5 ms·

This quip really annoys me. It only seems true because of a confusion or blurring of two very distinct concepts. There is tested treatment, which has been teste

by glomph 13y ago

This quip really annoys me. It only seems true because of a confusion or blurring of two very distinct concepts. There is tested treatment, which has been tested and come out effective. This can be put in dichotomy with untested or failed treatment. That is logical. Some treatments have been tested and passed some haven't. This is an entirely different dichotomy to that of mainstream and alternative or complementary medicine. Many forms of medicine have been thoroughly tested and come out effective and are not offered by pharmacies and national health services. Unless you want to claim that absolutely all proven effective treatment is offered by mainstream medical providers then this has to be acknowledged. Then on the other side there is a large array of medicine that is provided by mainstream medical providers that has not been proven effective. Many antidepressants consistently score the same or worse than a placebo in blind tests. The distinction between alternative medicine and mainstream medicine is not proof, but the provider. So while Minchin may be eloquent he is confusing terms to make his point.

reverius42 13y ago
The difference is not in the provider, but in what is being provided. Alternative providers provide alternative medicine. What you call "mainstream" providers provide tested, evidence-based medicine. Certainly there are some who provide both, but they should probably know better.
- carbocation 13y ago
  > What you call "mainstream" providers provide tested, evidence-based medicine. I think there is more nuance than that. Modern medicine is a mix of things that people have been doing for a long time and things that newer that are proven to work in randomized, controlled trials (for certain values of "work"). The things we've been doing for a long time might not work. An important difference between the field of modern medicine and the field of alternative medicine, in my biased view, is that modern medicine actively attempts to figure out what works based on evidence, and evidence hugely changes practice and standards of care. In contrast, I do not believe that the same is equally true in general in alternative medicine, at least not with well designed studies.
  - Alex3917 13y ago
    Exactly. Of the 11,714 drugs approved for marketing by the FDA, ~7,624 (65%) of them were approved with absolutely zero evidence of either safety or efficacy because they were grandfathered in by the 1962 amendments of the pure food and drug act. But of course the folks that big pharma pays to astroturf on Internet forums will never tell you that.
dllthomas 13y ago
Eh, I think the quip is entirely an appropriate expression of how things should work. It is also not horrifically inaccurate as a description of how things do work, 1) as far as it goes, and 2) in the medium to long term. Both of these caveats are important. It does not say that all mainstream medicine is proved - we should hopefully be moving in that direction, particularly with the EBM push, but while granting there is a lot of baggage the comment does not say "everything we call medicine is alternative medicine since proved", it says "when we prove alternative medicine, it just becomes medicine" - which it does, eventually, as demonstrably effective treatments are adopted by mainstream practitioners - which, over time, they do tend to be.

by glomph 13y ago

reverius42 13y ago

The difference is not in the provider, but in what is being provided. Alternative providers provide alternative medicine. What you call "mainstream" providers provide tested, evidence-based medicine. Certainly there are some who provide both, but they should probably know better.

carbocation 13y ago
> What you call "mainstream" providers provide tested, evidence-based medicine. I think there is more nuance than that. Modern medicine is a mix of things that people have been doing for a long time and things that newer that are proven to work in randomized, controlled trials (for certain values of "work"). The things we've been doing for a long time might not work. An important difference between the field of modern medicine and the field of alternative medicine, in my biased view, is that modern medicine actively attempts to figure out what works based on evidence, and evidence hugely changes practice and standards of care. In contrast, I do not believe that the same is equally true in general in alternative medicine, at least not with well designed studies.
- Alex3917 13y ago
  Exactly. Of the 11,714 drugs approved for marketing by the FDA, ~7,624 (65%) of them were approved with absolutely zero evidence of either safety or efficacy because they were grandfathered in by the 1962 amendments of the pure food and drug act. But of course the folks that big pharma pays to astroturf on Internet forums will never tell you that.

dllthomas 13y ago

Eh, I think the quip is entirely an appropriate expression of how things should work. It is also not horrifically inaccurate as a description of how things do work, 1) as far as it goes, and 2) in the medium to long term. Both of these caveats are important. It does not say that all mainstream medicine is proved - we should hopefully be moving in that direction, particularly with the EBM push, but while granting there is a lot of baggage the comment does not say "everything we call medicine is alternative medicine since proved", it says "when we prove alternative medicine, it just becomes medicine" - which it does, eventually, as demonstrably effective treatments are adopted by mainstream practitioners - which, over time, they do tend to be.