Hi Mervyn, I have been having a good time with the different perspectives. I am on vacation and have not had a chance to study the paper in the Archives of Medicine. In addition, to looking at the study details, I would also review the paper with acupuncturists. Or else we are arguing after the a few minutes of the usual web surfing.
Before I go into some details of this study, let me make a few important comments. We cannot accept at face-value of what works / should work. Just last week, I had a patient with an advanced cancer who convinced herself that she can boost her immune system with carrot juice and does not need cancer treatment. So self-medication, based on what one reads in the lay-press, or (even worse) an advertisement, is a disservice to oneself. Mind-over-body is not going to work for infection control, cancer, heart attack, etc. Also, an important part of treating an illness is to make a correct diagnosis and exclude other illnesses. In case of chronic low backache, it is important that more serious diseases are excluded including slip-disc and cancer. As I look at the controversy on goanet, I see some oscillation between true "science" and the true "practice of medicine". And within each group there are changing standards. Science: Frequently, we call ourselves scientists till it comes time to accept the scientific results that defies our preconceptions. I thought "advanced" science was the latest that is presented in a peer reviewed reputable medical journal. It is my impression from the Newsweek article, this was a SCIENTIFIC head-to-head TRIAL comparing "standard medical care" to acupuncture treatments which some people call placebo. I have met many Indian physicians with their MD training are hesitant to accept acupuncture, which is a well accepted treatment for pain - one option in the armamentarium of pain management. Some refuse to accept the effect of 'mind over body' which the author, a neuro-scientist is presenting. Remember THIS IS NEW, that is why it is being presented in a scientific journal and written up in Newsweek. In the above SCIENTIFIC study, some hesitate to accept the clinical results - granted all the details of how acupuncture (including sham acupuncture) works are not known. Certainly, the results are intriguing and more work needs to be done in this this field. This is no different than advances need to be done for better drugs of help patients with chronic backache. Clinical Practice: The issue becomes: Does the 'scientific doctor' prescribe the "proven / accepted standard of care" for chronic low backache, which provided LESS benefit (39 percent) than acupuncture (60 percent)? This has been PROVEN by THIS SCIENTIFIC STUDY. Further what does one do for the 61 percent of patients, who do not benefit from "accepted standard of care"? Despite all the science, in the case of backache management, the patient is the best judge in how much pain relief they have achieved and if they undergo more treatments. There is also changing standards for practical allopathy from practical non-allopathy. In the practice of allopathy, often we prescribe "empirical treatment", which is based on teaching and experience of the practitioner (and rightly so). When the doctor strongly suspects urinary tract infection, the patient is prescribed Cipro without or before the results of bacterial culture. The same applies in pneumonia where patient may be prescribed Zithromax-pack without sputum bacterial exam (trying to keep this a lay dialog). So I would give the same latitude to a non-allopathy doctor, (without using words like deception) who advice their patients what in their opinion and experience works, guarding their own reputation and deep sincere desire to help a patient who has entrusted their care (life) in their hands. Certainly there are SOME in the allopathy and non-allopathy field who may not practice the "standard of care" of their respective fields of expertise. Yet, every field has its own "bad apples". I encourage all practitioners to be aware that their treatments even if "proven", may not work, in which case they need to be humble enough to accept the limitations of their skill and treatment. Regards, GL --------------- Mervyn Lobo whether it is Western medicine or traditional, the medicine-man has to collect information. What may work for one patient, may not work for another. The bottom line being that the giant western multi-nationals have paid people to be guinea-pigs while researching the drug and its effects. When the traditional drug from the traditional healer does not work on you, guess what? You are the guinea-pig. ------------------ Santosh Helekar wrote: "The physician who prescribes a placebo to his patient is engaging in deception. He is intentionally lying to the latter that he is administering a real treatment with a predictable effect, when he clearly knows that he is not. The ethics of such deception are questionable outside the confines of a scientific clinical trial. The latter circumstance is exceptional because a legally and ethically valid informed consent is obtained from all participants of a study."
