Blessed by the Potato

The College of Physicians and Surgeons of Ontario is creating a new policy to guide physicians in dealing with CAM. There’s a bit of an uproar over the document, even down in the states. There’s a fair bit of good commentary around the web so I won’t get too far into it here, especially since there’s only a few days left on the consultation period. I did agree with the bit about using “their” word, allopathic, right in the title of the document. It framed the discussion all wrong right from the beginning.

My somewhat rhetorical questions for the College on the policy:

• If the College is willing to allow physicians to recommend CAM therapies on weak evidence of a chance of improvement then they should equally allow placebos. If the College currently has an ethical objection to physicians prescribing placebos, it should examine why the same rationale does not apply to CAM.
• The current regulations are quite rigorous for prescribing medications that have good evidence of safety and efficacy but which have not yet received Health Canada approval for use in Canada. Why is it much harder to prescribe a drug that does have some evidence than a CAM therapy that has none?
• The College permits in the policy draft physicians to associate with for-profit CAM clinics, even to offer such services themselves. Why is that not a considered a conflict of interest?

Note that I wasn’t able to quickly dig up the College’s current policy regarding prescribing of placebos, but I doubt it’s looked upon favourably.

Also note that in general I’m not all that hard-line on CAM, but though there may be a place for it, it’s not in the CPSO.