General Question

snowberry's avatar

If you're medically oriented, what do you think of this survey?

Asked by snowberry (27664points) September 17th, 2013
55 responses
“Great Question” (1points)

I’m especially interested in the survey in the article that says that 75 out of the 125 medical schools in the US offer courses in alternative medicine. 57 percent of family physicians interviewed are willing to recommend alternative medical treatment. http://www.lasvegassun.com/news/1999/nov/24/cancer-survivor-speaks-out-for-alternative-medicin/
I expect you all to show up teeth bared and claws out. LOL

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Answers

zenvelo's avatar

Why do you expect people to be combative about this? Finally, medical schools are admitting they don’t know all the answers, and are veering away from the idea that there are only two alternatives: Prescribe, or surgically remove.

A physician that knows what will work best for a patient is much more valuable as a doctor than one who only considers one modality.

Rarebear's avatar

It’s reprehensible and I am ashamed of my specialty.

snowberry's avatar

@zenvelo Actually, my comments about teeth and claws were light hearted, and half way intended as a joke. After all, There are some (such as @Rarebear) who are always combative with me or sarcastic on this subject, and look at that! He showed up, right on time. No hard feelings, @Rarebear. :)

Besides, it’s controversial, and Fluther thrives on controversy. Disagreement is to be expected, but I’d be thrilled if we could actually have a proper discussion without flames.

Hopefully more people will respond. I am actually interested in starting a conversation about this.

snowberry's avatar

@Cupcake Sounds like they’re talking about it, at least, which is a good start. I do find it interesting that so many medical doctors are willing to recommend alternative medical treatment. I wish my mother had been around for this. It might have helped her.

Rarebear's avatar

I wasn’t being combative nor sarcastic. I answered the question honestly.

whitenoise's avatar

This time, the animation is really cool and Tim Minchin has already said it far better than I ever could.

Youtube

ragingloli's avatar

It is indeed a sad state of affairs when medical professionals recommend quackery.
Simply embarrassing.
Will not be long until a university offers courses in Alchemy, Astrology and Ufology.

Rarebear's avatar

@ragingoli what saddens me even more is that they’re wasting their time on stuff like this at the sacrifice of really important neglected subjects such as nutrition.

snowberry's avatar

Like it or not, the face of medicine is changing. Conventional medicine today will likely look very different than what it will look like in 20, 30, 40 years from now. There are many things I’ll like about it, and probably just as many that I’ll hate, but it is changing.

gailcalled's avatar

@snowberry; Since the article you cited was dated 1999, 14 years ago, I cannot give it much credence.

Again, in the universe I live in, my PCP’s have been open to other modalities in addition to the traditional allopathic medicine.

Over the years I have tried, with varying success rates; none of my doctors seemed to get upset and most were interested in my reactions and responses.

Chiropractic (Boo)
Massage therapy (Yay)
Acupressure (Boo)
Hypnotherapy (Meh)
Mind-body wellness classes (based on Jon Kabat-Zinn’s program (Yay)
Acupuncture (Meh)
Osteopathy (Boo)
Physical therapy (Yay)
Tai chi, chi gong (Meh)
Nutritionist (Yay)
Paychotherapy (Yay)

Rarebear's avatar

Actually osteopaths are qualified medical professional just as well trained as MDs

snowberry's avatar

It seems to me that the Japanese are doing something right. They have an array of what we call alternative medicine in their health care system. They are doing remarkably well and live far longer than about any other industrialized country. Yet the very methods they use to treat wounds for example (ionic water), are called quackery here. That’s arrogant on our part.

gailcalled's avatar

@Rarebear: Nine years ago I took a bad fall and, along with some other injuries, I partially damaged a rotator cuff. The ortho. doc on call that night in the ER was a DO. He was wonderful.

I am dealing with an ortho. surgeon now in prep for knee surgery and see that the same young DO is still a member in good standing of that ortho practice; does hundreds of joint surgeries each year.

drhat77's avatar

It is an old study. I wonder where things have gone.
I think some sort of overview maybe important for doctors to have, especially if they’re going to have patients who mix traditional and alternative medicine. It’s not as applicable for my practice. Honestly I do not think that patients come to traditional doctors for alternative medicine, so they do not need to spend a lot of time studying this. Indeed, traditional medicine already covers a lot of ground, and anything you try to cram in there will force something else out.
I think if a doctor wants to perform rigorous scientific analysis on alternative practices, they probably need more advanced formal exposure beyond what the Med school was planning on offering anyway.
I took a clinical skills course, and what I think is that maybe one class from that should have been devoted to showing me scientific resources to make recommendations by in case my patient ever asked me what my opinion of xyz therapy was. I think more than that is just too much for little yield. If I ever had a patient who decided some therapy, I could always read up on it later.

drhat77's avatar

The Japanese have large difference in genetics, culture, etc. It is impossible to say that differences are from medical delivery alone.
Oh, as I understand the Japanese have a very high burden of death in the working years. Dying on the job is in fact considered honorable, like a 21st century samurai. I’m gonna jaunt over to WHO to see if I can find stats for this.

Cupcake's avatar

My guess is that for the schools that mention alternative therapies in required classes, it is more of a “this is what they do… this is what the literature says about it… just in case your patient brings it up” kind of approach.

snowberry's avatar

@drhat77 I was more thinking of their success in the area of wound care. They are having great results with ionic water from what I hear (daughter is in Japan).

Rarebear's avatar

@snowberry what is ionic water?

Neodarwinian's avatar

I am patient oriented, being one, and I am concerned by this survey.

What do they call alternative medicine when it is shown to work?

Medicine.

All the rest is bunk.

snowberry's avatar

@Rarebear It’s snake oil to you.

I’m not much good at looking up studies, but here’s a sample of what I’ve found.
http://www.ncbi.nlm.nih.gov/pubmed/16945392
http://link.springer.com/article/10.1023%2FA%3A1023936421448
http://link.springer.com/article/10.1385%2FABAB%3A135%3A2%3A133
Here’s a placebo controlled double blind study: http://sciencelinks.jp/j-east/article/200113/000020011301A0419248.php
Cleaning pesticides and microorganisms from fruit and vegetables: http://sciencelinks.jp/j-east/article/200113/000020011301A0419248.php
Acidic, electrolyzed water kills salmonella and ecoli:
http://www.ingentaconnect.com/content/iafp/jfp/2003/00000066/00000004/art00002
Activity of Electrolyzed Oxidizing Water Against Penicilium expansum in Suspension and on Wounded Apples http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2621.2004.tb17872.x/abstract
Roles of Oxidation–Reduction Potential in Electrolyzed Oxidizing and Chemically Modified Water for the Inactivation of Food-Related Pathogens
http://www.ingentaconnect.com/content/iafp/jfp/2000/00000063/00000001/art00003
Inactivation of Escherichia coli O157:H7 and Listeria monocytogenes on Plastic Kitchen Cutting Boards by Electrolyzed Oxidizing Water http://www.ingentaconnect.com/content/iafp/jfp/1999/00000062/00000008/art00004

The ones below don’t have links, but I bet you can find them if they exist.
Anti-diabetic effect of alkaline, ionized water:

Anti-Diabetic Effect of Alkaline, Reduced Water on OLETF Rats
D Jin, SH Ryu, HW Kim, EJ Yang, SJ Lim, YS – Bioscience, Biotechnology, and Biochemistry (2006)

The Scientifically Proven Benefits of ACID WATER from Your Ionizer:
Acidic, ionized water is an effective sanitizer for kitchens and bathrooms:

Disinfection effects of electrolyzed oxidizing water on suppressing fruit rot of pear caused by Botryosphaeria berengeriana
Muhammad Imran Al-Haq et al – Food Research International (2002)

Application of electrolyzed oxidizing water on the reduction of bacterial contamination for seafood
Huang et al – Food Control (2006)

Electrolyzed acidic water (EO water) shows promise as an environmentally friendly broad spectrum microbial decontamination agent:

Reduction of bacteria on spinach, lettuce, and surfaces in food service areas using neutral electrolyzed oxidizing water
Guentzela et al – Food Microbiology (2008)

Anti-Diabetic Effect of Alkaline, Reduced Water on OLETF Rats
D Jin, SH Ryu, HW Kim, EJ Yang, SJ Lim, YS – Bioscience, Biotechnology, and Biochemistry (2006)

I am half way down the first page of my search. I’m sort of tired by now, and I’m not at all sure that I matched up all the topics with their links. But I tried. Anyway, it’s a start.

Take care!

Response moderated (Off-Topic)
Rarebear's avatar

@snowberry You misunderstand. I am totally agnostic when it comes to stuff like this. I go by evidence. If the evidence shows that a certain treatment has efficacy, then fine. Just as a for example, there was a relatively recent study in NEJM that stated that Vitamin E was superior to pioglitazone for the treatment of nonalcoholic steatohepatitis. I now use Vitamin E routinely.

My process for reading a medical article is as follows:
1) Look at conclusion to see if it answers the question asked
2) Look at methodology to see if the study is well designed.
3) Look at results to see if results are clinically significant
4) Look back at conclusion to see if the conclusion reflects what the results say they do.

Usually I skim past step #1 because the conclusions are almost always written in such a way to make their paper relevant. Otherwise it wouldn’t be published.

The following link is mostly for the skeptics with a statistics background reading this, but I encourage you to read this: Why Most Published Research Findings Are False

The math gets a bit esoteric and hard to understand, but if you read the corollaries it will be good enough.

Snow, your post is an example that has a whiff if shotgun argumentation and cherry picking(fallacy) but I do appreciate the effort. I’ll get to a few of the studies, look at the methodology and tell you what I like or don’t like about them.

Rarebear's avatar

Okay, here goes:
Study 1: Done in mice. No methods shown.
Study 2 and 3 page not found
Study 4 (if you’re keeping up, this is the RCT): Promising conclusion. I need to see the methods
Study 5 (pesticide): It was the same study linked above.
Study 6: Conclusions showed that acidic water decreased bacterial counts as much as chlorine water. I’m not sure what this means. Bacteria don’t like acid—that’s why your stomach is acid.
Study 7: Similar study to study 6. Again agricultural, a field I don’t know anything about so I can’t really comment on clinical significance. But it showed that acidic PH can limit bacterial growth.
Study 8: Another food prep one. Same results.
(At this point, without looking at methods, I’m willing to stipulate that rinsing food in acidic water can result in decreased bacterial counts)
Study 9 (cutting board): Similar results (see stipulation above).

I actually have to go do a sonogram on a patient right now, so I’ll look up the links on the other studies later.

Response moderated (Off-Topic)
snowberry's avatar

You asked what alkaline water was. My bad. I didn’t give you a definition. Here’s the best one I can find because I’m not going to dig out my books and I made the other grievous mistake of not being a scientist. Here’s your definition, or as good as I can get it (you could have done this yourself you know). http://en.wikipedia.org/wiki/Electrolysed_water#Drawbacks

Every other time I’ve interacted with you, you’ve demanded “scientific proof” of how effective whatever we’re talking about is, especially harping on placebo controlled double blind studies. So I gave it to you. Now I’m cherry picking.

I do not get you. At All.

Rarebear's avatar

Will you relax? This is an anonymous online web forum. No need to get upset.
The cherry picking fallacy, (which I do too), looks only for evidence that supports your position. That’s how debates work.

In terms of the studies, did you not read what I wrote? I said I appreciated the effort and I am giving you the benefit of the doubt. I actually pulled every link and read them, and gave you an honest objective opinion. I stipulated that acidic water will decrease bacterial counts.

I will add, though, acidic water is not alkaline water. So it’s actually, if you’ll pardon the expression considering that you posted a bunch of agricultural studies, comparing apples and oranges.

I have some time before my gig starts, so I will pull a couple of the medical articles if I can find them.

snowberry's avatar

@Rarebear Not upset. Just very mystified at your behavior.

Right. Good point. Alkaline and acidic are opposite. Ionic water covers both.

Response moderated (Off-Topic)
snowberry's avatar

Thanks @Rarebear One point for you! ” stipulated that acidic water will decrease bacterial counts.”

Response moderated (Off-Topic)
Rarebear's avatar

Okay in skimming the rest of the papers, most of them are agricultural, which I’ve stipulated that I accept the evidence, without the methodology. Spraying fruit with acidic water will decrease bacterial counts.

In terms of the diabetic studies, they’re done in rats, and I don’t have access to that data.

Part of modern Bayesian statistical thinking is looking at prior probability that something is true. Just adding to that, you need to have a valid scientific mechanism that something works. So the prior probability that drinking an alkaline solution will affect an automimmune disease is pretty low as there is no scientific mechanism, so I’d have to see extraordinary proof. Carl Sagan said it best “Extraordinary claims require extraordinary evidence.”

What I don’t understand, is if the pH in your stomach is very acidic (just puke and that burn you feel in the back of your throat is hydrochloric acid). How does drinking a dilute alkaline solution, which basically neutralizes the acid (which, we have stipulated in the agricultural studies kills bacteria), help? In fact, achlorhidria (lack of hydrochloric acid) will occur in patients on high dose proton pump inhibitors and actually results in INCREASED infection risk. It’s one of the reasons I don’t like to put people on chronic proton pump inhibition.

So acid reduces bacteria. Alkali neutralizes acid, which results in increased bacteria. So drinking alkaline solutions raises the pH of the stomach and if done chronically may result in increased bacterial growth—worsening the chance of illness.

It seems to me, and maybe I’m missing something, that you’re better off just eating healthy, and avoiding this altogether.

snowberry's avatar

OK, remember the many instances of vegetables contaminated by e-coli? http://www.huffingtonpost.com/2013/02/14/spinach-recall-taylor-farms-e-coli_n_2687967.html Soaking vegetables in a certain pH of acidic water (sorry, can’t find my source right now) will kill it. When the time is up, you rinse it off and eat without fear of contamination. This is how it can work in every day life, and in fact that’s exactly how many people who have ionic water machines are using them.

Rarebear's avatar

@snowberry Okay, once again, I stipulate that acidic water will kill bacteria. Some of the studies linked, though, compared it to dilute chlorine (which, ironically is alkali) and showed equivalency. But that’s okay.

There are a couple of things that perhaps you can help me understand:

1) How is acidic water any different than just using soap and water to wash things off.
2) Do ionic machines make water acidic or alkaline? The ones I’ve seen make them alkali, which is the opposite of acidic.

Rarebear's avatar

I’ve seen high quality telescopes for cheaper!

snowberry's avatar

@Rarebear You have a good point about alkaline water diluting stomach acid. That’s why they recommend drinking it when the stomach is empty.

Dr. Rarebear as I understand it, the intestines on the other hand, are supposed to be alkaline. So how does the acid (which really is released into the top of the small intestine as I understand it, and backs up into the stomach for digesting when needed). Another thing I don’t get is how acidophilus (which I understand to mean acid loving bacteria) can live in the gut, when the gut is supposed to be alkaline. So, I’m scratching my head on this…

Help?

Response moderated (Off-Topic)
Response moderated (Off-Topic)
Rarebear's avatar

The acid in the stomach is produced in the antrum of the stomach. This acid is always there, but is secreted in response to a food stimulus. So when your food hits the stomach, it gets bathed in acid which kills something like 99% of the bacteria.

The food sticks around in the stomach for awhile while the stomach churns it up and mashes it around. It then exits the pylorus into the duodenum. In the duodenum, the pancreas shoots out big jet of fluid that is alkali, which neutralizes the acid and contains a bunch of digestive enzymes. Also, the gallbladder will contract and bile will be produced. Bile is a substance that will assist in digesting fats by emulsifying them. The bile is also alkali. So all the acid is neutralized, thus the intestines are slightly alkali.

Your stomach is basically sterile of bacteria, but the intestines are not. Bacteria will colonize the intestines and form what is called a gut microbiome which is an area of very active research. Acidophilous is part of this microbiome, but there are many other bacteria.

Rarebear's avatar

Wait, do you understand the difference between acidic and alkali? If not, then everything I wrote won’t make any sense and I need to back up.

snowberry's avatar

@Rarebear Yes, I know what acidic and alkali is. As I recall, it’s the percent of H ions in whatever liquid you have. (I also know that you can also have acidic and alkaline solids, but testing them for pH must be very different).

I also know of many of the different types of beneficial bacteria, and some of the ideas how to restore them to the gut once they’ve been destroyed.

Rarebear's avatar

@snowberry Sort of. Close enough (It’s not a percentage, but a logarithmic scale difference).

snowberry's avatar

@Rarebear Ah, yeah, well I understood it when my 4th grade kid was competing in the regional science fair. She (therefore I) had to know the processes well. That was a long time ago.

Rarebear's avatar

Okay, this has been fun, thanks for the discussion. I have to switch gears now and tune my banjo.

whitenoise's avatar

@Rarebear

Your link doesn’t work, but I think you refered to this machine:

NewCell Genesis 7 Plate Water Ionizer / Alkaline Water Machine by NewCell
Link: http://amzn.com/B004BIUBTW

It offers:
”* 7 Platinum Titanium Plates providing 76 Programmable pH and ORP Levels”
”* Produces Water in an Incredible pH Range of 2.0 – 12.5”… blah blah blah…

Anyways… water “in an Incredible pH Range of 2.0 – 12.5”?
I don’t know what it is that this machines supposedly produces, but it sure as hell ain’t water…

At Ph of 12, we are talking about something akin to soap water and at 2 we are looking at acidity of pure lemon juice, or a couple of times more acidic than Coca Cola.

This device is quackery.

Seek's avatar

Wow. And to read the reviews (all two of them) it cures heartburn, back pain, and diabetes! Who knew dihydrogen monoxide would be so powerful.

snowberry's avatar

@Rarebear That was pretty much the attitude my doc had (telling me I needed to take ant-acids even though I didn’t have enough stomach acid to begin with) so I fired him.

Rarebear's avatar

There’s a sucker born every minute. I have a friend who is convinced that EMF radiation is harming her, so she bought a $4000 EMF reader that beeps and whistles every time that it’s near a wifi signal.

snowberry's avatar

@Rarebear I prefer the mango kind when I can get it. How about you?

Rarebear's avatar

@snowberry Mango suckers? That’s pretty funny. I’ve never had one, but I do like mango.

snowberry's avatar

@Rarebear I’ve never had one either, but since we’re talking about suckers, I’m calling the mango ones!

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