I live in a city where alternative medicine is a big thing. I work in safety net health care, and many of the clinics I work with offer alternative treatment. Part of my job is helping low-income or uninsured people find health care. Often, only the alternative medicine clinics are taking new patients without a six-week wait. As someone who cares about both evidence-based medicine and health care for all, I am frequently conflicted about this part of my work. On one hand, in my state, NDs have prescribing power, appointments are inexpensive (sometimes even free), and patients may have to wait too long to receive other care. On the other, some of these clinics probably fund their lower-cost care by charging more to other patients, and in any case, I simply don’t agree with most of their methods of treatment. So what’s a skeptic to do?
~Just Not That Into Acupuncture
Dear Just Not That Into Acupuncture,
This makes me so angry and sad at the same time and highlights a fundamental problem with the health care system in the United States. Quality, science-based health care is becoming more and more difficult for the average person to acquire. It is becoming an elusive privilege for the wealthy. Average people are being forced into choosing second rate care because it is that or nothing. How can you blame a person for picking a doctor rather than no doctor at all? You can’t blame that person but you can blame the flaws in the system.
This is also another example of a wedge that the alternative medicine practitioners have successfully used to infiltrate the health care industry. We discussed a similar topic in a post with Dr. Gorski a few months back. The post was titled, In the Workplace Skeptical Activism. The post was about a hospital that offered acupuncture services in the same setting as other science-based care thus creating false credibility for the alt-med practice. Gorski’s advice was essentially this:
If you do want to try to make a difference, you will have to be prepared to get in trouble or even to walk away from your job. If you’re not willing to do that, then you’ll have little choice but to grin and bear it, perhaps with as much passive aggressive obstruction as you feel you can safely get away with. You might be forced to go along with this, but there’s no reason you have to be enthusiastic about it.
Unfortunately, this situation is quite similar only a tad bit more depressing. Your job is supposed to help people get legitimate care who can not afford it. Some of these people are desperate for help. I have been in that situation myself. If you encountered me a few years back you would have found a low income, uninsurable person with a history of chronic illness coupled with depression and anxiety. Would you have told me, sorry there’s nothing you can do for me or would you give me the address of an alt-med practitioner who can at least prescribe me my asthma medicine? Any decent human would want to at least assist in helping me to get my hands on a rescue inhaler.
Sure, odds are, because I was helped and I felt better, I would become a long-term patient of the doctor who can help me breath even if they are recommending sham treatments along with my asthma meds. That is the whole point of offering no wait time and less expensive introductory visits. The average person doesn’t know that they are being scammed with the added vitamins supplements and herbal teas that are added on to the bill on the way out the door. All they know is they feel better after the first visit. Odds are they were not going to feel worse.
I speak from experience. That literally happened to me. It took years for me to realize that the clinic I could “afford” was actually convincing me to purchase products and treatments that had no effect on my asthma condition at all. All I knew was I could breath when I had the resue inhaler that was prescribed by what I assumed was an educated, trustworthy doctor and that I couldn’t afford a trip to the ER or health insurance. Heck, I still can’t afford quality health insurance. Few can these days.
So what can you do?
The best advice I can give is for you to educate people as best you can as to what treatments are reliable and what are just sugar pills and shams. And I realize that you probably can not do this in your workplace much, if at all. But outside of your workplace consider doing what you can to educate people on what is wrong with alt-med as a replacement for science based care. Speak up and speak often. Also, if you see any providers offering or claiming cures for illness that are unproven, take note. Then, when you are off the clock please notify the FDA. You can not stop people from being fleeced but you don’t have to be completely passive.
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*Photos by me.