I just read a wonderful post by a fellow medical blogger pondering how to deal with woo when it comes from patients. Woo is very much like religion–people believe, and a full frontal attack on beliefs helps no one.
A patient of mine called me today upset about her medicines. She is elderly (but youthful), with some severe cardiovascular problems. When I met her she showed me a list of herbs and supplements she was taking. Since her blood pressure was 250/120 and she was in atrial fibrillation, I wasn’t impressed with the regimen, but it was hardly the time to discuss it. I managed to convince her to go to the hospital, despite the lack of organic offerings (I suggested that she bring her own food).
Remarkably, she felt much better after her heart and blood pressure problems were treated with mainstream, proven medicine. She is visibly torn, though. She very much wants to believe that the medicine is making her ill, and her herbs will help her.
She asked me directly today what I thought about all her potions. I responded that, like anything else, if evidence supports it, so do I. Also, the converse is true–for instance, that beta-carotene is best left in the dust bin, as it can encourage the growth of aggressive tumors. I don’t think she will ever be satisfied by her treatment, despite feeling better, but the ongoing, respectful dialog has so far kept her taking her medicine.
I am, however, quite frank about certain types of alternative treatments when sold to patients by quacks. I usually tell them right out that they are wasting their money on unproven woo that hasn’t helped them. My patients are used to my frankness, but sometimes it’s the right approach, sometimes it’s not.
Since quacks have infinite resources to trick our patients, it unfortunately falls on us to try to educate them in a way that keeps them on our side.
And for the conspiracy theorists out there, remember–I’m not running out of patients. I don’t gain anything except the health of my patients by steering them away from woo.
September 4, 2007 at 5:22 pm
I believe that alternative medicine does become a religion to many people. They don’t realize it of course and, as you point out, it’s counter-productive to confront them head on.
Weaning off woo is a slow process that takes time and patience. You can’t educate someone in a 5-minute conversation.
That’s why medical blogs like this one are so important. In a setting like this, you have time to present a sound logical argument… and the reader can take their time absorbing and considering the information in a non-confrontational manner.
Dean