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Dr. Paul Offit

Q&A with Dr. Paul Offit

“Alternative medicine is a multibillion dollar industry. These products aren’t being made by hippies on mountainsides. They’re being made by big pharmaceutical companies,’’ says Dr. Paul Offit

April Saul

“Alternative medicine is a multibillion dollar industry. These products aren’t being made by hippies on mountainsides. They’re being made by big pharmaceutical companies,’’ says Dr. Paul Offit

Dr. Paul Offit, chief of the Division of Infectious Diseases at Children’s Hospital of Philadelphia, is co-inventor of the rotovirus vaccine, credited with saving hundreds of lives a day, especially in the developing world. Offit has now turned his attention to a different kind of health issue: alternative medicine. Offit acknowledges that alternative medicine can be helpful, but he’s worried that the largely unregulated, multibillion dollar alternative medicine industry may be dangerous to the health of some of the one-third of Americans who use its products. He’s especially worried about recent outbreaks of measles and other preventable diseases in communities where parents have refused vaccines for their children. Offit explores these concerns in his new book, “Do You Believe in Magic: The Sense and Nonsense of Alternative Medicine.”

Q. Why do you think that alternative medicine has become so popular?

A. I think there are a few reasons: One, people are dissatisfied with conventional medicine because medicine has limits and because doctors often don’t have a lot of time. Also, when you walk into the General Nutrition Center, you feel a sense of power. You feel: “I can treat my prostate, I can boost my energy, I can boost my immune system” — in theory — all with drugs available over the counter. And those who sell alternative medicine sell themselves as a spiritual force, whereas conventional medicine is seen as cold and distant. Alternative medicine is “our” medicine. It’s “the people’s medicine.”

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Q. Hasn’t there always been alternative medicine?

A. First of all, I think there’s no such thing as “alternative medicine.” If medicine works, then it’s medicine, and if it doesn’t work, it’s not an alternative. But, yes, “alternative medicine” has been practiced in various forms for 5,000 years. [It’s] not different than a lot of modern alternative medicine, which works because of the placebo response — which is real. Alternative therapists understand that there’s a value to spending time with the patient and there’s a value to evoking the placebo response.

Q. Can practitioners of conventional medicine learn from practitioners of alternative medicine?

A. Yes, definitely. For example, stress is harmful. It can weaken your immune system. It can affect the blood pressure. So ways in which you can calm down, ways in which you can have a positive attitude about your illness, are of value. Alternative medicine practitioners get this: that attitude is important. They can manipulate these physiologic responses to your benefit. My hospital has a Reiki master in the oncology department. Do I really think she’s manipulating your healing energy? No, because I don’t think there are healing energies. But I do think there are physiological processes that occur that can be valuable.

Q. Sometimes alternative medicine has had a religious component, including here in Boston, with the Christian Science Church.

A. Yes. By the late 1800s Christian Science was probably the fastest growing religious denomination in the United States. The mother church was here and so there was more faith healing here than in other places. The most famous case was that of Robyn Twitchell, a 2-year-old boy who, in 1988, had a bowel obstruction. His parents prayed for him instead of seeking medical attention. The boy died and the Commonwealth sued his parents. Massachusetts then eliminated the religious exemption to child abuse and neglect laws. It was the first state to do so, likely because of the concentration here of Christian Scientists.

Q. Don’t many states currently allow parents to refuse medical treatments for their children for religious reasons?

A. Yes. Forty-eight allow religious exemptions for vaccinations (all except West Virginia and Mississippi) and 38 allow exemptions to child abuse and neglect laws (but not Massachusetts).

Q. Is some of the popularity of alternative medicine related to affluence? For example, people in developing countries may not have the luxury of thinking about food sensitivities or dietary supplements or whether or not to accept vaccines.

A. Affluent societies are more technologically based. I think the appeal of alternative medicine in such societies is that it’s more “natural.” But alternative medicine is a multibillion dollar industry. These products aren’t being made by hippies on mountainsides. They’re being made by big pharmaceutical companies.

Q. Many studies have shown that vaccines don’t cause autism, yet this theory has gotten enormous traction with the help of celebrity spokespeople like Jenny McCarthy, who have no medical or scientific credentials. Why is this?

A. First, the theory that vaccines cause autism won’t go away until the cause of autism is discovered or until there’s a cure for autism. As to why people like Jenny McCarthy are listened to, at least by some, it’s the same reason they use celebrities to sell products. You see them on the screen, you think you know them, you’re comfortable with them. Jenny McCarthy is fun and upbeat and brash and speaks “truth to power.” So, at some level, you trust her.

Q. So what are you telling parents who have concerns about vaccinating their children, who are worried that vaccines might cause autism?

A. It’s reasonable to ask the question: “My child was fine, he got a vaccine, now he’s not fine. Could the vaccine have done this?” The good news is it’s an answerable question. It’s a scientific question that can be answered in a scientific way. You look at large numbers of children who did or didn’t get a vaccine, make sure those groups were alike in all other aspects, so you can isolate the effect of that one thing — in this case the MMR vaccine. That study’s been done over and over again. Different continents, different investigators, and the result has been very clear and consistent and reproducible: MMR doesn’t cause autism.

Q. You’ve paid a personal price for being vocal, particularly about the benefits of vaccines. Do you ever feel discouraged?

A. I do get a fair amount of hate mail. The thing that discourages me most is that people wrongly assume that they know my motives. My motive is that I work in a hospital where kids come in with and occasionally die from vaccine-preventable diseases. When I stand up to the anti-vaccine forces, that’s the image I have in my head. What they’re doing is putting bad information out there that’s causing parents to make bad decisions that hurt their children. I’m also the co-inventor of a vaccine, RotaTeq. I spent 25 years working on something that saves hundreds of lives a day. I was lucky that I happened to be part of a team that made a vaccine that I get financial benefit from, but that was never the motivation. I know why I do what I do. Watch a child come into a hospital and die of a disease you could have prevented. It changes you.

Dr. Suzanne Koven can be reached at inpracticemd@
gmail.com
.
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