Consider this: Mainstream Medicine May Not Work

Some years ago the Harvard School of Public Health published studies that established a 20 per cent effectiveness rate for methods and treatments used in medical care.

In the UK the Health Technology Assessment programme (HTA) is part of the National Institute for Health Research (NIHR). It produces independent research information about the effectiveness, costs and broader impact of healthcare treatments and tests for those who plan, provide or receive care.

The British Medical Journal (BMJ) says the following, from its Clinical Evidence project -

Clinical Evidence aims to help people make informed decisions about which treatments to use. It can also show where more research is needed. For clinicians and patients we wish to highlight treatments that work and for which the benefits outweigh the harms, especially those treatments that may currently be underused. We also wish to highlight treatments that do not work or for which the harms outweigh the benefits. For the research community our intention is to highlight gaps in the evidence, where there are currently no good RCTs or no RCTs that look at groups of people or at important patient outcomes.

So what can Clinical Evidence tell us about the state of our current knowledge? Figure 1 illustrates the percentage of treatments falling into each category. Dividing treatments into categories is never easy hence our reliance on our large team of experienced information specialists, editors, peer reviewers and expert authors. Categorisation always involves a degree of subjective judgement and is sometimes controversial. We do it because users tell us it is helpful, but judged by its own rules the categorisation is certainly of unknown effectiveness and may well have trade offs between benefits and harms. However, the figures above suggest that the research community has a large task ahead and that most decisions about treatments still rest on the individual judgements of clinicians and patients.

We are continuing to make use of what is ‘unknown’ in Clinical Evidence by feeding back to the UK NHS Health Technology Assessment Programme (HTA) with a view to help inform the commissioning of primary research. Every six months we evaluate Clinical Evidence interventions categorised as ‘unknown effectiveness’ and submit those fitting the appropriate criteria to the HTA.

BMJ Clinical Evidence published this report, with intervention effectiveness shown to be quite a concern because of the high level of ineffectiveness and unknowns. Source:   http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp

Background, 2006:

For those of you unfortunate enough to read any articles or see any television reports featuring Professor Jonathan Waxman, a natural products-hating oncologist from Imperial College, London, indulge yourself in some soothing words from Dr Damien Downing.

On seeing Professor Waxman's 'personal view' issued in the pages of the British Medical Journal yesterday (BMJ 2006; 333:1129), Damien immediately responded via the BMJ's Rapid Response pages and posted the following response:

Professor Waxman employs and perpetuates a crucial medical myth - that, in contrast to complementary therapies, conventional therapies are all evidence-based, on sound science. But the BMJ's website Clinical Evidence reports that, of the 2404 treatments they have surveyed, only 15% are rated as beneficial, while 47% are of unknown effectiveness1. In his own speciality, indeed, chemotherapy for cancer was found in a 2004 systematic review of studies in the USA and Australia2 to improve overall 5-year survival chances by less than 2.5%. Interestingly, the review of dietary interventions he cites3 derived an odds ratio for the effect of a healthy diet, with or without dietary supplements, of 0.90 - which appears to make them probably 4 times as effective as chemotherapy. Different end-points, granted, and a big confidence interval, but nevertheless "absence of evidence is not evidence of absence". 

Talk of "vile and cynical exploitation" could with equal justification be applied to the cancer industry, into which billions has been poured in recent decades, to very little effect. Surely Professor Waxman should be careful not to become, as discussed in the same issue of BMJ, "a lapdog to drug firms"?

1 http://www.clinical evidence. com/ceweb/ about/knowledge. jsp
2 Morgan G, Ward R, Barton M. The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies. Clin Oncol (R Coll Radiol), 2004; 16(8): 549-60.
3 Davies AA, Davey Smith G, et al.. Nutritional interventions and outcome in patients with cancer or preinvasive lesions: systematic review. J Natl Cancer Inst 2006; 14: 961-73.

It's clear from Professor Waxman's response that a threat is perceived not only from dietary/food supplements used by millions to support their health, he has also taken a sideswipe at organic food, produced by a branch of agriculture supported by increasing numbers of consumers that is threatening Big Food and agri-business. The irony, of course, is that those most interested in reducing the burden on the healthcare system and spending time in doctor's waiting rooms are those that will be more likely to consume both organic foods and high quality food supplements. Market research has demonstrated that most users of food supplements do not use these products to counter poor diet, but rather use them to add nutrients that they believe are missing as a result of modern agriculture and food products. 

The increasingly vocal hatred expressed by key opinion leaders within the orthodox medical community has to be an expression of the threat that they perceive from the millions of people around the world who continue to use products derived from nature as key components of their healthcare regime.
You'll appreciate that this is no time for anyone to put their head in the sand!

Please feel free to forward this as widely as you can to anyone who you feel may be interested.

Doctor offices do not honor privacy

Yesterday I was having a conversation with a woman at my local plumbing company. She was complaining about the lack of privacy at the area doctor groups and how there is no effort to protect patient data and financial information in front of other staff and patients.

To have any public credibility doctors have to honor their medical oath and be reasonably in tune with medical truth. This is exceedingly hard to do if your health care provider has bought the Big PhRMA/Big Insurance paradigm.

I explained to her that HIPPA is set up to collect and share your information and that the failure to provide private areas to discuss your information is a legal requirement.

Where one gets their information is telling and for doctors crucial. Pharmaceutical muscle is evident not only in medical schools but in medical organizations, local medical boards and in the governmental institutions that oversee medicine and public health. All of these medical organizations are in the business of strong arming doctors, creating fearful and highly conditioned environments that continue outrageous but profitable practices for the industry. http://imva.info/index.php/vaccines/a-rebellion-in-healthcare.

Natural Health and Psoriasis

I'm listening to NPR and their story about psoriasis. Of course it is only medical, with the standard comment "there is no cure".

Because so little is known in medicine about this situation, there isn't any approach other than drugs and the new "biologicals" that severely suppress the immune system and can lead to cancer.

No mention is made of very helpful natural approaches to correcting this concern, including evaluation of food allergy, especially wheat gluten and gliaden.

Of course there is the psych referral...under the guise of "mind-body medicine" because as you know, everyone with a chronic health problem is depressed, and there are drugs for that.

Stories like this make me think about the high number of people I have helped over the years with psoriasis. In those who wanted to be fully well, the condition cleared.

Nature surely does a good job if we just take the time to listen.

See also

How American Health Care Killed My Father

While this article is lengthy, it offers a very good picture of the state of mainstream medicine in the US today.

American Health Care contributed to killing my mother, who recently passed away, and I am sure it did the dame to many others.

Having seen this first hand during the years I worked in ICU and other medical venues, I', pleased to have found an ally in Mr. Goldhill.

How American Health Care Killed My Father - The Atlantic (September 2009)

Shared via AddThis

Diet and Lifestyle Best Cures for Worst Afflictions

Isn't this called "Back to the Future"?

A number of decades ago, I was much younger then, it used to be that the simplest approach was best, and least expensive.

Sound nutrition was the first place to start and then other more simple and health promoting changes were applied. And this approach has been flourishing in this country since before the Eclectics back in the 1800's. The approach really dates back to the B.C. era and was once a part of mainstream medicine until it was decided that we could make up a drug then make up a disease to go with it.

The last resort was always what has become today's health care SOP driven by profit, insurance and pharmaceutical industry motives.

People have also been left out of the loop. And sadly this has become a stanchion of "alternative medicine" whether from an integrative MD, holistic nurse, or licensed naturopath.

Still nothing has changed because everyone still wants control, and the same old mentality is being schmoozed over "alternatives".

And where in this equation is the "patient"?

I have been involved in "integrative, holistic, and natural health" since 1958. I see many things not observed by others, and I'm not sure I like it. I am also a health care professional with a very in depth background, and a lot of experience.

I am not convinced that this approach is "alternative" and I know it should not be relegated to licensing and more control.

After all, no self-respecting traditional healer on any reservation is going to fall for the licensing scam.

This reminds me of the crazy attitude held by Gritman Hospital in Idaho. Their definition of integrative care is massage.

My idea is certainly much broader than that expressed in this article, but it will work for starters.

JANUARY 9, 2009 'Alternative' Medicine Is Mainstream'
The evidence is mounting that diet and lifestyle are the best cures for our worst afflictions.
By DEEPAK CHOPRA , DEAN ORNISH , RUSTUM ROY and ANDREW WEIL

In mid-February, the Institute of Medicine of the National Academy of Sciences and the Bravewell Collaborative are convening a "Summit on Integrative Medicine and the Health of the Public." This is a watershed in the evolution of integrative medicine, a holistic approach to health care that uses the best of conventional and alternative therapies such as meditation, yoga, acupuncture and herbal remedies. Many of these therapies are now scientifically documented to be not only medically effective but also cost effective.

President-elect Barack Obama and former Sen. Tom Daschle (the nominee for Secretary of Health and Human Services) understand that if we want to make affordable health care available to the 45 million Americans who do not have health insurance, then we need to address the fundamental causes of health and illness, and provide incentives for healthy ways of living rather than reimbursing only drugs and surgery.

Heart disease, diabetes, prostate cancer, breast cancer and obesity account for 75% of health-care costs, and yet these are largely preventable and even reversible by changing diet and lifestyle. As Mr. Obama states in his health plan, unveiled during his campaign: "This nation is facing a true epidemic of chronic disease. An increasing number of Americans are suffering and dying needlessly from diseases such as obesity, diabetes, heart disease, asthma and HIV/AIDS, all of which can be delayed in onset if not prevented entirely."

The latest scientific studies show that our bodies have a remarkable capacity to begin healing, and much more quickly than we had once realized, if we address the lifestyle factors that often cause these chronic diseases. These studies show that integrative medicine can make a powerful difference in our health and well-being, how quickly these changes may occur, and how dynamic these mechanisms can be.

Many people tend to think of breakthroughs in medicine as a new drug, laser or high-tech surgical procedure. They often have a hard time believing that the simple choices that we make in our lifestyle -- what we eat, how we respond to stress, whether or not we smoke cigarettes, how much exercise we get, and the quality of our relationships and social support -- can be as powerful as drugs and surgery. But they often are. And in many instances, they're even more powerful.

These studies often used high-tech, state-of-the-art measures to prove the power of simple, low-tech, and low-cost interventions. Integrative medicine approaches such as plant-based diets, yoga, meditation and psychosocial support may stop or even reverse the progression of coronary heart disease, diabetes, hypertension, prostate cancer, obesity, hypercholesterolemia and other chronic conditions.

A recent study published in the Proceedings of the National Academy of Sciences found that these approaches may even change gene expression in hundreds of genes in only a few months. Genes associated with cancer, heart disease and inflammation were downregulated or "turned off" whereas protective genes were upregulated or "turned on." A study published in The Lancet Oncology reported that these changes increase telomerase, the enzyme that lengthens telomeres, the ends of our chromosomes that control how long we live. Even drugs have not been shown to do this.

Our "health-care system" is primarily a disease-care system. Last year, $2.1 trillion was spent in the U.S. on medical care, or 16.5% of the gross national product. Of these trillions, 95 cents of every dollar was spent to treat disease after it had already occurred. At least 75% of these costs were spent on treating chronic diseases, such as heart disease and diabetes, that are preventable or even reversible.

The choices are especially clear in cardiology. In 2006, for example, according to data provided by the American Heart Association, 1.3 million coronary angioplasty procedures were performed at an average cost of $48,399 each, or more than $60 billion; and 448,000 coronary bypass operations were performed at a cost of $99,743 each, or more than $44 billion. In other words, Americans spent more than $100 billion in 2006 for these two procedures alone.

Despite these costs, a randomized controlled trial published in April 2007 in The New England Journal of Medicine found that angioplasties and stents do not prolong life or even prevent heart attacks in stable patients (i.e., 95% of those who receive them). Coronary bypass surgery prolongs life in less than 3% of patients who receive it. So, Medicare and other insurers and individuals pay billions for surgical procedures like angioplasty and bypass surgery that are usually dangerous, invasive, expensive and largely ineffective. Yet they pay very little -- if any money at all -- for integrative medicine approaches that have been proven to reverse and prevent most chronic diseases that account for at least 75% of health-care costs. The INTERHEART study, published in September 2004 in The Lancet, followed 30,000 men and women on six continents and found that changing lifestyle could prevent at least 90% of all heart disease.

That bears repeating: The disease that accounts for more premature deaths and costs Americans more than any other illness is almost completely preventable simply by changing diet and lifestyle. And the same lifestyle changes that can prevent or even reverse heart disease also help prevent or reverse many other chronic diseases as well. Chronic pain is one of the major sources of worker's compensation claims costs, yet studies show that it is often susceptible to acupuncture and Qi Gong. Herbs usually have far fewer side effects than pharmaceuticals.

Joy, pleasure and freedom are sustainable, deprivation and austerity are not. When you eat a healthier diet, quit smoking, exercise, meditate and have more love in your life, then your brain receives more blood and oxygen, so you think more clearly, have more energy, need less sleep. Your brain may grow so many new neurons that it could get measurably bigger in only a few months. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease. Your sexual organs receive more blood flow, so you may become more potent -- similar to the way that circulation-increasing drugs like Viagra work. For many people, these are choices worth making -- not just to live longer, but also to live better.

It's time to move past the debate of alternative medicine versus traditional medicine, and to focus on what works, what doesn't, for whom, and under which circumstances. It will take serious government funding to find out, but these findings may help reduce costs and increase health.

Integrative medicine approaches bring together those in red states and blue states, liberals and conservatives, Democrats and Republicans, because these are human issues. They are both medically effective and, important in our current economic climate, cost effective. These approaches emphasize both personal responsibility and the opportunity to make affordable, quality health care available to those who most need it. Mr. Obama should make them an integral part of his health plan as soon as possible.

Dr. Chopra, the author of more than 50 books on the mind, body and spirit, is guest faculty at Beth Israel Hospital/Harvard Medical School. Dr. Ornish is clinical professor of medicine at the University of California, San Francisco. Mr. Roy is professor emeritus of materials science at Pennsylvania State University. Dr. Weil is director of the University of Arizona Center for Integrative Medicine.

Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved