Dr. Brian Goldman (@nightshiftmd), host of a great CBC radio show called White Coat Black Art that dares to pull back the curtain on the hidden world of medical practice, seems to be the latest victim of integrative medicine (IM). This IM movement has been gaining traction with Western physicians and medical institutions: many North American hospitals now include complementary and alternative treatments alongside evidence-based medicine. The world-famous Mayo Clinic in Rochester has done it; our own Jewish General Hospital has done it as well.
In a recent mini-podcast for the CBC show, Dr. Goldman was being interviewed on Dr. David Gorski and Dr. Steven Novella’s paper in Trends in Molecular Medicine entitled “Clinical trials of integrative medicine: testing whether magic works?”. While he seemed to agree with the authors that treatments like homeopathy and Reiki have no plausible mechanism and have not been shown to work, my “hmm” alarm went off a few times when I noticed that Dr. Goldman kept saying, “the authors of the study show”, “the authors say”, “the authors claim”, etc.
At the end of the interview, Dr. Goldman, in a most irritating fashion, seemed to contradict himself:
“When there were calls in the past for more studies […], I thought it was plausible to wait and see. These days, I think, that attitude holds less and less appeal. I think anyone who is considering alternative medicine should ask tough questions about scientific evidence and, and I–I’d turn a 180 degrees if I don’t get good answers that this is safe and that it’s–it’s active, that it’s doing something beneficial.”
A few seconds later (italics mine):
“But if you are determined to use alternative treatments, then do them with Western medicine in addition–in a complementary way, not an ‘either/or’ thing. […] Be safe, do both, and hopefully you’ll find an enlightened family doctor or specialist who will entertain both.”
You can listen to the whole interview here.
White Coat Black Art is one of my favourite podcasts. I think Dr. Goldman has shown remarkable drive and passion in bringing controversial topics in medicine to light. However, this is an instance where I think the IM movement is just too appealing. I don’t think physicians who “entertain both” are “enlightened”. I consulted with a Western physician a few years back when I wanted to “do both”, one last hurrah for wishful thinking before I became the staunch rationalist I would like to think I am today. This doctor did not agree to monitor my liver enzymes while I indulged in unproven Chinese herbs. He educated me and set me straight: he questioned my reasoning. That is being an “enlightened” physician.
Thank you, Dr. Tischkowitz. You did the right thing.
Dr. Goldman? How much negative evidence do you need to take a stronger stance? Enough of the wishy-washy stuff around alternative medicine. If it had been proved to work, it would be medicine. Let’s spend government money in more promising treatment modalities.