Tsavo wrote:I am unlettered in vet med so I had to ask vets WTF is up with non-evidence-based treatments. It's not that I can't understand the reasons. It is just I don't have the training to know what they are on my own.
Here’s the catch. Only approximately 45-60% of medicine (human or veterinary) is “evidence-based”. Much of it is still based on expert opinion, experience, and what has worked (or seemed to work) in the past.
I find the title of this thread interesting & revealing, “why acupuncture is complete nonsense.” To me, it speaks to perhaps a somewhat black-and-white approach , which doesn’t fit most scientific/medical questions in my experience. It also speaks to bias, which all scientists (and lay people) must be aware of in terms of how it colours our perceptions, approach, interpretations, and emotional reaction to hypotheses, premises, and study results (among other things).
In this case - acupuncture - it is neither true that it is “complete nonsense”, nor is it true that it is a panacea that heals all things (or most things). The reality is somewhere in between those two extremes. There are quite good studies that show a significant (statistically) improvement in the outcomes measured after acupuncture compared to other treatments for certain disorders. There are many poorer-quality studies that do the same thing. There are quite good studies that show no difference, and there are poor studies that do the same. My point is that one cannot, and should not, use so-called “evidence-based” as a lever to throw out an entire field (or support an entire field) as that is very unilateral and biased in itself.
Maintaining a level of skepticism is healthy, it’s how we have made progress in various areas of medicine. Being rigidly unilateral and calling it “evidence-based” (when in fact the balance of the evidence for acupuncture, in this case, does not read as a unilateral “it doesn’t work” or “it does work” result) can, for some, turn this interesting discussion into a “for” and “against” entity. I think that’s unfortunate.
My bias is that I am trained & currently practicing in both human medicine and veterinary medicine. I also have a post-graduate veterinary doctoral degree that included prospective research & a resultant thesis that I had to defend. I am trained in scientific methodology. I am also trained in both human acupuncture & veterinary acupuncture, but I do not currently practice it except for quite infrequently. Why? Because my western medical practice is SO busy that I just don’t have enough time and enough exam rooms to take the time needed to perform acupuncture properly. Plus, I work in Canada where, in human medicine, the bulk of mainstream medical care is covered financially by the government, but allied health services are not covered for all (this includes very evidence-based, tried & true entities like physiotherapy, occupational therapy, and also things like acupuncture —- although, some physiotherapy in my province IS covered and some physiotherapists use acupuncture among other treatments, so in those cases patients can receive acupuncture within their physio appt without having to pay extra). For me, there are no billing codes for acupuncture so I’d have to charge for it, and I choose not to (when I do use it, I do not charge for it ... it’s part of whatever else I do with the patient that day).
Anecdotally, when I’ve used acupuncture on either a human patient or a veterinary patient, in the vast majority of cases improvement in the treated condition has occurred. My veterinary patients are wildlife patients, so it’s a challenging field in various ways. Were the improvements solely because of acupuncture? I’d say, probably not. Would they have improved if I had not performed acupuncture? We’ll never know because this is anecdotal. Was the patient appreciative? No idea for the wildlife (but their improved function would imply it was beneficial), but the humans ... definitely (including one lady who was a HUGE skeptic, somewhat needle phobic, but let me perform acupuncture for her incredibly sore neck/shoulder with ++ muscle spasms, and nothing else had helped (medication, stretching gently, physiotherapy, I think she tried chiro, too but I can’t remember). I did the treatment, then didn’t see her for 3 mo so figured it hadn’t worked and she wasn’t pleased. I was wrong. I saw her 3 mo later (for another reason) and she was thrilled and hadn’t been back because the treatment had resulted in immediate improvement that lasted.).
I won’t go into the studies in acupuncture that show significant benefit - they are out there and searchable by anyone interested. My post is to suggest that acupuncture is neither “complete nonsense”, nor is it “the best thing since sliced bread”. It’s somewhere in between (like so, so many other things in medicine!).