Reader's Response to the Book Review Entitled "Complementary and Alternative Medicine in the United States"
Medscape General Medicine. 2005;7(4):76. ©2005 Medscape
Posted 12/22/2005
It is curious that you have provided space to a hostile reviewer to air his prejudiced view of Complementary and Alternative Medicine.[1] Dr. Barrett states in his first sentence that "health-related methods that are plausible should be tested with well-designed clinical trials." The studies conducted by the NIH [National Institutes of Health] National Center for Complementary and Alternative Medicine (NCCAM) are a step in providing the kind of test that Dr. Barrett says should be applied.
Dr. Barrett complains that "the IOM report does not contain a single word of criticism against methods that are sufficiently irrational to be discarded now." But the scientific test of whether a method is effective is not its rationality in the current medical paradigm, but how effective it is in treating human illness.
We are cautioned that this report is tainted because "the 17-person committee that was appointed to write it included at least 9 members with a financial conflict of interest, 5 of whom have received multiple grants from the NCCAM." But we should not be surprised that the experts for this piece have been involved in research in the field, and have received grants for their work. This is not really a conflict of interest; this is confirmation that these people have knowledge of the subject. A more fruitful area to look for conflict of interest might involve those who are paid by pharmaceutical companies to promote a particular product. Profits from patented drugs make the "conflict" that Dr. Barrett is concerned about seem awfully small.
Upon reflecting on the "conflict of interest" issue, I wonder whether Dr. Barrett receives any support from the pharmaceutical industry. His concern about the Dietary Supplement and Health Education Act (DSHEA) seems a bit excessive, unless he has some turf to protect. The pharmaceutical industry rightly considers the supplement industry to be a competitor for business, and would therefore have an interest in restricting the ability of the competition to bring their products to market. Can Dr. Barrett and his "Quackwatch" organization deny support from the pharmaceutical industry, or their lobbying groups?
Further, Dr. Barrett complains that "most medical school teaching about CAM promotes its unscientific theories and practices." It is probably more accurate to say that most programs take an unprejudiced look at CAM rather than rejecting the whole field just because it is different from conventional practice. We should be proud that medical schools are open-minded enough to consider anything that might work to alleviate suffering. This is not the "problem" that Dr. Barrett considers it to be.
Dr. Barrett has given us a clear description of his personal view of this subject, but not much information on the book that he was supposedly reviewing. I will need to look elsewhere for an unbiased review.
Sincerely,
William Stone, RN
UNC Hospitals, Chapel Hill, North Carolina
stonewill@mindspring.com
References
1. Barrett S. Complementary and Alternative Medicine in the United States. MedGenMed. 2005;7:17. Available at: http://medgenmed.medscape.com/viewarticle/513139. Accessed October 18, 2005.
Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eye only or for possible publication via email: glundberg@medscape.net
Disclosure: William Stone, RN, has disclosed no relevant financial relationships.
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