The rise of alternative medicine invites the question, what is conventional medicine doing, or not doing, that leads to this remarkable use of alternative medicine.
It's the lack of data in (some) "conventional" practice that drove me to seek "alternative" care - I was looking for evidence-based care. So much of conventional practice is what is in fashion - something sensible medicine has addressed many times. Oh, the irony!
Conventional medicine is one big super expensive failure. Sure, it keeps you doctors in fancy cars, homes and vacations but doesn't much help the majority of patients. Alternative medicines are by far less risky than conventional medicine. I/we have had good success with alternative medicines. I am doing fine with no vaccines and no drugs. I have used chiropractors several times over many decades and they have never failed me.
As a potential patient, I am looking for answers, and not to become the next drug junkie. I have experienced this enough times where the doc says "you'll be on this drug or drugs for the rest of your life". That is not a cure, nor is it addressing the real problems. This is why I will always avoid the health care mafia unless I have a dire emergency I can't handle myself.
China has used alternative medicine for thousands of years and I would never want to replace it with what you call conventional medicine.
The merging of evidence based medicine with observational medicine has been fascinating to me since I had an experience with my then 6 year old (in 2000). Since she was 1.5 yrs old, she had a history of vomiting for no reason, very randomly, and frequent stomachaches and diarrhea. We saw an excellent pediatric gastroenterologist who ran a gamut of tests from the time she was 1.5 -6 yrs old. He was quite stumped. She was actually gain too much weight rather than not thriving which was perplexing. Finally, out of desperation, we visited a holistic chiropractor who did some VERY hokey looking “tests” on her limbs. Pulling and pushing. He then dramatically announced…”this child should not eat wheat”. Well…that was a bummer, as she ate a lot of wheat based things. I dutifully pulled the breading off her nuggets and bought potato bread for her PB&Js 😉 She did seem to outgrow the symptoms except for the tummy aches and now some killer headaches. But she kept gaining weight, no matter the activity or the diet. I managed to find a doctor who was alarmed at her high insulin levels, yet no corresponding drop in blood sugar and at age 9, she started taking Metformin. It really helped her lose weight. But then…and here is the point of all this…at 15, she developed ataxia and debilitating brain fog, literally overnight. It was so freaky! We took her to every kind of specialist who all said she was fine. I finally went back to the Peds gastro, as he had been so very approachable years before (that practitioner placebo effect is so real!) and the minute he saw her he said “That is the ataxia associated with severe Celiac Disease!!” And sure enough, she had 99% villi destruction and was very ill. It took 4 years to correct her health (and yes, we used a lot of holistic type supplements to get that gut back in shape). So…the evidence based medicine failed us initially. She had been tested for celiac, but nothing showed up. The dr even suspected it but could not prove it, but it did not occur to him to tell us to follow a strict gluten free diet anyway. The chiropractor had a sense of it, but offered no practical advice about what a true “wheat free” diet was.
She is 30 now, gluten free for 15 years and happy, healthy and strong. And so many people know about CD now…if she was a baby at this point, we probably would have it all figured out so quickly!
I am a critical care and internal medicine physician practicing since the late 90s.
I think we “traditional doctors” face difficulties in the translating of biological plausibility into clinical significance.
We don’t differentiate anymore by having a sound pathophysiology background because Medicine became more complex than it was in the early days of Internal Medicine.
We must adapt. Otherwise we will be as lost in biological plausibility as the “integrative” are
Twenty minute visits with a doctor, any kind of doctor? In what world? I'm 67 and I can't remember ever spending 20 minutes with a doctor in all my life, and I've always had excellent access to health care. Maybe because I've never had 20 minutes worth of things wrong with me?
That would be like saying "there are unicorns living on a distant star; prove me wrong). Your statement is wrong because the science hasn't been done. Many people would like to know whether an organically grown tomato is "healthier" than an industrially grown tomato (one grown in dead, mineral deficient soil, supplemented by NPK fertilizers, genetically modified so it can be sprayed with herbicides and pesticides). Absent the research, reasonable people will just employ their common sense. Answering your statement would also require a scientific definition of health, but that, unfortunately, also doesn't exist. Science, together with its methods, operates within certain rules. Opinions and isolated studies don't make science.
I'll repeat one of my explanations to patients " the brain is the most powerful organ in the body!" reference: Love, Medicine, and Miracles by Bernie Siegel.
A medical doctor had a few patients that reported better results from one form of holistic medicine than what he was offering, and this prompted him to study that model. He made a statement that rings true. He says modern medicine is only required for traumatic injuries, life-threatening scenarios and crisis intervention.
Strictly speaking tai chi and reiki are not forms of medicine. But it’s unsurprising how little conventional doctors understand about holistic medicine which operates on a completely different paradigm. Though quite a few conventional medics, disillusioned with harmful ultimately unhelpful drug treatments, have decided to look outside of that box.
1) The American diet (too many processed foods; sugars; processed carbs) and subsequent obesity has driven a majority of symptoms and problems we see today. If people had a healthier diet and were at a healthier weight, we would have magnitudes less of chronic symptoms and conditions that patients seek medical care for.
2) the certainty that doctors have had over the years of the benefits of various medical interventions - vaccines, drugs, treatments - likely don't all have as much "evidence" as doctors have been led to and like to believe. This requires some introspection and humility on our part. Doctors are here to give advice. To the best of our ability with as much evidence as we believe exists. But we should not get bent out of shape or irritated if/when patients decide not to take or question our advice.
3) the Mind Body connection is a force at play in most people, most of the time. The brain is an amazingly powerful organ. The placebo effect is the positive aspect of this connection. The Mind Body Syndrome is the problematic side that can drive myriad symptoms that cause distress. To ignore this or to overlook will leave many issues "untreated" and drive the patient to continue to seek care, testing, diagnosis, etc.
This is where Alternative Medicine might factor in. Mind Body syndrome is not cured with a pill. It takes time and attention, listening and reassurance. If an Alternative therapy is helping, it generally functions within this sphere.
Anything that helps a patient feel better; relieve symptoms; improve quality of life has got to be viewed as a good thing. But, the alternative medicine focus on testing, supplements, etc can be expensive; sometimes don't help either and can waste a fair amount of time and money.
And recognize that with the limitations of allopathic medicine, alternative medicine has even less "evidence"
The better doctors are at recognizing the typical thoughts and patterns of Mind Body syndrome, the better we'll be at limiting unnecessary testing and treatment and the better at guiding patients towards more helpful approach.
we can all agree that doctors don't have the time or expertise to manage every aspect of "health" so other professionals can manage certain things. Physicians are trained and licensed to diagnose and use medications to treat when needed. There is no other professional able to do this. This isn't all we do, but again, we're the only ones who can do this. Doctors have a reasonable knowledge of health and prevention - but you can get much more detailed information and instruction re: healthy diet, detailed exercise info from other professionals and this isn't a bad thing.
Thank you for another thoughtful and thought-provoking article. I agree that placebo effect has an enormous effect in both conventional and alternative medicine. A lot of the disagreements can be traced to confusing the way one feels vs. the presence or absence of demonstrable disease. The two are obviously related but the correlation is certainly well short of 100%. Are there diseases that affect the way one feels but are not scientifically demonstrable with existing technology and knowledge? Certainly. Are there diseases with unknown causation? Of course---we can probably say that about most of them. And that is probably the reason so many are drawn into the alternative medicine arena. It is certainly a common human characteristic to want to feel that one has control over one's health and that is exploited by charlatans but also employed by well-meaning people in both fields. Throughout my career I tried to explain to patients that my role was to diagnose disease by conventional medical evidence and knowledge but that was limited and if something they were doing made them feel better despite the absence of demonstrable disease, they should continue with what was working for them.
Similar take... That 'care' has disappeared from conventional healthcare, and CAM provides that in spades. That's what I want first and foremost when I'm a patient, and conventional medicine's focus on diagnostic algorithms and guidelines, the history taking schema etc has actively undermined it in me as the doer... We're taught to run through an intellectual process, and any caring that happens is incidental. I'm fortunate in that I have a serious illness for which medication is critical to good management, but the conventional clinician has chosen to give me regular long appointments that are superfluous to standard care but which have a huge impact on my satisfaction with the medical model of care, and I think were crucial in the long-term to my excellent outcome.
Plus as a patient, I have migraines that don't respond to standard evidence-based treatments (simple analgesia), yet do respond to non evidence based ones that have been discredited - oxygen and codeine. Hence while I have a lot of time for evidence based medicine which is the rock on which conventional medicine is founded, I also know it has huge limitations when it comes to the individual and their response. Evidence based medicine can only ever tell you what a treatment does in other people, and what's likely to happen for you, never what will happen for you. I like evidence, but it has limitations. There's more to life than science.
Personally, what matters to me if I'm a desperate patient is that a treatment works, not the mechanism... Plus the effect size of most interventions is smaller than that of the bias from the conflict of interest.
So much of what we do in conventional medicine has marginal utility and we're not honest about that to patients, and the fee structure doesn't allow for informed decision-making - telling the patient the NNT and NNH (if the dr knows it) - given the gross inadequacy of what passes for informed consent in conventional medicine, I tend to think conventional medicine needs to clean up its own kitchen before taking on CAM. Observed a clinician give their 'detailed' spiel on the pros and cons of PSA testing to a patient that completely ignored the fact that the patient was outside the recommended age range, and didn't bother to tell him that.
I lean towards "alternative" or supplement/food based treatments for the following reasons:
1. It is reasonable to believe that Pharmaceutical companies are blocking and even disparaging the use of unpatentable, but safer, therapies because it competes with their bottom line.
2. There is less funding available to test non-patented methods of treatment, therefore lack of published evidence doesn't mean lack of efficacy.
3. Even if studies have been done, it's reasonable to believe that Pharma-supported journals will not publish them.
4. It's easier to test out a supplement yourself than to get a proper diagnosis from a doctor. This is especially true of thyroid patients. For example, I come in as "normal" on thyroid tests and yet I'm missing parts of my eyebrows (a sign of hypothyroidism I'm told), and my mother and grandmother are/were both on Levothyroxine.
5. Given that people were having trouble getting medications during Covid, having a broader set of solutions could save you - if taking an iodine supplement solves my problems, isn't it better to know that than to rely on a restricted medication like Levothyroxine? If my favorite iodine pill disappears, there are many other brands, plus shrimp, seaweed, and other foods.
5. Sometimes the correct solution isn't to pop a pill, but a lifestyle change. Alternative medicine embraces this kind of treatment.
6. There are few enough alternative practitioners that it's ok when their patients are healed and don't need to come back for routine care, the doc doesn't mind.
and finally
7. Supplement providers don't say "You don't have this condition, which one of us has the medical degree here?" They just sell you what you ask for.
Thoughtful post, Adam, but I think the primary reason alternative medicine is so popular is because allopathic medicine doesn't work very well for the large set of human problems that can be called medically unexplained syndromes. Think fatigue, regional musculoskeletal pain syndromes, chronic pain, depressed mood, anxiety, poor sleep, weight gain, problems with sexual interest or performance, etc. These make up a large proportion of people's "medical" concerns for which they present to allopathic practitioners. Then they find out that allopathic medicine doesn't have much to offer for these, and good allopathic physicians will candidly acknowledge as much and discourage medicalization of the problems.
A middle-aged man with sleep apnea could have all the symptoms you listed except pain. Similarly a menopausal woman in need of HRT. My concern is that doctors are not examining their blindspots and are skipping a thorough differential diagnosis with complex patients.
I'm mindful of the complexity of diagnosis and not trying to be snippy.
The problem is that "rebalancing the life force" might seem empty or meaningless to you because you are out of touch with the culture that employs it and/or the individual and what they mean in the context.
It's a double standard to say that doctors don't do the same thing all the time -- they explain to patients by analogy and much of the meaning or context is drawn from the culture. The only difference is that you don't know anything about the reality of alternative medicine probably because you are not immersed in that culture.
You should not mistake your own ignorance for someone else's. That would be the first key to "working together with alternative practitioners". There are actually systematic, sometimes centuries-practiced methodologies that go behind some of these practices. People who take the position that it's all new age gobbeldygook don't understand that these various methods have many sham practitioners, just like there are many sham MDs.
If anything, teaching patients how to evaluate a good alternative practitioner would actually be the thing to do to establish your own substantive opinion. Treating it like it's all the same reveals little understanding of the history of medicine itself, and deeply white washes the whole subject.
It's the lack of data in (some) "conventional" practice that drove me to seek "alternative" care - I was looking for evidence-based care. So much of conventional practice is what is in fashion - something sensible medicine has addressed many times. Oh, the irony!
If I'm not mistaken, this should be what the Chinese call acupuncture in traditional Chinese medicine!
If I'm not mistaken, this should be what the Chinese call acupuncture in traditional Chinese medicine!
Conventional medicine is one big super expensive failure. Sure, it keeps you doctors in fancy cars, homes and vacations but doesn't much help the majority of patients. Alternative medicines are by far less risky than conventional medicine. I/we have had good success with alternative medicines. I am doing fine with no vaccines and no drugs. I have used chiropractors several times over many decades and they have never failed me.
As a potential patient, I am looking for answers, and not to become the next drug junkie. I have experienced this enough times where the doc says "you'll be on this drug or drugs for the rest of your life". That is not a cure, nor is it addressing the real problems. This is why I will always avoid the health care mafia unless I have a dire emergency I can't handle myself.
China has used alternative medicine for thousands of years and I would never want to replace it with what you call conventional medicine.
The merging of evidence based medicine with observational medicine has been fascinating to me since I had an experience with my then 6 year old (in 2000). Since she was 1.5 yrs old, she had a history of vomiting for no reason, very randomly, and frequent stomachaches and diarrhea. We saw an excellent pediatric gastroenterologist who ran a gamut of tests from the time she was 1.5 -6 yrs old. He was quite stumped. She was actually gain too much weight rather than not thriving which was perplexing. Finally, out of desperation, we visited a holistic chiropractor who did some VERY hokey looking “tests” on her limbs. Pulling and pushing. He then dramatically announced…”this child should not eat wheat”. Well…that was a bummer, as she ate a lot of wheat based things. I dutifully pulled the breading off her nuggets and bought potato bread for her PB&Js 😉 She did seem to outgrow the symptoms except for the tummy aches and now some killer headaches. But she kept gaining weight, no matter the activity or the diet. I managed to find a doctor who was alarmed at her high insulin levels, yet no corresponding drop in blood sugar and at age 9, she started taking Metformin. It really helped her lose weight. But then…and here is the point of all this…at 15, she developed ataxia and debilitating brain fog, literally overnight. It was so freaky! We took her to every kind of specialist who all said she was fine. I finally went back to the Peds gastro, as he had been so very approachable years before (that practitioner placebo effect is so real!) and the minute he saw her he said “That is the ataxia associated with severe Celiac Disease!!” And sure enough, she had 99% villi destruction and was very ill. It took 4 years to correct her health (and yes, we used a lot of holistic type supplements to get that gut back in shape). So…the evidence based medicine failed us initially. She had been tested for celiac, but nothing showed up. The dr even suspected it but could not prove it, but it did not occur to him to tell us to follow a strict gluten free diet anyway. The chiropractor had a sense of it, but offered no practical advice about what a true “wheat free” diet was.
She is 30 now, gluten free for 15 years and happy, healthy and strong. And so many people know about CD now…if she was a baby at this point, we probably would have it all figured out so quickly!
I am just curious, did your daughter receive antibiotics as a baby?
I am a critical care and internal medicine physician practicing since the late 90s.
I think we “traditional doctors” face difficulties in the translating of biological plausibility into clinical significance.
We don’t differentiate anymore by having a sound pathophysiology background because Medicine became more complex than it was in the early days of Internal Medicine.
We must adapt. Otherwise we will be as lost in biological plausibility as the “integrative” are
I discuss this points here. Be my guess.
https://thethoughtfulintensivist.substack.com
Twenty minute visits with a doctor, any kind of doctor? In what world? I'm 67 and I can't remember ever spending 20 minutes with a doctor in all my life, and I've always had excellent access to health care. Maybe because I've never had 20 minutes worth of things wrong with me?
The idea that organic, non-GMO foods are somehow healthier than conventional food has absolutely no scientific basis. Prove me wrong.
That would be like saying "there are unicorns living on a distant star; prove me wrong). Your statement is wrong because the science hasn't been done. Many people would like to know whether an organically grown tomato is "healthier" than an industrially grown tomato (one grown in dead, mineral deficient soil, supplemented by NPK fertilizers, genetically modified so it can be sprayed with herbicides and pesticides). Absent the research, reasonable people will just employ their common sense. Answering your statement would also require a scientific definition of health, but that, unfortunately, also doesn't exist. Science, together with its methods, operates within certain rules. Opinions and isolated studies don't make science.
Check out Dr. Andrea Love on Substack
Well, most of them taste better. That's enough for me to shell out a little more.
I'll repeat one of my explanations to patients " the brain is the most powerful organ in the body!" reference: Love, Medicine, and Miracles by Bernie Siegel.
On another note: https://www.science.org/content/article/research-misconduct-finding-neuroscientist-eliezer-masliah-papers-under-suspicion
"Science" is getting harder to trust!! What am I going to do about my Alzheimers, when it comes?, now?!
A medical doctor had a few patients that reported better results from one form of holistic medicine than what he was offering, and this prompted him to study that model. He made a statement that rings true. He says modern medicine is only required for traumatic injuries, life-threatening scenarios and crisis intervention.
Strictly speaking tai chi and reiki are not forms of medicine. But it’s unsurprising how little conventional doctors understand about holistic medicine which operates on a completely different paradigm. Though quite a few conventional medics, disillusioned with harmful ultimately unhelpful drug treatments, have decided to look outside of that box.
Points I've come to realize:
1) The American diet (too many processed foods; sugars; processed carbs) and subsequent obesity has driven a majority of symptoms and problems we see today. If people had a healthier diet and were at a healthier weight, we would have magnitudes less of chronic symptoms and conditions that patients seek medical care for.
2) the certainty that doctors have had over the years of the benefits of various medical interventions - vaccines, drugs, treatments - likely don't all have as much "evidence" as doctors have been led to and like to believe. This requires some introspection and humility on our part. Doctors are here to give advice. To the best of our ability with as much evidence as we believe exists. But we should not get bent out of shape or irritated if/when patients decide not to take or question our advice.
3) the Mind Body connection is a force at play in most people, most of the time. The brain is an amazingly powerful organ. The placebo effect is the positive aspect of this connection. The Mind Body Syndrome is the problematic side that can drive myriad symptoms that cause distress. To ignore this or to overlook will leave many issues "untreated" and drive the patient to continue to seek care, testing, diagnosis, etc.
This is where Alternative Medicine might factor in. Mind Body syndrome is not cured with a pill. It takes time and attention, listening and reassurance. If an Alternative therapy is helping, it generally functions within this sphere.
Anything that helps a patient feel better; relieve symptoms; improve quality of life has got to be viewed as a good thing. But, the alternative medicine focus on testing, supplements, etc can be expensive; sometimes don't help either and can waste a fair amount of time and money.
And recognize that with the limitations of allopathic medicine, alternative medicine has even less "evidence"
The better doctors are at recognizing the typical thoughts and patterns of Mind Body syndrome, the better we'll be at limiting unnecessary testing and treatment and the better at guiding patients towards more helpful approach.
we can all agree that doctors don't have the time or expertise to manage every aspect of "health" so other professionals can manage certain things. Physicians are trained and licensed to diagnose and use medications to treat when needed. There is no other professional able to do this. This isn't all we do, but again, we're the only ones who can do this. Doctors have a reasonable knowledge of health and prevention - but you can get much more detailed information and instruction re: healthy diet, detailed exercise info from other professionals and this isn't a bad thing.
Thank you for another thoughtful and thought-provoking article. I agree that placebo effect has an enormous effect in both conventional and alternative medicine. A lot of the disagreements can be traced to confusing the way one feels vs. the presence or absence of demonstrable disease. The two are obviously related but the correlation is certainly well short of 100%. Are there diseases that affect the way one feels but are not scientifically demonstrable with existing technology and knowledge? Certainly. Are there diseases with unknown causation? Of course---we can probably say that about most of them. And that is probably the reason so many are drawn into the alternative medicine arena. It is certainly a common human characteristic to want to feel that one has control over one's health and that is exploited by charlatans but also employed by well-meaning people in both fields. Throughout my career I tried to explain to patients that my role was to diagnose disease by conventional medical evidence and knowledge but that was limited and if something they were doing made them feel better despite the absence of demonstrable disease, they should continue with what was working for them.
Similar take... That 'care' has disappeared from conventional healthcare, and CAM provides that in spades. That's what I want first and foremost when I'm a patient, and conventional medicine's focus on diagnostic algorithms and guidelines, the history taking schema etc has actively undermined it in me as the doer... We're taught to run through an intellectual process, and any caring that happens is incidental. I'm fortunate in that I have a serious illness for which medication is critical to good management, but the conventional clinician has chosen to give me regular long appointments that are superfluous to standard care but which have a huge impact on my satisfaction with the medical model of care, and I think were crucial in the long-term to my excellent outcome.
Plus as a patient, I have migraines that don't respond to standard evidence-based treatments (simple analgesia), yet do respond to non evidence based ones that have been discredited - oxygen and codeine. Hence while I have a lot of time for evidence based medicine which is the rock on which conventional medicine is founded, I also know it has huge limitations when it comes to the individual and their response. Evidence based medicine can only ever tell you what a treatment does in other people, and what's likely to happen for you, never what will happen for you. I like evidence, but it has limitations. There's more to life than science.
Personally, what matters to me if I'm a desperate patient is that a treatment works, not the mechanism... Plus the effect size of most interventions is smaller than that of the bias from the conflict of interest.
So much of what we do in conventional medicine has marginal utility and we're not honest about that to patients, and the fee structure doesn't allow for informed decision-making - telling the patient the NNT and NNH (if the dr knows it) - given the gross inadequacy of what passes for informed consent in conventional medicine, I tend to think conventional medicine needs to clean up its own kitchen before taking on CAM. Observed a clinician give their 'detailed' spiel on the pros and cons of PSA testing to a patient that completely ignored the fact that the patient was outside the recommended age range, and didn't bother to tell him that.
I lean towards "alternative" or supplement/food based treatments for the following reasons:
1. It is reasonable to believe that Pharmaceutical companies are blocking and even disparaging the use of unpatentable, but safer, therapies because it competes with their bottom line.
2. There is less funding available to test non-patented methods of treatment, therefore lack of published evidence doesn't mean lack of efficacy.
3. Even if studies have been done, it's reasonable to believe that Pharma-supported journals will not publish them.
4. It's easier to test out a supplement yourself than to get a proper diagnosis from a doctor. This is especially true of thyroid patients. For example, I come in as "normal" on thyroid tests and yet I'm missing parts of my eyebrows (a sign of hypothyroidism I'm told), and my mother and grandmother are/were both on Levothyroxine.
5. Given that people were having trouble getting medications during Covid, having a broader set of solutions could save you - if taking an iodine supplement solves my problems, isn't it better to know that than to rely on a restricted medication like Levothyroxine? If my favorite iodine pill disappears, there are many other brands, plus shrimp, seaweed, and other foods.
5. Sometimes the correct solution isn't to pop a pill, but a lifestyle change. Alternative medicine embraces this kind of treatment.
6. There are few enough alternative practitioners that it's ok when their patients are healed and don't need to come back for routine care, the doc doesn't mind.
and finally
7. Supplement providers don't say "You don't have this condition, which one of us has the medical degree here?" They just sell you what you ask for.
Thoughtful post, Adam, but I think the primary reason alternative medicine is so popular is because allopathic medicine doesn't work very well for the large set of human problems that can be called medically unexplained syndromes. Think fatigue, regional musculoskeletal pain syndromes, chronic pain, depressed mood, anxiety, poor sleep, weight gain, problems with sexual interest or performance, etc. These make up a large proportion of people's "medical" concerns for which they present to allopathic practitioners. Then they find out that allopathic medicine doesn't have much to offer for these, and good allopathic physicians will candidly acknowledge as much and discourage medicalization of the problems.
A middle-aged man with sleep apnea could have all the symptoms you listed except pain. Similarly a menopausal woman in need of HRT. My concern is that doctors are not examining their blindspots and are skipping a thorough differential diagnosis with complex patients.
I'm mindful of the complexity of diagnosis and not trying to be snippy.
Well said.
The problem is that "rebalancing the life force" might seem empty or meaningless to you because you are out of touch with the culture that employs it and/or the individual and what they mean in the context.
It's a double standard to say that doctors don't do the same thing all the time -- they explain to patients by analogy and much of the meaning or context is drawn from the culture. The only difference is that you don't know anything about the reality of alternative medicine probably because you are not immersed in that culture.
You should not mistake your own ignorance for someone else's. That would be the first key to "working together with alternative practitioners". There are actually systematic, sometimes centuries-practiced methodologies that go behind some of these practices. People who take the position that it's all new age gobbeldygook don't understand that these various methods have many sham practitioners, just like there are many sham MDs.
If anything, teaching patients how to evaluate a good alternative practitioner would actually be the thing to do to establish your own substantive opinion. Treating it like it's all the same reveals little understanding of the history of medicine itself, and deeply white washes the whole subject.