Mark Mosley: Not legitimate medicine

04/24/2014 12:00 AM

04/23/2014 5:42 PM

In 1910, the practice of medicine in America was transformed by the Flexner Report. Abraham Flexner was not a physician. He was an educator who demanded that medical education conform strictly to the scientific method.

Within a few years of the Flexner Report, almost half of all medical schools closed. The remaining schools changed dramatically. The professionalization of medicine for American physicians had been restructured on a foundation of scientific integrity.

What was the condition of American medicine before 1910 that necessitated such a cataclysmic change? Medical education and physicians used the medical field primarily as a financial enterprise without regard to valid scientific support.

“Proof” was provided by testimonials by patients who had been miraculously cured or by physicians claiming their personal experience. This approach, in its worst form, was epitomized by the “medicine show” selling “snake oil.”

The questionable therapies used to dupe the American public for personal financial gain included chiropractory, massage therapy, natural herbal therapy, homeopathy, electromagnetic therapy and probiotics. The professional scientific legitimacy of American medicine required the denial of these unproven therapies.

The 1960s, with the elevation of personal experience over organizational laws or truth, saw a resurrection of these “alternative medicines” into mainstream culture. The scientific medical community countered in the late 1980s and early ’90s with the advent of the “evidenced-based medicine movement.”

At this same time, the National Institutes of Health established the office of alternative medicine to see if these popular therapies could be scientifically validated. To date, almost none of these “natural” or “alternative” medicines, including a huge database of vitamin and mineral supplements, has shown much benefit. And when weighed against potential harm and cost, there is certainly no value in these therapies.

Yet they have become a massive financial industry every bit as popular as in the late 1800s. This is well-documented in the book “Nature Cures: The History of Alternative Medicine in America.”

Today, in 2014, the American medical profession is placing profit before professionalism and business strategy ahead of scientific integrity. Many “providers” have adopted vitamins, minerals, herbs, massage, chiropractory, homeopathy and other “alternative” approaches into some aspects of their practice to satisfy cultural and personal beliefs of patients.

“Alternative medicine” is less about medicine and more about “alternative income.”

We need another Flexner Report. Until then, the only power real physicians have to maintain the scientific integrity of our profession and to protect patients from harm is our duty to say, “Prove it first.” And if it cannot be consistently proved, we must have the moral courage to say: “No, I won’t. This is not legitimate medicine.”

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