Why "Two Views" On Health Means Bad Advice For Women

Providing different viewpoints on a issue is an important component of sound political or social policy study. But when it comes to stories about science, "telling both sides" can be dangerous and even harmful. Canada's leading women's magazine, Chatelaine, illustrates the problems of this approach in their recurring series, Two Views, where "Traditional and alternative medical experts face off on the best way to treat common health problems." With Two Views, Chatelaine propagates the idea that there is medicine, and equally valid "alternative" medicine that "traditional" practitioners don't know about, or haven't adopted yet. But the entire idea of "alternative" medicine is a fallacy advanced by advocates who embrace these therapies despite medical evidence. When it comes to scientific evidence, there simply aren't two equally accurate positions. There is evidence, and there is lack of evidence. When sufficient evidence accumulates to demonstrate that a particular therapy is effective, it ceases to be "alternative" and simply becomes"medicine". Consider the following "alternative" views, stacked up against conventional medical practice.

On head lice: the pharmacist suggests non-prescription lice treatment products with an evidence based treatment strategy. The alternative view, written by "Dula" a Toronto-based naturopath, includes advice like herbal rinses, essential oils ("kills the lice by suffocating the cells"), and anecdotal evidence ("I’ve used the natural alternative with my nieces and nephews, and it worked perfectly.") Overall, it's not supported by evidence, as I've blogged about over at Science-Based Pharmacy. The advice from the naturopath is almost certainly going to lead to recurrent lice infestations.

On back pain: the physiotherapist, Lorie Paterson, gives reasonable advice regarding stretching and strengthening. She strays into non-science, however, with a half-hearted endorsement of acupuncture, suggesting it may be helpful, but failing to note that it's no more effective than a placebo.
The Halifax-based acupuncturist, Diana Tong Li, delves deep in make-believe therapeutics with her recommendations. She claims, "Back pain is caused by blockages along meridians, which are energy pathways inside the body," despite the fact that meridians or energy pathways have never been shown to exist. In fact, it doesn't matter where you stick the acupuncture needles at all. She continues, "I examine the patient’s pulse, tongue and ears to assess how well her organs are functioning," which would have no bearing on back pain. She notes, "After the first few sessions, patients will notice relief, though it takes time for the pain to disappear completely," which is exactly consistent with the natural, untreated course of most back pain, with most cases improving rapidly within the first month. Acupuncture is positioned to be a real treatment alternative, when in fact fake acupuncture is as effective as "real" acupuncture. A Cochrane review, a respected appraisal group, concluded that evidence does not suggest acupuncture is effective for back pain.

On Cleansing: The dietitian, Jacqueline Ehlert, points out that cleansing is not supported by science, and don't make sense. And she accurately disputes the claims of detox advocates, noting, "20 pounds of waste isn’t clinging to your colon – that’s outlandish." Ehlert reflects the consensus that cleansing isn't an accepted medical practice.
The alternative view, by Simcoe, Ontario based Heidi Kussman-Armstrong, a naturopath, is not evidence-based . She espouses the merits of cleansing without actually telling you what's being removed from the body. She offers generalities like, "It’s like getting your car’s oil changed," and "As the toxins are removed from where they’re stored in your body, you might get headaches or feel tired," when in fact any headaches and fatigue are more likely due to the nonsensical detox diets recommendations that accompany a cleanse. Cleansing or detoxing is commonly recommended by naturopaths, and there's zero evidence to support their use.

On Smoking Cessation: Family doctor Christina Tunzi summarizes drug treatments demonstrated to improve quit rates, and includes a reference to counseling support, which has also been demonstrated to be effective. The alternative view, from Ottawa hypnotherapist Susan Barker, suggests that a client will quit smoking after a single visit. This despite evidence to suggest that hypnotherapy is no more effective than no therapy at all.

On Physical Exams, Dr. Catherine Cervin outlines the elements of a regular annual examination. The Markham, Ontario-based naturopath, Iva Lloyd, wants to check a patient's tongue for signs of stomach "toxins" and believes that the body's pH is something that needs to be tested, an idea not based on science. These are odd recommendations that suggest a lack of understanding of both disease and basic physiology.

Two Views, in its format of "telling both sides" of an approach to a medical condition, does little to improve one's understanding of what the scientific evidence actually says. Throughout the series, "conventional" practitioners tend to make cautious, evidence-based recommendations. Freed from the responsibility of relying on science or evidence, the assortment of naturopaths, acupuncturists and other "alternative" practitioners often make unsupported and unproven claims for treatment success.

Here's a suggestions, Chatelaine: Call the two columns "Science" and "Non-Science" to more accurately describe the content. Or better yet, drop the "alternative" perspective, and focus on providing accurate, science-based health information in your magazine.