Aging Begins at 30

Doctors Should Fight Junk Medicine

Let’s "stop the scientific community giving alternative medicine a free ride." Says Dr. Marcia Angell MD in an interview published in Medical Economics. She is the feisty editor-in-chief of the prestigious New England Journal of Medicine. Feisty comes from the dialect word for a small dog, and it means touchy, quarrelsome, spirited, and exuberant. That she is. She has a record of calling it right. She published Science On Trial. The Clash of Medical Evidence and the Law in the Breast Implant Case (WW Norton & Company). There is no scientific link between breast implants and immune diseases, and she called it long before the special medico-legal Committee came to the same conclusion.

It is time for the tort system, junk science, and the news media to face up to scientific evidence. It is not enough to say, "I think it’s raining," you should look out the window and make sure.

Dr. Angell supports physician-assisted suicide (although organized medicine is opposed), having watched her father, as I did mine, die an unnecessarily painful death. She supports a quicker, more comfortable death instead of a longer more agonizing death. She warns that the politically motivated "Pain Relief Promotion Act" to criminalize assisted suicide is retrogressive. Assisted suicide has been twice passed by popular vote in Oregon and is supported by the Supreme Court.

"There is only medicine that has been adequately tested and medicine that has not. Medicine that works and medicine that may or may not work." Dr. Angell and Dr. Kassirer (former NEJM editor) write in a scathing editorial. "It has now become politically correct to bash the scientific method in the name of diversity and multiculturalism."

Our advances in medicine and therapeutics are spectacular. Dr. Angell says, "I don’t think there is anything lacking in standard scientific medicine itself. What is lacking is the way it is delivered....What we have learned painfully and slowly over the last century has been the necessity to test....What we are seeing now is a regression to the old way of doing things in which word of mouth is taken as scientific evidence." Remember thalidomide! We don’t have very good science education in many high schools, news media often tell the new true medical miracles poorly and trumpet pseudoscience to the skies. Readers and listeners want more medical miracles so they can live forever.

Doctors have an obligation to have a detailed knowledge of alternative medicine but they should not impose it on their inadequately educated patients nor should a university give its unqualified blessing to courses that tout already disproved therapies.

Many doctors, hospitals, and managed care plans have embraced alternative medicine uncritically as a profitable business decision. I’m ashamed at my profession's duplicity. Respect for new ideas does not mean that they are equally valid. A new mistaken hypothesis can cost hundreds of millions of dollars to prove wrong.

Although Dr. Angell is the senior NEJM editor, she does not determine single-handedly what the NEJM publishes. The market alone will not correct medical lapses into hype. The for-profit health-care industry certainly will not contain cheaper witchcraft. Bless Dr. Angell for her feistiness. Please keep yapping at the heels of junk medicine.

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