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Dec. 13, 2005 -- If you need proof of the enormous popularity of alternative medicine, look no further than the New York Times best-seller list. A book titled Natural Cures 'They' Don't Want You To Know About, hawked by its author in nonstop TV infomercials, has topped the self-help list for months.
Unquestionably, the book's success is a testament to the abilities of the author, Kevin Trudeau, as a master huckster. Having appeared in numerous infomercials for everything from memory-enhancement systems to pain-relieving adhesive strips, Trudeau was sued by the Federal Trade Commission in 2003 for making bogus claims. He agreed in a settlement to pay $2 million and stop peddling health products in infomercials. (Books, oddly, are OK.) He's also been to prison for credit card fraud.
Beyond the author's salesmanship, though, is a larger phenomenon driving so many to buy the book: Consumers are hungry for information about alternative medicine and willing to go just about anywhere to find it.
It's a need frequently reflected in users' emails to WebMD. Many readers ask about dietary supplements or other alternative therapies, with some expressing disappointment and even anger over what they regard as WebMD's inadequate attention to such topics. For example, one user, weighing various options for relieving back pain, inquires why WebMD's treatment section on back pain barely mentions chiropractic care. "Would it not be reasonable for you to at least touch on the subject?" the reader asks. Likewise, another user observes that in WebMD's cholesterol information, there's no discussion of fish oil supplements, a therapy she says has helped her.
Both raise valid points. Some research (summarized by the NIH's ) suggests that chiropractic manipulation may be as effective as conventional care for treating back pain. Yet WebMD's "Health Guide" reference section on back pain, which goes into detail about medications, surgery, and even experimental therapies like Botox, devotes just two sentences to chiropractic care, saying only that it's unproven.
Likewise, studies show that omega-3 fatty acids, found in fish oil, may lower levels of blood fats called triglycerides. Typically, supplements are needed to get large enough doses to have an effect. But WebMD's Cholesterol Health Center refers only to the without discussing supplements.
The user pointing out the omega-3 omission offers an explanation for it: "My doctor ... ignored it like you have because you both are in bed with drug companies." Such a feeling echoes the main argument of Natural Cures - that there's a conspiracy by the government, drug companies, and the media to suppress information about "natural" remedies that have supposedly been proven to cure everything from diabetes to cancer.
I don't buy that idea, and I see no evidence that WebMD is deliberately withholding information about alternative remedies from its users, for financial or any other reasons. In fact, its news articles often cover studies about therapies outside the mainstream, and WebMD has a section of the site devoted exclusively to alternative medicine.
Still, WebMD's content on the subject is far from complete - a reflection not of systematic bias, in my view, but of the difficulty of gathering timely, reliable information on alternative remedies and presenting it in a balanced way.
As in politics, the middle ground in alternative medicine is fairly small. On one side are vocal cheerleaders for alternative therapies who insist, with little or no evidence, that nearly every remedy they encounter is a miracle cure. And because these therapies are "natural," the argument goes, they're also safe. (Never mind that arsenic and hemlock are natural, too.) Anyone who questions or challenges their assertions is typically accused of being in cahoots with drug companies.
On the other extreme are equally outspoken forces that label anything outside mainstream medicine as "quackery." Lumping all alternative treatments into the same category, they make no distinctions among those that show promise, those that are obvious scams, and those for which there are little data one way or the other. When asked about any alternative remedy, their standard and only response is that it's "unproven," even though the same can be said for a number of treatments in conventional medicine.
What consumers desperately want and need is advice from credible experts who aren't driven by agendas but are able to objectively and honestly assess a therapy's potential effectiveness and safety. That typically requires looking at incomplete evidence and laying out what's known and not known, helping consumers make educated guesses about whether something is worth trying. It also means reminding people that anyone who gets any therapy with limited science behind it is a guinea pig. A treatment that seems promising in early studies may not pan out later - or may prove to be harmful. Then again, it may turn out to be effective and eventually become part of mainstream medicine.
Unfortunately, guidance from the middle ground is in relatively short supply. Finding medical experts who occupy this territory, and who are skilled at leading consumers through the alternative medicine thicket, isn't easy. Plus, in a field that's so diverse (encompassing everything from acupuncture to coffee enemas) and evolving so rapidly, it's no small task to stay abreast of every development and continually update advice accordingly.
Despite these challenges, WebMD should expand its commitment to covering alternative medicine. Users visiting the site are right to expect thorough, balanced, and honest information about ALL their medical options - including those that fall outside the mainstream. Skeptics of alternative medicine may object, but I remind them that millions of Americans seek out alternative remedies every year, and will continue to do so, whether these critics approve or not. If more consumers can get help from a trusted source like WebMD, maybe fewer will feel a need to turn to TV hucksters.
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Robert Davis, PhD, is the reader's representative. His opinions and conclusions are his own.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.
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