Morie Gertz, a hematologist, who chairs the Mayo Clinic’s internal-medicine department. “Most of the doctors here were top of their medical-school class, top of their residency, blah, blah, blah,” he told me. “That’s technical mastery. That doesn’t make them effective healers. Over the past 30 years, I’ve seen hundreds of patients who clearly feel they’ve benefited from alternative therapies. It’s not my job to tell them they shouldn’t feel better. And I wouldn’t tell patients they shouldn’t try alternative medicine if they want to—we need to follow the clues patients give us about what might help them. If a patient chooses to walk away from the therapy I’ve prescribed and go to an alternative therapist instead, that’s not the fault of alternative medicine; it’s because I’ve failed as a doctor to do a good job of making my case in terms that are important to the patient.”
Gertz is among the many physicians who dismiss the lack of supportive randomized-trial data as a reason to write off alternative medicine. “The randomized trial is a very high bar,” he says. “Eighty percent of what I do here isn’t based on randomized-trial data.” Physicians routinely write “off-label” prescriptions, Gertz says—that is, prescriptions that call for drugs to treat conditions for which those drugs have not been officially approved. It’s a perfectly legal and ethical practice, and even one that physicians consider essential, accounting for about a fifth of all U.S. prescriptions. “It’s off-label not because it doesn’t work, but because there’s no good randomized-trial data on it. In the same way, we may not have great evidence that alternative medicine works, but that’s very different from saying it doesn’t work.”