The best definition seems to be “those practices that are not taught in conventional medical schools.” And why not? Because medical schools are sticklers for a little detail called “evidence.” After all, patients have a right to expect that a course of action recommended by a physician has a reasonable chance of working. In science, evidence means statistically significant results from properly controlled experiments, as evaluated by experts in the field. Lack of evidence of course does not mean that a particular treatment cannot work. Only that it has not been demonstrated to work. And that is when it can be termed “alternative.” If sufficient proof is mustered, “alternative” transforms into “conventional.”Â
Today, the conventional treatment of ulcers often involves the use of antibiotics. That’s because there is now clear-cut evidence that many ulcers are caused by the Helicobacter pylori bacterium. When the bacterial connection was first suggested by Drs. Barry Marshall and Robin Warren back in the 1980s, it was certainly in the “alternative” realm. After all, physicians “knew” that ulcers were caused by stress and excess stomach acid. Skeptics, appropriately, wanted evidence before they jumped on the bandwagon. And it didn’t take long for it to be provided.Â
In a cavalier, and somewhat foolhardy fashion, Marshall drank a solution of Helicobacter pylori and developed a case of gastritis. No ulcer formed, but the experiment managed to stir the scientific community into action and within a few years hundreds of papers were published on the subject. Controlled trials were carried out, and antibiotics were clearly shown to be an effective treatment for ulcers. Today, this is the preferred treatment and is taught in every conventional medical school. Although initially some physicians may have scoffed at the idea of ulcers being caused by bacteria, they were quickly won over by the evidence. Contrary to what is often claimed by alternative practitioners, physicians are not closed-minded about approaches they may not have learned about in medical school, they just would like to see some sort of evidence of efficacy before advocating them.
Alternative medicine encompasses a vast array of treatments, ranging from the possibly useful but unproven, to the ludicrous. If there is no efficacy in these alternative treatments, why do people flock to them? Because alternative practitioners are charismatic and often offer hope where mainstream medicine cannot. They use the placebo effect to great advantage and capitalize on the fact that many diseases are self-limiting and resolve by themselves. But when contemplating a course of treatment, it is prudent to reflect upon the words of the late Dr. Victor Herbert, renowned hematologist and champion of evidence-based medicine: “for every complex problem there is a simple solution, and it is always wrong.
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