Ernst (1) makes several valid and important points regarding complementary and alternative medicine (CAM) use. The benefit/risk ratio of CAM therapies should be evaluated in the same way that conventional therapies are. Patients often lack appropriate education to make these choices. Advice from untrained retail staff is often unreliable. The popular media often provides unsatisfactory coverage of health care issues.
However, through the use of anecdote, selective use of data, and oversimplification, Ernst reaches some unfounded conclusions. Consider that it would be easy to construct a similarly misleading portrayal of conventional medicine by focusing on the alarming rate of adverse drug reactions (the fourth leading cause of death in the U.S.) (2) and ignoring conventional medicine’s great benefits.
Significantly, Ernst dismisses the potential benefits of CAM therapies in diabetic care. Implicitly, CAM therapies have not enjoyed the scientific attention that conventional treatments have received. Increasingly, however, CAM therapies suggested for diabetes have been the subject of encouraging preliminary research into their efficacy, mechanisms of action, and safety (3–10). Each therapy should be rigorously evaluated using all available evidence, not dismissed collectively.
Ernst’s commentary bears a discouragingly hostile tone. The great majority of health care providers, whether alternative or conventional, are committed to serving their patients. Patients navigate a complex and shifting health care system to the best of their ability. Let all medical professionals strive to cultivate a cooperative relationship with their peers, respect their patients, and maintain an objective approach to medical science.
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