Medical Baloney Detector

Finally my Medical Baloney Detector makes an appearance. I’ve decided to do the Baloney Detector in several installments, in case there are things that come up that I keep wanting to add. Work has gotten in the way of this too long so it’s fitting that I use what happened at work today as an example for this post. There was enough baloney in this situation to cover a lot of what I wanted to say. Sadly, it was a conversation between two health professionals – an occupational therapist and a pharmacist. This just made it worse for me, and enduring the entirety almost made my head implode.

Anyway, onward to the pertinent question: How do we sort through claims that are true and too good to be true? Here I’ll provide some key features of each and how to tell the difference.

Example baloney claim: “I did Drug/Treatment X for my problem and I got better in no time. Drug/Treatment X totally works.”

This is the testimonial. Otherwise known as the useless bit of anecdotal information. The problem with this kind of information is that people are really good at fooling themselves and really bad at being objective. Although the person may attribute their feeling better to a particular antecedent treatment, it’s possible that A) something else they did was actually the “cure”, B) their problem would have resolved on its own, or C) only their perception of the problem has changed and they haven’t objectively improved (ex: in pain this might be measures as a subjective feeling of less pain, but maintaining the same level of pain medication).

More reasonable version of the claim: “I did Drug/Treatment X for my problem and I got better in no time. It might work for you too, but I don’t know. I’ll have to try it again to be sure and look it up.

Even better? Save your money and stick to traditional OTC (over-the-counter) symptom control recommended by your pharmacist or suck it up and eat lots of good food, push nutrient fluids and water, and exercise. Pharmacists are (or should be) willing to answer questions about OTC medication — you don’t have to stare blindly at the racks of a thousand choices by yourself.

Anyway, one person taking an OTC drug for a self-diagnosed ailment and then subsequently getting better is not evidence for the reasons stated above. Tried and true OTC medications are still around for a reason — they work. The trouble is people have been fed the idea that modern medicine isn’t to be trusted, that it treats symptoms and not the cause, and that there are major health concerns. While is is true that some drugs cause serious problems in a very small percentage of people, typically OTC medication is not harmful. Further, if you take a homeopathic remedy for your cough, how is that any less “treating the symptom” than cough medicine? The only difference is that one is medicine and the other is not.

Onto the head implosion conversation.

Pharmacist: I used to be unconvinced about ColdFX and now I’m convinced it works. I tried it a few times, and I know some other people who have tried it and it totally works.

OT: Some people find that the homeopathic remedies work better because they treat the cause rather than the symptoms.

Pharmacist: Yes, we sell lots of homeopathic remedies and people say they work.

And it went on like this.

Personal anecdotes are not evidence! I was particularly alarmed that this was a pharmacist. He is advising people on what drugs are effective. So when I say “talk to your pharmacist” I mean ask them 1) how does this work, 2) how do you know it works, 3) has this been scientifically tested? If they say “it worked for my aunt” or something, ask them a follow up question — how do you know they didn’t just get better on their own? Once they see you are a cognizant individual interested in actively participating in your medication regimen, they should explain the evidence further. If they don’t, I would seek a new pharmacist or do my own research.

I know how this is going to sound, but both of these professionals are of East Indian descent. This is relevant because in India, homeopathy and naturopathy are considered legitimate health practices and are very common and I think their common experience made them believe in it more than they might have otherwise…possibly. Unfortunately, there is no scientific evidence supporting the efficacy of homeopathic medicine. In fact, James Randi has ingested entire bottles of “potent” homeopathic sleeping pills with no ill effects. If there is no physiological effect, there is no mechanism by which to enact a “cure”. You could get the same effect by wearing your “lucky underwear”.

If there were evidence, I would happily accept its inclusion in health discussions and pharmacies and my head wouldn’t implode when I see two very experienced health professionals discussing it.

I think also my head would have imploded less had they been discussing homeopathy on it’s merits rather than who they know personally that some treatment happened to “work” for, which is debatable. Health care professionals should know better. All I could do was sigh, bite my tongue, and blog about it. [Note: I was not in the position to get into it with either person as one is my evaluator and one was the adult “child” of a patient that we were seeing at the time. It was not the time or place.]

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