FRONTLINE: The Alternative Fix
Raney Aronson
Producer
Friday, November 07, 2003; 1:30 p.m ET
Under pressure from everyone from consumers to Congress -- and tempted by huge grants -- major hospitals and medical schools have embraced therapies that they once dismissed as quackery. So accepted, in fact, have alternative medical treatments become that an entire center of the National Institutes of Health is now devoted to it. But the question remains: Do these treatments actually work? In "The Alternative Fix" FRONTLINE examines the
controversy over complementary and alternative medical treatments.
Producer Raney Aronson was online Friday, Nov. 7 at 1:30 p.m. ET, to discuss the film and the increasingly mainstream notion of alternative medicine.
"The Alternative Fix," airs Thursday, Nov. 6 on PBS. (check local listings)
A transcript follows.
Editor's Note: washingtonpost.com moderators retain editorial control
over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.
Raney Aronson: I'm very glad to be here today to discuss with all of you your questions regarding the show last night. This is one of my most favorite parts of the process which is talking to people who've actually seen the show and have further questions.
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Seattle, Wash.:
Is there any current demographic data describing the client utilizing CAM?
Raney Aronson: That's a great question. We actually looked into the demographics of the people who use alternative medicine. What we found was surprising. While most of the people who use alternative medicine are baby boomers, younger people in their teens and twenties are starting to use alternative medicine in increasing numbers. A lot of this is due to the intake of dietary supplements.
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Beaverton, Ore.:
Thanks for a well-balanced show which, for once, presented the skeptics' view of things. I would like to see a follow-up story detailing any progress made by the NIH in investigating alternative therapies; specifically, which ones have been shown to be ineffective. So far the NIH has a poor track record in dismissing useless alternative 'therapies'. It would also be interesting to see whether public interest in a particular therapy wanes following a negative outcome.
Raney Aronson: Let's talk about the issue of whether the public responds to information that comes out of studies. Because there are so few studies out there, the only one we can really look at is the reaction to the St. John's Wort study that came out last year. What we found was with the negative findings of the study there was an initial drop-off in sales but then shortly after there was a plateau effect. So really, the study had no impact on the sales.
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Montpelier, Vt.:
Almost everyone I know has used at least one herbal medication, yet there are very few studies of the effectiveness/safety of these treatments, or of their interactions with more "main stream" drugs. Do you know of any good studies that have been done? I'm particularly interested in black cohosh, which is taken by millions of menopausal-age women. Thank you.
Raney Aronson: I think what we can say at this point is that there's more anecdotal evidence rather than scientific evidence. For the strictly scientific evidence, you can find this information on the National Institutes of Health (NIH) Web site as well as FRONTLINE's which answers a lot of these questions regaring what works and what doesn't work.
Specifically about black cohosh, after hormones were found to be troubling, many women turned to this herb and have found it anecdotally to be helpful. However, there's no evidence to suggest this yet.
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Farragut West, Washington, D.C.:
Why has the public, and even many in the health professions, allowed alternative medicine a virtual free ride? So many of these alternative medicine "cures" have never been subjected to rigorous studies, as have just about every conventional medical advance. I've even heard ridiculous arguments that the scientific method doesn't apply to alternative medicine and one must simply accept that it works. Is there anyone out there railing against this quackery?
Raney Aronson: Sure. There are plenty of people railing against alternative medicine. For that point of view you should visit www.quackwatch.com.
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Haymarket, Va.:
Good afternoon,
I find this topic extremely interesting because of the ignorance of the medical establishment. However, I do believe they have a good point when they scientifically analyze the chemical, physical properties of alternative medicines and immediately debunk their effectiveness, and from pressure from pharmaceutical companies as well. But the medidal elite always seem to underestimate the power of the human mind. How successful is the human body with fixing itself? And with alternative medicines, if used correctly, can't hurt, right? Thanks
Raney Aronson: That's a difficult question. I think the medical establishment, as far as I can tell, is actually becoming more open to studying alternative medicice and from their framework and training, this is the best way that they think they can understand these treatments. Whether the mind has power over the body or can heal itself is one of the great mysteries that many scientists are now looking at but cannot provide real answers yet. It's a very new and exciting field of inquiry.
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Burke, Va.:
What do you hope will come of your series? As a result of your in-depth look at CAM, how would you go about finding a CAM practitioner who has proven results with his/her clients for the condition you have? How would you determine which CAM modality would be best for your condition? Health care for the most part has and will always be word of mouth because of its intimate nature. Bodies are not "products". How can small business people who are reputable CAM practitioners with proven results for specific conditions best offer their treatment options?
Raney Aronson: What I hope is that this film will raise awareness about the reality of where we are in terms of knowing what works and what doesn't work.
In terms of finding a CAM practitioner, first you should discuss with your primary care physician the issues that you're dealing with and in many cases they may be able to point you in the right direction. The other thing you can do is to again go on the NIH Web site and look at their directory.
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Carlos, Minn.:
Since chiropractic was rated one of the most likely forms of alternative health care why did your story not look at the large body of reasearch supporting this type of care -- for example the Rand study showing chiropractic to be much more effective for lower back pain, or the study that was in progress by NIH showing chiropractic greater effectiveness for headaches of all types?
Thank you.
Raney Aronson: When producing a film you have to make decisions and we only had 52 minutes. In the case of chiropractic, my feeling was it gets a lot of press already. And I always look at things that aren't in the public eye as much and I try to make these evaluations on a case-by-case basis.
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Saint Louis, Mo.:
Would you please fully disclose your personal position with alternative therapies? Have you or friends or family any experiences, positive or negative, with any alternative therapies or dietary supplements? With conventional medical care? Do you have any friends or family in
the healthcare field? Has your personal health history influenced your views of any aspect of American health care? In sum, what
is your personal stance on the subject of alternative healthcare? Thank you.
Raney Aronson: Part of being a journalist is separating your personal beliefs from your reporting. In this case I do in fact have a lot of prior knowledge on this subject. My father is a medical doctor and my mother uses herbs and opts out of the medical system whenever she can in favor of more natural approaches. So actually, I was brought up with both influences and have learned a great deal from both sides.
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Westport, Conn.:
Dear Frontline:
What the conventional people [i.e. M.D.'s] never address -- when they trot out the "placebo effect" as an explanation of how alternative therapies "seem" to work -- is that almost every patient tries an alternative therapy AFTER coventional ones have failed. Why didn't the placebo effect work when they first saw their M.D. -- the patient has more faith in him [her]. You mean placebo effect only works for alternative therapies?
Raney Aronson: Certainly not. As a matter of fact, a very interesting study was done that showed even in conventional medicine the placebo effect is a powerful force. But of course, you have to be careful to assume that this really answers the question about the placebo effect because there have been other contradictory studies that have come out of Europe. So right now the verdict's out.
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Medford, Ore.:
I enjoyed the program. I wonder if you would consider subjecting the dominant medical paradigm to the same kind of scrutiny? It certainly is the bigger business. It would be interesting to compare how many of the regularly utilized therapeutics are subjected to the gold standard of double blinding. Are the foxes in the henhouse pointing their fingers at the chickens?
Raney Aronson: I was interested to find out in this process that many of the conventional treatments that we take for granted have actually not been subjected to the gold standard. Perhaps this is a topic for another film.
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Columbus, Ohio:
Why don't we see scientifically validated complimentary information on glycobiology and the eight glyconutrients that are having a profound effect on wellness? This technology has documented benefits for everything from lupus to ADHD. Check out Glycoscience.com and the Fisher Institute studies. Dr. John Axford, noted for his work in glycobiology has joined Mannatech, Inc. in their quest for global wellness.
Raney Aronson: Right now there is very limited government funding. What I believe the NIH tries to do is study the supplements that are out on the market that people use the most.
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Fairfax, Va.:
My internist has retired and I'm very
interested in finding a new primary care
physician (preferably in Northern Virginia)
who practices INTEGRATIVE medicine
(conventional and alternative therapies for
the whole person -- body, mind, spirit).
How do I go about finding such a
physician? Could the NIH center provide
recommendations?
Raney Aronson: The NIH will not be able to provide specific recommendations but they may be able to point you to an association in your state that could answer these questions better. Good luck.
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Fort Lauderdale, Fla.:
Comment:
Fantastic program with meritorious approach toward the countering of these greed-driven and reckless modern-day snake oil caravans that prey upon a gullible public that waywardly needs direction. (Like dogs that don't realize the potential harm of the chocolate.)
Science and qualified medicine takes a worthy stand here to send the message. Very well done.
We need a few more Raney Aronsons in the world involved with propelling what the public gathers in.
Raney Aronson: Thank you.
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West Windsor, N.J.:
This whole show was an insult to my intelligence. Why not tell the story of folic acid for which there was abundant evidence to support its use in preventing spinal bifida but for which FDA delayed and delayed for years while more children got this dread problem? Similar results if not so dramatic apply to other supplements.
Raney Aronson: The thrust of our program was to look at what the NIH (National Center for Complementary and Alternative Medicine -- NCCAM) has found. Certainly folic acid and many vitamins have been found to work but what we wanted to focus on were the modalities such as acupuncture and other treatments. We mentioned the St. John's Wort study because it was in fact the only large-scale study that NCCAM had completed to date.
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San Francisco, Calif.:
When will the acupunture study (featured last night) be published?
Raney Aronson: I wish I knew. The University of Maryland has told me within the next six months.
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Fairfax, Va.:
How would a practitioner with documented case studies of outstanding treatment outcomes attract the attention of a producer like you or others? Would you accept an email from me? How would I reach you?
Raney Aronson: By all means, you can send us e-mails. Just go to pbs.org/frontline and you can e-mail me directly on that site.
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Chicago, Ill.:
Can you talk more about Harkin's motivation to pass
DSHEA? Did he think that he and Hatch made
strange bedfellows? Does he feel the same 10 years
later?
Raney Aronson: I think those are all terrific questions. What I would do if I were you is e-mail Sen. Harkin himself. He's been very open to talking about these issues with the public.
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Somewhere, USA:
My sister visited her physician with no other symptoms but of carpal tunnel and was given a diagnosis of a large inoperable brain tumor and prognosis of 6 mos.-1 yr. to live. Although I begged her to consider other remedies (dietary, prayer) she immediately commenced her doctors' prescribed regime of radiation and chemo. Three months later, she died. I believe that mentally she just gave in and had she NOT undergone radiation/chemo, she'd be alive today. I know a woman who was given the exact diagnosis 20 years ago, who simply said "ok" and went home and resumed her normal life, and who is alive and well today.
Raney Aronson: Many regret to you and your family about your sister.
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Raney Aronson: Thank you so much for all of your questions and concerns and if you have any other questions or concerns, you can e-mail me directly through the FRONTLINE Web site: www.pbs.org/frontline.
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