Thursday, February 01, 2007

Medical student blogger: Why all the fuss about medschool woo?

Orac, Kevin and I were taken to task for “whining” about the increasingly pervasive uncritical promotion of pseudoscientific fluff in medical school curricula. The author of Over my med body sets up this straw man: “They’re whining as if this is the most scandalous thing to have happened to American Medicine” and goes on to cite mainstream medicine’s questionable ties with drug and device companies.

The promotion of pseudoscience by academic medicine is unethical to be sure, but no one’s taking the position that it’s “the most scandalous thing to have happened to American Medicine.” Let’s get one thing straight. I acknowledge that there’s plenty of questionable promotion in medicine outside the field of woo. If my outrage about woo seems selective it isn’t because I don’t share the concerns about other types of ethical breaches.

I focus on the problem of woo for a number of reasons, one being that it’s under appreciated. The ethical problem of medicine’s ties to drug and device companies is on everyone’s radar screen. There are books, web sites and a documentary movie devoted to the problem. They cite legitimate issues, but I choose not to join the chorus because it’s being beaten to death while the problem with woo is largely ignored. Moreover there are organizations such as the American Medical Student Association whose concern about the drug companies undermining evidence based medicine seems disingenuous when they invoke chakras and promote therapeutic touch (pp43-46, Between Heaven and Earth) and promote chelation therapy for arthritis, lupus and spider bites (p 20, Complementary Therapies Primer).

Over my med body goes on with “Either way, many patients use CAM, whether I think it’s a good idea or not–and honestly, I’d much rather have some sort of idea about what CAM is and what I need to know about it than be ignorant of it completely. Some herbs affect medication dosages, for instance.” Fair enough. Medical students need to know what’s out there in the world of CAM so they can be aware of drug interactions and other consequences of alternative modalities. That’s not the type of teaching I object to. But as I’ve documented here, here, here, here, here and here, and has been systematically reviewed here, the “teaching” of medical students concerning CAM is largely promotional, unscientific and uncritical. That’s a big problem. Maybe it’s not the worst problem facing medicine, but it’s a problem that needs to be exposed because it’s not being addressed.

Update: Orac beats me to it, and weighs in here.

1 comment:

MedStudentGod said...

I completely agree with you on this front. Woo/ CAM should not be a component of medical education. If you're concerned about the interactions then take it upon yourself to research those. I've received a little bit here and there in my school and think of the time wasted to preach this "voodoo".

Anyway, here's one medical student who agrees with your side.