Here's an interesting piece, "Bitter Herbs: Mainstream, Magic, and Menace," by Thomas L. Delbanco on why physicians should take patients' interest in alternative medicine seriously. He says in part:
In today's frantic and increasingly impersonal world, replete with fax machines, voice mail, the tortuous information highway, and the bewildering technologies of medicine, people find hope in recreating the past. The "original instrument" movement in music, the renaissance of the portrait painter, the fascination with Wharton's Age of Innocence, and the urban dweller's flight to the country represent point-counterpoints to the suffocation that comes from today's headlong rush. And the countervailing simplicity, clarity, and directness that patients seek may be represented by a tablet or potion derived from an exotic "natural" herb.
At the same time, clinical trials investigate scientific medicine with increasingly sophisticated techniques that proliferate, confuse, and too often disappoint an avid audience. Methodologists who develop and critique their design and findings wield more and more complex tools. How many approaches to multiple regression now exist? Which statistical inference is right for the latest set of data? In 1994, is butter or margarine safer? When do you remove, radiate, or watch prostate cancer? Is lumpectomy for breast cancer really as safe as more mutilating surgery? What's best for back pain? So, even at a time of rich scientific endeavor and discovery, patients turn to plants or homeopathic distillates and announce, "I would rather swallow this! It's pure, it's safe, it's magic, and it will help me face the world"
But now their purity, safety, or magic also comes into question. The contents inside the Jin Bu Huan box, for example, are not Jin Bu Huan; the manufacturers either used the wrong plant or got it wrong on the label. Moreover, the safety is suspect; its effect is not magic alone. The ingredients have a pharmacologic effect that may help or hurt the patient, depending on the total dose and individual susceptibility.
How should the benefit that may come from alternative therapies, whether through the placebo effect or beyond, be maximized? And how should the dangers of these therapies be minimized? With respect to the benefits, the multibillion dollar industry that produces and promotes many of the therapies is not shy about extolling their putative virtues. As has been true in the United States since its founding, proponents of alternative therapies find it easy to attract the public's attention. The popularity may grow through future clinical trials that show efficacy, and interest in such trials is increasing. Small-scale experiments are sponsored by the highly visible, albeit modestly funded, Office of Alternative Medicine (OAM), established at the National Institutes of Health (NIH) "to encourage the investigation of alternative medical practices, with the ultimate goal of integrating validated alternative medical practices with current conventional medical procedures". Larger trials are funded with less fanfare through other branches of the NIH. Private philanthropies, led by the Fetzer Institute in Kalamazoo, Michigan, are investing aggressively in this area. All this activity likely represents a response to public demand and a carefully orchestrated effort to engender interest.
This piece foreshadows much of the argument in R. Barker Bausell's Snake Oil Science: The Truth About Complementary and Alternative Medicine (Oxford University Press, 2007), but it's obviously more succinct. It appeared in the Annals of Internal Medicine in 1994. Here's a link to the full article. Dr. Delbanco is also the author of "Leeches, Spiders, and Astrology: Predilections and Predictions," 280 Journal of the American Medical Association 1560-1562 (1998).