April 2006 Bravo to Dr James Miles for his article, “Snake oil revisited: For doctors’ eyes only” (BCMJ 2006;48:[1]:20-21). Being a UBC Med graduate of 1995, I would like your readers to know that his skeptical approach to alternative medical therapies is not limited to the cohort of retired physicians. In fact, I concede that patients may feel better and be happier pursuing alternative cures when we are quite satisfied that there is nothing interventional that can or should be done for them. This is especially true of patients suffering from no detectable physiologic pathology.
But we must be honest with ourselves and admit that we are using these alternative treatments as placebos, and, accordingly, must not give credence to potentially harmful or expensive modes of placebo. Furthermore, when these alternative approaches are dealt with in the medical curriculum, they must be taught scientifically. Impressionable young doctors should realize that these are placebos until proven—really proven—otherwise. The manufacturers and distributors of these remedies should be held to account as much as we would require of any pharmaceutical company.
—Ari Giligson, MD
Delta