Patients walk into allergist Dr. David Fischer’s office almost every day expressing interest in trying “natural” therapies. These range from harmless diet changes to the truly bizarre, like applied kinesiology, says the Barrie physician. It’s an experience shared by other doctors. “We’re on the front line of dealing with ideas for which there is often a dearth of scientific evidence.”

Alternative medicine is booming even without much proof it works. A record 20,000 people are expected at Toronto’s Whole Life Expo at the downtown convention centre next weekend. Three-quarters of Canadians regularly use some form of natural health product, opening their wallets to spend at least $4.3 billion yearly. And the herbs and homeopathic tinctures they buy are just one facet of unconventional medicine — a thriving sector encompassing everything from acupuncture to zone therapy (supposedly stimulating the body’s organs through hand or foot massage).

Ontario’s College of Physicians and Surgeons is bending to the trend with a new policy inhibiting doctors’ criticism of unconventional therapies. In doing so it risks encouraging even broader use of dubious and potentially harmful treatments.

Make no mistake — blind trust in alternative cures can be dangerous. An unknown number of Canadians are opting out of science-based medicine to treat even deadly conditions, like cancer, with unproven “natural” approaches. Monika Hevessy, for example, convinced her 67-year-old father to skip chemotherapy after surgery last year. Instead, he responded to bowel cancer by consuming fruit juice, massive doses of vitamin C and an alternative remedy called MMS. Health Canada last year warned against using it due to toxicity.

“I don’t believe in medication,” Hevessy says, adding she trusts only “natural ways” — not Health Canada. “They want people to be on medication.” Thankfully her father, Sandor Csorgo, remains healthy and cancer-free. But others who have gone this route aren’t so lucky.

Some pay a price for postponing, rather than outright rejecting, conventional care. Apple Inc. CEO Steve Jobs died in October reportedly regretting his decision to delay cancer surgery for nine months in favour of herbal remedies and spiritual healing. That wasted precious time while pancreatic cancer spread.

The field of allergy medicine, Fischer’s specialty, is especially prone to alternative approaches. Natural practitioners using applied kinesiology, for example, check for allergy by placing a food item in a patient’s mouth or in their hand. Then they pull down on the person’s free arm to assess its strength. If this “muscle testing” shows notable weakness, the patient is deemed to be allergic.

There is no good evidence that this method works, and no sound scientific reason why it should. Yet patients come in with an interest in that, says Fischer. “I’d like to be able to tell them it’s quackery.”

He may not be in a position to say so much longer under a new policy proposed by the college of physicians and surgeons. It states that doctors are obliged to give a patient their best professional opinion on an alternative treatment goal or decision, but physicians “must refrain from expressing personal, non-clinical judgments.”

Would calling applied kinesiology “quackery” be considered a personal, non-clinical judgment? The policy isn’t clear and Fischer is uncertain. There’s a grey area here. For a physician intent on avoiding complaints to the college from headstrong complementary medicine enthusiasts, the safest thing would be to just shut up.

“They make it feel like you can’t speak about these areas without getting yourself in trouble,” says Dr. Stuart Carr, president of the Canadian Society of Allergy and Clinical Immunology.

Carr is concerned by another section of the policy that would muzzle doctors. It says that physicians unfamiliar with an alternative therapy “must indicate as much to the patient, and explain that they are consequently unable to comment on the matter.”

But there are literally thousands of these therapies on the market, from crystal healing to exotic Asian herbs. More surface each year. No one is familiar with them all.

As it is, physicians scramble to keep up-to-date on scientific developments even in their own branch of medicine, says Carr, a specialist in children’s allergy and immunology.

“The rate of publications is through the roof,” he says. “So now I also have to make an effort to become conversant in all of these different unscientific approaches, or I’m not to discuss it? That’s really unfair and unrealistic.”

The college’s governing council is to consider its ill-judged guidelines at the end of this month. To give college officials some credit, the policy’s first draft was even worse, intentionally written in “value-neutral” language that set up a false equivalence between scientific medicine and alternative cures.

The college stepped back from that excess — but it needs to step further. Rather than endorsing a still-flawed policy, the council should stand up for doctors’ freedom of speech and end the ambiguity surrounding what constitutes non-clinical judgment.

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There’s no denying alternative medicine is immensely popular. Patients are more independent than ever before, often researching their illness and trusting their own solutions. And a host of unconventional “natural” healers has risen capitalizing on that trust — offering unproven therapies with little validity and which, in some cases, are a menace.

The college shouldn’t seek to accommodate that trend or retreat to a neutral corner. Rather it should leave doctors free to punch hard against those peddling dubious cures and to challenge people’s comforting, but irrational, beliefs. Science-based medicine serves patients best. If doctors can’t vigorously defend it, who will?