MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

big pharma

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.

Ad 1

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.

Ad 2

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.

Ad 3

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.

Ad 4

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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