MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

The queue outside my ‘ALT MED HALL OF FAME’ was getting restless because I did not admit any new members for some time. So, I better get cracking!

You remember, of course, who has been honoured so far; the list of members (main research interest, country) is as follows:

Nicola Robinson (TCM, UK)

Peter Fisher (homeopathy, UK)

Simon Mills (herbal medicine, UK)

Gustav Dobos (various, Germany)

Claudia Witt (homeopathy, Germany and Switzerland)

George Lewith (acupuncture, UK)

John Licciardone (osteopathy, US)

Today, we are going to have a look at Prof David Peters. This is what our friends from the ‘COLLEGE OF MEDICINE’ say about him:

“David Peters MB, ChB, DRCOG, DMSMed MFHom FLCOM trained as a GP, a musculoskeletal physician and also as a homeopathic and osteopathic practitioner. For fifteen years he directed the complementary therapies development programme at Marylebone Health Centre. Professor Peters is one of the founding faculty of the University of Westminster’s School of Life Sciences, where he is Clinical Director. Professor Peters is a member of the Council and former chair of the British Holistic Medical Association and Editor of its Journal of Holistic Healthcare. He has co-authored or edited six books about integrated healthcare. His research interests include the role of non-pharmaceutical treatments in mainstream medicine, wellbeing in long-term conditions and the development of integrated practitioners.”

I did my usual Medline search but found only 16 Medline-listed articles authored by David Peters. This is amazing because he has been involved in UK alt med much longer than I have. Even more amazing is that none of these papers seem to refer to clinical trials. Perhaps he is not convinced of this type of research?

In order to evaluate his output, I took the sentence that came nearest to a conclusion from the most recent 10 articles. Below you find first the titles of each paper (with the link to it), second the list of its authors and third the sentence that formulated a conclusion (in bold).

Patient outcomes and experiences of an acupuncture and self-care service for persistent low back pain in the NHS: a mixed methods approach.

Cheshire A, Polley M, Peters D, Ridge D.

BMC Complement Altern Med. 2013 Nov 1;13:300. doi: 10.1186/1472-6882-13-300.

The BBPS provided a MSK pain management service that many patients found effective and valuable. Combining self-management with acupuncture was found to be particularly effective, although further consideration is required regarding how best to engage patients in self-management.

Is it feasible and effective to provide osteopathy and acupuncture for patients with musculoskeletal problems in a GP setting? A service evaluation.

Cheshire A, Polley M, Peters D, Ridge D.

BMC Fam Pract. 2011 Jun 13;12:49. doi: 10.1186/1471-2296-12-49.

Provision of acupuncture and osteopathy for MSK pain is achievable in General Practice. A GP surgery can quickly adapt to incorporate complementary therapy provided key principles are followed.

Gatekeepers and the Gateway–a mixed-methods inquiry into practitioners’ referral behaviour to the Gateway Clinic.

Unwin J, Peters D.

Acupunct Med. 2009 Mar;27(1):21-5. doi: 10.1136/aim.2008.000083.

The Gateway Clinic has become an increasingly popular referral resource. The influences that drive referral to the clinic are multiple and follow “tacit guidelines”. GPs select patients on the basis of their individual clinical experience, informed by positive patient feedback and often only after more conventional medical treatment options have been exhausted.

Complementary medicine: evidence base, competence to practice and regulation.

Lewith GT, Breen A, Filshie J, Fisher P, McIntyre M, Mathie RT, Peters D.

Clin Med (Lond). 2003 May-Jun;3(3):235-40. Review.

This paper describes the current status and evidence base for acupuncture, homeopathy, herbal and manipulative medicine, as well as the regulatory framework within which these therapies are provided. It also explores the present role of the Royal College of Physicians’ Subcommittee on Complementary and Alternative Medicine (CAM) in relation to these developments. A number of CAM professions have encouraged the Royal College of Physicians Subcommittee to act as a reference point for their discussions with the conventional medical profession and the subcomittee believes that they are able to fulfil this function.

Using a computer-based clinical management system to improve effectiveness of a homeopathic service in a fundholding general practice.

Peters D, Pinto GJ, Harris G.

Br Homeopath J. 2000 Jul;89 Suppl 1:S14-9

It is possible to introduce rigour and reflectiveness when providing a homeopathic service in general practice by assessing the needs of patient and practitioners, agreeing intake guidelines, developing referral processes, implementing audit cycles. Clear lines of communication can be established and a patient-centred outcome measure can be introduced into the treatment cycle.

I could not find any further articles that I could classify as providing data; so I stopped well short of the envisaged 10 papers. I have to admit, I was hesitant: does David deserve to be in the ALT MED HALL OF FAME? In the end, I gave him the benefit of the doubt. Why? Mainly because I am impressed with his scope of practice. Here is what he himself wrote about this aspect:

“I use a range of approaches: osteopathy and medical acupuncture, as well as nutrition and mind-body medicine – meditation, relaxation techniques, breath-work, self-hypnosis, biofeedback, and simple yoga-based exercises.  Sometimes herbal medicines, complex homeopathy, nutritional supplements, trigger-point or joint injections can be a valuable too. Somatic Experiencing is a gentle form of body-centred psychotherapy for problems that have come on after traumatic incidents. When I want to assess the impact of stress on the body I use a painless approach involving computer-based heart rate variability testing and breath analysis; sometimes salivary cortisol profiling too. Where required I can prescribe conventional medicine and  were they are needed I might suggest scans, X-rays or blood tests.”

Peter is perhaps not the most industrious researcher when it comes to publishing papers, but he fulfils the criterion of not ever publishing anything negative that might rock the boat or distract from the true value of alternative medicine.

LONG LIVE THE POSITIVE RESULT!

 

6 Responses to Another researcher enters THE ALT MED HALL OF FAME

  • Good morning, Professor Ernst.

    Just out of curiosity, how many researchers have made it into your conventional medicine hall of fame? If you are only searching for “alt med” researchers who have published no negative studies, isn’t that selection bias? And don’t you lack a control group? So isn’t all of this completely meaningless?

    In other words, what percentage of so called “CAM researchers” only publish positive results? And how does that compare to “conventional medical” researchers as a control group? What’s the RR of CAM researchers reporting only publishing positive outcomes? If you don’t know the answer to this, then your hall of fame is meaningless.

    It’s widely accepted that there’s a positive outcome bias in all medical research, not just complementary medicine. Pointing it out only in CAM without impartially assessing it in the greater context demonstrates bias on your part.

    http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124
    http://archinte.jamanetwork.com/article.aspx?articleid=226270

    • GOOD POINT!
      except:
      1) you are employing a classical fallacy [tu quoque],
      2) negative publication bias is not quite what I was writing about,
      3) negative publication bias is huge in alt med [http://www.ncbi.nlm.nih.gov/pubmed/?term=ernst%2C+pittler%2C+nature],
      4) I am an expert in alt med and thus blog about alt med and not about ‘all medical research’ [if someone is an expert in road safety, would you accuse him of bias because he does not make statements about the risks of flying?],
      5) the post is meant to be a satire and is marked as such.
      BUT OTHERWISE YOU ARE PROBABLY CORRECT.

    • Lol, suddenly control groups are important.

      Actually, this is an exercise in that honourable tradition of taking the piss, rather appropriate for alt medders.

      The English have long maintained that Germans have no sense of humour, I am pleased to see Prof. Ernst destroy the stereotype. Are alt medders taking up the mantle?

  • I find it more elegant to term those who practice CAMs as ‘camists’.
    The field of endeavour as ‘camistry’.
    Might this catch on?

    • … and taking RR’s idea further, “CAMartists” would be entertainers (“altertainers”?) who perform CAM . And perhaps SCAMartist if supplements are a significant part of their goods? 😃

      • A “CAMshaft” would be a successful exploitation of the victim’s wallet by the camist. “CAMshafting” would be the core business model of camistry.

        The chosen “CAM profile” (branch of woo) determines the camist’s trade-off between economy and theatrical performance. Remote/distant Reiki being an exemplar of a “CAM profile” that has been finely-tuned to achieve maximal economy.

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