Stephen Barrett on unconventional therapies

Here's how to steer folks away from bogus or useless "cures."

Although some "complementary and alternative" therapies may, in fact, be helpful and others are either harmless or indirectly helpful because of the placebo effect, still others give patients false hope and may prompt them to forgo legitimate and needed care.

In some cases, practitioners of bogus therapies bilk patients out of big bucks, says Stephen Barrett, a retired psychiatrist from Allentown, PA, who debunks untested or fraudulent health treatments and exposes their practitioners at his Web site, Quackwatch (www.quackwatch.org). He has spent more than 20 years reviewing evidence and debunking claims about alternative medical therapies and is co-author of Consumer Health: A Guide to Intelligent Decisions with PowerWeb (McGraw-Hill, 2001) and The Health Robbers: A Close Look at Quackery in America (Prometheus Books, 1993).

"It's a good idea to find out what other treatments your patients are getting," says Barrett. "You could do this on your intake questionnaire, by asking, 'Are you taking anything beyond prescription medicines, or getting any other treatments?' Finding out that way allows you to decide how to deal with it during the patient visit, and perhaps you can avoid getting into a 15-minute discussion about the alleged merits of harmless treatments," he says.

It may be a good idea, though, to deal with each questionable treatment or supplement individually, says Barrett. "Ask what problem the patient's trying to solve. For example, say a patient goes to a chiropractor. If the patient's problem requires stretching his back joints and muscles to relieve lower back pain, a chiropractor may help. But if the chiropractor's promoting nutritional supplements or encouraging lifelong back treatments, that's beyond the field's scope of practice."

Consider preparing a brief informational pamphlet for patients. The pamphlet can present detailed pros and cons of alternative therapies and the evidence—or lack thereof—supporting their efficacy, suggests Barrett. And don't hesitate to take a strong stand if you think a treatment is nonsense.

"Certainly, you can make a moderate statement, such as 'there's no evidence that Treatment A can influence the course of any disease.' That merely implies that there haven't been enough studies done to uncover the evidence. But it might be better to say, 'There is no plausible theory or evidence to support this treatment, and scientists aren't studying it because it makes no sense and does nothing,' " he says. "Not all patients will listen, but you may be able to influence some."

Here are a few treatments that you might want to warn your patients about, says Barrett:

Algae products: Blue-green algae supplements and other algae products supposedly increase energy, make hair shinier, deepen sleep, and can improve conditions such as chronic fatigue, depression, hypertension, and viral infections—including HIV. "There is no competent and reliable scientific evidence that algae products help any of those conditions," says Barrett. "The claims are fraudulent and misleading."

Coral calcium: These supplements supposedly contain calcium from elements in the ocean water around coral reefs near Japan, as well as other minerals. Coral calcium allegedly creates healthful benefits by balancing and adjusting the pH in your blood. According to the purveyors of coral calcium, it reduces pain, aids the nervous system, helps with arthritis, and increases oxygen uptake.

None of the claims are verifiable, says Barrett, but the supplement remains popular. "When I published my investigative article on coral calcium at www.quackwatch.org, I got 17,000 hits in the first month," adds Barrett.

Seasilver: This liquid product contains a variety of vitamins, minerals, and amino acids. Its supporters claimed that it balances the body's chemistry, cleanses vital organs, and strengthens the immune system, among other things. Seasilver USA, the company that markets it, earned $180 million last year, according to its founder. Seasilver's Web site has toned down some of its claims since 2003, when Federal Trade Commission action forced the company to stop making unsubstantiated claims. However, other sellers of Seasilver continue to promote unproven health effects.

To find out what official actions have been taken by the Federal Trade Commission against purveyors of various alternative treatments, check www.ftc.gov/bcp/conline/edcams/cureall/index.html. You might also think about referring patients to the site, the home page of the FTC's consumer education campaign Operation Cure.All, which targets false and unsubstantiated health claims. The site offers information on how to recognize health fraud, guidance for businesses on how to market health products and services truthfully, and information about the FTC's initiatives.

 

Leslie Kane. Stephen Barrett on unconventional therapies. Medical Economics Sep. 17, 2004;81:27.