Skepticism

Ask Surly Amy: Alt Med and and an OB/GYN

Hi Surly Amy,

I’m fairly new to skepticism; among other things, I was totally into alt-med woo. I’m now trying to make evidence-based health choices. So here’s my situation: I saw a new OB/GYN today. She was really nice and comforting, listened well, and was collaborative when coming up with a treatment plan for my (complicated) issues, taking into account my concerns. The only downside was that, in addition to recommending good (science-based, workable) options, she also encouraged me to try acupuncture and Traditional Chinese Medicine. There was also some alt-med stuff around the office (advice on a natural home-birth experience, “Mothering” magazine). Other than this, it was a positive experience and I liked her. I’m worried I’m just oversensitive to alt-med stuff, having recently come out of being very involved in it. Should I be concerned about having a doctor who embraces some woo, eventhough she also practices real medicine? Thank you!

~Erin

Dear Erin,

Get a new doctor. Today. Seriously. Go. Find a new one.

This message you sent made me so angry I had to answer it right away. First of all, be VERY proud of yourself for being an intelligent skeptic and noticing that there was something awry in the doctor’s office. Also, congratulate yourself for knowing that you deserve legitimate science-based care and for knowing the difference between alt med and legitimate medical practices. Now, tell yourself that if something goes wrong with you, or if indeed something is wrong with your health and you need treatment that you deserve the best, most reliable, peer reviewed proven treatments that you can get. You also deserve a doctor who understands the difference between potential medicine and placebo effect and actual medicine and long term benefit.

This cup of tea may make you feel better temporarily but it will not cure HPV.

I’m sure the doctor you visited seemed willing to listen and appeared to care. The Alt med-crowd seems to have really cornered the market on time spent with patients and the science based medical establishment in general could learn a thing or two about bedside manner from this, but what you really need isn’t herbal teas or acupuncture. You need someone you can trust to help you make serious decisions with your health care that can effect your quality and quantity of life and the life of a child should you conceive. This is no joke. It’s not tea time with friends. It’s a doctor patient relationship and a doctor should be trustworthy and should know better.

It’s one thing for a medical professional to acknowledge that a patient is seeking alternative treatments outside the office and to not interfere with that but it is quite another thing to have a doctor actively pushing these treatments from within the office. Recommending these treatments displays a complete lack of understanding of science based medicine and should not be tolerated. My advice? Find a better doc.

Good luck on your search and I hope you quickly find a doctor that understands the processes of the scientific method and not just how to pacify a patient.

And congratulations on educating yourself and being a skeptic. I’d hug you right now if I could!

Got a question you would like some Surly-Skepchick advice on? Send it in! We won’t publish your real name, unless you want us to and creative pseudonyms get bonus points! Just use the contact link on the top left of the page.

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Amy Roth

Amy Davis Roth (aka Surly Amy) is a multimedia artist who resides in Los Angeles, California. She makes Surly-Ramics. She is the fearless leader of Mad Art Lab. Support her on Patreon. Follow her on twitter: @SurlyAmy or on Google+. Tip Jar is here.

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46 Comments

  1. Yeah, except that acupuncture does help to relief pain, even under scientific methods. I really really want to get acupuncture done again, it’s so much better than a message. I just wish there were people doing it who don’t try to put me on their chinese food “system” diet, too…

    1. Great. Acupuncture sometimes relieves pain temporarily. It is not a cure nor is it better than placebo in the mass majority of circumstances. Nor is it better than sham acupuncture in the mass majority of circumstances. It is also subjective and people are reporting how they feel as opposed to being objectively better. I could recommend a hot bubble bath were I a doctor or in a position of authority and a lot of people would report feeling much better temporarily. That does not mean that acupuncture or a bubble bath meet up to the high quality of care I expect and we ALL should receive from the medical establishment.

    2. The evidence that acupuncture does anything is very flimsy, especially given that any distraction has been shown to reduce pain. Music, chocolate, swearing, pain (yes, pain can distract from pain), and happy thoughts for example. Discomfort, in general, is highly subjective.

      What you’re left with is a magic-based treatment with no biological mechanism that barely rises above statistical noise. The only remotely successful acupuncture studies I’ve ever seen all introduce new variables (electrifying the needles, using lasers, etc) and even then, the results are pretty sad or patently negative.

      Plus, it should strike you as silly that this ancient remedy that can purportedly cure all that ails you suddenly only treats the lowest hanging fruit of human maladies when under the slightest modicum of scrutiny.

    3. No, it doesn’t.

      It’s actually most likely the practitioner-patient encounter that decreases the subjective experience of pain. It’s not that acupuncture does anything to relieve pain, it’s that knowing that someone is spending time paying attention and taking your pain very seriously helps you feel better. This is also the case with biomedical providers and patients (see two bottom links)

      For example: “TCA was not superior to sham acupuncture. However, acupuncturists’ styles had significant effects on pain reduction and satisfaction, suggesting that the analgesic benefits of acupuncture can be partially mediated through placebo effects related to the acupuncturist’s behavior.” (http://www.ncbi.nlm.nih.gov/pubmed/20506122)

      And: http://www.cmaj.ca/content/152/9/1423.short
      And: http://www.springerlink.com/content/j4703v52kxw3p7xg/

    4. That is rather like wishing that people selling UFO tee shirts didn’t also believe in UFOs, while claiming that its the only sort of shirt you are comfortable in. There is a reason they are trying to sell the other woo, along with what you find “useful”. And, as Amy points out, its indistinguishable from faking the acupuncture.

      It should be noted, btw, that the “principle” behind the treatment is the same used with “pressure point” therapies. Guess what? The only difference between them is that “most” acupuncturists follow the Chinese system of identifying the supposed spots to use. There are a dozen “pressure point” systems out there, and none of them use the same points as each other, never mind the acupuncture system, yet they tend to claim exactly the same effect, as “how they work”. They also all do work, just as much as acupuncture does.

      This tells you one of two things:

      1. Poking people randomly, any place you want, works just as well as thousands of years old Chinese chi/chakra/what-ever points do.

      2. Its people’s belief that those people are not poking them at random that is having the effect.

      The former is just absurd. The later, a lot of people don’t like, and the “science based” medical establishment tends to call, “unethical manipulation”. Which is why they have a damn hard time finding “good” ways to apply placebos, save as part of tests, where patients are allowed to know that they *might* be taking fake medicines.

      1. Alright, so I think it’s number 1. So where to I go to get a rational person ram needles in my back without woo then?
        I mean, I don’t even care if it’s placebo or not. All I know is that mainstream painkillers do nothing for me to relieve pain (how many doctors have told me “that’s not possible”…) while acupuncture does, despite all the woo.
        I don’t believe in TCM but I do disagree that homeopathy and acupuncture are supposed to be the same kind of evil. There is no study at all that would give homeopathy any credibility besides placebo effect, while there is for acupuncture.

        Please care to enlighten me while staying openminded to a practice that has studies with mixed results, some pointing at obvious health benefits beyond placebo, and that has helped me personally is not being critical?

        http://www.urmc.rochester.edu/news/story/index.cfm?id=2880

        1. Uh, from that link you gave:

          “scientists were able to triple the beneficial effects of acupuncture in mice by adding a medication approved to treat leukemia in people.”

          You don’t see a problem here?

        2. I was fortunate enough to be in a relationship with a professional piercer that was willing to do temporary surface piercings on me. If you have a significant other they can easily learn acupuncture. Surface piercing is a little harder and requires some hands on training. The body modification and the BDSM communities are good places to look for someone that would be willing to do that.

        3. Oh, I should mention that surface piercing has a different set of dangers. You’re much less likely to end up with a needle in your heart, but more likely to get an infection. I still think the good night’s sleep that comes from not giving your money to scam artists is worth it.

        4. Get a good massage. Seriously, as noted, the big thing that kicks in on these is not any medical effect, but being the subject of someone else’s attention and care. So pay for that up front–a decent masseur will be able to get much the same result, and probably charge a fraction of the price.

    5. I used acupuncture for non-medical purposes for a while. I actually stopped after I read a study in which researchers looked at some of the quality issues with the disposable needles. Many had tips that were off center, and they also observed that many needles left a residue on tissue paper when they were wiped down. The people that make these needles don’t really worry too much about quality.

      It’s also pretty dangerous to have needles planted vertically in your skin, a minor accident could drive one of those needles through your skin and into important organs. This has unfortunately killed a number of people.

      I ultimately made the decision to find an alternative that didn’t require giving money to alt-med scammers.

  2. True story: I’ve been visiting plastic surgeons lately in preparation for a breast reduction. Last week, in a consultation with a plastic surgeon, I was informed that he would provide me with a “homeopathic arnica gel that would greatly reduce bruising after the surgery.” I prepared to say my niceties and move on to the next surgeon, but for some reason I decided to speak up. I threw out a quick sentence that was something to the effect of, “you know, I’m not sure this is the right practice for me. I believe in a science-based approach to medicine, and the inclusion of homeopathy is kind of a deal breaker.” The relief on this guy’s face was hilarious. He then gushed for a moment about how refreshing it is to hear that from a patient, and said that they provide that stuff because their patients expect it. I live in Austin, which is a notoriously hippie-centric city, but I suspect this is a problem cropping up all over – physicians pushing things that they know are nonsense because they believe it will give them more credibility in their patients’ eyes.

    I appreciate that he doesn’t believe the kookery, but I still don’t think I’ll go with a practice that prefers to sell it as a “service” rather than educate its patients about the nonsense.

  3. Personally, if I had a doctor tell me I should look into alt med I would feel like they weren’t taking my medical needs seriously. They may as well pat you on the head and give you a lolli, “Here you go, this’ll make everything aaaaaall right.”

  4. I don’t agree. If you feel that she’s fairly partitioning science-based medicine from the bunk, I don’t think it’s unreasonable to keep seeing her. If she excels at other aspects of being a doctor, it may be worth dealing with a few casual suggestions that you know aren’t well-founded. One can recommend crap-based medicine while still being an otherwise excellent doctor as long as the woo is stricly reserved for adjunct therapy.

    If, however, you get the impression that she’s substituting woo for science, I’d recommend that you get the heck out of there. You could also mention that you don’t want any alt-med treatments and gauge her response.

    Incidentally, I’d love to see a study comparing doctors who recommend woo compared to those who do not. Based on my experience, I’m not so sure that avoidance of woo correlates strongly with being a good doctor.

    1. How is she fairly partitioning it while simultaneously advertising and recommending it? You are not an excellent doctor if you are recommending treatments that there are no evidence of efficacy for. You are either uninformed, lazy, ignorant or trying to make an extra buck off unproven treatments.

      1. She may be an excellent diagnostician. She may have superb knowledge of the state of medical science. And she may be more patient than most doctors. If this is the case, I wouldn’t necessarily drop her just because she also recommends looking into some alt-med.

    2. A lot of doctors think their patients will want to hear this stuff. Like other posters have said, even if you leave her practice, speak up. I know a number of doctors who don’t think it’s worth it to educate patients because it just pisses them off and makes them less likely to return to the doctor when they need treatment later.

      I work in health care in San Francisco, where woo is pretty routine and it’s more or less socially unacceptable to say this stuff is b.s. I would actually agree with posters that say it’s perfectly possible to be a good doctor who believes in some woo as long as it’s kept out of their practice. It seems counter-intuitive, but usually doctors that recommend acupuncture know much less about acupuncture than science based medicine (or they wouldn’t be recommending it!).

      However, I personally would still discuss alt med with my doctor because the stress of dealing with such a personality clash would be too much for me.

  5. I don’t believe that home birth should be lumped in with alt-med. I am a very skeptical person, but the more I learn about home birth as a safe option for some women, the more I support it. Many feminists and skeptics support home birth because in some cases, it can be a better experience for both mother and child. I support women having as many options as possible. Many developed countries have a larger ratio of nurse-midwives to OB’s and have better infant and maternal mortality rates than the U.S. Our c-section and episiotomy rates are embarrassing compared to other countries. In a lot of ways, birth has been over-medicalized to the point that we forget it’s a natural process. In most cases (“normal” or low-risk pregnancies) our bodies know what to do. Half of the women around the world give birth unattended or with only a friend or relative with them (I’m not saying this is good, it’s very dangerous!). We need more trained midwives and more options for women!

    1. I think home-birth is worse than acupuncture or other nonsense used as an adjunct treatment.

      From Science-Based Medicine:

      Its authors boast that it is one of the ten most downloaded papers from the British Medical Journal (BMJ). That makes it even more unfortunate that the conclusions of the paper are directly at odds with the findings of the paper. Outcomes of planned home births with certified professional midwives: large prospective study in North America by Kenneth Johnson and Bettye Ann Davis is the premier paper on the safety of American homebirth. It claims to show that homebirth is as safe as hospital birth, but actually shows that homebirth has nearly triple the neonatal death rate of hospital birth for comparable risk women.

      Alt-med used strictly as adjunct therapy doesn’t, as far as I know, lead to an increased risk of adverse outcomes even if it’s a waste of the patient’s time and money.

      We don’t need more midwives. We need to make the hospital experience better.

      1. To be fair, Dr. Amy Tuteur isn’t the most unbiased source of information about midwifery and home births. It’s something she’s built her name crusading against, and has routinely dismissed studies that go against what she believes while misrepresenting studies that go with her beliefs (see http://theskepticalmother.blogspot.com/2011/10/will-real-dr-amy-please-stand-up.html).

        Also, Michelle recently wrote a post on home birth that might be of interest to you: http://skepchick.org/2012/01/nuance-of-risk-and-homebirth/

        And, there are plenty of alt-med treatments that may “lead to an increased risk of adverse outcomes.” See: http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/c.html and http://www.umm.edu/altmed/articles/st-johns-000931.htm

        1. You should know that “The Skeptical Mother” is anything but. Don’t get fooled by buzzwords. This woman is beyond silly and, among other things, believes that positive thinking ensures good outcomes, that serious complications should be ignored, and that “midwives” who have negligently killed women and their children should be permitted to practice unhindered.

          1. And yet she provides evidence of how Amy Tuteur is a hateful bigot with an ideological bent parading around as a skeptic. I’m not endorsing The Skeptical Mother’s beliefs. You can look at the evidence in the posts about Amy Tuteur get an idea of who she is.

            My point to Chexuma was that they are overstating and oversimplifying home birth, just as Amy Tuteur does. And this is why I linked to Michelle’s post on the topic, because I think it gets at the nuance of the issue. Dismissing all home birth and midwifery as quackery is not supported by the evidence.

          2. And, by the way, I’d love to see some links supporting your claims against the Skeptical Mother. Just the few posts I’ve read on her site have not been anything like what you’re saying. Granted, I haven’t read through the entire site, nor do I have the time to. But I will remain *ahem* skeptical of your accusations unless you can point me to something to convince me otherwise.

          3. Try reading her website. She’s a loon.

            And, the problem with homebirth is very complicated and a cursory reading of Dr. Tuteur’s site reveals this. The biggest problem is of course being away from emergency services and that a quick transfer is frequently not quick enough http://www.10centimeters.com/friday-fallacies-the-hospital-is-just-minutes-away/. The next issue is the culture of nonsense that pervades nonnursemidwifery and the spotty regulation of these substandard “practitioners” who then convince women to avoid prenatal testing and prophylaxis for basic complications that can prevent more serious interventions. The evidence is that birth with these hobbyists is killing people. And state and national level data is very clear on that.

          4. WPBD- It amazes me that you could lie so blatantly. As Will asked, where is this evidence that I have ever said these things? First of all, I absolutely do NOT believe that negligent midwives should be able to practice unhindered and that major complications should be ignored. Pleas post a link to where I ever stated such things. As far as positive thinking goes, I do believe, as someone who suffered from anxiety attacks and is well aware of the impact that our own fearful thinking has on the body, that the *experience* of birth can be affected by fear. I have never stated that someone is assured a safe and perfect birth, with positive thinking. But I do personally believe that fearful thinking can make our *perception* of the birth experience worse.
            That’s beside the point, though. And, if you are going to attack me because I believe in positive thinking, I also hope that you will question the legitimacy of Dr. Amy. It’s pretty obvious that Amy is out there. Her *own* words have shown time and time again, that she is anything but rational. And, *she* is the one who wants everyone to believe that she is the final say on just about every subject that she shows interest in. According to her, she is never, ever wrong.
            But I can see how you would not be interested in that since you are one of her biggest fans.

          5. @theskepticalmother

            WPBD- It amazes me that you could lie so blatantly.

            Holding an opinion that is different from your own does not make one a liar. @WPBD stated the opinion that you are a loon and, while that’s not very nice, it doesn’t mean they are lying. In fact, I sincerely believe they mean what they said.

  6. I have become pretty sick recently with three very complicated diseases.

    I was pretty much thrust into the whole scene and (thankfully) got brand-new insurance thanks to my husband’s union.

    I see six doctors, and several others at the hospital when I’m there. From the very start, I asserted to as many professionals as possible that I was only interested in evidence-based medicine, and I would have no visits from clergy.

    They ask these things every time I am given blood, which is quite often. Now, I know that in my community, there’s a good chance that I’m going to get fundamentalist Christian and Mormon nurses. I deal with it by reminding myself I am not ashamed of who I am, and telling people who I am in a very deliberate, unapologetic manner.

    I used to worry so much about what others thought, and when I found myself in an emergency situation 10 years ago, I let them assert their woo and religion on me.

    So now, as an adult, I realize: I’m not ashamed of being an atheist or a skeptic, so why should I act like I am? And you know what? I always receive top-notch service. Maybe one of the nurses tries to suggest a lot of Christian music to me, but that’s ok. She likes terrible music, and I pretend to appreciate her suggestions a little bit. Give and take.

    But not when it comes to my health. Or my lack thereof.

  7. Meh, I completely disagree. I live in the Czech Republic and woo is broadly accepted, although not taken seriously. Magazines about all kinds of stuff are sometimes present in doctor’s offices and doctors regularly recommend what are mostly placebos or non-medical remedies (lots of rest, herbal tea and vit-C?). However, science-based medicine is always placed first at any doctor’s you visit. They offer science-basaed treatment but if there is none they offer a placebo (alt-med/herbal/placebo).

    Essentially what often happens is that the doctor provides what people want – they want alt-med, enjoy acupuncture, find homeopathy consoling, etc. Your GP’s job IS often providing placebos so I wouldn’t reject them based on that sole criteria.

    Your advice is like advising rejection of a doctor or other health professional based on their religion (belief in woo) in a highly religious area.

    I’d say: make it clear whenever your doctor recommends alt-med as a placebo, that you’re not interested or procure your own placebo (herbal tea etc.). What is a game-changer is if the doctor recommends alt-med as a primary treatment, or if the doctor shows ignorance or contempt for science-based medicine.

    1. dxman

      02.24.2012

      Reply

      Meh, I completely disagree. I live in the Czech Republic and woo is broadly accepted, although not taken seriously. Magazines about all kinds of stuff are sometimes present in doctor’s offices and doctors regularly recommend what are mostly placebos or non-medical remedies (lots of rest, herbal tea and vit-C?). However, science-based medicine is always placed first at any doctor’s you visit. They offer science-basaed treatment but if there is none they offer a placebo (alt-med/herbal/placebo).

      Essentially what often happens is that the doctor provides what people want – they want alt-med, enjoy acupuncture, find homeopathy consoling, etc. Your GP’s job IS often providing placebos so I wouldn’t reject them based on that sole criteria.

      A bit problem is that doctors are not even “expected” to be scientists. My father recently joked that, if he had to pick a new doctor, he would pick the one that used to be a veterinarian. Why? Because those people have to have a broad idea about how different species are similar, and different, and **why**. A GP almost doesn’t have to know jack about anything, beyond which tests to run, and what list of diseases “might” correlate with the results of those tests. Many GPs don’t even study much, beyond what was needed to get a license. They certainly do not, and usually can’t afford, even if they wanted to, to either a) spend a lot of time perusing places like PubMed, or b) having expensive, often over priced, medical journals delivered to them. They might not get their “new” knowledge from anything different than you do, which could be:

      1. Sales pitches from Pharma companies, who would rather they use the “expensive” new product, than an older, less cost effective to produce, but proven medicine (shortages happen often due to this, since only about 3 companies in the world make all the generic, and low cost, **staple** meds, and they have run into everything from the inability to produce enough, to failures in product control, resulting in contamination, and loss of entire shipments as a result).

      2. Demands by insurance agencies that they provide you with ineffective/less effective things, instead of what is needed.

      3. The “Vital Signs” section of a certain science mag, which documents something that happened to another patient some place.

      Oh, and 4. The articles in that same magazine, which while mostly accurate, tend to be incomplete, not always 100% correct, and are targeted at everyone *except* doctors.

      They simply don’t have the time, given patient loads, and paperwork, to keep up on everything they might, if they had to actually deal with such things, working in a large hospital, or even a research hospital. And, if they don’t know it themselves, the “default” result is to send whom ever has the problem to a dozen specialists, who don’t even know the whole picture. Heck the tech that did one exam on me recently did so in a room that flat out *said*, “Your technician cannot answer questions about what the results of the tests are.” Not won’t, or shouldn’t, or something else, but “can’t”. As in, they are trained to take the pictures, but its still up to someone else, like your GP, days, or even weeks, later, to find something in them. So much for “specialists”.

      The net result of this is, in, I am am pretty sure, one of the Vital Signs articles, talking about a patient that very nearly died, but was smart enough to go to an emergency room, after weeks of his doctor treating him with herbal supplements, which the GP had “read some place” boosted a persons energy, and concluded that the symptoms, against all probability, was due not to a major medical problem, but purely “low energy”. What ever the bloody heck *that* constitutes are a diagnosis. He might as well been saying “ill humors” and suggesting the man wear garlic around his neck, to ward of vampires, for all it had anything to do with actual medicine.

      And that is why there is no bloody place, at all, for this kind of BS in a doctors office. They might not be killing you, but someone out there isn’t getting treated for a real problem, and it might just be the next fool that walks into the same office, because they “symptoms” match some ancient Chinese list of conditions found in people being haunted by Jiang Shi, or something.

  8. I would also disagree about changing doctors immediately. I live in a place where there are very few pharmacies or doctors’ offices free from woo (France). That doesn’t mean they’re unaware it’s woo, because as people have pointed out, these people have to make a living. GPs aren’t the kinds of doctors who are rich, at least not where I live, and in the city, there’s plenty of competition. I agree that I would respect them more as *people* if they took the principled stand and informed patients about woo instead of indulging in it, but I don’t judge and I don’t assume they’re bad doctors because they made a business decision. None has every proposed woo to me unless all conventional options were exhausted, and with only one exception, I’m almost certain they were using it as a placebo.

    Now I have to decide about the one who genuinely believes in homeopathy. But you have to remember that doctors are *not* scientists. They are not even trained scientifically in most cases. (I used to teach undergrad physics to pre-meds, and I can tell you just how scientific they are not.) What they are is highly trained in medicine. They have a great deal of rote knowledge and training in a set of treatments. They can be very good at applying that knowledge without knowing that the physics of homeopathy is bunk.

    1. Are you honestly suggesting that we should excuse medical doctors for either not understanding how the mechanisms of the human body work or for pretending not to understand how medicine works? I’m not going to forgive someone who thinks that it is plausible for magical energy points in the body to transfer information or that water is capable of possessing memory.

      Even if the doctor is suggesting these treatments as trickery to invoke a placebo effect in a particular patient they are being dishonest and in my opinion acting unethically. A placebo effect can be elicited just as well from genuine proven treatment.

      By recommending treatments that the doctor knows does not work means the doctor is lying to the patient. Have we forgotten that CAM treatments also cost money? Is false costly hope still hope?

      And every time an MD recommends an unproven CAM treatment they give the treatment credibility that is undeserved. Future patients will put more “faith” in unproven treatments because they are easier instead of seeking treatments that are sometimes uncomfortable but truly needed.

      I will not excuse ignorance nor will I give my hard earned money to a doctor that is either ignorant to the facts or too lazy to understand things.

      At least in the USA it is a buyer’s market. Don’t give your money or respect to the doctors who are not doing their job.

      1. When I started working in health care, I agreed with you. Then I met patients who didn’t come in for weeks for fungal infections because they were using “teas and herbal remedies” and people who had put up with bacterial infections for months because they “usually don’t really like western medicine”.

        I was surprised that the doctor handled these cases by just suggesting that “well, do whatever works for you but if you want me to write you a prescription we can do that”. And just like that, these patients, who had been going way out of their way to avoid “western medicine” opted for the real treatment.

        I don’t know if that doctor knows or cares about science based vs. woo medicine, but she knew how to get her patients to come back to the clinic. And even though the ideal would have been them abandoning woo in favor of real medicine every time, but if they aren’t going to do that they should at least be coming in for real treatment along with woo.

        That said, a doctor that wouldn’t give me correct information after a direct question is a doctor I would leave. But talk about it first! Doctors are human too, and sometimes just making your concerns clear at the offset teaches them something too.

  9. Please, if you leave that doctor make sure you tell her why. When asked about CAM, too many doctors seem to fall back on the excuse “well, its what my patients want”. They need to hear from patients who actually don’t want CAM. Even if you stay with her you should definitely discuss it with her.

    1. Yes! This! And to be honest, it’s true. A lot of patients won’t come back if they feel their deep knowledge and understanding of “other ways of thinking” aren’t being respected. Unfortunate but true. So speak up!

  10. Amy’s advice is right on! It can be hard sharing issues with the doctor and it is great to find someone you can you can develop this kind of relationship with. BUT like Amy said, you also need the kind of medical care that is the very best. Your health is important! You don’t even want to waste a minute of your time, let alone take on health risks trying treatments that aren’t proven. Best wishes Erin and way to go at looking at the doctor’s advice in a skeptical way!

  11. Harriet Hall wrote an excellent article on SBM recently about the pros and cons of an annual physical. One point which was brought up in both the article and the comments was that even if the annual physical has no direct medical benefits, a well-visit is a great time to assess a doctor’s compatibility with your medical needs and views.

    Trust me on this, you do NOT want to realize you can’t stand your OB when you’re five months pregnant. (In my case it wasn’t alt-med that was the problem, just a MAJOR personality clash that wasn’t obvious when I was only seeing him ten minutes a year for my pap smear.)

    So while I wouldn’t say drop this doctor immediately, I would definitely have a conversation with her about your concerns over the alt-med materials in the waiting room. Don’t wait until you are sick or pregnant to find this stuff out.

  12. I’m seeing a new doctor this Thursday. My regular GP has moved on to a position tending to the jocks at a local university. So I’ve decided to be up front with the new doc about my opinion of CAM and woo and let the chips fall where they may. I’ve googled the new doc as much as I can so hopefully it’ll work out as I really don’t want to shop around for a doctor I’ll be seeing on a regular basis.

    1. That’s a fantastic approach. The more people that make it clear they aren’t going to put up with woo medicine the better. Cases like the one in the letter don’t happen because the doctor is incompetent, they happen because the only patient voices doctors hear are the woo woo ones. If we skeptics speak up too, it will help balance that out and keep the doctors on their toes. Good luck doctor hunting!

  13. And yet she provides evidence of how Amy Tuteur is a hateful bigot with an ideological bent parading around as a skeptic.

    Evidence? What I saw in that post was a reposting of otherpeople’s opinion of Dr. Amy. That is not evidence, that is argumentum ad populum.

    What I have read of Dr. Amy she is very abrasive, arrogant, and angry but I haven’t seen any evidence that she is lying or wrong; being a jackass does not make you wrong by default just as being nice, and saying you hate insults, while reposting others’ insults, doesn’t make you right.

    3 out of the first 4 posts on the Skeptical Mother site were shots at Dr. Amy by someone who claims to not care what she thinks so, while she may not be wrong, I couldn’t get past the pot on the front page screaming at the kettle.

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