Even if doctors don't put much stock in alternative therapies, they have an obligation to address their patients' use of such remedies. Alternative medicine and conventional medicine share some important goals, which provide some support for a limited professional obligation toward alternative medicine. Patients spend about $13 billion a year on alternative medicine, and out of respect for the patients, a physician should be ready to address alternate remedies. Physicians should learn about alternate remedies so they can prevent patients from injuring themselves. This is critical since some alternative medicine therapies are known to be harmful. In addition, there may be harmful interactions between conventional and alternative medicine therapies.

The Journal of the American Medical Association November 11, 1998;280:1623-1625.

COMMENT: This is the first of the journal articles that were published in JAMA this week. Fortunately, it is the only one with which I disagree. This article fails to take into consideration the fourth leading cause of death in this country. Heart attacks, cancer and strokes are the leaders. But does anyone care to guess number four? It is called ADR which is a fancy term for adverse drug reactions which is a euphemism for doctor prescribed drugs that KILL patients. More than 100 patients a day are killed by drugs that physicians prescribe. Clearly, we need to be cautious with alternative therapies, but I am confident that traditional medicine kills more patients in one day than natural therapies do in one year. That is a conservative estimate as I suspect it is closer to ten years. Why don't we see headlines in JAMA or NEJM and on the front pages of our newspapers proclaiming this fact?