can we just put lifestyle changes in the overlapping bit in the Venn diagram?

On condition that that overlap is then declared "integrated medicine", so that practice exclusively founded on good evidence can declare itself already Integrated Medicine, and all the rubbish without any good scientific evidence can become "disintegrated medicine," reduced to dust and swept out the door, yes. That would be bloody brilliant.

But the CAM crowd would never go for that, because the reason they talk up diet and exercise and pretend MDs never recommend it really is a bait-and-switch trick.

@prn @20
That whole "Skeptics call it alternative because they're ignorant / it threatens their world view" thing is a real canard. Stuff falls in that bucket if it relies on dogmatic belief (like that tongue map)and can't provide reproducible empirical evidence that it works.

For example, one of my grandmothers swears by accupuncture. Never mind that it failed to help any of her friends she suggested it to. Never mind she had a self-limiting pain condition. Never mind she's never recieved any expanation of how it works and a huge body of studies say its all placebo effect. Any suggestion that there's a shortage of evidence or that people should test ideas and toss out false ones she brushes off by saying "you're no fun!" Because she chooses what she believes by how amusing it is. (See also: dowsing rods.)

So I say to that old canard "it's alternative because you're ignorant and don't like it" a solid no. It's about evidence.

By Scott Cunningham (not verified) on 01 Feb 2011 #permalink

"It's about evidence" I just cited reasonable steps for you: published journal articles, gathering signed recommendations from other medical professionals with better creditials, measurement and observation.

Turned out one of the drugs, Reglan, was specifically questioned earlier by the RPh review as in conflict with another drug, and had been duly ignored by Dr CowTech. Later, Reglan's removal, by one of my medical signatories, over local staff objections, accounted for 2/3 of the shaking. "Diet" got the other 1/3. However, digestive supplements stopped persistent nausea and vomiting and returned an appetite overnight, where Reglan had failed for weeks. A tank and a tube, both biological, chemical reactors restarted, no magical thinking involved.

Medicine has no monopoly on Ego, bullheadedness, and ignorance, happens all the time. You've read about them in the newspapers and it costs us all money. Whether we like it or not. I've seen similar behavior elsewhere trash a billion+ dollars.

What's annoying are such denials point blank in the face of reality. The public is going to relearn an old phrase, "You're fired. Don't come back."

As I've commented before, I think that, in the long run, altmed is more dangerous than antivax because it is more subtle. Since the antivax movement seems to be waining, I think we should pay more attention to CAM/IM and to slick, celebrity quacks like Dr. Oz.

I think one thing that further complicates the issue is the amount of doctors and dentists out there who perform unneeded operations, give questionable prescriptions or make mistakes. I have heard and been through enough horror stories that, quite frankly, make me question the establishment of modern medicine. I realize, unlike many, however, that the other side is complete and utter garbage, and that modern medicine, while nowhere near perfect, is all that we have.

prn, I doubt anyone is going to dispute that some MDs who operate entirely within the conventional system will behave poorly, or even in a manner not becoming of people who are supposed to update their practice based on the incremental improvement of evidence.

How does that invalidate Scott Cunningham's point that the objection to, say, the Ayurvedic remedies proposed in Dr Oz's show is based on the solid ground of that same body of evidence?

The impression I have is that your comments #20/24, while valid in and of themselves, are tangential or even outright non sequiturs compared to the topic of this post and the commentary thus far.

Not to be contrary ... ok maybe to be contrary ... it's probably a chicken or egg thing as to who thought exercise etc was valuable first ... suspect science was not the first though ... Lots of "science" came from "quack" doctors using traditional healing remedies...

FYI I am not a Dr Oz fan ... not even remotely ...

Just think sometimes you scientists who rant ought to take a step back and see stuff from an unbiased ,.. although often (admittedly) ignorant point of view. There are a majority of folk who are uninformed and intelligent and who might dismiss your rant because of it's excess ...

If you are writing for likeminded, equally knowledgeable science folk just to rant ... that's ok .. if not ... that's my point.

By all4kindness2all (not verified) on 01 Feb 2011 #permalink

@27 Scott seemed to reply defensively, introducing "skeptics", to my comment about the social dimension of "alternative" probably often being aggresively (mis)applied by low caliber "MSM" mossbacks, without any respect to current literature.

Orac seems to imply "science based medicine" is mutually exclusive from "alternative medicine" because if it was any good or science based, it would be "medicine". I have to respectfully disagree, given the history of science and medicine, a new science based medicine can stay outside in the cold for a long, long time, even permanently.

Will the alt-med people and the conventional-med people ever agree on the definition of CAM? The CAM side seems to see the word "alternative" as meaning "alternative to prescriptions or surgery," which would include diet changes, exercise, relaxation, etc. but the conventional side defines alternative medicine as anything that uses the word "mystery" in its explanation, i.e. dismisses RCTs as irrelevant.

I'd be interested in knowing where you got that definition of "alternative"; it doesn't seem to accord with anyone else's usage of the word that I've ever seen. Alternative practitioners don't seem loath to "prescribe"; they simply want to prescribe "natural" products like OSR#1 or homeopathic plutonium rather than anything that's actually part of the accepted materia medica (though obviously not all alternative practitioners feel that restriction.)

It's true that alternative practitioners generally don't perform surgery; this might be less due to a philosophic opposition than the fact that alternative practitioners have not managed to get the law changed to create as many loopholes for useless surgeries as there are for useless "nutritional supplements" and "traditional remedies." Even at that, though, there are still exceptions, such as the "liberation procedure" that supposedly treats MS.

By Antaeus Feldspar (not verified) on 01 Feb 2011 #permalink

@prn,

given the history of science and medicine, a new science based medicine can stay outside in the cold for a long, long time, even permanently.

I'm not a doctor, but I'd like to believe that if something were truly science based, it would at least be used by doctors who pay attention to the science. I understand that not all do - some doctors don't keep up with the latest, and some treat based on their own idiosyncratic views. But assuming that the science is good and the information is made available, I'd like to think that many doctors would adopt good, science-based medicine.
Do you have examples of science based medicine that has stayed in the cold permanently?

By Mephistopheles… (not verified) on 01 Feb 2011 #permalink

@all4kindness2all

it's probably a chicken or egg thing as to who thought exercise etc was valuable first ... suspect science was not the first though

It really doesn't matter who thought of it first. The question really is, how do you prove it? In the case of exercise, which exercise provides the most benefit for a given condition, and how much do you need? Someone could guess at it and be right, but how would you know that person was right? Someone could guess and be totally wrong - either not helping or causing harm - and how would you know? That's where science comes in.

By Mephistopheles… (not verified) on 01 Feb 2011 #permalink

@31 Do you have examples of science based medicine that has stayed in the cold permanently?
I think immunotherapy a la Coley's toxins for late stage cancer (from ca 1890s) might still classify as one of the older candidates.

@30 "homeopathic plutonium"
The Russian FSB sure showed UK NHS how well homeopathic Po-210 6X cures political heresy and related antisocial(ist) mentation :)

@ Antaeus Feldspar
You're right. I was just trying to characterize the position that CAM usually seems to take. How would you say they describe their modality, differentiating themselves from conventional medicine? CAM is such an amalgam of silly ideas and wildly different paradigms that they may have no unifying stance against conventional medicine at all.

@ wow, if you compare the history of vaccines versus yoga I think it's fair to suggest one is new comparatively to the other. Which is my point. The fact that CAM types refer to the age of their various treatments I think verifies my assertion.
The point you raise about testing is valid to some degree in that users of CAM dont seem to care much about research, and rely simply on the fact that "it's been around for over 2000 years". There have been studies undertaken to test the validity of CAM claims, none of which have proven their efficacy that I am aware of.
As for asbestos, I suspect they tested it once people developed illness via handling. The reason this is unlikely with CAM is that it is mostly inocuous.

"Yogi Cameron Alborzian" has got to be the least promising Indo-Hiberno-Persian appellation of all time.

"if you compare the history of vaccines versus yoga I think it's fair to suggest one is new comparatively to the other."

And comparing two other things, you find the opposite.

Sorry to be so down on you, but I really don't see why you said that.

"As for asbestos, I suspect they tested it once people developed illness via handling. The reason this is unlikely with CAM is that it is mostly inocuous."

However, it's cheap and effective and people were making money from it (cf CFCs as a refrigerant). And even if you paint CAM as "mostly innocuous", you still have the problems that plagues faith healing: believing you are doing something about the problem stops you from doing something that DOES do something about the problem.

I was using vaccines as an example of a new science compared to yoga. Nothing complex about that. And then carrying through the point about Alt medicine types often being anti vax. A topic recently covered on this site. I thought it was a very simnple point and not worthy of deconstruction. But anyway if you wish go ahead. I cant see the point myself.

I totally agree with your comment re. people taking CAM 'treatments' may well be harmed by avoiding proper medical care. Where I am in Australia a woman recently died after doing just that. My point was that without people suffering obvious physical ailments as a result of usng CAM products there is no inpetus on the industry to prove either it's efficacy or safety. Unlike asbestos, which was carcinogenic.
While recently boring a pharmacist stupid with my rant about why I think it inappropriate for them to even stock Homeopathic remedies, he said the FDA is now 'cracking down" on claims made on all new prodcucts, inlcuding vitamins. So perhaps we shall see a challenge coming in the future to those who peddle their voodoo water.

My fibro flared in Jan 2007 and since then I have gone from a working mom to a helpless cripple waiting for disability. Sorry for non-PC language. My grandpa, aunt and father were doctors, and I wanted to be one but they told me I couldn't get through an internship (I have chronic fatigue syndrome also). So I became a lawyer. They don't come any more skeptical of woo than I am.

BUT.

I'm 52. Been to 2 dozen licensed medical doctors. Been to world famous medical centers. They have nothing but pain pills to offer me. Physical therapy..I can barely move.

I do woo (rohun plus supplements plus guaifenisen which is backed by a board certified endocrinologist who has taught at UCLA Medical for 52 years-he started the year I was born)--and I take pain pills and probably die when my liver blows out.

The only alternative is pain at Level 10 24/7. And that will kill you quickly anyway, both in body stress and psychological stress.

I also eat healthy and can still fit into my college jeans.

Could anyone kindly direct me to some good science-based deconstructions of ayurveda? I've searched through Scienceblogs and this article appears to be the only one that (semi-)seriously discusses it's concepts, if only a commentary of Yogi Cameron's video.

It would be nice and much apreciated if I could find some good deconstructions of Ayurveda and/or excellent discussion about research into it and whether scientific verification exists for it's claims. Thanks.

Journal of Ayurveda and integrative Medicine http://www.jaim.in/

It is near impossible to use the western scientific model on Ayurveda as a whole when they are such different approaches to looking at the world/ human being. Quite simply put.

@RUVeda,

The "western scientific model" is a method for figuring out what works and what does not.

There is nothing explicitly "western" about it and it is used by people from all around the world including:

Charles Kuen Kao
Yoichiro Nambu
Makoto Kobayash
Toshihide Maskawa
Masatoshi Koshiba
among others.

It also worked pretty well for

Subramanyan Chandrasekhar.

But I could use some enlightenment today, so please inform me, what model does Ayurveda use to figure what works and what does not?

And, more importantly, what treatments, medications, etc. has Ayurveda figured out do NOT work in the last 100 years or so?

Personally, I'll bet my health on a method that does not keep repeating the mistakes. Also, I don't like arsenic in my medications.

By squirrelelite (not verified) on 13 May 2011 #permalink

Ah, the appeal to "other ways of knowing."

To put squirrelelite a little more succinctly: Stuff works or it doesn't work. How do you know your stuff works?

Keep repeating mistakes? What does that mean? It works because the properties have been studied by Ayurvedic experts/vaidyas/ rishis/etc (their way) for 5000 years. Its just not possible for a science that doesnt recognize the mind & soul to be so important an influence on the body to find validity in it. Parts of it, sure. But reducing it to study about herbs or even just herbs/diet is missing the point of Ayurveda. Its truly holistic.
Arsenic, shmarsenic. I grow many of my own herbs on a farm. No arsenic or lead there. The rest are bought from a reputable, clean, mold free (more of a problem than arsenic) herbal pharmacy. Ever heard of Sushruta ? You know... father of surgery particularly rhinoplasty. Ayurveda is not hocus pocus like you dolts make it to be. Denying other sciences or views on the mind-body-soul interaction just shows lack of sense. Not all that unexpected on a site like this. Namaste, bitches.

There is not "Western" or other flavor of science. There is science and then other stuff. Your word salad is not about science. And unless you support your statements with real evidence that has replicated independently we will assume you made it all up out of thin air.

The mind-body-soul connection just hasnt been discovered by your empirical-based science but it has in others. Dont worry. You will catch up at some point in time.

Oh, you've gone beyond dualism and you've entered tertiarism! Wow, you've truly exceeded all that science has to offered.. Testeste woo boy!

He's holistic, Jerry!

I don't watch tv, but I'm glad he's putting this stuff out there.

It's really just about science and I always and without exception, come to conclude that God's ways are always better than man's; he has given us his wonderful natural things... but the simple truths that have all but vanished with modern medicine are not profitable.

This will be a major wonderful change for all as these simple truths come out, used to be people took care of disease. I think people long ago were way smarter than us as I read about what the Egytians did in med/sci, and people from the 1800's.

Let this be a profound statement from this point on; Doctors need to go back to healing by teaching. Oz is doing just that. Let's get off this arsenic tit called 'Modern Medicine' and Pharma, because we know drs dont actually heal you anymore, to the few exceptions I apologize. China and India we can and are learning from.

I know from my own personal experience these statements I have made.

God's ways are always better than man's; he has given us his wonderful natural things

Like cholera, polio and smallpox...

used to be people took care of disease. I think people long ago were way smarter than us as I read about what the Egytians did in med/sci, and people from the 1800's.

In the 1800s life expectancy at birth was around 40 (as it was in Ancient Egypt), 15% of babies died before they were a year old, childbirth was the commonest cause of death and 25% of surgical patients died. Antibiotics didn't exist and people routinely died of infections and diseases that are unknown today. Those were the days...

China and India we can and are learning from.

You mean where life expectancy was the same as it was in the West before modern medicine was introduced? Life expectancy in India is still 14 years lower than in the USA.

I know from my own personal experience these statements I have made.

You were around in Ancient Egypt and in the 1800s? Why do people believe such nonsense?

By Krebiozen (not verified) on 26 Jun 2011 #permalink

teresa:

It's really just about science and I always and without exception, come to conclude that God's ways are always better than man's; he has given us his wonderful natural things... but the simple truths that have all but vanished with modern medicine are not profitable.

I think people long ago were way smarter than us as I read about what the Egytians did in med/sci, and people from the 1800's.

Oh, yes. They were very smart. They had to get lots done since their average lifespan was half of what it is now.

Stupid blockquote error. Rats!