I really am not a fan of alternative medicine.

Now, I'm not talking about folks who think hypnotherapy or aromatherapy as an addition to conventional medicine is helpful, nor do I mean those who go for acupuncture when conventional medicine has failed them. There's no conflict there. I'm definitely all for folks having alternative therapy on top of what is evidence-based if it works for them, as long as they are aware of the lack of evidence.

No, I'm talking about those who convince gullible patients to eschew evidence-based therapy for alternative medicine.

Recently I saw two patients who were into Traditional Chinese Medicine (TCM), which is often quite a bit of a problem for medical practitioners, mainly due to frequent interactions between herbal concoctions of unknown contents and quantities and western medicine and when it encroaches into Western medicine territories.

Rick is an obese 70-year-old man with heart disease, previous stroke, and an irregular heart rhythm (atrial fibrillation) and as such he is at high risk of further strokes. He takes a blood thinner to lower that risk of stroke. He tells me he's stopped that medication. I ask him why. He said his Chinese medicine practitioner has been brewing herbal teas to 'clear his vessels' and he feels his pulse to show me how 'clear' his vessels are.

He won't be getting a stroke due to blocked vessels, but rather from a clot forming in his heart chamber due to incomplete emptying of blood within that chamber due to the irregular heart beats. I don't know about you, buddy, but feeling a pulse in the wrist can't predict when a clot will form in your heart chamber and fire it into your brain to give you a stroke. I tell him I can't force him to take medications he doesn't want, as long as he understands the risks. He understands. That was that. No more blood thinner for Rick who is at high risk of stroke.

Jenna is a 30-year-old woman who comes in for a post-discharge follow-up after her stay for fever and infection. She is well after her recovery and is otherwise in good health.

She tells me her Chinese practitioner has diagnosed her with valvular disease.

I stare. What the eff.

Yes, valvular disease. Disease of the heart valves. I wonder silently to myself how any human can diagnose that without the use of an echocardiogram or another type of scan. Jenna has a normal heart trace (ECG) and a normal chest x-ray. She has no heart murmurs. She has no health problems in the past. She has no symptoms of valve disease. There is literally zero reason, beyond the BS this practitioner spewed, to believe she has any valve disease. However, to rule it out now that she's obviously so anxious about it, I have to get an echocardiogram.

This pisses me off. The Chinese practitioner so brazenly diagnosed her. They can do me the honour of investigating and managing her. Why should I have to pick up after them? Instead of discharging this well, recovered, young, now very anxious patient who needs no further medical follow-up, I now have to give her further appointments awaiting her unnecessary echocardiogram in two years' time for a disease she doesn't have. This is an utter waste of some already very limited resources and unnecessary anxiety for her.