I have written previously about the philosophical foundations of alternative medicine and how they differ from those of science-based medicine, and I feel this is a critical issue for those of us advocating for the latter. It is important to remember that while proponents of alternative therapies may use the language of science to market their products and ideas, they often don’t really accept the principles that underlie the scientific method. Much of alternative medicine is based on ideas about how health and disease work and how knowledge is acquired and tested that have far more in common with religion than with science.

I recently ran across a fairly explicit example of this from a Dr. William Pollak, who has written at length about the beliefs underlying his holistic practices, and who demonstrates why so-called holistic medicine often requires an outright rejection of the practice of science and the means by which science produces knowledge. Dr. Pollak redefines science and knowledge in terms that allow him to preserve his belief system regardless of the evidence arrayed against it, and he rejects some of the most fundamental and well-established principles of scientific medicine.

This raises the question, of course, why such people can take advantage of the exclusive professional rights and privileges that go along with being a licensed veterinarian. If the legal and ethical standard of medical care is based on science, as is explicitly stated in many of the laws and ethics statements that define the practice of veterinary medicine, how is it possible to reject science and still practice medicine? Should not this sort of healing practice be treated more as a form of personal faith, not a form of regulated, professional medicine? While there will always be differences of opinion in medicine, how far does one need to go in rejecting the foundations and core principles of a discipline before one can no longer legitimately claim to be a practitioner of that discipline?

Scientific Method- The Marriage of Intellect and Intuition

In this essay, Dr. Pollak essentially redefines science, complete with cherry-picked quotes from Einstein and others, to suggest that intuition is as useful as intellect and far better than objective scientific data for guiding our understanding and medical practice. He uses the tropes of post-modernism to make this claim, arguing that there really is no objective knowledge only a point of view. And he invokes the once popular idea that the Heisenberg Uncertainty Principle, which involves measurements at a subatomic level, somehow invalidates all objectivity because of some mystical unity of all things.

Dr. Pollak goes further, implying that scientific experimentation is just a ritual for confirming belief, rather than a mechanism for uncovering the truth about nature. While I believe the evidence is clear this is untrue, even if it were it is hard to see how uncontrolled intuition and opinion would be more reliable or less subject to bias. Dr. Pollak’s essay is quite poetic in places, but it is poetry without logic or any connection to the real world outside his own thoughts. It is simply the projection of his own feelings and desires, as are all models of nature that do not test themselves against reality in a systematic way.

Heisenberg’s uncertainty Principle states that an electron can be either be a wave or a particle depending on how you set up the apparatus to view it. The experiment set up in most cases structures the results of the investigation. The experimental result includes the intent of the researchers from the beginning; consciously or unconsciously; through attention and desire the outcome is created. It is just what it is — a set up.

Why create an elaborate structure to justify a belief? This is done if there is a need to convince others. The “others” might be officials who want proof before something is allowed; or it may be industry that needs to convince others of a product’s potency or safety. The scientific method, conscious attention, and allocated resources take an already given intent and clothe it in a garment of supposed objectivity. The ends justify the means, money well spent.

[Intuitive personal observation] is in contrast to measuring, an action performed by people who claim to be scientists but still assume that they are separate from what they are measuring.. Measuring can thus never reveal the truth of anything because the separation between observer and observed is an apparent one…

This approach of science devoid of intuition is still quite prevalent in the world today, as intuition is not a valued part of experience in our society. Lower scientists (would be measurers, as it is less inclusive) set out not to seek truth, but to justify their original supposition through manipulating physicality to produce the wanted end.

This mask of the truth of the laboratory coat without intuition gives rise to the strength and conviction behind most of the scientific studies at universities and industries today. It is the common… assumption that by scientifically showing results of scientific studies, that certain implications by association are likely to be true. This type of lower science is a paid exercise in measurement, created to prove a point that the measurers already know and want to make beforehand. It attempts to objectify when it is impossible to do so- in the name of Science.

More accurate diagnosis and treatment does not require more facts or fancies, but a free exchange of intuition and intellect from one form to another in the field of our conscious attention. There in the playing ground of our thoughts and feelings, the joyful dancing duo will make the music that will sing to us and remind us of a most proper course of action to allow the healing to flow to those around us who want it.

The Energetics of Immunization and Vaccination

Dr. Pollak rarely deals in specifics, preferring vague poetic musings on the nature of the universe that can mean whatever one wants to project onto them and are too slippery to really analyze. However, he does sometimes try to connect his philosophical speculations to his alternative medical practice, and this is most specific in his discussion of vaccination.

He begins by suggesting that vaccination is an idea copied from the “like-cures-like” notion of homeopathy, which is of course nonsense in its own right and ignores the fact that the foundations of immunization, such as variolation, were known and practices well before Hahnemann invented homeopathy. He then goes on to argue that vaccines don’t actually prevent disease but simply exchange acute illness for chronic illness, again despite the complete absence of evidence this is true and the overwhelming evidence for the efficacy of vaccination. Finally, he starts down a path he will delineate more clearly in other essays suggesting that infectious organisms don’t actually cause disease and even that disease doesn’t really exist except as a projection of the human psyche.

The concept of vaccination is based on the mechanics initially understood from homeopathy. In this system of remedies, “like cures like”; giving the biological system an artificial short term disease (a remedy), temporarily displacing a more long term situation in which symptoms are seen.

Vaccination does not confer immunity. Vaccination might express an underlying pre-existing immunity in term of observable titers or might stimulate the latent immune capabilities of the biological system and thus enhance quicker more efficient action in the future. A healthy immune system does not need vaccination, as it is capable and waiting to perform its function with minimal disturbance. [The overwhelming evidence that vaccination does, in fact, protect against disease, and that the introduction of vaccines has saved billions from unnecessary suffering, disability, and death somehow doesn’t count against Dr. Pollak’s personal observations or theories]

In an ideal sense vaccination in its unfounded basis attempts to use an indication of weakened immunologic function (the organism itself or its products) as a means to strengthen the immune system. This is not only unfounded but often times counter productive. Where in fact vaccination agitates, distorts, and helps to corrupt the less competent immune systems…In the short run it appears that susceptibility to a specific disease has been reduced (allaying human fear), when in fact this fear transfer is deposited deeper in the biological system as seeds for future chronic disease. [Again, the evidence does not actually support the claim that vaccination is a significant risk for chronic disease.]

Humans fear disease, animals know it as transient restriction, easily making adjustments with very little complaint. Disease as a real thing for animals is non-existent; for they are ever in the flow of nature herself, yet they reflect how we see them. As the companion animal is the recipient of human thought, feeling and action it absorbs unconditionally the fear as well as the love. The human fear of acute disease as expressed in unsubstantiated over vaccination can only result in added chronic disease, fibrosarcomas and end stage renal disease are some of the best indicators of this disease transfer. [The idea that disease is simply a projection of human fear and at the same time caused by vaccines we give to assuage our fear is ludicrously anthropocentric and denies the palpable reality of both physical disease and the effects of vaccination]

Vaccination as it is currently being over used in Veterinary medicine today helps alleviate the fear of acute disease in the client (and veterinarian) and transfers it into chronic disease in the patient. The Veterinary profession is viewed as “protecting” the animals for which it is monetarily compensated. Protecting from what? [Pain and death, mostly.]

Epilepsy

Another area in which Dr. Pollak makes fairly specific claims about medicine and medical treatment, claims which are contradicted by scientific evidence and supported only by his personal faith, is on the subject of epilepsy. He blames commercial diets, vaccines, medicines (the bulk of science-based healthcare, in other words) and parasites for seizures and claims to be able to cure them in most animals with raw diets, parasite treatment and, of course, withdrawal of conventional medical care. Detailed discussion of the evidence that Dr. Pollak is wrong about this would be beside the point since these theories are based entirely on personal experience and ideology, and he has already rejected the idea that scientific evidence could ever legitimately contradict personal experience or belief. It is sufficient to point out that real experts in neurology who know a great deal more about the subject of epilepsy, and the accumulated scientific evidence of decades, do not agree with Dr. Pollak’s theories, and there is no real evidence to support them. This is simply another example of the utter rejection of science and medicine in favor of idiosyncratic individual theories and belief.

Most commonly seizures in the younger and middle aged animals are due to parasites combined with a poor diet… The most common major factors that layer upon each other and predispose the nervous system to seizures is: 1. Parasites along with 2. the extensive feeding of a solely commercial pet food diet, along with 3. over-vaccination and 4. over treatment of chemical based medicines.[As usual, no reliable evidence to support this, and if we are taking mere opinions seriously, the overwhelming majority of opinions among veterinary neurologists disagree with Dr. Pollak’s.]

The poor diet in these pets predisposes the body to seizures due to the migrating larvae (immature stages of the parasites) that roam throughout the body, including the CNS. The nutritionally compromised system (on a solely processed diet) overreacts in a disjointed fashion to this disturbance. Animals fed a natural raw food diet better limit the parasitic numbers and are much less likely to seizure in response to them.[Raw foods are actually a risk factor for parasites, which is one of the main reasons we cook our food.]

Today’s modern approach to dealing with these problems is the administration of more chemicals,.. These chemicals oftentimes do not work and further confuse the biological system as already described earlier. The underlying imbalance is not directly addressed. Deranged metabolic disorders due to chemical shortages or imbalances are superficially addressed by further limitations in the diet; i.e.even more severely processed foods. These efforts though well intended are short sighted and short lived. After a brief period of lessened clinical signs the system must restabilize at a lower level of health, due to the continued lack of essential raw materials in a natural state. This results at best, in the reoccurrence of the disease and at worst, a deeper set of symptoms (“another” disease— that is really the same disease) or death. [The neat thing about this claim is that if no evidence is required to support it one can simply claim any disease that ever happens is the result of this supposed misguided attempt to prevent disease. You basically can’t lose!]

An active electrical network surrounds the physical body in all sentient beings. The CNS is constantly generating this network; this is the subtlest functioning of the DNA relationship. This non-physical energy of the relationship of matter resonates with the electrical fields of all other resonating bodies. When there is some threat; real or otherwise, the electrical system responds by either short-circuiting or overloading to some degree. This is a signal to the physical body to respond. If the body does not succeed, the imbalance is physically manifested… A seizure is an obvious instance of electrical overloading, without the appropriate physical response. [This sort of vague mixing of real physical phenomena like electricity and DNA with spiritual concepts like universal “energy” is a common bit of misdirection designed to steal some of the legitimacy from real scientific concepts and paint it on faith-based beliefs. This sort of explanation for disease was the norm for most of human history, with little in the way of success compared to the benefits realized by a scientific understanding of nature.]

Vitalism

The core idea that seems to underlie Dr. Pollak’s rejection of science and scientific method is vitalism, the belief that the physical aspects of nature are only a part of reality and that the real cause and management of illness lies with some non-physical spiritual essence of life force. This is a core idea behind many alternative practices, and it undermines any distinction between medicine and religion. While people are welcome to believe whatever they choose about the ultimate nature of reality, medicine is not simply any belief anyone chooses to have about health and disease.

If one believes God will cure disease if petitioned through prayer, that is their business. However, using this belief as a basis for calling oneself a doctor and then selling not only prayer but herbs, supplements, and other medical therapies to cure illness is not legitimate. Science has proven far more effective than any other means for understanding nature, and it has led, in a mere few centuries, to better health and less disease than all of the beliefs and practices that went before it in all of human history. Because of this, science has been granted a special position as the foundation of medicine, and society expects doctors to treat patients with methods compatible with and supported by science. Faith healing may be a fine spiritual practice, but it is not medicine and it cannot be sold as such.

Yet Dr. Pollak very clearly blurs the line between his private spiritual beliefs and the practice of medicine until he becomes far more of a shaman than a doctor, and it is disingenuous to market his services in any other way.  He claims that the true cause of disease, insofar as the concept of disease has any reality at all, is in non-physical entities that cannot be objectively studies, measured, or manipulated. If true, then all medicine is a spiritual exercise based entirely on what each healer intuits about the spiritual essence of the patient and the general nature of the Universe. While it is not possible to disprove a notion like this, it is clear that moving away from such ideas and towards a science-based approach to medicine has had tremendous, unprecedented benefits, so we should be wary about giving up the distinction between medicine and religion or giving personal faith equal weight with scientific evidence in healthcare.

Physical substance no matter how crude or refined is only a partial vehicle for the life giving flow that is healing. [But, of course, the non-physical is detectable only by intuition or belief, so not claim about it can ever be proven or falsified, which leads us to abandoning any hope of knowledge and leaves us relying on idiosyncratic and ephemeral personal opinion as the only guide to how to treat disease. Not a successful approach in the past!]

When the physical substance (gross, essence or quintessence) is seen as the only balancing agent in the pursuit of greater health the doctor has removed the predominant health giving force. This makes health care impotent; not much better than a system that pushes disease from one system of the body to another while every specialist claims “Cure”.

Scientific/objective research attempts to remove the practitioner from the scenario of healing by only allowing a framework that takes into account physical substance. An almost total intellectual perspective and lots of commercial money drive the current type of research…what is sought is a specialist’s panacea; and there are many, for if disease is defined narrowly, within that narrow definition cure will readily be found again and again. Keeping the scope of investigation within the physical framework keeps the illusion of cure very much alive. [So attempts to control error and bias through systematic scientific investigation are futile. But we can see the real truth by just letting our intuition and imagination free. Uh-huh….]

The use of holistic measures to eliminate disease is the key to enhancing wellness. This flow of higher balance (resulting in cure) can come on three levels; the first is from physical substance, usually natural, vibrant material. The second source of cure is from the essence or sound of the material (homeopathic potency or any pure essence or thought of such material). The third and most powerful means of cure is the direct infusion of wholeness into the patient, either directed through the healer via “hands-on healing”, telepathic, prayer or under the guise of any modality.[So anything works, as logn as you believe it works.]

Disease is resistance to the changing aspect of life.. Without constant changing scenery, life would be not only boring, but unable to fulfill is purpose of containing Wholeness. Disease can be seen as allowing the attention of lack to persist longer than it’s needed and then creating a mental structure based on it; justification, blame and helplessness follow. Our animal friends of earth are there to absorb innocently what the humans around them project…Animal disease is an understanding of humans. Animal restriction viewed as disease by humans, is a lack that is not focused upon by animals. The animal and plant kingdoms are forever in the flow of life’s energy. It is just through the effect of humans that their lives are remolded through relationship, either enhanced or made shorter. The life of the animal and plant kingdoms prior to the presence of humans was serene and peaceful (and not as full). [So all disease in our animals is caused by human beliefs, since we somehow perturb the blissful state of nature that existed before us when there was no disease and no suffering. Arrogant and ridiculous.]

Disease arises through a weakened Vital Force. Strengthening the Vital Force dissolves disease through life’s nature to maintain and express greater balance.

Disease is fluid, not confined to bodily parts, it can move easily through the mind, emotions, body and environment. Movement of disease from mental to emotional to physical, and downward and out from the center of the body indicates a strengthening of the Vital Force.

Tissue changes are the ultimates (end results) of disease; not the disease itself. Tissue changes are the expression of the interplay of the nature of the flow of life energy, observing these changes allows for further refinement and expansion of life’s flow. The predisposition allowing the tissue changes lies closer to the source of disease.

The healer consciously bestows desired life force through intent and knowledge of the nature of its flow. In the intent and act of healing through any modality, a process of harmonizing is appreciated and felt to what ever extent. Tapping into this sea of potentiality with focus of intent, begins the wheels of the universe turning in the direction of that which is wanted. If healing is one’s desire, then from this foundation of wholeness, healing arises via any modality. The wholeness of the healer joins with the wholeness of the one desiring healing. The strength of resonance between the two, determines the degree of healing. Modality is a matter of preference.[All that matters is that you believe, not what you actually do. Except, of course, if what you do is vaccinate and prescribe drugs, in which case you are doing harm.]

Here, Dr. Pollak has made explicit (if not necessarily clear) his belief that attention to abnormalities in the physical body is misguided, that disease is simply one state of matter brought about by nonmaterial forces, even manufactured by human feelings and foisted upon our otherwise healthy pets. The nature of being a doctor, in this world view, is not to heal the physical body but to facilitate certain desirable alignments of spiritual energies. He claims that it doesn’t matter how one does this (“modality is a matter of preference”), which allows him to do what many alternative practitioners do, which is accept the truth of numerous mutually contradictory therapeutic practices. On the other hand, he clearly doesn’t really believe this since he derides the modalities of science-based medicine as ineffective and harmful. But perhaps this is only because our “intention” and belief as doctors is mistaken? Perhaps toxic chemicals would become as healthful as homeopathy if only we shared his understanding of the true nature of the Universe? In a world view such as this, anything is possible.

Death-Just Another Kind of Healing

In terms of my own philosophical perspective, I see death as an inevitable and natural part of the existence of living beings. In a metaphorical sense, it can be viewed as just one more natural life event or stage. However, that doesn’t mean that the death of a child from preventable infectious disease and the death of a centenarian from the accumulated physical ailments of the years are both to be viewed and treated as the same. The natural and inevitable nature of death doesn’t mean it isn’t a real phenomenon involving failure or breakdown of the physical body, and it doesn’t mean we shouldn’t make reasonable efforts to avoid it when possible.

Dr. Pollak writes at length about death from the perspective of his particular spiritual philosophy, and his views on the subject are no more or less legitimate than anyone else’s. However, his treatise on the subject is problematic from the point of view of the veterinarian’s responsibility to reduce suffering in our patients. He writes about animals as idealized archetypes of nature incapable of suffering except from a flawed human perspective. Disease and death are, in this view, not fundamentally real, and the suffering our pets experience is an illusion we project on them. Such a view may offer psychological comfort, but it also discounts the reality and the significance of the pain our pets experience in their own right, independent of any beliefs we hold about it.

The implication that our pets experience disease and pain and death only as a function of our projecting our feelings on them diminishes the reality of their experience and can discourage appropriate intervention. It denies our pets the dignity of being treated as beings in their own right, not merely reflections or recipients of our needs and fears. And coupled with belief in useless therapies like homeopathy, this raises a very real risk of inadequately treating our patients’ discomfort and accepting not only death in general but death in circumstances where it could be reasonably and appropriately prevented. And it implicitly blames the victim of disease for bringing it on themselves or on their pets with wrong thinking, as well as, of course, the error of believing in science-based healthcare.

From a truly holistic perspective, death is a continuation of the healing process.

Understanding disease from a holistic perspective as healing episodes (periods in which the individual mind/body releases or sheds what is no longer wanted or is no longer of use) will help us to understand the deeper spiritual significance of the experience of death.

At the basis of disease understanding lies the notion of fear, not so much fear of something in the world, but of fear itself. The base fear, as a metaphor, is fear of death; an obvious end with an unsure beginning. This is fear of the unknown, arising from a lack of conscious love. If symptoms are seen or felt, and the fear of fear (lack of love) is active, then dis-ease grows stronger, this can only happen when unconditional love seems so far away.[So if you get ill, it’s your own fault for having the wrong thoughts or feelings.]

Our pets do not suffer as we do, they greet the new situation of temporary restriction with ease and love rekindled; this lends itself to quick adjustment. When we extend our discomfort onto them, and see them as ourselves in situations that we greatly fear, then we can only see ugly disease, devoid of love, all around us…The basis of suffering and overwhelming pain is the interpretation we place on the temporary restriction.[And you pets only suffer because of your feelings too.]

It is natural law that physical disease will follow this kind of thinking and feeling of lack and self-unworthiness, as there is a continuum between the different levels of life, from gross to subtle and beyond. In the absence of conscious unconditional love disease will express itself in a myriad of forms as long as the underlying bed of discontent continues.

Our pets mirror us through the reflection of love. This picture is not like that of a simple mirror that hangs in the dressing room and simply reverses left and right. This new image is a reflection that passes through a mirror with crystals of unconditional love on the back, warming the light with the glow of freedom and security as it passes through. These crystals are our pet’s conscious knowing of its place in the universe combined with the joy of having a family and master all wrapped into one. This makes their living, their role in life clear, simple and extremely fulfilling, all they do in their unconditional joy is innocently reflect back.[A clearer explication the human species’ arrogance and narcissism would be hard to find.]

Sometimes our pets linger in pre-death waiting longer than is necessary because it is important to them that their master(s) is well. They oftentimes do not understand the grief that is being emitted by the master with reference to their soon be departure. Grief and loss associated with this eternal process of transformation is unknown to them. They feel uncomfortable in leaving at a time when their master seems so confused, saddened and disoriented. They will stay, as long as they can, to further bring comfort to someone they truly love. If we are incapable or unwilling to let them go, they will stay around as long as they can, even to the point of obvious discomfort.

…They wish to know with certainty, that through your relationship with them, you have gained some increased sensitivity in the nature of your own being, for it is theirs as well. Our pets are in tune with the deepest of our knowing, a mixture of projected feelings, pictures and intentions. They barely hear our words that don’t ring true, but sense to their core, our core feelings, and reflect them back in love. This is done whether they are playful in health or restful in the physical weakness of great transformation.

The Pollak Protocol for Eliminating 85% of Common Disease in the Dog and Cat

Like most believers in a simple, mysterious, universal truth about health and disease, Dr. Pollak believes he has found answers not seen or understood by other veterinarians. And like several others, he has created a simple recipe for dramatic reductions in disease which requires accepting his view of the world but doesn’t apparently require any scientific evidence to validate it. And, of course, he’s named this recipe after himself. Sadly, the vast majority of scientists and healthcare professionals don’t have the insight to abandon their ineffective approach to health and follow this simple recipe.

The Pollak Protocol addresses seven basic areas:

1. Diseases amenable to the Pollak Protocol
2. Feeding the Natural Raw Food Diet
3. Transitioning on to the Natural Raw Food Diet (NRFD) and Fasting
4. Understanding Healing Episodes
5. Deworming (if necessary)
6. Least Medical Interference as possible
7. Enjoying the Onset of Cure

This simple protocol is for those who still believe, if only somewhere deep inside, that curing disease, not treating disease, is the guiding light of real health care. Following this protocol will bring results beyond imagination and give strength to an intuitive learning that has been put on the back burner in a society gone mad about treating disease while giving up on cure. [In other words, anyone who believes in scientific medicine has given up on actually curing disease, despite all of the illusory improvements in health and longevity brought about by the scientific approach.]

This protocol is based on the dramatic and consistent improvement in health and vitality seen in thousands of dogs (~10,000) and cats (~6000) (1) when dietary changes were made. Based on the large numbers, a protocol emerged that helped bring Wellness to over 90% of the animals. Success was directly related to owner compliance with the dietary changes in a large majority of the cases. Understanding the protocol and interest and appreciation by owners of their pet(s) are the primary limitations on the level of Wellness obtainable. [In other words, if it doesn’t work it’s the owner’s fault for not understanding or adhering to the magic formula sufficiently. Oh, and it must be true because he made up some numbers.]

Excessive internal heat from unnatural breakdown of processed food is also the main cause of arthritis in our pet population. Dogs or cats showing arthritis in any form will usually respond quite nicely to a diet of only raw food. Return them to cooked or any processed food and the arthritis usually returns.[No evidence, as usual, just opinion. This is very typical of the kind of pre-scientific attempts to explain disease that had us killing patients with bloodletting for thousands of years.]

Switching to raw foods is very powerful medicine. Healing episodes can occur as deep house cleaning starts in the pet’s body. This can happen within hours of starting to feed raw food. Our pets have been waiting for this raw food their whole life, and when they get it, the body can over do it a bit in trying to make up for lost time. Diarrhea is the most common symptom seen…The strengthening of Wellness can sometimes bring symptoms suggestive of disease. [Just as death is a sign of healing, so is illness. If your pet gets better using his regime, of course his regime worked. But if it gets worse, that also means the regime worked and at an even more profound level. A nifty marketing trick, making every outcome a sign of success, but it’s not a legitimate way to validate any therapy.]

Bottom Line
It is common for alternative medicine practitioners to claim a respect for legitimate science or to claim that science supports their practices. Often, however, these claims are inconsistent with the evidence or with the behavior of these practitioners when confronted by the evidence. While some undoubtedly do believe science is the best way to understand nature and guide their medical practice, many turn out to have beliefs about health and disease and about the role of healer that are inconsistent with the basic principles of science and the core knowledge of science-based medicine. These beliefs often privilege personal faith and vague, ill-defined spiritual forces above scientific investigation of the material world.

I have no objection to spiritual beliefs per se, even when they touch on the causes and remedies for disease. And I understand that alternative practitioners will bring their core values and beliefs with them to work to some extent, as we all do. However, I do believe that science has proven itself far superior to any other system for understanding nature, and it has led to unprecedented and real improvements in health. Further, I believe society as a whole, at least in the developed world, accepts this and stipulates in the legal and institutional context of medicine that science should be the foundation for medical practice. When doctors are granted a license to practice medicine, they have great freedom to interpret and apply scientific knowledge, but they cannot legitimately reject or ignore it entirely.

When someone like Dr. Pollak explicitly rejects the definitions, principles, and core knowledge of medical science and uses personal spiritual beliefs as the foundation for his medical practice, I believe he has strayed outside the legitimate purview of the practice of medicine. He has declared himself a shaman or spiritual guide, rather than a doctor, in all but name. Again, this is fine by me so long as he represents himself honestly as such. But to call oneself a veterinarian while abandoning the epistemological foundations of the profession and declaring nearly all science-based medical practice to be vain and misguided is fundamentally misleading.

In any case, while I think the evidence against Dr. Pollak’s specific claims is strong, delineating that would be pointless since we are using entirely different systems of understanding. The best I can do is call attention to Dr. Pollak’s philosophical views, which he has expounded on at length on his own web site, and illustrate how they conflict with the principles that underlie conventional medicine. Those who share his beliefs are free to choose the shamanistic approach, and those who believe in the reality and value of science-based medicine are free to choose that approach, with the distinction made clear.

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.”

Reiki
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).

Crystal 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
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.

Consultations
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.

Bottom Line
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.

A while ago, I wrote about a bill in the California legislature intended to remove non-medical exemptions to vaccination requirements for children in the state. Despite often vicious and irrational opposition, science and reason and public health have won the day! The bill passed all committees and both houses of the legislature, and it has now been signed into law by the governor.

SB_277_Signing_Message

It wouldn’t surprise me if there are legal challenges to the law ahead, but I am proud of my state and grateful as a parent that the politicians have made the right choice for public health.

This is an article I originally posted on a preliminary SkeptVet website which I no longer update since it has been replaced by this blog. I have copied it here since the links to the prior site no longer function.

Acquiring clinical experience is a major part of improving one’s medical knowledge and skills. Unfortunately, extensive practical experience can often lead to the erroneous the belief that we can reliably determine the safety and efficacy of a particular therapy based on our personal experiences or those of other doctors, especially specialists or experts. “I’ve used it, and I know it works/doesn’t work” is the most common response by doctors or clients to the suggestion that research evidence contradicts what we believe about a given medical practice. Another common response from experienced veterinarians is “I don’t need to run Test X. I know what this is because I’ve seen a hundred cases like it.” Such personal experiences are very compelling, but science is built on the premise that our imperfect brains can make mistakes and that careful use of appropriate research techniques can compensate for our limitations. Here are a few reasons to be skeptical of one’s own clinical impressions and those of “experts” and to look for guidance in good quality research evidence when it is available. (much of this has been adapted from “Why Bogus Therapies Often Seem to Work” by Barry Beyerstein, Ph.D.)

1. Self-Limiting Disease Many diseases are self-limiting. If the condition is not chronic or fatal, the body’s own recuperative processes usually restore the sufferer to health. Thus, to demonstrate that a therapy is effective, its proponents must show that the number of patients improved exceeds the number expected to recover without any treatment at all. Without detailed records of successes and failures for a large enough number of patients with the same complaint, someone cannot legitimately claim to have exceeded the norms for unaided recovery.

2. Waxing and Waning Chronic Disease (also known as Regression to the Mean) Such conditions as arthritis, allergies, and gastrointestinal problems normally have “ups and downs.” Naturally, clients tend to seek therapy during the period or greatest clinical symptoms. In this way, a treatment will have repeated opportunities to coincide with upturns that would have happened anyway.

3. Placebo Effect Through suggestion, belief, expectancy, cognitive reinterpretation, and diversion of attention, people given biologically useless treatments often experience measurable relief. Some placebo responses produce actual changes in the physical condition; others are subjective changes that make patients feel better even though there has been no objective change in the underlying pathology. Of course, in veterinary medicine, the effect is mostly “by proxy,” in which the owner’s beliefs and desires lead to a report of improvement in the pet’s symptoms when none has actually occurred.

4. Multiple Concurrent Therapies If improvement occurs after a pet has had several interventions, and probably other unremarked changes in the owner’s treatment of the sick pet, one or another of the changes often gets a disproportionate share of the credit or blame. Frequently, the latest in a series of interventions or the newest thing tried is credited with improvement even though many things were done.

5. Misdiagnosis Scientifically trained veterinarians are not infallible. A mistaken  diagnosis, followed by an irrelevant intervention, can lead to a glowing testimonial for curing a condition that would have resolved by itself. In other cases, the diagnosis may be correct but the time frame, which is inherently difficult to predict, might prove inaccurate.

6. Human Psychology Even when no objective improvement occurs, people with a strong psychological investment in the pet can convince themselves the treatment has helped. And doctors, who want very much to do the right thing for their patients and clients, have a vested interest in the outcome as well. A number of common cognitive phenomena can influence one’s impression of whether a treatment helped or hurt a patient. Here’s a brief list of common cognitive errors in medical diagnosis. Any of these sound familiar.

7. Cognitive Dissonance When experiences contradict existing attitudes, feelings, or knowledge, mental distress is produced. People tend to alleviate this discord by reinterpreting (distorting) the offending information. If no relief occurs after committing time, money, and “face” to a course of treatment internal disharmony can result. Rather than admit to themselves or to others that their efforts have been a waste, many people find some redeeming value in the treatment.

8. Confirmation Bias is another common reason for our impressions and memories to inaccurately represent reality. Practitioners and their clients are prone to misinterpret cues and remember things as they wish they had happened. They may be selective in what they recall, overestimating their apparent successes while ignoring, downplaying, or explaining away their failures. Or they may notice the signs consistent with their favored diagnosis and ignore or downplay aspects of the case inconsistent with this.

9. Anchoring This is the tendency to perceptually lock onto salient features in the patient’s initial presentation too early in the diagnostic process, and failing to adjust this initial impression in the light of later information. This error may be severely compounded by the confirmation bias.

10. Availability The disposition to judge things as being more likely, or frequently occurring, if they readily come to mind. Thus, recent experience with a disease may inflate the likelihood of its being diagnosed. Conversely, if a disease has not been seen for a long time (is less available), it may be underdiagnosed.

11. Commission Bias results from the obligation toward beneficence, in that harm to the patient can only be prevented by active intervention. It is the tendency toward action rather than inaction. It is more likely in over-confident veterinarians. Commission bias is less common than omission bias.

12. Omission Bias the tendency toward inaction and rooted in the principle of nonmaleficence. In hindsight, events that have occurred through the natural progression of a disease are more acceptable than those that may be attributed directly to the action of the veterinarian. The bias may be sustained by the reinforcement often associated with not doing anything, but it may prove disastrous.

13. Diagnosis Momentum Once diagnostic labels are attached to patients they tend to become stickier and stickier. Through intermediaries (clients, techs, other vets) what might have started as a possibility gathers increasing momentum until it becomes definite, and all other possibilities are excluded.

14. Feedback Sanction Making a diagnostic error may carry no immediate consequences, as considerable time may elapse before the error is discovered, if ever, or poor system feedback processes prevent important information on decisions getting back to the decision maker.

15. Gambler’s Fallacy Attributed to gamblers, this fallacy is the belief that if a coin is tossed ten times and is heads each time, the 11th toss has a greater chance of being tails (even though a fair coin has no memory). An example would be a vet who sees a series of patients with dyspnea, diagnoses all of them with a CHF, and assumes the sequence will not continue. Thus, the pretest probability that a patient will have a particular diagnosis might be influenced by preceding but independent events.

16. Posterior Probability Error Occurs when a vet’s estimate for the likelihood of disease is unduly influenced by what has gone on before for a particular patient. It is the opposite of the gambler’s fallacy in that the doctor is gambling on the sequence continuing.

17. Hindsight Bias Knowing the outcome may profoundly influence the perception of past events and prevent a realistic appraisal of what actually occurred. In the context of diagnostic error, it may compromise learning through either an underestimation (illusion of failure) or overestimation (illusion of control) of the decision maker’s abilities.

18. Overconfidence Bias A universal tendency to believe we know more than we do. Overconfidence reflects a tendency to act on incomplete information, intuitions, or hunches. Too much faith is placed in opinion instead of carefully gathered evidence. The bias may be augmented by both anchoring and availability, and catastrophic outcomes may result when there is a prevailing commission bias.

19. Premature Closure A powerful error accounting for a high proportion of missed diagnoses. It is the tendency to apply premature closure to the decision making process, accepting a diagnosis before it has been fully verified. The consequences of the bias are reflected in the maxim: ‘‘When the diagnosis is made, the thinking stops.’’

20. Search Satisfying Reflects the universal tendency to call off a search once something is found. Comorbidities, second foreign bodies, other fractures, and coingestants in poisoning may all be missed. Also, if the search yields nothing, diagnosticians should satisfy themselves that they have been looking in the right place.

21. Yin-Yang Out When patients have been subjected to exhaustive and unavailing diagnostic investigations, they are said to have been worked up the Yin-Yang. The Yin-Yang Out is the tendency to believe that nothing further can be done to throw light on the dark place where, and if, any definitive diagnosis resides for the patient, i.e., the vet is let out of further diagnostic effort. This may prove ultimately to be true, but to adopt the strategy at the outset is fraught with the chance of a variety of errors.