MD, PhD, FMedSci, FSB, FRCP, FRCPEd

gullible consumer

Some time ago, we published a systematic review aimed at identifying what patients might hope for when they consult a practitioner of alternative medicine. The most common expectations that emerged from this research are listed here:

  • Less side-effects
  • Symptom relief
  • Cure of their disease
  • Cope better with their condition
  • Improve quality of life
  • Boost immune system
  • Prevention of illness
  • Good therapeutic relationship with a clinician
  • Holistic care
  • Emotional support
  • Control over their own health

In several ways, I think, these expectations are revealing; here I want to focus on one particular aspect, and ask the following question: To what extent are patients driven to see alternative practitioners simply because conventional medicine is letting them down? It seems to me that several items in the list above are an implicit criticism of mainstream medicine. This might get much clearer, if I re-phrase the points a bit: according to our findings, patients feel:

  • that conventional treatments have too many side-effects;
  • that they frequently fail to ease their symptoms;
  • that they often do not cure the disease;
  • that doctors do not enable their patients to cope with their condition;
  • that doctors care not enough about their patients’ quality of life;
  • that many conventional treatments neglect the importance of the immune system;
  • that prevention is not given the importance it should have;
  • that doctors are often no good at establishing good therapeutic relationships with their patients;
  • that doctors fail to realise that their patients are not just “cases” but whole human individuals;
  • that doctors are not providing enough emotional support;
  • that doctors fail to empower their patients to be in control of their health.

Some of these points will probably strike a cord with most of us. I for one know of many instances where conventional physicians have failed their patients most miserably. All too often, the failings of modern medicine are as obvious as they are inexcusable! I can fully understand that disappointed patients look for help and compassion elsewhere, and I am quite sure that the failings of modern medicine are an important motivator for people to try alternative medicine.

But looking elsewhere might not be the best approach for improving health care. Alternative practitioners may well be more compassionate than conventional clinicians but features like empathy, time and attention can never make good medicine, if they are not accompanied by effective therapies.

The conclusion is therefore simple: whenever we encounter one of the many failings of conventional medicine, instead of turning away in disgust, we ought to make sure that mistakes are corrected, lessons are learnt and improvements are found and put into practice. Our aim must be to generate progress, and it cannot be reached by opting for unproven or dis-proven treatments.

“Don’t take this therapy lightly. Multiple sclerosis, colitis, lupus, rheumatoid arthritis, cancer, hepatitis, hyperactivity, pancreatic insufficiency, psoriasis, eczema, diabetes, herpes, mononucleosis, adrenal failure, allergies and so many other ailments have been relieved through use of this therapy. After you overcome your initial gag response (I know I had one), you will realize that something big is going on, and if you are searching for health, this is an area to investigate. There are numerous reports and double blind studies which go back to the turn of the century supporting the efficacy of using urine for health”. This quote refers to a treatment that I, and probably most readers of this blog, find truly amazing – even in the realm of alternative medicine, we do not often come across a therapy as bizarre as this one: urine therapy.

Urine therapy enthusiasts claim that your own urine administered either externally, internally or both, has a long history of use, that most medical cultures have usefully employed it, that many VIPs swear by it, that it can cure almost all diseases and that it can save lives. What was new to me is the claim that it is supported by numerous double-blind studies.

Such trials would, of course, be entirely feasible; all you need to do is to give one group of patients the experimental treatment, while the other takes a placebo. Recruitment might be a bit of a problem, and the ethics committee might raise one or two eyebrows but, in theory, it certainly seems doable. So where are the “numerous” studies?

A quick, rough and ready Medline-Search found several unfortunate authors with the last name of ”URINE”, yet no clinical trials of urine therapy emerged. A little more time-consuming search through my books on alternative medicine revealed nothing that remotely resembled evidence. At this point, I arrived at the conclusion that the clinical trials are either non-existent or extremely well hidden. Further searches of the proponents’ literature, websites etc made me settle for the former explanation.

All this could be entirely irrelevant, perhaps slightly amusing, would it not reveal a pattern which is so painfully common in alternative medicine: anyone can claim anything without fear of any type of retribution, gullible consumers are attracted through the exotic flair, VIP-promotion, long history of use etc. and follow in droves [yes, amazingly, urine therapy seems to have plenty of followers]; consequently, lives are put at risk whenever someone starts truly believing the bogus, irresponsible claims that are being made. 

I do apologise for the rudeness of my words but I really do think THEY ARE TAKING THE PISS! 

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