MD, PhD, FMedSci, FSB, FRCP, FRCPEd

big pharma

Each year, during the Christmas period, we are bombarded with religious ideology, soapy sentimentality and delusive festive cheer. In case you are beginning to feel slightly nauseous about all this, it might be time to counter-balance this abundance with my (not entirely serious) version of the ’10 commandments of quackery’?

  1. You must not use therapies other than those recommended by your healer – certainly nothing that is evidence-based!
  2. You must never doubt what your healer tells you; (s)he embraces the wisdom of millennia combined with the deep insights of post-modernism – and is therefore beyond doubt.
  3. You must happily purchase all the books, gadgets, supplements etc. your healer offers for sale. For more merchandise, you must frequent your local health food shops. Money is no object!
  4. You must never read scientific literature; it is the writing of evil. The truth can only be found by studying the texts recommended by your healer.
  5. You must never enter into discussions with sceptics or other critical thinkers; they are wicked and want to destroy your well-being.
  6. You must do everything in your power to fight the establishment, Big Pharma, their dangerous drugs and vicious vaccines.
  7. You must support Steiner Schools, Prince Charles and other enlightened visionaries so that the next generation is guided towards the eternal light.
  8. You must detox regularly to eliminate the ubiquitous, malignant poisons of Satan.
  9. You must blindly, unreservedly and religiously believe in vitalism, quantum medicine, vibrational energy and all other concepts your healer relies upon.
  10. You must denounce, vilify, aggress and attack anyone who disagrees with the gospel of your healer.

The volume of medical research, as listed on Medline, is huge and increases steadily each year. This phenomenon can easily be observed with simple Medline searches. If we use search terms related to conventional medicine, we find near linear increases in the number of articles (here I do not make a distinction between types of articles) published in each area over time, invariably with a peak in 2013, the last year for which Medline listing is currently complete. Three examples will suffice:

PHARMACOTHERAPY        117 414 articles in 2013

PHARMACOLOGY               210 228 articles in 2013

ADVERSE EFFECTS              86 067 articles in 2013

Some of the above subjects are obviously heavily industry-dependent and thus perhaps not typical of the volume of research in health care generally. Let’s therefore look up three fields where there is no such powerful industry to support research:

PSYCHOTHERAPY              7 208 articles in 2013

PHYSIOTHERAPY                7 713 articles in 2013

SURGERY                           154 417 articles in 2013

Now, if we conduct similar searches for topics related to alternative medicine, the picture changes in at least three remarkable ways: 1) there is no linear increase of the volume per year; instead the curves look flat and shapeless (the only exception is ‘herbal medicine’ where the increase even looks exponential). 2) The absolute volume does not necessarily peak in 2013 (exceptions are ‘acupuncture’ and ‘herbal medicine’). 3) The number of articles in the year with the most articles (as listed below) is small or even tiny:

ACUPUNCTURE                    1 491 articles in 2013

CHIROPRACTIC                      283 articles in 2011

HERBAL MEDICINE           2 503 articles in 2013

HOMEOPATHY                        233 articles in 2005

NATUROPATHY                         69 articles in 2010

You may think: so what? But I find these figures intriguing. They demonstrate that the research output in alternative medicine is minimal compared to that in conventional medicine.  Moreover, they imply that this output is not only not increasing steadily, as it is in conventional medicine, but in the case of chiropractic, homeopathy and naturopathy, it has recently been decreasing.

To put this into context, we need to know that:

  1. there is a plethora of journals dedicated to alternative medicine which are keen to publish all sorts of articles,
  2. the peer-review process of most of these journals seems farcically poor,
  3. as a result, the quality of the research into alternative medicine is often dismal, as regularly disclosed on this blog,
  4. enthusiasts of alternative medicine often see rigorous research into their subject as a dangerous threat: it might disprove their prior beliefs.

In their defence, proponents of alternative medicine would probably claim that the low volume of research is due to a severe and unfair lack of funding. However, I fail to see how this can be the sole or even the main explanation: areas of conventional medicine that do not have industry support seem to manage a much higher output than alternative medicine (and I should stress that I have chosen 5 sections within alternative medicine that are associated with the highest number of articles per year). Research in these areas is usually sponsored by charitable and government sources, and it needs to be stressed that these are open to any researcher who submits good science.

What follows, I think, is simple: in general, alternative medicine advocates have little interest in research and even less expertise to conduct it.

Some of the recent comments on this blog have been rather emotional, a few even irrational, and several were, I am afraid, outright insulting (I usually omit to post the worst excesses). Moreover, I could not avoid the impression that some commentators have little understanding of what the aim of this blog really is. I tried to point this out in the very first paragraph of my very first post:

Why another blog offering critical analyses of the weird and wonderful stuff that is going on in the world of alternative medicine? The answer is simple: compared to the plethora of uncritical misinformation on this topic, the few blogs that do try to convey more reflected, sceptical views are much needed; and the more we have of them, the better.

My foremost aim with his blog is to inform consumers through critical analysis and, in this way, I hope to prevent harm from patients in the realm of alternative medicine. What follows, are a few simple yet important points about this blog which I try to spell out here as clearly as I can:

  • I am not normally commenting on issues related to conventional medicine – not because I feel there is nothing to criticise in mainstream medicine, but because my expertise has long been in alternative medicine. So commentators might as well forget about arguments like “more people die because of drugs than alternative treatments”; they are firstly fallacious and secondly not relevant to this blog.
  • I have researched alternative medicine for many years (~ 40 clinical studies, > 300 systematic reviews etc.) and my readers can be confident that I know what I am talking about. Thus comments like ‘he does not know anything about the subject’ are usually not well placed and just show the ignorance of those who post them.
  • I am not in the pocket of anyone. I do not receive payments for doing this blog, nor did I, as an academic, receive any financial or other inducements for researching alternative medicine (on the contrary, I have often been given to understand that my life could be made much easier, if I adopted a more promotional stance towards my alternative medicine). I also do not belong to any organisation that is financed by BIG PHARMA or similar power houses. So my critics might as well abandon their conspiracy theories and  focus on a more promising avenue of criticism.
  • My allegiance is not with any interest group in (or outside) the field of alternative medicine. For instance, I do not see it as my job to help chiropractors, homeopaths etc. getting their act together. My task here is to point out the deficits in chiropractic (or any other area of alternative medicine) so that consumers are better protected. (I should think, however, that this also creates pressure on professions to become more evidence-based – but I see this as a mere welcome side-effect.)
  • If some commentators seem to find my arguments alarmist or see it as venomous scare-mongering, I suggest they re-examine their own position and learn to think a little more (self-) critically. I furthermore suggest that, instead of claiming such nonsense, they point out where they think I have gone wrong and provide evidence for their views.
  • Some people seem convinced that I have an axe to grind, that I have been personally injured by some alternative practitioner, or had some other unpleasant or traumatic experience. To those who think so, I have to say very clearly that none of this has ever happened. I recommend they inform themselves of the nature of critical analysis and its benefits.
  • This is a blog, not a scientific journal. I try to reach as many lay people as I can and therefore I tend to use simple language and sometimes aim to be entertaining. Those who feel that this renders my blog more journalistic than scientific are probably correct. If they want science, I recommend they look for my scientific articles in the medical literature; I can assure them that they will find plenty.
  • I very much invite an open and out-spoken debate. But ad hominem attacks are usually highly counterproductive – they only demonstrate that the author has no rational arguments left, or had none in the first place. Authors of insults also risks being banned from this blog.
  • Finally, I fear that some readers of my blog might sometimes get confused in the arguments and counter-arguments, and end up uncertain which side is right and which is wrong. To those who have this problem, I recommend a simple method for deciding where the truth is usually more likely to be found: ask yourself who might be merely defending his/her self-interest and who might be free of such conflicts of interest and thus more objective. For example, in my endless disputes with chiropractors, one could well ask: do the chiropractors have an interest in defending their livelihood, and what interest do I have in questioning whether chiropractors do generate more good than harm?

If you think that homeopathy is risk-free, you should read what this US homeopath proclaims on his website. I have copied several sections from his lengthy article (everything that is in normal print is his writing; mine is in bold). The author first gives a general introduction into homeopathy and why he believes in it; then he continues:

…Now, on the surface, you might think that since there is some common ground between homeopathy and vaccinations, that homeopathic doctors would be, all-in, when it comes to vaccines. The fact is, most homeopaths today are against vaccinations. The main reason for that is not because of the underlying principle, but because the process have been perverted by eugenics. Today, the real purpose of vaccinations is to cause sterilization and early death. Bill Gates spends billions of dollars on global vaccination, admittedly, to reduce the population. All kinds of heavy metals like aluminum, mercury and other poisons and pathogens are put into vaccinations. People, especially children, are given many more times the amount of vaccinations today than they were decades gone by, when it can be argued, vaccinations were effective and were needed.Even cancer viruses have, on record, been put into vaccinations. There is no actual vaccine for cancer. The only reason to put cancer viruses in the mix is to create more cases of cancer. In this day and age, one of the most dangerous things you can do for your health is to get vaccinated…

With homeopathy, you never have to worry about heavy metals, cancer viruses or other poisons being mixed in with the natural ingredients. Even though some of the underlying foundations of homeopathy and vaccinations are similar, there are a number of differences. With vaccinations, the actual disease that they are allegedly trying to build up immunity to is in the injection. In homeopathy, that is not the case, except in rare exception, and due to the dilution process, there is never any risk. Another difference is that homeopathic remedies are taken orally, rather than injected…

Homeopathic remedies have no side effects. That’s a great thing. On the other hand, every drug comes with lots of side effects. And then, you can get in a vicious cycle where you keep taking (or being prescribed) more and more drugs to deal with more and more side effects. In time, this often leads to emergency “live saving” surgery. When they are successful and the patient doesn’t die on the operating table, everyone praises modern medicine for saving those millions of lives, all the while ignoring that the reason those millions of surgeries were needed in the first place, was due to those allegedly wonderful and so-called scientifically proven drugs. Plus, many times, these surgeries aren’t truly needed. If the patient would simply quit taking the drugs, the body could, often, heal itself from life threatening conditions…

Homeopathy is much more well known in Europe and various other nations than it is known in the United States. There is a huge medical conspiracy against the use of homeopathy and other medical modalities that threaten the financial dominance of the current medical industry. The conspiracy extends world-wide, but it is strongest in the USA…This conspiracy is being perpetrated on a conscious level, for going on 200 years. Then, on the heels of that, there is a massive amount of ignorance from ironically, highly educated people, who have been influenced by the conspirators. (Most of these people you might not be able to classify as conspirators, because they believe what they are saying.) Doctors who have never even tried a homeopathic remedy on themselves, or their patients, often say that there is no evidence that homeopathy works. When you point to the innumerable raving fans of homeopathy around the world, each of whom have testimonies of homeopathic remedies working extremely well, the detractors simply call those, anecdotal evidence, not worthy of consideration. When you point out some of the clinical case histories of undeniable healings that have come to patients of homeopathic doctors, the opponents of homeopathy chalk it all up to the placebo effect. They say they want scientific proof and that none exists, but the truth is, numerous studies have shown very positive results, and have outperformed drugs and/or placebo. There are more than 150 placebo controlled clinical studies, most of which have shown positive results, either compared with a placebo or compared with a conventional drug. Moreover, they did so with zero side effects, (unlike drugs, which often have that little side effect known as, death.) And yet, the detractors always have a Rolodex of never ending excuses, why those studies, “don’t count.” They range from, the studies are too small; they are conducted by people who believe in homeopathy – (I’m serious!); the doctors aren’t well known enough; there must have been some breakdown of the scientific procedure that has yet to come out, etc. These people are unable to deal with the conundrum, that homeopathic remedies become more potent, with dilution, instead of less potent, like you would assume. From there, they assume that it can’t work, and no matter how much healing is done with homeopathic remedies, it’s nothing more than mind of matter, (placebo effect.) …The evidence is overwhelming to anyone with an open mind that homeopathy is for real. Does everyone magically become well? Will you not have to die? You know the answers to that, and nobody is suggesting it.

What is undeniable is that the pharmaceutical industry peddles toxic drugs that do more harm than good, by far. Big pharma corporations get caught faking studies, bribing doctors and all kinds of dirty, illegal activity, for which they are fined billions of dollars. To call them purveyors of science is laughable. There are drugs like Vioxx, that have killed anywhere from tens of thousands to more than a million people (depending on whether you go by Merck and the FDA statistics, or outside investigators), which, shockingly, aren’t even pulled from the market by the government. The company finally quits peddling them once the lawsuits make it unprofitable…

I’ve finally come to the conclusion that these people aren’t interested in finding the truth. They only want to protect their status quo, and well as their paradigms of how the world works. They don’t have room for experiential evidence. When these type of people write research papers smearing homeopathy, they are being intellectually dishonest. They consciously obfuscate facts and mold findings to seem to conform to their beliefs – let the evidence be damned…

These medical mafia type of people, don’t even care about logic. They stopped making sense a long, long time ago. When you are done reading these two articles, if you have a modicum of an open mind, you will at the very least, not be able to deny that there really is a very genuine conspiracy against homeopathy…

Such utter nonsense speaks, I think, for itself. Therefore perhaps just this as my comment. 

I have said and written it often: the homeopathic remedy might be harmless, however, many homeopaths are clearly not.

In a way, I should be thankful to the author of this truly amazing article enforcing my point.

 

A recent US study found that belief in conspiracy theories is rife in health care. The investigators presented people with 6 different conspiracy theories, and the one that was most widely believed was the following:

THE FOOD AND DRUG ADMINISTRATION IS DELIBERATELY PREVENTING THE PUBLIC FROM GETTING NATURAL CURES FOR CANCER AND OTHER DISEASES BECAUSE OF PRESSURE FROM DRUG COMPANIES.

A total of 37% agreed with this statement, 31% had no opinion on the matter, and 32% disagreed. What is more, the belief in this particular conspiracy correlated positively with the usage of alternative medicine.

Essentially, this implies that the current popularity of alternative medicine is at least partly driven by the conviction that there is a sinister plot by the FDA or more generally speaking ‘the establishment’ that prevents people from benefitting from the wonders of alternative treatments.

I think it was Woody Allen who noted that, just because you are paranoid does not mean that they are not following you. So, let’s look for evidence suggesting that the FDA or any similar organisation is suppressing alternative medicine.

A prime candidate is, of course, the often implicated, thoroughly evil ‘BIG PHARMA‘. I am not a fan of the pharmaceutical industry and I know few people who are. But where is the evidence for BIG PHARMA’s conspiracy against alternative medicine? In the many years of researching this sector, I have never come across a jot of evidence to support this notion. On the contrary, BIG PHARMA seems all to keen to jump on to the alternative bandwagon and make a few quick bucks from the gullibility of the consumer.

What about the rest of the medical establishment? All I see is that universities, hospitals, charities and other organisations in health care currently bend over backwards in order to accommodate as much alternative medicine as they possibly can get away with in view of the often embarrassing lack of convincing evidence for the treatments in question. Conspiracy against alternative medicine? I don’t think so.

The closer we look, the more we arrive at the conclusion that the conspiracy against alternative medicine is a myth and a figment of the imagination of those who religiously believe in alternative medicine. They seem to long for an explanation why their favourite therapy is not in even more wide-spread use. Cognitive dissonance seems to prevent them to consider that the lack of evidence has anything to do with this situation. Consequently, they prefer to invent a conspiracy theory.

And this is where an interesting question emerges, in my view: do people who believe that the FDA or other organisations prevent the public from getting more alternative medicine really need more alternative medicine, or do they perhaps just need an effective treatment for their paranoia?

When we talk about conflicts of interest, we usually think of financial concerns. But conflicts of interests also extend to non-financial matters, such as strong beliefs. These are important in alternative medicine – I would even go as far as to claim that they dominate this field.

My detractors have often claimed that this is where my problem lies. They are convinced that, in 1993, I came into the job as PROFESSOR OF COMPLEMENTARY MEDICINE with an axe to grind; I was determined or perhaps even paid to show that all alternative medicine is utter hocus-pocus, they say. The truth is that, if anything, I was on the side of alternative medicine – and I can prove it. Using the example of homeopathy, I have dedicated an entire article to demonstrate that the myth is untrue – I was not closed-minded or out to ditch homeopathy (or any other form of alternative medicine for that matter).

What then could constitute my ‘conflict of interest’? Surely, he was bribed, I hear them say. Just look at the funds he took from industry. Some of those people have even gone to the trouble of running freedom of information requests to obtain the precise figures for my research-funding. Subsequently they triumphantly publish them and say: Look he got £x from this company and £y from that firm. And they are, of course, correct: I did receive support from commercially interested parties on several occasions. But what my detractors forget is that these were all pro-alternative medicine institutions. More importantly, I always made very sure that no strings were attached with any funds we accepted.

Our core funds came from ‘The Laing Foundation’ which endowed Exeter University with £ 1.5 million. This was done with the understanding that Exeter would put the same amount again into the kitty (which they never did). Anyone who can do simple arithmetic can tell that, to sustain up to 20 staff for almost 20 years, £1.5 million is not nearly enough. There must have been other sources. Who exactly gave money?

Despite utterly useless fundraising by the University, we did manage to obtain additional funds. I managed to receive support in the form of multiple research fellowships, for instance. It came from various sources; for instance, manufacturers of herbal medicines, Boots, the Pilkington Family Trust (yes, the glass manufacturers).

A hugely helpful contributor to our work was the sizable number (I estimate around 30) of visitors from abroad who came on their own money simply because they wanted to learn from and with us. They stayed between 3 months and 4 years, and importantly contributed to our research, knowledge and fun.

In addition, we soon devised ways to generate our own money. For instance, we started an annual conference for researchers in our field which ran for 14 successful years. As we managed everything on a shoestring and did all the organisation ourselves, we made a tidy profit each year which, of course, went straight back into our research. We also published several books which generated some revenue for the same purpose.

And then we received research funding for specific projects, for instance, from THE PRINCE OF WALES’ FOUNDATION FOR INTEGRATED HEALTH, a Japanese organisation supporting Jorhei Healing, THE WELCOME TRUST, the NHS, and even a homeopathic company.

So, do I have a conflict of interest? Did I take money from anyone who might have wanted to ditch alternative medicine? I don’t think so! And if I tell you that, when I came to Exeter in 1993, I donated ~£120 000 of my own funds towards the research of my unit, even my detractors might, for once, be embarrassed to have thought otherwise.

One of the perks of researching alternative medicine and writing a blog about it is that one rarely runs out of good laughs. In perfect accordance with ERNST’S LAW, I have recently been entertained, amused, even thrilled by a flurry of ad hominem attacks most of which are true knee-slappers. I would like to take this occasion to thank my assailants for their fantasy and tenacity. Most days, these ad hominem attacks really do make my day.

I can only hope they will continue to make my days a little more joyous. My fear, however, is that they might, one day, run out of material. Even today, their claims are somewhat repetitive:

  • I am not qualified
  • I only speak tosh
  • I do not understand science
  • I never did any ‘real’ research
  • Exeter Uni fired me
  • I have been caught red-handed (not quite sure at what)
  • I am on BIG PHARMA’s payroll
  • I faked my research papers

Come on, you feeble-minded fantasists must be able to do better! Isn’t it time to bring something new?

Yes, I know, innovation is not an easy task. The best ad hominem attacks are, of course, always based on a kernel of truth. In that respect, the ones that have been repeated ad nauseam are sadly wanting. Therefore I have decided to provide all would-be attackers with some true and relevant facts from my life. These should enable them to invent further myths and use them as ammunition against me.

Sounds like fun? Here we go:

Both my grandfather and my father were both doctors

This part of my family history could be spun in all sorts of intriguing ways. For instance, one could make up a nice story about how I, even as a child, was brain-washed to defend the medical profession at all cost from the onslaught of non-medical healers.

Our family physician was a prominent homeopath

Ahhhh, did he perhaps mistreat me and start me off on my crusade against homeopathy? Surely, there must be a nice ad hominem attack in here!

I studied psychology at Munich but did not finish it

Did I give up psychology because I discovered a manic obsession or other character flaw deeply hidden in my soul?

I then studied medicine (also in Munich) and made a MD thesis in the area of blood clotting

No doubt this is pure invention. Where are the proofs of my qualifications? Are the data in my thesis real or invented?

My 1st job as a junior doctor was in a homeopathic hospital in Munich

Yes, but why did I leave? Surely they found out about me and fired me.

I had hands on training in several forms of alternative medicine, including homeopathy

Easy to say, but where are the proofs?

I moved to London where I worked in St George’s Hospital conducting research in blood rheology

Another invention? Where are the published papers to document this?

I went back to Munich university where I continued this line of research and was awarded a PhD

Another thesis? Again with dodgy data? Where can one see this document?

I became Professor Rehabilitation Medicine first at Hannover Medical School and later in Vienna

How did that happen? Did I perhaps bribe the appointment panels?

In 1993, I was appointed to the Chair in Complementary Medicine at Exeter university

Yes, we all know that; but why did I not direct my efforts towards promoting alternative medicine?

In Exeter, together with a team of ~20 colleagues, we published > 1000 papers on alternative medicine, more than anyone else in that field

Impossible! This number clearly shows that many of these articles are fakes or plagiaries.

My H-Index is currently >80

Same as above.

In 2012, I became Emeritus Professor of the University of Exeter

Isn’t ’emeritus’ the Latin word for ‘dishonourable discharge’?

I HOPE I CAN RELY ON ALL OF MY AD HOMINEM ATTACKERS TO USE THIS INFORMATION AND RENDER THE ASSAULTS MORE DIVERSE, REAL AND INTERESTING.

Several sceptics including myself have previously commented on this GP’s bizarre promotion of bogus therapies, his use of disproven treatments, and his advocacy for quackery. An interview with Dr Michael Dixon, OBE, chair of the ‘College of Medicine’, and advisor to Prince Charles, and chair of NHS Alliance, and president of the ‘NHS Clinical Commissioners’ and, and, and…was published on 15 November. It is such a classic example of indulgence in fallacies, falsehoods and deceptions that I cannot resist adding a few words.

To make it very clear what is what: the interviewer’s questions are in bold Roman; MD’s answers are in simple Roman; and my comments are in bold italic typeface. The interview itself is reproduced without changes or cuts.

How did you take to alternative medicine?

I started trying out alternative medicine after 10 years of practising as a general physician. During this period, I found that conventional medicine was not helping too many patients. There were some (patients) with prolonged headaches, backaches and frequent infections whom I had to turn away without offering a solution. That burnt me out. I started looking for alternative solutions.

The idea of using alternative treatments because conventional ones have their limits is perhaps understandable. But which alternative therapies are effective for the conditions mentioned? Dr Dixon’s surgery offers many alternative therapies which are highly unlikely to be effective beyond placebo, e.g. ‘Thought Field Therapy’, reflexology, spiritual healing or homeopathy.

But alternative medicine has come under sharp criticism. It was even argued that it has a placebo effect?

I don’t mind what people call it as long as it is making patients better. If the help is more psychological than physiological, as they argue, all the better. There are less side-effects, less expenses and help is in your own hands.

I have posted several articles on this blog about this fundamental misunderstanding. The desire to help patients via placebo-effects is no good reason to employ bogus treatments; effective therapies also convey a placebo-response, if administered with compassion. Merely administering placebos means denying patients the specific effects of real medicine and is therefore not ethical.

Why are people unconvinced about alternative medicine?

One, there are vested interests – professional and organizational impact on it. Two, even practitioners in conventional medicine do not know much about it. And most importantly, we need to develop a scientific database for it. In conventional medicine, pharmaceutical companies have the advantage of having funds for research. Alternative medicine lacks that. Have people who say alternative medicine is rubbish ever done research on it to figure out whether it is rubbish? The best way to convince them is through the age-old saying: Seeing is believing.

1) Here we have the old fallacy which assumes that ‘the establishment’ (or ‘BIG PHARMA’ ) does not want anyone to know how effective alternative treatments are. In truth, everyone would be delighted to have more effective therapies in the tool-kit and nobody does care at all where they originate from.

2) GPs do not know much about alternative medicine, true. But that does not really explain why they are ‘unconvinced’. The evidence shows that they need more convincing evidence to be convinced.

3) Dixon himself has done almost no research into alternative medicine (I know that because the few papers he did publish were in cooperation with my team). Contrary to what Dixon says, there are mountains of evidence (for instance ~ 20 000 articles on acupuncture and ~5000 on homeopathy in Medline alone); and the most reliable of this evidence usually shows that the alternative therapy in question does not work.

4) Apologists lament the lack of research funds ad nauseam. However, there is plenty of money in alternative medicine; currently it is estimated to be a $ 100 billion per year business worldwide. If they are unable to channel even the tiniest of proportions into a productive research budget, only they are to blame.

5) Have people who say alternative medicine is rubbish ever done research on it to figure out whether it is rubbish? Yes, there is probably nobody on this planet who has done more research on alternative medicine than I have (and DM knows it very well, for about 15 years, he tried everything to be associated with my team). The question I ask myself is: have apologists like Dixon ever done rigorous research or do they even know about the research that is out there?

6) Seeing is believing??? No, no, no! I have written several posts on this fallacy. Experience is no substitute for evidence in clinical medicine.

Will alternative medicine be taught in UK universities?

US already has 16 universities teaching it. The College of Medicine, UK, is fighting hard for it. We are historically drenched in conventional medicine and to think out of the box will take time. But we are at it and hope to have it soon.

1) Yes, the US has plenty of ‘quackademia‘ – and many experts are worried about the appalling lack of academic standards in this area.

2) The College of Medicine, UK, is fighting hard for getting alternative medicine into the medical curriculum. Interesting! Now we finally know what this lobby group really stands for.

3) Of course, we are ‘drenched’ in medicine at medical school. What else should we expose students to?

4) Thinking ‘out of the box’ can be productive and it is something medicine is often very good at. This is how it has evolved during the last 150 years in a breath-taking speed. Alternative medicine, by contrast, has remained stagnant; it is largely a dogma.

What more should India do to promote integrated medicine?

India needs to be prouder of its institutions and more critical of the West. The West has made massive mistakes. It has done very little about long-term diseases and in preventing them. India needs to be more cautious as it will lead the world in some diseases like the diabetes. It should not depend on conventional medicine for everything, but take the best for the worst.

To advise that India should not look towards the ‘West’ for treating diabetes and perhaps use more of their Ayurvedic medicines or homeopathic remedies (both very popular alternatives in India) is a cynical prescription for prematurely ending the lives of millions prematurely.

One thing that unites all (well, almost all, in my experience) proponents of alternative medicine is their intense dislike for BIG PHARMA. Essentially, they see this sector as:

  1. Driven by profit
  2. Employing unethical means to maximise profit
  3. Not caring for the needs of patients
  4. Attacking alternative medicine for fear of losing profit

And, of course, they claim that alternative medicine, LITTLE ALT MED, is fundamentally different from the cynically capitalist, malign BIG PHARMA.

I have no intention to defend the ways of the pharmaceutical industry – neither on this blog nor anywhere else. This industry is usually responsible to their share-holders and that constellation can lead to excesses which are counter-productive to our needs, to put it mildly. However, what I will question is the notion that LITTLE ALT MED is fundamentally different from BIG PHARMA.

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We all have to make a living; to some extend at least we are therefore all driven by our desire to earn money. In alternative medicine, there are certainly not as many mega-enterprises as in the pharmaceutical industry but nobody can deny that many sizable firms exist which make a profit selling alternative remedies of one type or another.

And those parts of alternative medicine which are not into the sale of remedies, you may well ask – think of acupuncture, for instance. Well, those therapists are not exempt either from the need to make a living. Sure, this is on a different scale from BIG PHARMA, but it constitutes still a need for profit. If we multiply the relatively small sums involved by the vast number of therapists, the grand total of LITTLE ALT MED might approach similar orders of magnitude as that of BIG PHARMA.

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Ok, but the alternative sector would not employ unethical means for securing or maximising profits! Wrong again, I am afraid.

My 20 years of experience of LITTLE ALT MED have let me witness several incidents which I would not hesitate to call unethical. One of the most recent and least pleasant, from my point of view, was the discovery that several German homeopathic manufacturers had given money to a ‘journalist’ who used these funds to systematically defame me.

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What about the charge that BIG PHARMA does not care for the suffering patient? LITTLE ALT MED would never do that!!! Sadly this is a myth too.

Alternative practitioners and their organisations make a plethora of therapeutic claims which are not substantiated. Who would deny that misleading patients into making wrong health care decisions is not the opposite from ‘caring’? What seems even worse, in my view, is the behaviour that might follow the exposure of such behaviour. If someone is courageous enough to disclose the irresponsibility of bogus claims, he might be attacked or even taken to court by those who, in reality should be in the dock or, at least, do their utmost to get their house in order.

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Finally, we have the notion of BIG PHARMA trying to suppress LITTLE ALT MED. I call this a myth too because I see absolutely no evidence for this rumour. Even those who circulate it can, when challenged, not produce any.

And, anyway, we all know how many of the big pharmaceutical firms buy into the alternative medicine market as soon as they see a commercially viable opportunity. Does that look like suppression?

So, what is the conclusion? BIG PHARMA can behave badly, no doubt, and when they do, I am as disgusted as the next man. However, LITTLE ALT MED also can behave badly – in fact, wherever there is money to be made, some people will behave badly some of the time.

Perhaps we should not judge an entire sector just by the bad actions of some of its members, but perhaps we should also consider whether or not it has done any good. Who would doubt that BIG PHARMA has helped to save lives – millions of lives?!

And now ask yourself: can we honestly say the same about LITTLE ALT MED?

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