"Do you have any more questions?" I asked, wrapping up a routine visit.  She had been my patient for a long time, so communication was easy.

"Sure.  What do you think of those foot baths people are using?"  she asked with a little bit of embarrassment in her expression.

"The ones that change color as the draw out toxins?"  I said, waving my fingers downward in a wiggly pattern to emphasize the drawing-out process.  I have seen people describe this process, and they always do their fingers that way when they describe toxins coming out of the feet.

She nodded, and I grinned at her as I gave my response.  "I am very certain that they will cause considerable weight loss in a specific area:" I paused for effect, "your wallet."

She laughed, and we discussed the mysterious notion that somehow toxins would accumulate in the feet.  Her question wasn't because she was herself considering the treatment, but because many around her were swearing by it.  My glib answer reflected the fact that I knew her purpose in asking.  I didn't have much time to explain my feelings about these treatments, but I did assure her that I don't really care if people spend their money as long as they don't hurt themself.   If sticking your feet in water that changes colors makes you feel better, more power to you.  The placebo effect is a well-documented phenomenon.

The irony of this conversation is that it came almost immediately after I had a discussion with a colleague about the American obsession with alternative medicine.  Here are the facts:

  • Americans spent $34 Billion on alternative medicine treatments in 2007 (1)
  • 74.6% had used some form of complementary and alternative medicine (CAM).
  • 62.1% had done so within the preceding twelve months.
  • When prayer specifically for health reasons is excluded, these figures fall to 49.8% and 36.0%, respectively.
  • 45.2% had in the last twelve months used prayer for health reasons, either through praying for their own health or through others praying for them.
  • 54.9% used CAM in conjunction with conventional medicine. (2)

These statistics obviously hinge on what is considered to be "alternative."  Because I pray for the health of my elderly parents, does that mean that I have engaged in alternative medicine?  Do people taking melatonin or glucosamine chondroitin qualify as well?

Still, nobody argues that the use of CAM ("Complementary and alternative medicine") is widespread.  Websites and blogs such as Science-Based Medicine and Orac's well-known blog, Respectful Insolence, have challenged many of the outrageous claims made by proponents of alternative medicine.  I will leave that job to them.  That is not the purpose of this post.

My question, and the question I discussed with my colleague, is this: why do people spend so much money on alternative medical therapies?  Are we practitioners of "conventional medicine" doing something wrong?  Is it bad PR on our part, or is it the smooth talking of the purveyors of alternative therapies that have made so many choose them instead of us?  Is it simply the stupidity or gullibility of people that gives an opening to alternative providers, or is there something lacking in conventional treatments?  Seriously, why would someone ever do a colonic if they weren't forced to at gunpoint?

The answer, I believe, is summed up in a single word: magic.  There are three facts that explain why so many people turn to alternative therapies:

  1. People want their problems to magically go away.
  2. Conventional medicine is not magical.
  3. Alternative medicine promises magic.

1.  People Want Magic

Life is full of pain.  We all face circumstances that are frustrating, confusing, and difficult.  If we are given the choice between explanations as to why things are hard or promises to fix things quickly, we tend to choose the latter.  It is human nature to seek out the easiest solutions to our problems.  This is not a bad thing, nor is it a sign of ignorance, it is simply a consequence of our desire to not feel pain (be that physical or emotional).  Magical solutions offer an easy way out.

There is another reason why people are drawn to magic: the appeal of the mysterious.  The child looks at his father in wonder when he produces a coin from behind her ear.  She wants her father to be magical and powerful.  The mystery doesn't decrease her admiration, it increases it.  As she gets older and finds out that he is not magical, she still may admire him; but she won't hold him in the awe she did as a young and naive child.

Which is the better state to be in?  It's hard to say.  I don't like being ignorant, but I do miss the wonder I had as a child.

2. Medicine is Not Magic

When one of my kids comes to me with a pain in their leg or a stomach ache, they are not coming for an explanation, a plan, or a differential diagnosis; they want me to fix their problem.

Unfortunately, medicine often does not work that way.  If someone gets an upper respiratory infection, the cure for it is to wait until it goes away.  If a person has diabetes, the main approach is not to cure the problem, but accept its presence and minimize the damage.  There are often people who come in with problems I can't solve.  I go through my usual approach: rule out serious problems first, then work to minimize pain; but am often left without a solution.

3.  Alternative Medicine Promises Magic

Look at the testimonials of people who have used the foot-soaking therapy:

  • A customer came to use our Aqua Chi Machine. She had recently retired because of severe arthritis in her hands. After one treatment She was able to open and close both hands. She commented her pain was 80% better. After five treatments, she had no more pain and 100% mobility back. She then asked her husband to try the Aqua-Chi treatments. He had Asthma and used oxygen at night and inhalers during the day. After two treatments he stopped using the oxygen and night and after five treatments was able to quit using the inhalers. He saw a remarkable change in his ability to breathe.
  • "I have experienced kidney failure and poor kidney function throughout my life. I obtained an Aqua-Chi machine and had amazing results! Since using the Aqua-Chi Machine I have not had kidney failure."
  • "I was suffering from Candida overgrowth which was localized in my bladder and uterus. This was the cause of my low energy. After receiving a 35-minute Aqua-Chi foot bath, I felt much stronger. The therapist and I were shocked to find that the Candida seemed to have cleared out of my bladder and uterus. She stated that she had never seen anyone's energy field shift so dramatically in such a short period of time! Since using the Aqua-Chi Machine on a regular basis, I have noticed that I have more energy and stamina and that I sleep more soundly."

Before

After

This is what happens to blood cells in your feet!  Apparently, they do line dancing when they are sick!

You could find similar claims/testimonials on websites pushing MonaVie, colonics, and chelation therapy.  Alternative treatments promise magical results, curing problems for which conventional medicine doesn't have answers.  You don't find nearly as many alternative treatments for ear infections, ankle sprains, or appendicitis - things that conventional medicine handles quickly and effectively, in most cases.  Alternative treatments usually go after chronic symptoms such as fatigue, and chronic diseases such as arthritis.  They fix problems that I often tell patients they have to live with.

This is, by the way, why scientifically repudiating alternative therapies does little good.  They don't require science since they are magical.

So What's the Point?

What are we to do with this information?  Here are several things I get from this:

  1. There will always be a market for magical treatments.  The desire for magic comes from a normal human desire - to be rid of pain as quickly as possible.  It's fine to be critical of the hucksters that rob people of their money in exchange for fake magic; but portraying the people who seek alternative therapies as naive and silly is not productive.
  2. Conventional medicine cannot and should not compete. We don't offer magic, we offer applied science.  The majority of healthcare dollars are spent on technological "miracles," not the hum-drum treatment and management of disease.  When we in medicine go for the glamor, we sell our soul to the highest bidder and walk away from where we can do the most good.
  3. Medicine is what it is. We don't offer miracles, and that is OK.  We don't give guarantees and don't pretend there are always simple answers to problems.  Since we take on a losing battle - every one of our patients eventually dies, and all of them will suffer - we will eventually feel and look powerless.  We will be powerless.  That's OK, because medicine doesn't try to deal with the metaphysical, mysterious, or unscientific.  We are focused on reality, and reality is often hard.
  4. I am going to get one of those Aqua-Chi foot baths. I have toxins in my spleen that are causing me to ache behind my left elbow.  I am sure it will fix that.

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