Discussing with a patient who is fond of SCAM
One of the most difficult things in so-called alternative medicine (SCAM) can be having a productive discussion with patients about the subject, particularly if they are deeply pro-SCAM. The task can get more tricky, if a patient is suffering from a serious, potentially life-threatening condition. Arguably, the discussion would become even more difficult, if the SCAM in question is relatively harmless but supported only by scarce and flimsy evidence. An example might be the case of a cancer patient who is fond of mindfulness cognitive therapy (MBCT), a class-based program designed to prevent relapse or recurrence of major depression. To contemplate such a situation, let's consider the following hypothetical exchange between a patient (P) and her oncologist (O). P: I often feel quite low, do you think I need some treatment for depression? O: That depends on whether you are truly depressed or just a bit under the weather. P: No, I am not clinically depressed; it's just that I am worried