Is It Science?

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Mainstream Medicine vs Alternative Healthcare:  One of my early mentors was an old time chiropractor, J. LaMoile DeRusha, who lived through the era in which chiropractors, inclulding himself, had served time in jail for practicing their profession.  His motto for new chiropractors was, "Take a backseat to no one." I am just beginning to fully appreciate his wisdom and experience.

 

 

 

 

 

 

 

 

 

 

 I think that many of us "alternative" healthcare practitioners tend to have an inferiority complex in regards to this issue.  And I am certain that many patients and most of the American public are certain that medicine is completely scientific while alternative care is somewhat suspicious.   The opposite is the case.

Is Medicine Scientific?

I remember having a conversation between an acquaintance who was writing a medical text on Evidence Based Medicine, and another friend who was quite enthusiastic about her own experience with alternative therapies.  As it turns out, Evidence Based Medicine asks us to completely ignore the evidence of our own experience and rely on the placebo controlled, double blind trial.  

This is a big discussion but there are a number of serious and fundamental problems with trying to run health care on the model of the placebo controlled, double blind clinical trial.

Such trials can only answer very small specific questions.  They are notorious for producing conflicting results.

It is also impossible to measure real world outcomes because in the real world, there are lots of variables. This is particularly true with genuine holistic health care in which we treat the patient rather than the disease.  

It tends to produce a protocol driven mentality.  So if I have a patient with rotator cuff syndrome the protocol shows that x is the most effective treatment in a large trial.  In my personal experience I have seen, in one week, three patients with rotator cuff syndrome with three different causes which required three different treatments.

Second, there is clearly a large element of skewed results because of institutional bias.  One way this happens is through experimental design.  It is quite easy to demonstrate ineffectiveness by what can be fairly subtle alternations in the experimental setup.  For example, a study showed no effect for echinacea.  The study used the wrong species, the wrong part of the plant and the wrong dose.

"Everyone should know that most cancer research is largely a fraud, and that the major cancer research organizations are derelict in their duties to the people who support them." Linus Pauling, two time Nobel Prize winning chemist.

As Mark Twain said, "There are liars, damn liars and statistics."  One of the most influential large studies in recent medical history was the Frammingham Heart Study which is the basis of much of the connection between cholesterol and heart disease. In his book, The Cholesterol Myth,  Uffe Ravnskov, MD, PhD, a Danish medical researcher, demonstrated that statistics were misused to prove a correlation which did not exist in fact, or were so marginal as to be insignificant. A whole generation of Americans have been raised to fear cholesterol and take dangerous drugs to lower their "numbers," based on these studies.

Besides sloppy experimental design and questionable statistics there is apparently a great deal of outright fraud in science in general and in medical research in particular.

"Two teams of researchers with access to thousands of documents gathered for lawsuits over the painkiller Vioxx allege that Merck waged a campaign of deception to promote its drug, moving slowly to warn of possible hazards while at the same time dressing up in-house studies as the work of independent academic researchers." Maker of Vioxx Is Accused of Deception, Washington Post.

This fraud was published in the Journal of the American Medical Association, was relied upon by thousands of doctors and lead to tens of thousands of early deaths.

Evidence based medicine that is based on wrong or incomplete facts is worse than because it generates a sense of false confidence and undermines common sense in both patients and practitioners.

Finally, there is the evidence of our health care system itself.  

 Is Alternative Healthcare Science?

As a teen I was smitten by the glamor of science.  I read Arrowsmith and dreamed of wearing a lab coat and making scientific discoveries. I studied biochemistry on my own and though I would become a biochemist until I met one.  That may not be fair but for better of worse the glamor wore off. Years later I returned to my first love in a new guise, combining my love of science with my craftsman soul. She Blinded Me With Science

What is science?  First we have to make a distinction between science as a process of rational discovery based on experience, the glamor of science and what we might call "Big Science," or the institutions which decide what is true and what is not true. 

Real science is a process that has produced dramatic results in all our lives.  It has taken on a glamor, in the sense that a bright shining light can blind us.  Most people are awed by science, but it's power to explain and explore.  And there is good reason for that, but the allure can bordr on enchantment.  

Big science is the realm of politics and power.  It is not particularly about the truth.  The examples above are about big science.

In my opinion every good practitioner is a scientist.  I see a patient.  I make a hypothesis about the cause of her complaint.  I make a hypothesis about what will help.  And then we make the experiment.

The advantage of alternative practitioners is that we rarely kill people since, by and large, our treatments are vastly more safe than drugs or surgery.  For example, it has been shown that the risk of a chiropractic adjustment is less than the risk of taking an over the counter pain reliever.

I often use intuition.  The intuition may be in the form of a thought popping into my head.  And then I test it.  I test it against my knowledge.  I may test it using kinesiology.  But the only test that counts is whether the patient gets better.

Many of the techniques I use have not been proven in a double blind study.  I will admit that I wrestled with and resisted using kinesiology for many years because I could not explain fully how it worked.  We can, of course understand much of how it works, but not all.  Yet "the proof is in the pudding."   And as a practitioner, I am satisfied if, using kinesiology, I can get people better who I would not have helped otherwise.

I do believe that kinesiology, as one example, should stand up to scrutiny.  As an example, I had a patient with persistent rotator cuff problem that resisted the best treatment from a number of practitioners.  Using kinesiology I found what I thought was a heart problem which seemed to be causing her symptoms.  When I gave her the correct supplements to support her heart, her shoulder got better after over a year of constant pain.  Subsequent medical testing showed that she did indeed have a heart problem.

I like doing lab testing because it keeps me honest and confirms my findings. 

I do not think all research is fraudulent, but I do think that what matters most is treating the patient, not the labs and not based only on the results of large clinical trials.

And I think that attitude is completely compatible with science.

Where I differ is with some people who claim the mantle of science who insist that if we do not fully understand a diagnostic technique or a therapy we should never use it.  I do not understand Chinese medicine in terms of Western science but I have seen it work wonders with patients.

I had a patient who used to say, "I don't know what your do, or how you do it but it works."   I am always willing to explain what I do and how I think it works.  As much as possible I follow science and logic, but the only thing that really counts is that it works.

Jeffrey Bland, PhD, is a biochemist who has taught a whole generation of nutritional practitioners.  He said, "The clinical trial is not a belief system or a metaphysic, but the best predictor of which therapies will transfer from one practitioner to another." 

 Axioms: 

• The body is an orderly, lawful system.  In principle it can be known.
• The body is a system which has evolved to be self correcting and self healing.
• When something is wrong, there is some block in the natural self correcting systems of the body.
• It is the job of the practitioner to find the block and support the natural healing process in overcoming it.
• Because of the level of complexity within the body itself, the social and environmental system within which it operates, the unfathomable depths of the mind and human spirit, and the limits of our understanding, we may not always be successful.
• People and animals  have an innate knowingness about what is wrong and what needs to be done to correct the problem. 
• They frequently do not trust their knowingness or may misinterpret the cues they receive.
• If we listen to our patients, they will usually tell us what is wrong and what to do about it.
• This is not to discount the importance of the practitioner's internal database of information and experience which can be equally important to solving the riddle of health.
• Models of health are just that.  They are not holy icons and have limits. 
• Multiple models may apply.  i.e. both Chinese energetics and Western biochemistry may apply.
• What counts is helping the patient get better whatever the model or process involved. 
•  Honoring the model above the well being of the patient is a form of ignorant egotism.
• Getting better is not only physical and there may be times when physical health is less important than emotional or spiritual health.

Alternative Research

I am not a researcher or a statistician, but I understand that there are relatively new statistical tools for deriving good information from small studies and which could produce meaningful results using small numbers of patients and multiple interventions.  This uses the mathematics of complex systems.   I discussed this with a medical researcher who confirmed that these tools do indeed exist and are valid, but are not accepted by mainstream science and the results would never be published.  

Dr. Manlove

Disclaimer: The entire contents of this website are based upon the opinions of Dr. Manlove, unless otherwise noted. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Manlove. Dr. Manlove encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional.

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