As goes Vermont…

I hadn’t realized that Vermont has passed a law requiring insurers to cover naturopathic care.

We’ve covered extensively the quackery that is naturopathy, but really, if a patient chooses to see a quack, it’s their business. But with health care costs soaring, requiring insurers to pay for voodoo is a rather bad idea. Already, many plans cover chiropractic, another unproven treatment. Throwing more health care dollars at more unproved and disproved treatments will help no one (except the quacks who have boat payments to make).

There are many causes of high costs of health care: we hate the idea of rationing, so many American cities have more MRIs than the whole country of Canada; we incentivize doctors and others to order tests and treatments that may or may not be necessary; we inadequately reimburse preventative care. The list goes on.

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Thanks for playing

First, thank you for all the wonderful comments on yesterday’s post. I never really know which posts are going to rake in the comments—my favorites are usually the quietest, and some of my quickies bring ’em in by the dozen. According to my uber-seekrit data, I’ve had two unique visitors to my naturopath post. As erv would say, “UR DOING IT RONG!11!!”

Anyway, I would like to thank my commenters on that post. Even those of you who I think are terribly wrong were at least civil.

I’d love to address all of the issues raised in the comments but I’m far too lazy busy at the moment, but I’d like to focus on a few issues.

First, I still haven’t found an over-arching authority over naturopathic education and practice equivalent to real doctors. Second, much of what I’ve read so far follows an new and interesting path—a large number of very intelligent, very well-educated, very well-intentioned shamans.

Anyway, let’s examine some of the misconceptions raised in the comments.
Continue reading “Thanks for playing”

Can’t get into med school? Legislate your own doctorate!

I guess it’s not just doctors watching this one—an alert reader and a fellow SciBling both picked up on this one. Apparently, in my neighboring state of Minnesota (really, check the map), home to Greg Laden, PZ Myers, and lutefisk, doctor wannabes have legislated themselves into “doctorhood”. You see, there is this entity called a “naturopath”, or “naturopathic doctor”, which is some sort of shaman that likes to think that if you study woo long enough, it becomes science.
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First, do no harm—Chiropractors, are you listening?

As you may have read earlier, the only thing chriopractic has ever really been shown to do is to help low back pain about as well as conventional therapy. That doesn’t stop chiropractors from doing whatever they want. It sure seems harmless enough, though—you back or neck hurts, some guy moves it around, and you feel better—and all without drugs! What could it hurt, right?

With any medical or physical intervention, things can go wrong, sometimes horribly wrong. For example, when I treat someone with an ACE inhibitor, I run the risk of causing a serious drug reaction. But the benefits far outweigh the risks. Also, I know what problems to look for, and how to treat them. These drugs save kidneys, hearts, and lives, so the payoff is worth the small risk.

What of chiropractic? Well, Harriet Hall over at just saved me a lot of time. Vertebral artery dissection (VAD), a rare type of stroke, has been linked to chiropractic neck manipulation. It’s hard to count precisely, but the Canadian literature has some decent reports. What the reports show is that there is a clear link between VAD and chiropractic. How many of these strokes are caused by neck manipulation is less clear, and that’s where some serious crankery comes in.

Some chiropractors will tell you that if there is a risk, it is quite small, so why worry? But about 10% of people with VAD die. That’s DIE. And they are often young (average early 40s).

There is no proven benefit to chiropractic manipulation of the neck. It is associated with a rare and very dangerous type of stroke. In judging the risk/benefit ratio, the answer here is clear—don’t let a chiro touch your neck—never, never, never.

Physical therapy+massage+woo=chiropractic

This is a reprint from my old blog that will provide necessary backgroud for an upcoming story. Thanks for your indulgence.
Blogging on Peer-Reviewed ResearchI am often asked my opinion of chiropractic care. My usual answer (based on evidence) is that it can be somewhat helpful in the treatment of low back pain. That’s it. Any further claims are complete and utter bullshit. Many chiropractors practice ethically, and recognize the correct scope of their abilities…many do not.

Adapted from RationalWiki
Chiropractic is the theory and practice of correction of “vertebral subluxation processes” to treat and cure disease. It was developed in the late 19th century, just before the development of modern medical education in the United States.
Chiropractors subscribe to the theory of “vertebral subluxation”. This differs from the medical definition considerably. An orthopaedic (real) subluxation is a painful partial dislocation of a vertebral body. A “chiropractic subluxation” is an asymptomatic misalignment or a “vertebral subluxation complex” thought to be a cause of disease. The mechanism posited is usually the blocking of nerve impulses from spinal roots, or some such nonsense. Such a subluxation has never been proven to exist.

Lest you think that this unproved hypothesis has died away, in July 1996, the Association of Chiropractic Colleges issued a consensus statement that:

Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation. A subluxation is a complex of functional and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

This hypothesis has never been tested, and ignores significant anatomical reality, such as the fact that much of the nervous system does not pass through “subluxations” in any way. This especially applies to the autonomic nervous system that “influences organ system function”.

According to the American Chiropractic Association:

The ACA Master Plan, ratified by the House of Delegates in June 1964 (Amended June 1979, June 1989, July 1994 and September 2000), and will govern future policies of ACA as quoted:
“With regard to the core chiropractic principle, which holds that the relationship between structure and function in the human body is a significant health factor and that such relationships between the spinal column and the nervous system are highly significant because the normal transmission and expression of nerve energy are essential to the restoration and maintenance of health.

That’s basically a re-statement of subluxation theory without the “s” word. It’s also patent bullshit.

So the chiropractors haven’t given up the absurd theory behind their “profession”—but does it work despite the poor theory? After all, outcomes are what count.

Continue reading “Physical therapy+massage+woo=chiropractic”

GM foods cause delusions

Here at denialism blog, we’ve written a bit about so-called Morgellons syndrome. Every once in a while, when I tire of sanity, I scan the news for more Morgellons madness, and when it comes to madness, Mike Adams never disappoints.

In his latest foray into paranoid idiocy, he tries to link this non-existent illness to genetically modified (GM) foods. And what abuses of logic does he use to create this connection?

He starts with the classic “begging the question“. The entire first section of his article simply assumes that Morgellons exists as some sort of unique pathology. On what does he base his assumption? On two things: anecdotal reports, and the fact that it is being studied by the CDC (at the urging of “interest groups”). The CDC study has not been completed, and there is still no reason to think that Morgellons is anything other than delusions of parasitosis in a shiny new polyester suit. That doesn’t stop him from creating broad, unsupported connections.

He quotes a noted fake expert, Randy Wymore, who has spent a great deal of time studying Morgellons—at least, he says he has. He hasn’t really published anything to support his claims. Then he quotes many un-notable people who have supposedly analyzed Morgellons “fibers”—-this has never been done systematically and published. All that exists is anecdotal reports of individual “researchers”. According to some of these folks, they have found Agrobacterium DNA in these fibers.

And then he stops.

Because I’m not a paranoid conspiracy theorist, I had to look this up. Apparently, Agrobacterium is a favorite bugaboo of the wackier wing of the anti-GM food movement.

This is a pretty classic piece. In trying to link two somewhat wacky ideas, a crank uses smoke and mirrors to distract from the fact that he has no logical argument. But the reason to look for logical fallacies in an argument is not to immediately invalidate an idea—it is to evaluate whether or not a particular argument is prima facie invalid. Might there be a link between this new form of delusional parasitosis and GM foods? Sure, I suppose it’s not beyond the realm of the possible. The point is that his reasoning does not support his assertion.

When reading about assertions that seem a little strange, it pays to parse the argument for logical fallacies and denialist tactics.

That is, if you are interested in the truth.

Is injecting yourself with a human pregnancy hormone a good idea?

Certainly not! But unfortunately we need to look a little more closely.

It’s been a while since I’ve posted on hard-core woo, and I miss it, so here’s a little tip for you: if a diet sounds too good to be true, then it is. Weight loss is very hard, unless you are very sick. In fact, a colleague of mine ran into a friend who had lost a lot of weight and said, “You’re OK, aren’t you?” As an internist, when I see dramatic weight loss, my first thought is cancer, not a wildly successful new diet. But all of us overweight types wish there were an easy way.

There isn’t. A friend of mine heard about a diet that involves extreme calorie restriction along with injections of human chorionic gonadotrophic hormone (hCG). My first thought was if you restrict yourself to 500-800 calories per day, it doesn’t matter what you inject—you’re going to lose weight. But as is the usual pattern with woo, each time you try to rebut it, there is a new claim. For example, when you point out that starvation diets will always make you lose weight, they say that this one makes you not hungry. When you say that it sounds dubious, they say that it not only makes you not hungry, it causes you to somehow lose weight where you want it, and keep it where you like it.

So what experts are behind this revolutionary diet? Well, the biggest proponent appears to be Kevin Trudeau, the infomercial guy who keeps going to jail for fraud. What kind of claims is he making?
Continue reading “Is injecting yourself with a human pregnancy hormone a good idea?”