Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

Whenever a doctor prescribes a proven treatment, then the patient hopefully experiences a biochemical and physiological benefit. However, it is important to remember that the impact of a proven treatment is always enhanced by the placebo effect. Not only will the treatment deliver a standard benefit, but it should also deliver an added benefit because the patient has an expectation that the treatment will be effective. In other words, patients receiving proven treatments already receive the placebo effect as a free bonus, so why on Earth would a patient take a placebo on its own which delivers only a placebo effect? And why on Earth would a therapist prescribe just a placebo? This would simply short-change the patient.

Doctors are well aware that all their treatments come with a placebo effect, the extent of which depends on a whole host of factors. These include the doctor’s clothing, confidence and general attitude. The best doctors fully exploit the placebo impact, while the worst ones add only a minimal placebo enhancement to their treatments; this explains why the neurologist J. N. Blau suggested, ‘The doctor who fails to have a placebo effect on his patients should become a pathologist.’

Earlier we outlined a list of conditions that homeopaths might treat which would improve due to the placebo effect. Returning to these same conditions, we can see that conventional doctors will generally advise a more reliable medical treatment that will not only offer a direct benefit to the patient, but will also offer an indirect benefit via the placebo effect. So, instead of recommending homeopathic Arnica for a severe bruise, a doctor might suggest a cold compress within the first day of the injury and then a damp, warm cloth thereafter. Instead of homeopathy for high blood pressure, a doctor might suggest a change in diet, or less alcohol consumption or fewer cigarettes, and if this does not work then the condition can also be treated with effective drugs. Similarly, for patients suffering from hay fever, a non-drowsy antihistamine that has been proved to work, plus its inevitable placebo effect, would be a much better option than a homeopathic placebo on its own. A cure for the common cold still eludes science, so conventional medicine can only treat this condition in terms of addressing the accompanying symptoms, but even this is more than homeopathy can achieve. The proven benefits of conventional cold tablets plus their placebo effect are, again, better than just the placebo effect of homeopathic tablets.

For the hardest problems, such as back pain, doctors have a limited arsenal of truly effective options, but these are still more powerful than anything that homeopathy or any placebo-based alternative therapy can offer. In 2006, B. W. Koes and his Dutch colleagues published a clinical review entitled ‘Diagnosis and treatment of low back pain’ in the British Medical Journal:

The evidence that non-steroidal anti-inflammatory drugs relieve pain better than placebo is strong. Advice to stay active speeds up recovery and reduces chronic disability. Muscle relaxants relieve pain more than placebo, strong evidence also shows, but side effects such as drowsiness may occur. Conversely, strong evidence shows that bed rest and specific back exercises (strengthening, flexibility, stretching, flexion, and extension exercises) are not effective.

As we approach the end of this book, it becomes increasingly clear that much of alternative medicine is ineffective and should not be encouraged, even at the level of being a benign placebo. In many ways, today’s alternative medicine is a modern version of the snake-oil remedies that were sold widely in America a century ago, such as Tex Bailey’s Rattlesnake Oil and Monster Brand Snake Oil. They offered no medical benefit to patients, but they made plenty of profits for the huxters who sold them. One of the most famous snake-oil salesmen was Clark Stanley, who promoted his product as ‘A Liniment that penetrates Muscle, Membrane and Tissue to the very bone itself, and banishing pain with a power that has astonished the Medical Profession’. Of course, it offered no such benefit, and when his Snake Oil Liniment was tested in 1916 it was found to be devoid of any actual snake oil. Instead, it consisted of ‘principally a light mineral oil mixed with about 1 percent of fatty oil, probably beef fat, capsicum and possibly a trace of camphor and turpentine.’