Unit 8Section 3 Exercise 10Evidence-Based Medicine versus Alternative Medicine

Clinical correlate #5 Complementary and Alternative Medicine

Here's a skit representing a dialogue between a doctor and patient arong the use of 'alternative medicines.' Alternative treatment modalities are a multi-bilion dollar industry. Often, patients are more willing to accept such treatments without proven efficacy than they would conventional treatments. Physicians, in turn, are not necessarily well-informed about these types of treatment. For comprehensive information, see the following website. http://nccam.nih.gov View the video and answer the study questions.

Alec Anders

Study Questions

1. The physician dismisses the patient’s use of alternative remedies, advising her not to waste her money on such “garbage.” How do you feel about the physician’s demeanor? What specifically bothered you about the way he interacted with this patient? What effect does the physician’s attitude have on the patient-physician relationship?

2. What is the physician’s responsibility regarding knowledge of alternative treatments? Should healthcare providers be expected to know of treatments such as homeopathy and herbal remedies, and to what extent? What are the two sides of the argument depicted in this scenario?

3. Does the physician have a realistic view of the power of FDA-approved medications? The doctor says, “Everything we do is hard scientific evidence…Stick with us. We’re the people leading the world in healthcare.” What is your reaction to his statement? In its first health system scorecard released two years ago, The Commonwealth Fund Commission on a High Performance Health System found that the United States "fell far short of benchmarks for access, quality, efficiency, andother key measures of health system performance." The 2008 edition of the scorecard "paints an even bleaker picture, with the U.S. scoring an average of 65 out of a possible 100 across 37 indicators--slightly below the overall score in the 2006 report." Realistically, how much protection does FDA approval grant to patients? You may be asked to research some of the controversies surrounding the FDA’s decisions on premature or delayed approvals.

4. If the patient sees another physician or returns to this clinic, do you think she is likely to mention her use of alternative medications? How should the physician have handled this encounter to foster communication and trust, while providing quality medical advice and therapy?