MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

fraud

The U.S. Department of Health and Human Services alleges that Jason James of the James Healthcare & Associates clinic in Iowa, USA — along with his wife, Deanna James, the clinic’s co-owner and office manager — filed dozens of claims with Medicare for a disposable acupuncture device, which is not covered by Medicare, as if it were a surgically implanted device for which Medicare can be billed. According to the lawsuit, more than 180 such claims were filed. Beginning in 2016, the lawsuit alleges, the clinic began offering an electro-acupuncture device referred to as a “P-Stim.” When used as designed, the P-Stim device is affixed behind a patient’s ear using an adhesive. The device delivers intermittent electrical pulses through a single-use, battery-powered attachment for several days until the battery runs out and the device is thrown away.

Because Medicare does not reimburse medical providers for the use of such devices, DHHS alleges that some doctors and clinics have billed Medicare for the P-Stim device using a code number that only applies to a surgically implanted neurostimulator. The use of an actual neurostimulator is reimbursed by Medicare at approximately $6,000 per claim, while P-Stim devices were purchased by the Keokuk clinic for just $667, DHHS alleges. The department alleges James knew his billings were fraudulent as the P-Stim device is “nowhere close to even resembling genuine implantable neurostimulators” and does not require surgery.

The lawsuit alleges that on June 15, 2016, when Jason James was contemplating the use of P-Stim devices at the Keokuk clinic, he sent a text message to P-Stim sales representative Mark Kaiser, asking, “Is there a limit on how many Neurostims can be done on one day? Don’t wanna do so many that gives Medicare a red flag on first day. Thanks.” After realizing the “large profit windfall” that could result from the billing practice, DHHS’s lawsuit alleges, James “told Mark Kaiser not to mention the Medicare reimbursement rate to his nurse practitioner or staff – only his office manager and biller needed that information.” James then pressured clinic employees to heavily market the P-Stim devices to patients, even if those patients were not agreeable or, after trying it, were reluctant to continue the treatment, the lawsuit claims.

In October 2016, the clinic’s supplier of P-Stim devices sent the clinic an email stating the company had “no position on what the proper coding might be for this device if billed to a third-party payer” such as an insurer or Medicare, according to the lawsuit. The company advised the clinic to “consult a certified biller/coder and/or attorney to ensure compliance.” According to the lawsuit, James then sent Kaiser a text message asking, “Should we be concerned?”

DHHS alleges the clinic’s initial reimbursement claims were submitted to Medicare through a nurse practitioner and were denied for payment due to the lack of a trained physician’s involvement. In response, the clinic hired Dr. Robert Schneider, an Iowa-licensed physician, to work at the clinic for the sole purpose of enabling James Healthcare & Associates to bill Medicare for the P-Stim devices, the lawsuit claims. James then informed Kaiser he had a goal of billing Medicare for 20 devices per month, which would generate roughly $125,573 of monthly income, the lawsuit alleges. The lawsuit also alleges Dr. Schneider rarely saw clinic patients in person, consulting with them instead through Facebook Live.

In April 2017, Medicare allegedly initiated a review of the clinic’s medical records, triggering additional communications between James and Kaiser. At one point, James allegedly wrote to Kaiser and said he had figured out why Medicare was auditing the clinic. “Anything over $7,500 is automatically audited for my area,” he wrote, according to the lawsuit. “We are now charging $7,450 to remove the audit.”

The clinic ultimately submitted 188 false claims to Medicare seeking reimbursement for the P-Stim devices, DHHS alleges, with Medicare paying out $4,100 and $6,300 per claim, for a total loss of $1,028,800. DHHS is suing the clinic under the federal False Claims Act and is seeking trebled damages of more than $3 million, plus a civil penalty of up to $4.2 million.

An attorney for the clinic, Michael Khouri, said Wednesday he believe the federal government’s lawsuit was filed in error because a settlement in the case had already been reached. However, the assistant U.S. attorney handling the case said no settlement in the case had been finalized and the lawsuit was not filed in error.

Previous legal cases

In 2015, the Iowa Board of Chiropractic charged Jason James with knowingly making fraudulent or untrue representations in connection with his practice, engaging in conduct that was harmful or detrimental to the public, and making untruthful statements in advertising. The board alleged James told patients they would be able to stop taking diabetes medication through the use of a diet and nutrition program, and that he had claimed to be providing extensive laboratory tests when not all of the tests for which he billed were ever conducted. The board also claimed James referred patients to a medical professional who was not licensed to practice in Iowa. The case was resolved with a settlement agreement in which James agreed to pay a $500 penalty and complete 10 hours of education in marketing and ethics.

In 2019, Schneider sued the clinic for failing to comply with the terms of his employment agreement. Court exhibits indicate the agreement stipulated that Schneider was to work no more than two days per month and would collect $2,000 for each day worked, plus $250 per month for consulting, plus “$250 per device over six per calendar month.” In March 2020, a jury ruled in favor of the clinic and found that it had not breached its employment agreement with Schneider.

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Before some chiropractors now claim that such cases represent just a few rotten apples in a big basket of essentially honest chiropractors, let me remind them of a few previous posts:

To put it bluntly: chiropractic was founded by a crook on a bunch of lies and unethical behavior, so it is hardly surprising that today the profession has a problem with ethics and honesty.

It been reported that the German HEILPRAKTIKER, Holger G. has been sentenced to serve a total of 4 years and three months behind bars. He made himself a pair of glasses out of aluminum foil and appeared at the start of his trial wearing a Corona protective mask. The accusations against him were fierce: He was accused of having issued false Corona vaccination certificates en masse in Munich and of having given medication to patients. A woman, who had contracted Corona and had been treated by Holger G. with vitamin solutions, had died last year.

According to the verdict, Holger G. had violated the German Medicines Act. The court announced he was also convicted of 96 counts of dangerous bodily harm and 102 counts of unauthorized trading in prescription drugs. In addition, the court ordered the HEILPRAKTIKER to be placed in a rehab facility.

The 71-year-old MAN had issued Corona vaccination cards since April 2021, without actually vaccinating the people concerned. For the forged vaccination cards, he charged several tens of thousands of Euros. In addition, the former HEILPRAKTIKER illegally sold prescription drugs. The judgment is so severe because Holger G. has form. He also ordered to bear the costs of the proceedings.

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I have long criticized the German HEILPRAKTIKER. In my recent book on the subject, I make the following points:

– Today, no one can provide reliable data on the number of HEILPRAKTIKER in Germany.
– The training of HEILPRAKTIKER is woefully inadequate.
– The far-reaching rights of the HEILPRAKTIKER are out of proportion to their overt lack of competence.
– This disproportion poses a serious danger to patients.
– This danger is further increased by the fact that there is no effective control of the activity of the HEILPRAKTIKER does not take place.
– Existing laws are almost never applied to the HEILPRAKTIKER.
– Most HEILPRAKTIKER mislead the public unhindered with untenable therapeutic claims.
– The federal government seems to put off over and over again any serious discussion of the HEILPRAKTIKER.

Cases like the one above show that it is high time for reform – or, should that prove impossible, the discontinuation of this utterly obsolete and highly dangerous profession.

An impressive article by John Mac Ghlionn caught my attention. Allow me to quote a few passages from it:

The U.S. House of Representatives and the U.S. Senate recently reintroduced legislation to increase access to Medicare-covered services provided by chiropractors. Last year, the US chiropractic market size was worth $13.13 Billion. By the end of the decade, it will be worth over $18 billion. Each year, a whopping 35 million Americans seek chiropractic care.

But why? It’s a questionable science full of questionable characters.

Last year, a Georgia woman was left paralyzed and unable to speak after receiving a neck adjustment from a chiropractor. She’s not the first person to have had her life utterly ruined by a chiropractor, and chances are she won’t be the last. Many patients who visit chiropractors suffer severe side effects; some lose their lives

As Dr. Steven Novella has noted, what used to be fraud is now known as holistic medicine. Dr. Edzard Ernst, a retired British-German physician and researcher, has expertly demonstrated the many ways in which chiropractic treatments are rooted not in science, but in mystical concepts…

Spinal adjustments, also known as “subluxations,” are also common. A dangerous practice that has been heavily criticized, spinal manipulations are associated with a number of adverse effects, including the risk of stroke. As Dr. Ernst has noted, the cost-effectiveness of this particular treatment “has not been demonstrated beyond reasonable doubt.”

Not content with spinal and neck manipulations, some chiropractors offer to treat other conditions — like diabetes, for example. They are not trained to treat diabetes. Other chiropractors appear to take joy in torturing infants. In August of 2018, a chiropractor made headlines for all the wrong reasons when a video emerged showing him hanging a two-week-old newborn upside down by the ankles

Finally, as I alluded to earlier, the chiropractic community is full of fraudsters. In 2019, in the US, 15 chiropractors were charged in an insurance fraud and illegal kickback operation. More recently, in February of this year, a New York federal judge sentenced Patrick Khaziran to 30 months in prison after he pleaded guilty to being part of a widespread scheme that defrauded the NBA out of at least $5 million. In recent times, the chiropractic community has come under scrutiny for abusive care and illegal billing practices. When it comes to instances of healthcare fraud, chiropractic medicine is unrivaled.

None of this should come as a surprise. After all, the entire chiropractic community was constructed on a foundation of lies. As the aforementioned Dr. Ernst told me, we should be skeptical of what chiropractors are offering, largely because the whole practice was founded “by a deluded charlatan, who insisted that all human diseases are due to subluxations of the spine. Today, we know that chiropractic subluxations are mere figments of Palmer’s imagination. Yet, the chiropractic profession is unable to separate itself from the myth. It is easy to see why: without it, they would at best become poorly trained physiotherapists without any raison d’etre.”

… Dr. William T. Jarvis famously referred to chiropractic as “the most significant nonscientific health-care delivery system in the United States.” Comparing the chiropractic community to a cult, Dr. Jarvis wondered, somewhat incredulously, why chiropractors are licensed to practice in all 50 US states. The entire profession, he warned, “should be viewed as a societal problem, not simply as a competitor of regular health-care.”

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In my view, this is an impressive article, not least because it is refreshingly devoid of the phenomenon known as ‘false balance, e.g. a chiropractor being invited to add his self-interested views at the end of the paper claiming, for instance, “we have years of experience and cause far less harm than real doctors”.

Guest post by Ken McLeod

Readers will have no trouble recalling that crank ‘naturopath’ Barbara O’Neill has graced these pages several times. She is subject to a Permanent Prohibition Order by the New South Wales Health Care Complaints Commission. It goes like this:

“The Commission is satisfied that Mrs O’Neill poses a risk to the health and safety of members of the public and therefore makes the following prohibition order:

“Mrs O’Neill is permanently prohibited from providing any health services, as defined in s4 Of the Health Care Complaints Act 1993, whether in a paid or voluntary capacity.’ 1

Evidently Ms O’Neill has scrambled her chakras or muddled her meridians because she continues to forget the Order. For example;

O’Neill did a video interview concerning the Prohibition Order and that has been posted online at YouTube.2 The video was posted ‘1 year ago,’ has had 323,000 views and had 1,598 comments. She goes into great detail what she regards as the appalling treatment at the hands of the HCCC.

In the video she admits that she has continued to travel the world spreading her lies and misrepresentations. Some of the lies are that she is a naturopath, and was a nurse, and ‘I used to work in the Operating Theatre as a psychiatric nurse….’

In the video at 53:20 in the video she refers to an aboriginal man ‘Dan’ who works at her Misty Mountain Lifestyle Retreat, (note the present tense), who is in his 50s was obese and recently had a heart attack, ‘was on a lot of medications,’ ‘was a bit scared of coming off medications,’ ‘I said Dan, I think it’s time to stop your blood pressure medications, you’re going too low, you’re a 100 over 60,’ ‘three days later his blood pressure was 100 over 75,….’ 3

Call me a cynic, but that strikes me as rather dangerous advice, worthy of an investigation by the HCCC. Meanwhile, there is no sign of ‘Dan ‘ in Misty Mountain’s ‘About page.’ Dan’s brother Dave appears, but no Dan.4 Could it be that O’Neill’s advice led to some incapacity? Tips are welcome.

Meanwhile, readers could learn much more about Barbara O’Neill at Wikipedia.5

 

This article first appeared in the June issue of the Australian Skeptic Magazine,6 reprinted with kind permission.

REFERENCES

1 https://www.hccc.nsw.gov.au/decisions-orders/public-statements-and-warnings/public-statement-and-statement-of-decision-in-relation-to-in-relation-to-mrs-barbara-o-neill

2 https://www.youtube.com/watch?v=tsbK5TLdAPo

3 This was dangerous and reckless advice. The full transcript is here

4 https://www.mmh.com.au/our-story

5 https://en.wikipedia.org/wiki/Barbara_O%27Neill

6 https://www.skeptics.com.au/magazine/

I have seen some daft meta-analyses in my time – this one, however, takes the biscuit. Here is its unaltered abstract:

Although mindfulness-based mind-body therapy (MBMBT) is an effective non-surgical treatment for patients with non-specific low back pain (NLBP), the best MBMBT mode of treatment for NLBP patients has not been identified. Therefore, a network meta-analysis (NMA) was conducted to compare the effects of different MBMBTs in the treatment of NLBP patients.

Methods: PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched for randomized controlled trials (RCTs) applying MBMBT for the treatment of NLBP patients, with all of the searches ranging from the time of database creation to January 2023. After 2 researchers independently screened the literature, extracted information, and evaluated the risks of biases in the included studies, the data were analyzed by using Stata 16.0 software.

Results: A total of 46 RCTs were included, including 3,886 NLBP patients and 9 MBMBT (Yoga, Ayurvedic Massage, Pilates, Craniosacral Therapy, Meditation, Meditation + Yoga, Qigong, Tai Chi, and Dance). The results of the NMA showed that Craniosacral Therapy [surface under the cumulative ranking (SUCRA): 99.2 and 99.5%] ranked the highest in terms of improving pain and disability, followed by Other Manipulations (SUCRA: 80.6 and 90.8%) and Pilates (SUCRA: 54.5 and 71.2%). In terms of improving physical health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Pilates (SUCRA: 72.3%) and Meditation (SUCRA: 55.9%). In terms of improving mental health, Craniosacral Therapy (SUCRA: 100%) ranked the highest, followed by Meditation (SUCRA: 70.7%) and Pilates (SUCRA: 63.2%). However, in terms of improving pain, physical health, and mental health, Usual Care (SUCRA: 7.0, 14.2, and 11.8%, respectively) ranked lowest. Moreover, in terms of improving disability, Dance (SUCRA: 11.3%) ranked lowest.

Conclusion: This NMA shows that Craniosacral Therapy may be the most effective MBMBT in treating NLBP patients and deserves to be promoted for clinical use.

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This meta-analysis has too many serious flaws to mention. Let me therefore just focus on the main two:

  1. Craniosacral Therapy is not an MBMBT.
  2. Craniosacral Therapy is not effective for NLBP. The false positive result was generated on the basis of 4 studies. All of them have serious methodological problems that prevent an overall positive conclusion about the effectiveness of this treatment. In case you don’t believe me, here are the 4 abstracts:

1) Background and objectives: The study aimed to compare the effectiveness of craniosacral therapy (CST), muscle energy technique (MET), and sensorimotor training (SMT) on pain, disability, depression, and quality of life of patients with non-specific chronic low back pain (NCLBP).

Methodology: In this randomized clinical trial study 45 patients with NCLBP were randomly divided in three groups including CST, SMT, and MET. All groups received 10 sessions CST, SMT, and MET training in 5 weeks. Visual analogue scale (VAS), Oswestry functional disability questionnaire (ODQ), Beck depression inventory-II (BDI-II), and 36-item short form health survey (SF-36) were used to evaluate the pain, disability, depression, and quality of life, respectively, in three times, before treatment, after the last session of treatment, and after 2 months follow up.

Results: The Results showed that VAS, ODI, BDI, and SF-36 changes were significant in the groups SMT, CST and MET (p < 0.001, p < 0.001, p < 0.001). The VAS, ODI, BDI, and SF-36 changes in post-treatment and follow-up times in the CST group were significantly different in comparison to SMT group, and the changes in VAS, ODI, BDI, and SF-36 at after treatment and follow-up times in the MET group compared with the CST group had a significant difference (p < 0.001).

Conclusion: Craniosacral therapy, muscle energy technique, and sensorimotor training were all effective in improvement of pain, depression, functional disability, and quality of life of patients with non-specific chronic low back pain. Craniosacral therapy is more effective than muscle energy technique, and sensorimotor training in post-treatment and follow up. The effect of craniosacral therapy was continuous after two months follow up.

2) Background: Craniosacral therapy (CST) and sensorimotor training (SMT) are two recommended interventions for nonspecific chronic low back pain (NCLBP). This study compares the effects of CST and SMT on pain, functional disability, depression and quality of life in patients with NCLBP.

Methodology: A total of 31 patients with NCLBP were randomly assigned to the CST group (n=16) and SMT (n=15). The study patients received 10 sessions of interventions during 5 weeks. Visual analogue scale (VAS), Oswestry disability index (ODI), Beck depression inventory-II (BDI-II), and Short Form-36 (SF-36) questionnaires were used at baseline (before the treatment), after the treatment, and 2 months after the last intervention session. Results were compared and analyzed statistically.

Results: Both groups showed significant improvement from baseline to after treatment (p < 0.05). In the CST group, this improvement continued during the follow-up period in all outcomes (p < 0.05), except role emotional domain of SF-36. In the SMT group, VAS, ODI and BDI-II increased during follow-up. Also, all domains of SF-36 decreased over this period. Results of group analysis indicate a significant difference between groups at the end of treatment phase (p < 0.05), except social functioning.

Conclusions: Results of our research confirm that 10 sessions of craniosacral therapy (CST) or sensorimotor training (SMT) can significantly control pain, disability, depression, and quality of life in patients with NCLBP; but the efficacy of CST is significantly better than SMT.

3) Background: Non-specific low back pain is an increasingly common musculoskeletal ailment. The aim of this study was to examine the utility of craniosacral therapy techniques in the treatment of patients with lumbosacral spine overload and to compare its effectiveness to that of trigger point therapy, which is a recognised therapeutic approach.

Material and methods: The study enrolled 55 randomly selected patients (aged 24-47 years) with low back pain due to overload. Other causes of this condition in the patients were ruled out. The participants were again randomly assigned to two groups: patients treated with craniosacral therapy (G-CST) and patients treated with trigger point therapy (G-TPT). Multiple aspects of the effectiveness of both therapies were evaluated with the use of: an analogue scale for pain (VAS) and a modified Laitinen questionnaire, the Schober test and surface electromyography of the multifidus muscle. The statistical analysis of the outcomes was based on the basic statistics, the Mann-Whitney U test and Wilcoxon’s signed rank test. The statistical significance level was set at p≤0.05.

Results: Both groups demonstrated a significant reduction of pain measured with the VAS scale and the Laitinen questionnaire. Moreover, the resting bioelectric activity of the multifidus muscle decreased significantly in the G-CST group. The groups did not differ significantly with regard to the study parameters.

Conclusions: 1. Craniosacral therapy and trigger point therapy may effectively reduce the intensity and frequency of pain in patients with non-specific low back pain. 2. Craniosacral therapy, unlike trigger point therapy, reduces the resting tension of the multifidus muscle in patients with non-specific lumbosacral pain. The mechanism of these changes requires further research. 3. Craniosacral therapy and trigger point therapy may be clinically effective in the treatment of patients with non-specific lumbosacral spine pain. 4. The present findings represent a basis for conducting further and prospective studies of larger and randomized samples.

4) Background: Non-specific low back pain is an increasingly common musculoskeletal ailment. The aim of this study was to examine the utility of craniosacral therapy techniques in the treatment of patients with lumbosacral spine overload and to compare its effectiveness to that of trigger point therapy, which is a recognised therapeutic approach.

Material and methods: The study enrolled 55 randomly selected patients (aged 24-47 years) with low back pain due to overload. Other causes of this condition in the patients were ruled out. The participants were again randomly assigned to two groups: patients treated with craniosacral therapy (G-CST) and patients treated with trigger point therapy (G-TPT). Multiple aspects of the effectiveness of both therapies were evaluated with the use of: an analogue scale for pain (VAS) and a modified Laitinen questionnaire, the Schober test and surface electromyography of the multifidus muscle. The statistical analysis of the outcomes was based on the basic statistics, the Mann-Whitney U test and Wilcoxon’s signed rank test. The statistical significance level was set at p≤0.05.

Results: Both groups demonstrated a significant reduction of pain measured with the VAS scale and the Laitinen questionnaire. Moreover, the resting bioelectric activity of the multifidus muscle decreased significantly in the G-CST group. The groups did not differ significantly with regard to the study parameters.

Conclusions: 1. Craniosacral therapy and trigger point therapy may effectively reduce the intensity and frequency of pain in patients with non-specific low back pain. 2. Craniosacral therapy, unlike trigger point therapy, reduces the resting tension of the multifidus muscle in patients with non-specific lumbosacral pain. The mechanism of these changes requires further research. 3. Craniosacral therapy and trigger point therapy may be clinically effective in the treatment of patients with non-specific lumbosacral spine pain. 4. The present findings represent a basis for conducting further and prospective studies of larger and randomized samples.

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I REST MY CASE

 

A Nutrient Mix Designed at the Dr. Rath Research Institute is Effective Against Different Types of Coronavirus.” With these words (and the picture below), the ‘Dr. Rath Research Institute’ recently announced its sensational finding on Twitter.

Clicking on the link they provided, got me to the following article:

In this new study we wanted to find out whether certain natural substances could help fight against SARS-CoV-2 (the virus that causes COVID-19), and another type of coronavirus known as HCoV-229E which infects humans and is associated with the common cold and its symptoms.

The importance of the study relates to the fact that COVID-19 is still a big problem, especially for older people and those with weak immune systems. Current approaches using RNA- and DNA -based vaccines are not effective in preventing the infection and spread of SARS-CoV-2, or its variants such as Omicron. The anti-viral drugs used against the pandemic are similarly not fully effective. It is therefore important to develop other approaches, especially those involving safe, natural substances, that could be used alongside or instead of conventional treatments.

For the study, scientists at the Dr. Rath Research Institute used a combination of natural substances including vitamin C, polyphenols, and other nutrients. They gave the nutrient mix to mice infected with one or other of the two types of coronaviruses, to see if it could reduce the numbers of viral particles and spike proteins in the animals’ lungs.

Based on our earlier work using human cells growing in culture we already knew that the combination of nutrients in this mixture was effective in controlling key cellular mechanisms of SARS-CoV-2 infection, including inhibiting the multiplication of the virus.

We had found that the nutrient mix could inhibit an enzyme, RNA-dependent RNA polymerase (RdRp), which is needed for a virus to make copies of itself. The mix was also effective in preventing viral spike protein from binding to cell surfaces and entering cells. It additionally worked in decreasing the number of so-called ACE2 receptor proteins, which are expressed by cells in the lungs, blood vessels, and other organs, and that help the virus to get into cells.

In this latest study the nutrient mix was administered daily to mice infected with either SARS-CoV-2 or HCoV-229E, to see if it could reduce infectivity in terms of the amounts of viral particles and spike proteins found in the lungs. Infected mice in the control group were fed a normal diet without nutrient supplementation. The amounts of viral particles and spike proteins in the lungs were evaluated using special molecular-based tests. We also examined the effects of the nutrient mix on the presence of immune cells in the lungs, as an indication of tissue inflammation.

The results showed that, compared to mice in the control group, the nutrients significantly reduced the amounts of viral particles and spike proteins in the lungs of infected mice. Moreover, the mix was equally effective in mice infected with either of the two types of coronaviruses. This indicates that the nutrients affected common mechanisms of infection and were not specific to a particular type of virus. It also explains the results of our previous studies, which showed that the nutrient mix was effective in stopping SARS-CoV-2 and several of its mutated forms, including Omicron variants, from entering the cells.

Crucially, we found the nutrient mix affected not only the virus itself; it also reduced the ability of the virus to enter cells by decreasing the number of ACE2 receptors on cell surfaces. In the presence of inflammation, which is commonly associated with infections, there were similarly less ACE2 receptors on cells. Nutrient anti-inflammatory effects were also observed in the lung tissue of the mice.

In conclusion, our study showed that the nutrient mix could help reduce the infectivity of SARS-CoV-2 and the associated common cold virus HCoV-229E in mice at different stages of infectivity. The fact that different mechanisms were affected simultaneously demonstrates the superior efficacy of nutrients compared to drugs, the latter of which usually target only a single mechanism and allow the virus to escape by mutating.

The unique composition and efficacy of our nutrient mix has been awarded US and international patents. While more research is needed in order to fully confirm its efficacy in human clinical trials, the application of this safe micronutrient combination as soon as possible should ultimately benefit people worldwide and save on healthcare costs.

So, the claim that a Nutrient Mix is “Effective Against Different Types of Coronavirus” rests on some lousy experiments on rats?

Might we call this misleading or dishonest?

And what is the Dr. Rath Research Institute?

Could it belong to the Dr. Rath Foundation?

The very foundation that once published this about me:

Professor Edzard Ernst: A Career Built On Discrediting Natural Health Science? 

Professor Edzard Ernst, a retired German physician and academic, has recently become a prominent advocate of plans that could potentially outlaw the entire profession of naturopathic doctors in Germany. Promoting the nonsensical idea that naturopathic medicine somehow poses a risk to public health, Ernst attacks its practitioners as supposedly having been educated in “nonsense”. Tellingly, however, given that he himself has seemingly not published even so much as one completely original scientific trial of his own, Ernst’s apparent attempts to discredit natural healthcare approaches are largely reliant instead on his analysis or review of handpicked negative studies carried out by others.

SAY NO MORE!

An article in the German publication  T-online is, I think, relevant to us here on this blog. I translated part of it for you:

The suspicion of particularly serious fraud against a doctor from the German Meißen district has been substantiated. Since the beginning of the pandemic, the 66-year-old physician is said to have issued “certificates of convenience” in the thousands throughout Germany, a spokesman for the public prosecutor’s office said. In return for a payment of 25 euros, the doctor from Moritzburg is said to have issued blanket and unjustified certificates stating that the wearing of mouth and nose protection was not medically justifiable. In other cases, the physician stated an unlimited inoculation prohibition or that Corona quick tests were possible only over saliva.

After an initial search in February, the public prosecutor’s office had assumed to be dealing with merely 162 false vaccination and mask certificates. But the extent of the fraud seems to go far beyond that: The accused is now said to have taken in at least 60,000 euros with the fake certificates.

Based on further investigations, the public prosecutor’s office assumes that the medical practitioner has managed to issue false corona attestations “every minute” with so-called collective appointments. These appointments were arranged in cooperation with Heilpraktiker from all parts of Germany and partly even with funeral homes.

On Tuesday, more than 360 police officers searched 140 homes of exemption certificate holders in nine states – mainly in Bavaria. In the process, 174 incorrect Corona attestations were found. They now must face instigations into using illegal health certificates. In addition, the office of a Bavarian Heilpraktiker, as well as a further commercial area, were searched.

This is not the first time that the Moritzburg doctor has come into conflict with the law. The 66-year-old physician considers herself a ‘Reichsbuerger’ (citizen of the Reich, a right-wing extremist). She was a member of the Moritzburg shooting club, and owned eleven weapons. Because they were not all registered and several hundred rounds of ammunition were found in the house, she stood trial for the first time already in 2014.

 

At first glance, the article entitled ‘Homeopathy: A State of the Science Review With Recommendations for Practical Therapies in Midwifery Practice‘ looks interesting and fairly solid; it was published in a mainstream, peer-reviewed midwifery journal; it is lengthy and thus seems thorough; it cites 125 references; and its two American authors have respectable affiliations (Art of Nursing Care Inc., Playa del Ray, California. Sonoran University of Health Sciences, Tempe, Arizona.). Yet, it does not take long to discover that ‘solid’ is not the term to describe it accurately. In fact, the paper is one of the worst examples of pseudo-science that I have ever come across. Let me just show you its conclusions:

This state of the science review has explored the history of homeopathy, its evidence base, manufacturing, regulation, and licensure. We have examined some of the controversies between homeopathy and conventional medicine in an effort to provide an overview and understanding of homeopathic science. Suggestions for practical therapies for use in midwifery practice have been given.

Despite misperceptions, homeopathy has become a well-established global practice with a growing body of research to support its benefits. Homeopathic medicines provide a comprehensive treatment approach to the myriad of conditions encountered in the midwifery practice model of care. With homeopathy’s generally accepted safety profile, low risk of side effects, few drug interactions, and low risk of overdose, midwives educated in homeopathic science can be confident that homeopathy provides a satisfactory complement for patients seeking alternative practices.

Increased opportunities for clinical research of homeopathic medicines by large funding organizations is recommended to advance patient care, understanding, and acceptance of the whole person and inform future health policy. Researchers around the world have begun to investigate the unanswered questions verifying the safety and efficacy of homeopathic treatment and the future of homeopathic research is promising. As homeopathic science continues to evolve, many health care professionals, including midwives, now seem open to adding homeopathy to complement their system of care for the whole person.

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In the article, we find two short paragraphs dealing with the effectiveness of homeopathy:

Essential to these debates are questions surrounding theories of homeopathy, such as the Law of Minimum Dose, like cures like, nonstandardized dosing, and symptom evaluation in a manner different from that of conventional medicine. It has been argued that the homeopathic paradigm is different from conventional scientific concepts associated with evidence-based medicine such as independent replication, confirmation of findings, measurement, and interpretation of results based on homeopathy’s reliance on individualized treatments and it basic tenets of the Principle of Similars and Law of Minimum Dose.6968 Conventional medicine practitioners find it counterintuitive that further dilution of a substance is believed to enhance its healing power when compared with a less dilute substance.65 For example, if the level of dilution is unmeasurable, how can the active ingredient be found, and is it even there?22 Recent research using nanopharmacology is beginning to uncover, identify, and characterize these ingredients in ultradiluted remedies and may help to answer these questions.3970 Debates arise concerning why individuals with similar symptoms often receive different treatments.22 Others ask whether homeopathic remedies perhaps inadvertently lead consumers to forgo conventional treatments that have been proven to work.5212265

Interestingly, studies examining placebo therapies have appeared in scientific literature with increasing frequency, and some have compared the effectiveness of placebos with homeopathic remedies.687173 Multiple studies that have examined homeopathic treatments have found them equivalent to or no more effective than placebo,6568 whereas other studies found either measurable success or that patients perceived their outcomes as improved following homeopathic treatment.267574 Mathie et al conducted a systematic review and meta-analysis focused on randomized controlled trials of nonindividualized homeopathic treatments. Authors reported that the quality of evidence was too low to determine whether homeopathic treatment results were distinguishable from those of placebo.72 These issues cited above represent some of the inconsistencies surrounding the theoretical basis and effectiveness of homeopathic therapies.

WHY WOULD ANY RESPECTABLE AUTHOR WRITE SUCH MISLEADING NONSENSE?

WHY WOULD ANY RESPECTABLE JOURNAL PUBLISH IT?

The answers to these questions might be found at the end of the paper:

Support for this supplement has been provided by Boiron USA. Boiron representatives provided no input into the article content.

Sharon Bond, CNM, PhD, who was an Associate Editor of the Journal of Midwifery & Women’s Health during the initial drafting of the manuscript, received compensation from Boiron USA for the assistance she provided the authors with editing and proofreading of the manuscript. Dr. Bond was not involved in the editorial review of or decision to publish this article.

The findings and conclusions in this supplement are those of the authors and do not necessarily reflect the official position of the host organizations, the American College of Nurse-Midwives, John Wiley & Sons, Inc., or the opinions of the journal editors.

I would argue that publishing such an article is unethical and amounts to scientific misconduct!

A regional court in the Bavarian city of Ingolstadt has sentenced a natural healing practitioner, i.e. Heilpraktiker, and her supplier to jail for fraud. The pair were found to have deceived patients suffering from terminal cancer to put their faith in a remedy that they touted as a miracle cure. The practitioner was jailed for three years for her part in the scam, while the supplier was sentenced to six years and nine months.

The defendants in the case were a 57-year-old Heilpraktiker from the town of Schrobenhausen and a 68-year-old businessman from Ingolstadt who supplied the preparation. Both defendants were said to have promoted the remedy BG-Mun, saying that it could quickly cure cancer without any evidence of this being the case.

The court heard that patients paid up to €6,000 for the remedy. According to the court, the practitioner had boasted of “great successes” with one patient, Sabine H., who had acquired the remedy and stopped her course of chemotherapy at the defendant’s advice. The court was told that the pair would have known at this point that the substance would have no effect. A drug researcher from the University of Bremen had described the defendants’ actions as “profiteering” from the suffering of desperate patients. “Ultimately, it is a hustle against those who really are clutching at straws when it comes to their illness,” he said.

Even after the death of former patients, the defendants continued to promote their bogus remedy, the prosecutor emphasized. The Heilpraktiker advised several patients to rely exclusively on BG-Mun for their treatment and to discontinue the chemotherapy advised by orthodox medicine.

The defense lawyers demanded a comprehensive acquittal for both clients. The central argument: Both the Heilpraktiker and the entrepreneur had tried BG-Mun on themselves, found it helpful and therefore believed in its effect. The two had therefore acted without any intention to deceive. Without an intention to deceive, however, there is no fraud. In addition, BG-Mun had only ever been advertised as a “component in an overall therapy” and never as a sole medicine. According to the defense lawyers, BG-Mun is a means of alternative medicine and “therefore does not belong to evidence-based medicine”. In the opinion of the lawyers, empirical effectiveness, therefore, does not have to be proven. The public prosecutor, on the other hand, quoted experts who say that BG-Mun is a protein solution that has no effect whatsoever against cancer and is also not approved as a medicine.

Elsewhere it had been reported that the court also dealt with the charge of misuse of title, specifically with the fact that the Heilpraktiker used the title of professor orally and also on advertising flyers. The title of professor comes from an educational institution in the USA, which itself is not recognized as a university in the USA. The German Conference of Ministers of Education and Cultural Affairs does not recognize this title in this country and calls it a “decorative certificate”.

____________________

What I find particularly fascinating about this case is that the defense lawyers claimed, that BG-Mun is a means of alternative medicine and “therefore does not belong to evidence-based medicine”. This type of argument crops up regularly when quacks go to trial. I am not a legal expert and can thus only judge it from a medical point of view. Medically speaking, I find it hard to think of an argument that is more ridiculous than this one. To me, it seems like saying: “I am a charlatan and therefore you cannot judge by by the standards of regular healthcare.”

The second argument of the defense is hardy any better: “I was convinced that it worked, therefore, my prescribing it was honest and correct.” Imagine a doctor saying such nonsense! The argument makes a mockery of evidence by replacing it with belief. I am glad that the German court did not fall for such pseudo-arguments.

This systematic review was aimed at determining if there has been a change in the reporting of adverse events associated with spinal manipulation in randomized clinical trials (RCTs) since 2016.

Databases were searched from March 2016 to May 2022: MEDLINE (Ovid), Embase, CINAHL, ICL, PEDro, and Cochrane Library. The following search terms and their derivatives were adapted for each platform: spinal manipulation; chiropractic; osteopathy; physiotherapy; naprapathy; medical manipulation and clinical trial.

Domains of interest (pertaining to adverse events) included: completeness and location of reporting; nomenclature and description; spinal location and practitioner delivering manipulation; methodological quality of the studies and details of the publishing journal. Frequencies and proportions of studies reporting on each of these domains were calculated. Univariable and multivariable logistic regression models were fitted to examine the effect of potential predictors on the likelihood of studies reporting on adverse events.

There were 5399 records identified by the electronic searches, of which 154 (2.9%) were included in the analysis. Of these, 94 (61.0%) reported adverse events with only 23.4% providing an explicit description of what constituted an adverse event. Reporting of adverse events in the abstract had increased (n=29, 30.9%) while reporting in the results section had decreased (n=83, 88.3%) over the past 6 years. Spinal manipulation was delivered to 7518 participants in the included studies. No serious adverse events were reported in any of these studies.

The authors concluded that, while the current level of reporting of adverse events associated with spinal manipulation in RCTs has increased since our 2016 publication on the same topic, the level remains low and inconsistent with established standards. As such, it is imperative for authors, journal editors and administrators of clinical trial registries to ensure there is more balanced reporting of both benefits and harms in RCTs involving spinal manipulation.

In fact, it is an ethical imperative to accurately report adverse effects. Not reporting adverse effects amounts to a violation of medical research ethics. Adverse effects of spinal manipulation occur in about 50% of all patients. This means that investigators reporting significantly lower figures are likely guilty of under-reporting. And under-reporting of adverse events is also a breach of ethical standards.

My conclusion thus is that the vast majority of trials of spinal manipulation are unethical and should be discarded.

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