Despite the real harm unproven or bogus alternative therapies can cause, I get a lot of flak here for being critical of alternative practitioners. Some of that stems from the natural resentment of having one’s beliefs questioned. Alternative medicine is more of a philosophy, even a religion, than it is a rational approach to healthcare (1,2,3), so challenging it is much like questioning someone’s religious beliefs, and it tends to draw the same sort of response as illustrated by the sometimes vicious hate mail I get (4,5). And pointing out the lack of scientific evidence or a plausible theory behind an alternative practice can (hopefully) dissuade people from pursuing it, which obviously threatens the livelihood of some practitioners, so naturally this would engender some angry responses.
However, this criticism of criticism is pretty hypocritical given that the foundation of most alternative medicine marketing is exaggerating the risks and minimizing or ignoring the benefits of science-based medicine. The criticism alternative practitioners level at conventional medicine in promoting their own practices is often dramatic, and even those who claim their methods are compatible with conventional therapies and that they employ these still most often give more credit to the alternative treatments they use.(6, 7, 8, 9, 10, 11, 12) Ultimately, most alternatives to science-based medicine have to be sold with the claim, or at least the implication, that they work better than conventional medicine or in situations where it does not, whether or not there is evidence to support these claims.
A reader recently pointed me towards a particularly egregious example of the marketing of complete nonsense as a substitute for real medical care. See if you can spot the subtle suggestion that the methods being offered can replace conventional care.
That wasn’t hard, was it? Now in the U.S. it is illegal to claim to diagnose or treat any disease without a license to practice veterinary medicine. I presume the same rule applies in Canada, where this quack is located, and as a result the web site is all about implying therapeutic powers without ever actually directly stating this. The usual sort of disingenuous CYA disclaimer appears on the home page:
The information contained on this website is for educational purposes only. It is not to be used as medical treatment or diagnoses. Do not alter any medical treatment, or the use of any medication without the permission of your medical care provider.
So if you aren’t supposed to use these products and services as medical treatments, why is the site called “No Vet for My Pet?” And why are there lists of medical conditions, from allergies to infections to cancer, paired with the names of specific products? Doesn’t that perhaps suggest the products are recommended as treatments for those conditions?
The site belongs to a veterinary technician/nurse named Salina Bhimji. Veterinary nurses, like nurses in human medicine, are in many ways the backbone of clinical medicine. They provide much of the direct patient care, and they serve as eyes, ears, hands, and often brain and conscience for veterinarians. I am blessed to work at a hospital with an amazing staff of highly intelligent, motivated, and trained nurses, and they make life incalculably better for me and my patients.
Unfortunately, in human medicine nurses are often a driving force for the integration of pseudoscience and nonsense into patient care, and I have seen at least some examples of the same problem in veterinary medicine. Healing Touch is the classic example of such a method among nurses in the human medical field. A form of “energy medicine,” which really amounts to a spiritual rather than a medical practice, it was invented by a nurse and has been accepted and promoted primarily by nurses despite clear evidence that it is nothing but a placebo ritual.
It is actually understandable that nurses in human and veterinary medicine might be more inclined towards alternative therapies than many doctors. Their training is often more practical and involves less basic science and scientific method and theory. And nurses provide most of the direct comfort to patients, so treating psychological, emotional, and spiritual needs more often falls within their domain than in the territory of doctors.
Most nurses, fortunately, believe in providing comfort and high-quality, science-based medical care, but a small group do tend to be sympathetic towards the kind of nonsense Ms. Bhimji sells. It is critical that those of us committed to evidence-based medicine include the nursing/technician community in our ranks and in our education and training efforts, because they are a large and indispensable part of the healthcare system for our patients.
According to her bio, Ms. Bhimji has an undergraduate biology degree and became a certified veterinary technician working at veterinary emergency hospitals. Apparently finding real medicine not to her liking, she has begun offering a wide array of the most ludicrous pseudoscientific and mystical nonsense available in the alternative medicine “toolbox.”
So what sort of alternatives does she offer? She seems to specialize in the more spiritual styles of therapy. This may be because of her personal beliefs, but I suspect it has more to do with legal restrictions on providing the more “medical” forms of alternative therapy (herbal remedies, acupuncture, chiropractic, and so on) without a license to practice medicine. She states that she is pursuing a doctorate in naturopathy, so I expect once she achieves that she will expand her product line—uh, I mean “toolbox.”
This is is essentially a form of spiritual healing in which a healer directs a mysterious form of spiritual “energy” to heal physical disease.(13) It has the advantage over some alternative therapies of being benign in itself since it relies on magic rather than plant chemicals or needles. Nevertheless, no reliable scientific evidence has demonstrated any actual healing effects. If magic is real, then perhaps someday we will be able to demonstrate such effects, but as Tim Minchin has pointed out, “Throughout history, every mystery ever solved has turned out to be—not magic.”
The process of performing Reiki, however, might have some actual behavioral and physical effects on animals. It does, after all, involve quiet, gentle interaction and sometimes touch from a human. Anyone who has ever shared a bed or petted a dog or cat will be unsurprised by the idea that animals might enjoy this sort of interaction and find it comforting. It seems gratuitous to take ordinary kind and comforting interaction that might help shelter animals and load it down with a pile of mystical baggage and then claim that is why the animals benefit.
The use of spiritual practices in medical care does come with significant risks. While the humans involved may find such practices comforting, and that is a good thing, there is no reason to think our animals share any of our many specific and often incompatible spiritual beliefs. I have personally seen animals who are suffering be denied appropriate pain control and human euthanasia by owners whose spiritual beliefs precluded the use of these therapies. While animal owners are entitled to these beliefs, veterinarians have a duty to advocate for the welfare and interests of our patients. It is all too easy for psychologically comforting rituals like Reiki, acupuncture, homeopathy, and so on to fool us into thinking we have done something real to reduce an animal’s suffering when we actually have not. We must rely on objective scientific evidence to help us determine if what we are doing is truly comforting our patients and not just us.
Ms. Bhimji has a variety of certificates from training as Reiki practitioner. This may qualify her as a spiritual advisor of sorts to people who believe in the sort of ideas behind Reiki, but it does not give her any legitimate medical expertise or right to imply that she can treat health problems in veterinary patients.
A separate service Ms. Bhimji lists on her site is “energy healing,” but it is unclear how this differs from Reiki, which is just one of many forms of “energy medicine” (aka faith healing).
Here is how Ms. Bhimji describes this therapy:
What is Crystal Healing
This is a healing method that is used to heal animals using various types of crystals. There are many different crystals that work well with animals, it is about what crystal resonates with you. If a crystal jumps out at you, or you are attracted to one, that is the stone that you are meant to use.
What does it do?
Using crystals in conjunction with other healing methods can enhance the healing process for an animal. They simply amplify the energy that is flowing throught [sic] the animal.
It should be fairly obvious that this is again more religion than medicine, but there is no scientific evidence that crystal healing is anything other than a placebo therapy. (14, 15) While one can legitimately debate the merits of offering people placebos, it is clear that it is ethically unacceptable to treat disease in animals with placebos for their owners. (16)
Essential oils are one of the products and services Ms. Bhimji offers which sound less obviously like religion and more like actual medicine. The claim that odors distilled from plants can heal disease, however, is still pseudoscience unsupported by reliable research evidence. There is little doubt smells can have potent emotional effects on humans, and they could potentially have behavioral effects on veterinary patients. BThere is weak evidence for beneficial effects on subjective mood states, such as anxiety, in humans, but the notion that they can influence the outcome of serious diseases, such as cancer, diabetes, and so on, is entirely unproven and highly implausible. (17, 18, 19, 20)
Ms. Bhimji specifically offers a type of essential oil therapy called Raindrop, and she proudly attributes the practice to Gary Young. Mr. Young is an infamous character with a long history in alternative medicine. Though the details are often in dispute, and Mr. Young does not hesitate to threaten legal action against those who criticize him, he has apparently been in regular legal trouble for practicing medicine without a license, making illegal drug claims, and other alternative medicine marketing activities for decades. (21, 22, 23, 24, 25, 26). This is not a source anyone should trust, and the fact that Ms. Bhimji uses Mr. Young’s method and appears to admire him speak poorly of her own judgment and reliability.
Finally, Ms. Bimji offers consultations in person or via Skype for $50-65 per hour to help pet owners “achieve their goals in enhancing the health and wellness of their pet.” She also offers a variety of educational presentations in person and online. While I suspect there is nothing illegal in this, it seems obviously unethical and fraudulent by every other definition. Ms. Bhimji essentially offers either spiritual guidance or completely unsupported pseudoscience and calls it “healing” or “wellness.” It is hard to imagine how anyone could come to this web site and view the material there as anything other than healthcare advice for their pets, despite all the careful language and disclaimers, so the site strikes me as misleading even if Ms. Bhimji actually believes the nonsense she is preaching.
I have no quarrel with people who find comfort during times of illness from spiritual practices. And I see no problem with utilizing these practices for our pets when they are intended to give us spiritual and emotional comfort. But there is a meaningful difference between medicine and religion, and when the distinction gets muddled patients suffer. Treating serious disease in animals with religious rituals and pseudoscience in lieu of science-based medicine denies these patients real, effective medical care and causes real and unnecessary suffering. Advertising oneself as a spiritual advisor helping people cope with their pets’ illness is perfectly fair. Advertising spiritual services and bogus treatments as if they had real medical benefits is misleading and dangerous.
Ms. Bhimji seems to take great care to avoid explicit claims that could get her in trouble with the law though I suspect those will appear if and when she gets licensed as a naturopath. But she clearly creates the impression that what she offers can have real medical benefits and can replace science-based medical care, and that is wrong whether legal or not.