Readers of this blog will be familiar with Dr. Shawn Messonier and his style of promoting alternative veterinary medicine by lying about scientific medicine and veterinarians who practice it (e.g. Here, Here, and Here). The latest example of this behavior is also a fine example of the bogus CAM marketing approach known as “healthcare choice.” I written about this strategy before, but in brief it is the claim that any argument against alternative methods, and certainly any attempt at regulation that requires proof of safety and efficacy before marketing a medical intervention, is an unjust suppression of people’s right to choose their own form of health care. Usually the argument is paired with accusations or implications that anyone who questions whether CAM works or is safe is only interested in protecting their own income.
Dr. Shawn makes this argument in its classic form in a recent blog post.
“As an integrative, naturopathic doctor, my practice is all about choice. While I hope I can convince my pet owning clients that using natural therapies whenever possible is the better, safer, usually less expensive, and healthier way to go, ultimately the choice of therapy chosen is up to the client.
If the client chooses a more conventional drug therapy, that’s her choice and I will never interfere with that choice…
It seems to me however that skeptics who rally against natural therapies don’t want their patients or clients to have this choice.
For many of these skeptical doctors, it’s “their way or the highway!”
They consistently try to talk patients out of a more natural approach to healthcare, all the while demeaning and insulting this choice, as if this choice is invalid or irrational…
The only answer I can come to after researching this question is this: economics.
If a doctor only offers one choice, in this case conventional drug or surgical therapy, and you choose a more natural approach, that means you will have to find another doctor. Your current doctor loses your business, and your choice punishes his pocket book. He won’t like that and will do anything to keep you as a patient.”
This argument is, of course, merely a cynical attempt to convince pet owners to choose Dr. Shawn’s methods by hypocritically claiming to offer more “choice,” which sounds better than admitting he has nothing but his word to offer as proof that his alternative methods actually are better for his patients. He criticizes conventional veterinarians for trying to talk clients out of using unsupported or outright quack therapies yet he admits to trying to convince his clients these therapies are better than scientific medicine, to which end he has many books, a radio program, and of course his web site, all of which are ways he makes his living. The argument is blatantly hypocritical on the face of it.
On his website, the good doctor discourages vaccination; claims commercial diets are full of toxins that lead to cancer; refers to pets taking conventional drugs as “pharmaceutical cripples” and encourages pet owners to “say NO to drugs,” and in many other ways discourages conventional medical therapies. Granted, he also makes use of many of the treatments provided by sound scientific medicine, and his practice philosophy seems to consist mostly of adding the unproven and the opinion-based on top of conventional medicine, but this is not about giving pet owners more choice, it is about pushing his own beliefs and opinions and then slandering anyone who challenges him to back those up with real evidence. If trying to convince clients about what one believes to be the true facts regarding a particular treatment is “interfering” with teir choice, than Dr. Messonier is as guilty of this as anyone.
CAM practitioners often claim to promote choice while actively claiming scientific medicine is mistaken and causes great harm. And it is not unusual to find statements such as the following from self-professed “holistic” veterinarians:
“Use of Other Modalities and Medications
The treatment program that we use is not compatible with the simultaneous use of conventional drugs such as antibiotics, corticosteroids, thyroid hormones, etc. As the cases progresses, you may be guided in the gradual discontinuance of some or all these medications. This is necessary so that our methods can take full effect. In addition, if other symptoms appear during treatment (or older, previous conditions return) you will be expected to contact us for appropriate response rather than use drugs that you may have used before. The reappearance of older problems can be a very good sign that the body is beginning to heal and this is usually a very delicate and important time. The use of conventional medications and treatments might make this healing impossible!”
However, the “health care choice” argument is wrong in many ways besides merely being hypocritical. It evades the underlying issue of what the choices being offered actually are. If a client is told that an unproven treatment is safe and effective and that conventional preventative or treatment interventions are toxic and harmful not helpful, then they are being deceived, intentionally or by the genuine mistaken beliefs of the practitioner. A choice to rely on placebos or therapies that don’t work and may very well do harm based on an “educational” harangue is not a true informed choice in an meaningful sense. The whole point of evidence-based medicine is to support our recommendations with objective scientific research, not merely our own biases and opinions. And the motivation behind practicing evidence-based medicine is better patient care, not simply making money.
Alternative therapies have not earned any special exemption from rigorous objective testing or criticism. They should be judged, as scientific medicine is judged, on their merits, not on the strength of the faith their proponents have in them. Viewing the implausible skeptically and asking for evidence rather than taking Dr. Shawn’s or anyone else word for the safety and efficacy of alternative methods is the right way to protect the well-being of our patients, an trying to label it an unfair restriction of consumer choice motivated by greed is simply another example of the unprofessional, hypocritical, and vapid marketing strategies many CAM proponents have to rely on absent the real convincing evidence they fail to provide.
Dr. Shawn has the zeal of a true believer, and the inability to consider the possibility he might be wrong. Claims like his of offering more freedom of choice than conventional veterinarians are simply a marketing strategy based on caricaturing and slandering veterinarians who practice science-based medicine and evading the challenge of backing up their medical practices with something more convincing than their own opinion and experience. Such language is unfortunately often effective in a society that sees choice as automatically a virtue and that likes simple, personalized arguments rather than complex, nuanced, and fact-based ones. We who adhere to the standards of evidence-based medicine are at the disadvantage of not being able to make any claim we like regardless of whether we can support it, and those of us who believe in challenging ideas and arguments rather than people and their motives are at a disadvantage in such debates as well. Rarely do you see too sober, polite, and well-informed adversaries arguing complex scientific issues on daytime television, since it is far less compelling to watch than vapid appeals to emotion like the “healthcare choice” argument. More’s the pity.