A tough pill to cover

Barbara Feder Ostrov is a contributing health reporter at CalMatters, a nonpartisan, non-profit newsroom, in San Jose, California. On her office desk sits a bottle of horny goat weed capsules. The herbal alternative to Viagra reminds Feder Ostrov that when reporting on health she needs to focus on science, and tune out the noise of some trendy alternative cures.

Studies revealed that some brands of horny goat weed were revealed to contain lab-produced sildenafil, the active pharmaceutical ingredient in Viagra. If someone took horny goat weed while on heart medication, she said, it could kill them.

The bottle reminds her that some supposed cures are “full of shit.”

Sticking to the scientific consensus is becoming more important, as distrust of journalists and scientists grows. The 3M State of Science Study in 2019 found that only 60 per cent of people surveyed believed the science reported in news.

Ultimately, journalists can’t report that “alternative medicine” as a whole is bad. There is too much disparity between treatments. Some treatments are not backed by science, while some are scientifically proven to be helpful. Journalists need to learn how to report the difference. And remember that readers who find themselves looking to alternative medicine are often desperate for relief because the medical system has failed them.

What’s the difference?

Part of the confusion with alternative medicine is that there is no accepted definition of the term. The term “complementary and alternative medicine” encapsulates a huge range of treatments that fall outside mainstream medicine.

Think of it this way: would this treatment be regularly performed in a hospital or a doctor’s office by a G.P.? If the answer is no, it probably falls under the massive umbrella of complementary and alternative medicine.

Perhaps the best definition emerged in a 2011 study by Cochrane Complementary Medicine, based in the Center for Integrative Medicine at the University of Maryland. It is an independent organization that aims to promote quality reviews of complementary and alternative therapies.

The study defined alternative medicine as “therapeutic practices which are not currently considered an integral part of conventional allopathic medical practice.” As part of this quest to define alternative medicine, researchers divided treatments into five types. Cochrane has identified 259 practices that fall under its umbrella of complementary and alternative medicine, each finding a spot underneath the umbrellas.

Pseudoscience

Health reporters are familiar with the term pseudoscience. Defined by Martin Curd and Jan Cover in their classic Philosophy of Science: The Central Issues, pseudoscience is “practices that are claimed to be both scientific and factual but are incompatible with the scientific method.”  One example is homeopathy. This treatment follows the ancient principles of “like cures like,” and “law of the minimum dose.”

Homeopathy is considered pseudoscience because practitioners have presented it to the public as based on laws of science and explained through physics, which scientists say is not true. The National Center for Complementary and Integrative Health, a U.S. federal agency for scientific research on alternative medicine, says that it is not possible to explain, in scientific terms, how a homeopathy product containing little or no active ingredient can have any effect.

Psychics, for example, are not considered pseudoscience, because for the most part they do not present themselves as relying on scientific methods.

Journalists need to be aware of pseudoscience and the way that it is used to promote some alternative medicine. They need to focus on the independent scientific consensus, not claims of a treatment’s ties to science.

Cochrane is a great place to start, providing journalists with comprehensive definitions and studies. The National Center for Complementary and Integrative Health is also a valuable resource that provides both information and sources, so journalists can do further research.

 

Do the research

Timothy Caulfield, a professor and researcher at the University of Alberta, has spent 15 years studying how science and health issues are presented to the public. He believes the best way to report on alternative medicine is to look to the body of evidence. Multiple clinical studies that come to the same conclusions create a general scientific consensus.

Caulfield recommends a few questions to get to the root of scientific studies. The most important question when interviewing a health practitioner is “what kind of evidence are you using to support that claim?” Often, if they can point towards an area of study, it can help the reporter dig deeper into the evidence in that field.

“Is this an animal study?” he says, “if so, it’s almost completely unrelatable to humans…is it an observational study? If so, then it’s not a clinical study, and is possibly correlation, not causation.”

Before speaking with alternative medicine practitioners, journalists need to do their research. Knowing the kind of things that the practitioner claims on a website or social media is a good start.

False equivalency

Michelle Cohen, a family doctor and assistant professor at Queen’s University in Kingston, Ont., has written on how reporting on alternative medicine can mislead audiences. One of her major concerns is false equivalency.

This type of reporting implies that an alternative health professional, like a naturopath, is at a basic level, the same as a medical doctor. Cohen believes this tells the reader all that matters is a difference of opinion, not a difference of science.

A naturopath and a medical doctor are not, in fact, the same. Naturopaths need an undergraduate degree, three to four years at an accredited naturopathy school, to pass an exam, and a one-year residency. That is enough to grant them a licence. Medical doctors need exceptional grades, as well as a phenomenal standardized test score to even get into medical school. Following that, they spend four years in a competitive program, then anywhere from two to seven years as a resident, before they can practice medicine.

Some stories require a medical doctor to “debunk” an alternative medicine treatment. There are some hard and fast rules to follow when writing in this format.

Jane Lytvynenko, a disinformation reporter at Buzzfeed News in Ottawa, recommends trying to put the accurate information above the inaccurate information. This way, if readers stop reading your story halfway through, they are left with the accurate data.

Journalists, she says, should never write as if scientific fact is up for debate.

Polarization

There is frustration in Dugald Seely’s voice as he talks about the media’s take on alternative medicine. Seely, a naturopathic doctor and researcher, is the executive director of research and clinical epidemiology at the Canadian College of Naturopathic Medicine in Toronto. If we want people to trust reporting on health issues, he says, journalists need to stick to the science around alternative medicine, and not moralize the issue into “good” vs. “bad”.

Moralizing, he says, “creates this idea where there are ‘believers’ and ‘nonbelievers’ in alternative medicine.”

The conventional medicine system is far from perfect, and few people come across alternative health treatments when they’re perfectly healthy. It is not the journalist’s job to shame anyone for finding relief from a treatment. Being transparent about the lack of scientific evidence for a treatment is different than damning the entire alternative medicine community.

Anecdotal reporting

Goop is a wellness and lifestyle brand founded by actress Gwyneth Paltrow in 2008. In a scene from the Goop Lab, a six-part documentary series on Netflix, Gwyneth Paltrow and Elise Loehnen, goop’s editor-at-large, sit in a bright office in Santa Monica, California. They’re discussing the ancient hallucinogenic drink made from the bark of the ayahuasca. Ayahuasca is not FDA-approved in the United States, but goop is sending five of its employees, including Loehnen, to Jamaica to experience an ayahuasca treatment.

Documentaries use storytelling techniques that make them fascinating for viewers to watch. In this episode, you watch the characters work through their various traumas and wake up from the treatment healed. The 2019 3M study found that 77 per cent of people around the world believe science that is presented to them in documentaries, like the Goop Lab, without doing any other research.

It’s not that these experiences shouldn’t be shared. The problem is that there is no acknowledgement that the experiences being portrayed are not proven to be factual.

Caulfield, the Alberta professor, says the Goop Lab “is just horrible,” and believes these types of narrative docuseries have normalized pseudoscience in popular culture and media. It’s what he calls an “infodemic.”

If you don’t have someone speaking to the objective truth of these treatments, Caulfield says, “a compelling anecdote will overwhelm scientific evidence, every time.”

Reporting on alternative medicine comes down to interpreting and reporting on the scientific consensus. Feder Ostrov describes herself, when it comes to horny goat weed and everything else, “biased to the science.”

About the author

Natalie MacMillan

Natalie MacMillan is from Toronto, Ontario, and works out of Halifax.