"Just about everyone I've ever talked to about the subject believes in one or two alternative therapies and are sure they work," he said. "The question is - and it's a big question - what if all these people were wrong? What could explain that?"
In Bausell's book, the answer in most cases is the placebo effect. But some scientists say that's too simplistic a response in an age when much of the mind-body connection remains a mystery.
In fact, the placebo effect shows up in studies of conventional medicine, too. Berman cited a recent Harvard analysis of different treatments for irritable bowel syndrome. More than 40 percent of the patients responded positively to the placebo, whether the treatment tested was conventional or alternative.
Some studies have shown alternative treatments work, he said. For example, acupuncture works for lower back pain, Berman said. Meanwhile, he said, the science is still new, and the body of evidence for most alternative therapies remains small.
"In most cases, there's not enough data from quality trials," Berman said. "We need more research."
He said conventional medicine is often "in the same boat."
"We very rarely hit a home run in any research. It's more trying to get singles or doubles, trying to build upon" existing knowledge, he said.
In some cases, definitive studies have proved that therapies don't work - yet people continue to use them. For example, glucosamine and chondroitin supplements, promoted to improve joint pain, don't work better than placebos - yet the tablets are big sellers. Echinacea, the purple cone flower, remains popular even though a major study found that it doesn't shorten a cold.
And, experts say, some patients flock to alternative medicine when they think conventional treatment has failed them.
"What people get from CAM is an immersion in a world of hope, an immersion in a world of possible improvement for people who have chronic [problems]," Kaptchuk said.
Dr. Robert L. Park, a physics professor at the University of Maryland, College Park who has served as an adviser to the national center on alternative medicine, said he tried to write a book like Bausell's a few years back. His publisher told him that people didn't want to hear bad news about treatments they feel passionate about or learn how their minds could be tricked into thinking a treatment works when it doesn't.
"People really want to believe it," he said. "It's disconcerting to anyone who tries to battle this."
stephanie.desmon@baltsun.com
