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Old 03-19-2007, 06:44 PM   #22
Jae Onasi
@Jae Onasi
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Answering a bunch of stuff here....

Homeopathic medicine--just open a bottle of Perrier and hand it to the patient, you'll get the same result.

Originally Posted by
placebo effect
n. The beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itself.
Placebo effect works about 30-35% of the time. It does not mean the placebo pill itself is effective (because it's usually nothing more than a sugar pill). It just means the patient got better because he a. believed the pill would make him better or b. his body healed itself.

Believe me, docs do not just throw their hands up in the air because of ego if the usual treatments aren't working. If I have a person who's just not responding to a treatment appropriate for their condition, I send them to the appropriate sub-specialist. If the specialist can't figure it out, that person ends up getting sent to one of the university centers that are researching that particular condition, and they go from there.

Why don't doctors prescribe alternative treatments on a regular basis? There are several reasons.

1. We don't want to make the situation worse (or keep it from getting better) by using something that may have no value. Sometimes people discover things on accident that make a particular condition better, but those things go through a lot of study before they become part of the standard of care.

2. We often don't use herbals because the potency can vary tremendously, ie the amount of the effective ingredient can vary wildly from plant to plant, which means it can vary wildly from pill to pill as a result. You don't want someone getting varying doses, and especially don't want doses that aren't enough to be adequately effective or worse are too strong and cause overdose damage.

3. In the US, at least, using alternative 'treatments' that are outside the acceptable standard of care makes us wide open to malpractice lawsuits. If I try to prescribe a homeopathic or herbal medicine for an aggressive bacterial eye infection, and the person's eye infection gets so bad that he ends up losing some portion of his sight in that eye, I would be held liable, because use of homeopathic eye drops is not considered an acceptable standard of care.

How are these standards of care developed? They're created by the academic leaders in that particular medical specialty based on the tons of research going on in the field, and standards are usually established only after studies show the various medications or other treatments are effective. Some treatments get fast-tracked in the US if they show a reasonable effectiveness rate (AIDS treatments being the most noteworthy), but they're still subject to a lot of study, and some standards of care may change again based on later research. Every common condition has a set of treatments that are considered acceptable/efficacious. For extremely rare conditions that don't have an established standard, or for those patients who are not responding to the conventional treatments in established standards, what happens is the specialist will usually study the condition, confer with other experts in the field, study the disease, how it works, its cause, etc., and in conjuction with pharmacologists (or other experts for non-drug remedies) develop a potential treatment plan. Those get tested to see if they work, and if so, further studies are developed from that. There are standards on how experimental treatments are established and tested, so it's not a 'let's throw x at the problem and see if it works'.
I take a couple vitamins/herbals myself, but only because I've seen some decent studies indicating their benefits, have seen they have a low risk profile, and chatted with my doc about it.

Aspirin--is a derivative of the active ingredient found in willow bark.

Marijuana--in the past has been used for a. treatment of nausea in chemotherapy and b. treatment of glaucoma. I don't know much about oncology other than to say the treatments have gotten much better and the anti-nausea meds have improved tremendously, so it's not as useful as it may have been at one time. With glaucoma, 40 years back the only real treatment was pilocarpine, and if that didn't work the patient was screwed. Marijuana does have the effect of lowering pressure in the eye (high pressure contributes to the damage), and so some people did find a benefit from it when the one conventional treatment failed. However, the number of effective treatments for glaucoma have just exploded over the last 10-15 years, and so even if it was legal, I'd probably never even suggest it as an option.

Codeine--can cause deadly reactions in those who are allergic, just like any medication or herbal remedy can cause such allergic reactions. Codeine and its analogues are great pain relievers for those who are not allergic, however.

From MST3K's spoof of "Hercules Unchained"--heard as Roman medic soldiers carry off an unconscious Greek Hercules on a 1950's Army green canvas stretcher: "Hi, we're IX-I-I. Did somebody dial IX-I-I?"

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