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Monday, November 28, 2005

Thank you, HR, for wasting my time

My employer is on some kind of employee wellness kick for the last year or so. For the most part, I like what they're doing. For example, they piloted flex time and compressed work weeks, and are now offering it more widely to help employees with work/life balance issues. The benefits are good; the union just negotiated a way improved medical/dental package; and every once in a while they have casual week that you don't have to pay into the social committee/united way/other charity fund for - it's supposed to encourage you to go for a brisk walk on your lunch break if you don't have to wear a suit. Pretty enlightened for the behemoth entity it is.

Unfortunately not all the initiatives pan out. Take, for example, the series of seminars they've arranged with the Doctors' Speakers Bureau - today's topic was Natural Solutions to Headache Pain. The blurb said, "Millions of Americans suffer from chronic headaches. This results in millions of doctors visits, millions of lost work days, and billions of dollars in medical bills. This presentation was designed to educate the audience about the different types of headaches, what causes them, how to prevent them, and safe, natural and effective alternatives to treating them." I was keen to go to this (and my boss was keen for me to go too) because I am a chronic headache sufferer and it definitely impacts my work.

I should admit up front I don't have a really positive view of so-called "alternative medicine". As far as I am concerned, there are treatments that scientific evidence shows they work, and then there are treatments without that kind of evidence. The former, regardless of whether it was first invented by a scientist in a lab, or a shaman in a sweat lodge, is real medicine. I don't really see why anybody would want an alternative to that, but maybe it's just me.

But I felt I went in with a fairly open mind. I was hoping for 'can't hurt, might help' type stuff I hadn't heard of (or had forgotten about) for headache self-care, things to try when you first start having a migraine aura besides taking hardcore drugs, or some relaxation exercises to try if you feel a tension headache coming on. Nice basic stuff like that, that would have a good chance of improving both my productivity at work, and my overall quality of life.

What I got was an infomercial on acupuncture, with a major de-emphasis on "info". The speaker, a local acupuncturist, was, I'm sure, a very nice and caring person, but she was completely unqualified to be giving the presentation. Her public speaking was at the level of a moderately gifted eighth grader. She finished every sentence like it was a question? You know? And she ran out of content? After ten minutes? And it was supposed to have been, you know, an hour presentation? So after she ran out of content, people just asked her non-critical questions for the rest of the hour.

A meta-analysis of trials of acupuncture for headache pain (1) found "Overall, the existing evidence suggests that acupuncture has a role in the treatment of recurrent headaches. However, the quality and amount of evidence is not fully convincing. There is urgent need for well-planned, large-scale studies to assess effectiveness and efficiency of acupuncture under real life conditions." Apparently an erratum was published in a later issue, but I haven't been able to find the text online to find out of the error caused their conclusions to be too generous or too strict, or if it was something more minor.

The bottom line for me is, at the end of it, all I had to take home was the option of a long course of therapy, twice a week over several weeks, and then regular maintenance care, at over $50/appointment, which might help a bit as long as I would make changes in the rest of my life too. And I gave up an hour of time I could have been using to get shit done to hear about it.
1 - Melchart D,Linde K, Fischer P, White A, Allais G, Vickers A, Berman B, (1999). Acupuncture for recurrent headaches: a systematic review of randomized controlled trials. Cephalalgia. 1999 Nov;19(9):779-86; discussion 765


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