Ominous signs and symptoms of serious disease are often overlooked, misinterpreted, and minimized by many overconfident and under-trained “professionals” in complementary and alternative medicine (CAM). It’s the most disastrous form of distraction from appropriate medical diagnosis and treatment, the steepest “opportunity cost.”1Distraction from a better option, basically. “In microeconomic theory, the opportunity cost, or alternative cost, of making a particular choice is the value of the most valuable choice out of those that were not taken. In other words, opportunity that will require sacrifices.” Opportunity cost is regarded by anti-quackery activists as the main non-obvious reason why alternative medicine is not “harmless.”
The only thing worse than ineffective treatment for dire health problems is to be deprived of good diagnosis in the first place. Patients may make poor choices even when they know exactly what they’re dealing with, but they’re doomed to it when the diagnosis is wrong or completely missing. The consequences are the most tragic when minor problems are missed until they become serious.
Controversies about appropriate treatment are conspicuous issues. There’s a lot of human drama involved in treating deadly diseases, which often involve impossible dilemmas and ethical puzzles with no right answer. The film Dallas Buyers Club is a really excellent example. And it’s always big news when celebrities make tough treatment choices: Steve Jobs initially treating his cancer with diet, or Angelina removing her breasts to prevent cancer. But their eyes were wide open.
There is almost no drama involved in diagnostic failure. Failed CAM diagnosis — wrong or missing — is almost never a story. It’s less newsworthy, because no one’s really all that surprised when CAM blows a diagnosis. And so the problem is constantly overlooked and underestimated.
Diagnostic failure in CAM is mostly caused by frank ignorance, and particularly by bad ideas drowning out better ones. Of course, physicians don’t know everything either and also have bad ideas — nobody’s perfect (see Medical Errors in Perspective). However, the chances of a doctor missing a scary diagnosis are much lower, especially because they have vastly more experience with much sicker people (see Chiropractor, Naturopath Training Way Less Than Doctors). In any event, failure in CAM is never excused by the failings of medicine (the tu quoque fallacy).
Diagnostic disaster is also caused by ideology and zealotry: a haughty disdain for “mainstream” medicine is extremely common among naturopaths, chiropractors, acupuncturists, and massage therapists. Many are much more alternative than they are complementary: not just dismissive but contemptuous of medical knowledge and opinion, extremely uncomplimentary complementary medicine. I have been constantly exposed to that attitude for many years now — it is much too common. See Alternative Medicine’s Choice: Alternative to What? Alternative to what? To cold and impersonal medicine? Or to science and reason?
About Paul Ingraham
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.