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

The love-affair of many nurses with complementary medicine is well-known. We have discussed it many times on this blog – see for instance here, here and here. Yet the reasons for it remain somewhat mysterious, I find. Therefore I was interested to see a new paper on the subject.

The aim of this ‘meta-synthesis‘ was to review, critically, appraise and synthesize the existing qualitative research to develop a new, more substantial interpretation of nurses’ attitudes regarding the, use of complementary therapies by patients. Fifteen articles were included in the review.

Five themes emerged from the data relating to nurses’ attitude towards complementary therapies:

  1. the strengths and weaknesses of conventional medicine;
  2. complementary therapies as a way to enhance nursing practice;
  3. patient empowerment and patient-centeredness;
  4. cultural barriers and enablers to integration;
  5. structural barriers and enablers to integration.

Nurses’ support for complementary therapies, the authors of this article claim, is not an attempt to challenge mainstream medicine but rather an endeavour to improve the quality of care available to patients. There are, however, a number of barriers to nurses’ support including institutional culture and clinical context, as well as time and knowledge limitations.

The authors concluded that some nurses promote complementary therapies as an opportunity to personalise care and practice in a humanistic way. Yet, nurses have very limited education in this field and a lack of professional frameworks to assist them. The nursing profession needs to consider how to address current deficiencies in meeting the growing use of complementary therapies by patients.

In my view, there are two most remarkable misunderstandings here:

  1. While it is undoubtedly laudable that nurses “endeavour to improve the quality of care available to patients”, it has to be said that such an endeavour does not require complementary medicine. Are they implying that with conventional medicine the quality of care cannot be improved?
  2. I fail to understand why the lack of good evidential support for most complementary therapies did not emerge as a prominent theme. Are nurses not concerned about the (lack of) evidence that underpins their actions?

73 Responses to Complementary therapies as a way to enhance nursing practice?

  • I agree 100% that “The nursing profession needs to consider how to address current deficiencies in meeting the growing use of complementary therapies by patients.”

    Those current deficiencies are the result of false news and fraudulent claims about the value of camistry.
    I do hope nurses who are as concerned as I about the ‘growing use of complementary therapies’, will address the deficiencies in patient understanding, and support all endeavours to have patients apply critical thinking, demand evidence, and give informed consent with full information about the failure of any ‘complementary therapy’ to affect any specific condition.

    Nursing patients well requires honesty and integrity, not diversion of professional effort into outmoded, pseudo-scientific or fraudulent practices.
    A good nurse should be able to ‘personalise care and practice in a humanistic way’ without resort to camistry.
    If they cannot, they are not up to much and might need re-training, in modern nursing.

  • I do not see how patients are empowered by being misled. The correct way to make care patient-centred is quite clear to me. First, set out the treatment options, with benefits and risks of each. Then help the patient to decide by answering their questions truthfully. Make sure they know that nothing is devoid of uncertainty, and where the data exist quantify the uncertainty. Above all else, do not tell them fairy stories about how the body works.

  • Edzard

    You are a classic example of “can’t see the wood for the trees”.

    Nurses are the closest to the patients and care zilch about what you push for medicine. Their first hand experience shows them day-in, day-out, the benefits their patients get from complementary medicine.

    “Are they implying that with conventional medicine the quality of care cannot be improved?”
    You have made correct inference. This is the real picture on the ground.

    “I fail to understand why the lack of good evidential support for most complementary therapies did not emerge as a prominent theme.”
    I believe it was so because showing this analysis is your job. Nurses are the first line of care for patients. If you can get nurses to 100% adhere to the “scientific medicine”, I will bet deaths and disabilities from medicines, will over night, become the largest reason for patient deaths. And by a large margin compared to the next cause!

    • Nurses may, dear Iqbal, be those who spend most time with the patients. But doctors are the one’s who see to it that nurses can do anything real for them. Try staffing a hospital with nurses only. Or better, throw in some chiropractors,homeopaths and needle pushers for flavour. Send real patients there, the kind treated daily at real hospitals and see what becomes of it. Try advertising your establishment as a “physician and surgeon free hospital” and find out how many want to be treated there 😉

      Your comment reveals your seemingly total ignorance of how medicine and health care works. What made you so despondent and resentful towards modern knowledge, science and medicine? Is it because deep in your deluded heart, you know that your own make-believe medicine doesn’t do zilch?

      • …you know that your own make-believe medicine doesn’t do zilchanything?

        or

        …you know that your own make-believe medicine doesn’t do does zilch?

        FTFY

        Zilch = nothing. 😉

        • Sigh…
          I had the feeling there was something amiss when I rushed away to the pre conference get-together at the Beer-Garden instead of reading through my comment again.
          Thank you for the lecture 🙂

      • Geir wrote, “try advertising your establishment as a ‘physician and surgeon free hospital’ and see how many want to be treated there.” Unbeknownst to Geir, such has been successfully accomplished in the past.

        Take medicine and osteopathy in the early part of the last millenium and into the 1960’s, for example. MD’s in the late 50’s and in 1960 referred to DO’s as quacks, quacksters, rabid dogs, uneducated zealots, and killers…certainly not physicians; of course MD’s claimed that such descriptors were based on science. Interestingly, the true political nature of organized medicine’s “turf protection” was exposed when the medical profession acquired the COP&S to benefit itself financially and, as a quid pro quo, offered DO’s the opportunity to simply exchange their DO degrees for MD degrees. Of course this blatantly expedient action exposed medicine as hypocritical, political, and self-serving. Think of it: medicine stated that osteopaths were quacks in 1960 but then conferred to osteopaths MD degrees in 1961 simply to advantage itself. Surely “modern medicine” must always be viewed as altruistic! lol Moreover, osteopaths advertised their hospitals successfully for years and plenty of “real patients” were treated in their facilities. (Geir has soooo much to learn!).

        Medical and osteopathic docs were ostensibly part of the same profession, and certainly co-actors in the healthcare system, but political motivations and individual prejudices by so-called objective medical physicians prevented practitioners of the professions from co-practicing, or even associating with each other. I think that our dear Geir needs a history lesson as to “how medicine and health care works.”

        • Seems like the L-B missed over fifty years of development within medicine.

          • Seems like Geir selectively forgets some of the history of “modern medicine’s” development. lol

          • “Development within medicine……,” babbled Geir. Uh huh! Yeah, right! “Modern medicine’s” actors continue to do today what they have incessantly and predictably done for decades: mix good science and treatment protocols for illness/disease in with measures to pluck, via bogus conclusions regarding evidence for its drugs and treatments, healthcare dollars from unsuspecting patients and their insurance companies. The estrogen debacle and the more recent Paxil/GSC quack-scam are glaring examples of the “development within medicine” claimed by our dear Icelander Geir. While I don’t doubt the altruism of the majority of practicing physicians, “modern medicine’s” pharmaceutical foundation, and its known penchant for “educating” PCP’s regarding their medicines via commissioned sales reps, exposes Geir’s laughably chimerical implication regarding organized medicine’s altruistic selflessness as nothing but a dullard’s musings.

          • I must be good

            Would be more entertaining if we were dealing with clever people who know something about medicine, not just disgruntled dimwits 😛

      • Björn Geir

        “But doctors are the one’s who see to it that nurses can do anything real for them. Try staffing a hospital with nurses only.”

        You never learn.There is no need to be so self important. When the hospitals are staffed with only nurses, mortality comes down. When doctors come back on job, death rates increase, especially with surgeons.
        https://www.ncbi.nlm.nih.gov/pubmed/18849101

        This is the trend for past 40 years and there is NO change.

        “… throw in some chiropractors,homeopaths and needle pushers for flavour.”
        You really want to become jobless!!!

        “Try advertising your establishment as a “physician and surgeon free hospital” and find out how many want to be treated there.”
        There is no requirement for advertising. Please visit Delhi and I will expose you to hospitals with no surgeon or physician (modern medicine) who do not even have to advertise for patients. The patients seeing zero benefits and most times adverse effects from modern scientific hospitals reach here based upon experiences of their colleagues and friends.They in turn send more patients.

        “Your comment reveals your seemingly total ignorance of how medicine and health care works. What made you so despondent and resentful towards modern knowledge, science and medicine?”

        I have 4 class mates who joined modern medicine. 3 married doctors. They cover a range of medicine area: Surgery, gynecology, orthopedics, pediatrics: for their children and many times for themselves they use alternative medicine. After 30+ years of practice, they understand the difference between cure and quick fix with a drug and its repeated requirement that creates more problems than curing the initial problem.

        “Is it because deep in your deluded heart, you know that your own make-believe medicine doesn’t do zilch?”
        I don’t think with my heart. My discussions with these doctors, their need for alternative medicines for their children and themselves is great knowledge to absorb as none of them is paid for sharing such information with me.

        • Iqbal, BG has a unique skill: he looks at something for a minute or two and can determine if it is ‘rubbish’ or ‘not rubbish’.

          A couple of days ago, he quickly scanned a Master’s dissertation on a NMR study of ‘Natrum Muriaticum’ that I referred him to, and he concluded: it is rubbish.

          Given this well honed skill, I am sure that he can see through stuff like PUBMED articles with aplomb.

          • you should sometime try to do something other than ad hominems – you are not very good at them, you know.

          • A couple of days ago, he quickly scanned a Master’s dissertation on a NMR study of ‘Natrum Muriaticum’ that I referred him to, and he concluded: it is rubbish.

            Oh, yes, and it was easy. It is never difficult to find flaws in homeopath’s attempts at science. I even provided a short excerpt that clearly shows the problem.
            Now you explain to us dear Greg, how and why I am wrong in my analysis of this thesis about homeopath’s using fancy apparatus to analyse water and found statistical “noise”.

          • but he hardly ever plays the ball, only the player.

  • I am afraid this phenomenon can be more readily understood as (some) nurses’ attempts at embellishing themselves.
    I have almost four decades accumulated experience of working alongside nurses. The majority of them are the most wonderful, sound and genuinely skilled people. Many are absolutely fantastic professionals and team players.
    But some do not seem to accept the reality of life and what they perceive as an inferior status to doctors. They are not content with their status as our coworkers and assistants but wish to embellish and elevate their status, preferably above us. That is why you sometimes see courses or lectures with titles paraphrasing the subject: “the problems with doctors and their faults and shortcomings” 😛 .
    Some nurses have found such needs fulfilled by entering administration and management. Most of them laudably substantiate this role by adding MBA or similar continued education.

    But others find new roles and perceive a status lift in adopting complementary or integrative activities and “knowledge”, which they see as filling the voids in modern medicine.
    In my little part of the world this is perhaps most apparent in (some!) nurse-midwifes’ interest and practice of acupuncture and aromatherapy pre-, peri- and post partum. They are reluctantly allowed to practice this nonsense inside the auspices of our University hospital. No one seems willing to take the fight because any critique is doomed to be met with fierce accusations of discrimination and mistreatment, even sexist persecution and unlawful attaacks on their academic authority :/
    Any attempts at questioning the validity of these practices will be met with a cavalcade of references to the panorama of published papers of the kind we are so familiar with here, and most colleagues have a hard time refuting such arguments. Therefore the medically responsible and authorities shrug their shoulders and hope for the best.

    One of the roots of this problem lies in the nursing academia where several avid proponents of “alternative/complementary/integrative nursing” seem to have fortified themselves.
    Young nurses have told me several tales of lectures with titles indicating genuine scientific knowledge turned out to be incoherent ramblings about woo.
    A tragicomic piece of evidence to the abysmal level of intelligence these people seem to function at, is the following article where a lecturer and professor of nursing at the University of Iceland, department of nursing present a “study” involving the application of reflexology to a few sufferers of fibromyalgia. The stupidity burns.

    WARNING: Reading this absurd abuse of science may bring out tears in those to whom genuine academic proficiency and principles is important.
    The link should lead to the full text of this opus:
    http://www.sciencedirect.com/science/article/pii/S174438811000006X

    • “http://www.sciencedirect.com/science/article/pii/S174438811000006X”

      Good grief!

      • Good grief!

        Indeed. It is even worse than reading through an homeopathic ‘proving’. You expect homeopaths to be off their rockers so you are expecting and on your guard for the baloney, but these ladies are in high academic positions at a national University. The author is a Senior lecturer who seems to have a special interest in complementary and alternative therapies in nursing, reflexology, massage and aromatherapy. The co-author is a full professor and Dean! Note the “Keywords for specialisation” below in their presentation pages.

    • @Björn Geir on Wednesday 22 March 2017 at 15:24

      Thanks, and for the sake of others who won’t or can’t get to the link, here is the abstract:

      **************************************************
      Abstract
      Purpose
      In the previous study the effects of reflexology on symptoms of fibromyalgia (FM) were investigated. In this paper it will be explored whether healing crisis is experienced after reflexology in the same sample of women.

      Methods
      Multiple case study method as developed by Stake was used to investigate the effects of reflexology on six cases of women with FM who were given ten weekly sessions of reflexology. Data were collected with observation, interviews and diary. Within and across case data analysis was employed.

      Results
      Several different symptoms were experienced by all of the women after reflexology sessions, although differently for each of them. The symptoms presented as mixture of pain, fatigue, and flu like along with a variety of some other symptoms. This constellation of symptoms was more in tune with descriptions of the healing crisis phenomenon than with fibromyalgia. It gradually became worse until rather abruptly started to diminish around the seventh and eighth session.

      Conclusions
      For the majority of the women the healing crisis symptoms gradually became worse before they started to decrease. This has similarities with other health professionals’ accounts in the literature. Nurses and health professionals need to be aware of healing crisis effects when offering reflexology to patients.
      *****************************************************

      I tried to find a synonym for stupidity to reflect its truly awesome “glory”;
      stupidity
      stʃʊˈpɪdɪti,stʃuːˈpɪdɪti,stjʊˈpɪdɪti,stjuːˈpɪdɪti/Submit
      noun
      behaviour that shows a lack of good sense or judgement.
      “I can’t believe my own stupidity”
      synonyms: lack of intelligence, unintelligence, foolishness, denseness, brainlessness, ignorance, mindlessness, dull-wittedness, dull-headedness, dullness, slow-wittedness, doltishness, slowness, vacancy; More
      the quality of being stupid or unintelligent.
      “a comedy of infantile stupidity”

      but even aggregating the words doesn’t adequately describe the article and, commensurate, quality of the authors.

    • “But some do not seem to accept the reality of life and what they perceive as an inferior status to doctors. They are not content with their status as our coworkers and assistants but wish to embellish and elevate their status, preferably above us. That is why you sometimes see courses or lectures with titles paraphrasing the subject: “the problems with doctors and their faults and shortcomings” .
      Some nurses have found such needs fulfilled by entering administration and management. Most of them laudably substantiate this role by adding MBA or similar continued education.”

      Your arrogance and dismissal of the important role nurses play is stunning – simply stunning. I have been an RN for 37 years (USA) and worked in a number of different settings ;years at a large urban hospital, with a large insurance co. doing catastrophic case management and transplant, homecare, providing education to MD’s (who refuse to consult NIH guidelines) and now well over a decade in public health. Your words are exactly the reason the nursing community pushes so hard to be recognized as an important part of the health care team. We are not ‘assistants’ nor are we trying to embellish our role. Without nurses providing the exceptionally skill and knowledge driven care required in todays hospitals and clinics, patients would not survive. Our role is as important as your is – just in a different way. We provide individualized care and manage everything your patient needs before, during and in many cases, even after they have left the building. Nurses are the monitoring and alarm system when your patient’s health suddenly crashes.
      You’ve drank the “I am a Doctor, therefore worship me” Koolaid. Here’s a little news for you – Nurses have saved doctors asses more times than I can count. Doctors make mistakes and believe in ‘Woo” just like everyone else. I follow Ernst’s blog because I don’t believe in all the naturopathic, homeopathic garbage but I don’t have the skills to argue the case when I’m presented with boat loads of supposedly ‘scientific’ research saying there’s evidence all the woo works. As an RN, I’m fighting against the NIH as they mish mash wording using ‘may’ or ‘potential’ instead of flat out saying ‘homeopahty/naturopathy and their associated Woo does not work’. I fighting huge hospital systems (Mayo Clinic, Cleveland, Baylor etc.) who’ve buried their pride and ignoring science to make a few bucks offering garbage medicine. My own PCP, a physician I adore recommends yoga, accupuncture, massage therapy, aroma therapy (even though she knows I have asthma!). I push back – have conversations with her but tell this RN how we’re supposed to determine whats is/is not truly accurate, scientifically sound research when garbage is published in PubMed, and other well known journals. No, most nurses do not have the ability to decipher which research is garbage and which is sound but neither do doctors, clinical systems, and even public health.

      Instead of insulting and attacking nurses as if we’re all idiots and looking for ways to ‘elevate’ ourselves, try helping nurses understand the research and provide insight into why the research presents as it does. Instead of being an arrogant dick, try remembering whose care you’re leaving your patients in when you’re at home having dinner. Try treating Nurses as equals – we are because we’re human beings and we all have unique talents and skills – and see what happens. Nurses who are promoting alternative ‘medicine’ are simply following the lead of MD’s and institutions who should know better. Help them understand why homeopathy, naturopathy is garbage and maybe we’ll make a dent in the ignorance.

  • I used to study for a bachelor of nursing in Switzerland those last few years. I certainly cannot tell for sure why nurses are attracted to complementary therapies, but I can offer some insights from the inside.

    Part of the reason is a general lack of understanding of both research and clinical trials (we might be able to find them, but almost none of my peers could explain their pitfalls and how easy it is to manipulate their results). The English language remains a very strong barrier to entry, as it is not our first language and many won’t make the effort past their thesis (teachers aren’t any better). Study appraisal remains quite limited to a brief overview, closer to a summary than appraisal in my opinion and if the authors say something and show “significant results” (obviously the p value was emphasized and wrongly explained, and we were told Impact Factors was a good way to measure if the studies were trustable), most of my colleagues would believe them straight away.

    Then we have the influence of nursing theorists, which we have to learn by heart and apply their theories to clinical practice, many of which with ideas of the unique patient, patient as a whole, patient in relationship with the cosmos, holistic care, lots of voodoo and impossible to disprove contents worded in the most wierd ways. And we have anecdotes, lots and lots of anecdotes from teachers (one said a patient could break large patches of his skin almost instantly by belief alone), which seemingly don’t get that they are exagerated anecdotes, as with wierd beliefs (moon causes births?). Now, not all of them are like that and some certainly make the effort of having strong evidence, but I would say it is a minority.

    Finally, I can’t remember a single course on pseudosciences, but we certainly had a couple alternative practitioners (sometimes also nurses) coming to both talk about their professions and sometimes offer to try them. Also, many in the classroom were already using homeopathy and such, explaining their use with the usual “it worked for me”.

  • Ensirem: Also, many in the classroom were already using homeopathy and such, explaining their use with the usual “it worked for me”.
    Edzard: thank you; very interesting!

    Does ‘very interesting’ mean that Edzard is about to flip again? No, that is impossible.

    But, this is the thing: A quote from Karl Popper: ‘our knowledge can only be finite, while our ignorance must necessarily be infinite.’ I know that this applies to all of us but it seems to fit Edzard like a glove.

    Commenters on this site seem to believe that human life began in the 17th century or thereabouts in a ‘state of nature’ where people were dropping dead from infections etc and then, lo and behold, modern medicine was discovered. The duty of the ‘scientists’ that comment on this blog is to extinguish completely the superstitious unscientific beliefs that existed hitherto.

    In my view, there is some good and some not good in this show. The not good is that the ‘pseudosciences’ predated Hippocrates and the great civilizations of antiquity.

    I asked the question before: how did humanity survive for thousands of years before modern medicine came along? Edzard (deflect) and others (snicker snicker).

    Why don’t you people grow up and accept the diversity of existential paradigms? There appears to be an element of solipsism and narcissism in one dimensional consciousness .

    What is your response this this?

    • Greg

      You think Edzard’s writings are important for those who matter in the medical world?

      Think again. Check WHO:

      http://apps.who.int/iris/bitstream/10665/92455/1/9789241506090_eng.pdf

      • @iqbal

        One third of their way through the period their strategy covers, what money have they spent on their strategies, what projects started and what progress have WHO made in achieving their aims?

      • Iqbal, you can be proud of the fact that India is ahead of the UK on the enlightenment curve with TM (Extract from your source WHO):
        In India, all six traditional systems of medicine with official recognition (Ayurveda, Yoga, Naturopathy, Unani Medicine, Siddha and Homeopathy) have institutionalised education systems. India has 508 colleges with an annual admission capacity of 25 586 undergraduate students, 117 of these colleges also admitting 2493 Postgraduate students. Colleges can only be established with the permission of central government and the prior approval of their infrastructure, syllabi and course curricula. Annual and surprise inspections ensure that ducational and infrastructural standards are met. Central Government has the power to recognize or rescind any qualification and college.

        • Yet less than 7% use AYUSH (Ayurveda, Yoga & Naturoathy, Unani, Siddha, and Homeopathy) in India…

          Mind you, that’s a higher percentage than use homeopathy in the UK.

          • But remember, that 7% is those using any of the systems that come under AYUSH, at least two of which are decidedly allopathic.

        • Alan, what’s the percentage of people whining about the use of homeopathy in the UK? Y’all get pretty emotional about the issue.

          Might be worth a study to see if the agitated emotions are more dangerous than homeopathy itself. You should also get some hard data on any benefit from complaining about homeopathy on a blog. From the outside, it appears that the risk outweighs the benefit.

          • @jm

            Another attempt at a diversion…

            But you still fail to understand: I get ’emotional’ seeing the misleading claims made by homeopaths.

            Oh, but perhaps this: Advertising standards for homeopathy

          • Alan, the risk/benefit ratio is never a diversion. It’s pretty important.

          • jm said:

            Alan, the risk/benefit ratio is never a diversion. It’s pretty important.

            And your comment had nothing to do with risk-benefit.

          • It has everything to do with risk/benefit, Alan. If you can’t prove benefit from getting overly emotional about homeopathy on a blog…only risk remains.

          • Oh dear, jm. Let me explain. Your comment said:

            Alan, what’s the percentage of people whining about the use of homeopathy in the UK? Y’all get pretty emotional about the issue.

            Might be worth a study to see if the agitated emotions are more dangerous than homeopathy itself. You should also get some hard data on any benefit from complaining about homeopathy on a blog. From the outside, it appears that the risk outweighs the benefit.

            Nope. Nothing about the risk-benefit of homeopathy. Now, you might want to blabber on about something unrelated: that’s up to you – and Prof Ernst to tolerate it. If you want, we could even talk about the action taken by the ASA to get homeopaths to comply with the advertising rules.

          • jm wrote: “It has everything to do with risk/benefit, Alan. If you can’t prove benefit from getting overly emotional about homeopathy on a blog…only risk remains.”

            It is shameful that you didn’t equally apply that to yourself in your previous: defences of Gua sha and TCM; insults and accusations aimed at Björn Geir, Edzard Ernst, and others. E.g.,
            http://edzardernst.com/2016/06/an-invitation-resulting-in-a-rare-insight-into-the-acupuncturists-mind-set/#comment-79435

          • I did, Pete. Bjorn is using a fictional definition of gua sha. It’s a bodywork technique, and you can palpate the effects. And according to what little research is out there, there are no harmful effects (check Edzard’s links). You can palpate the benefit, and no real evidence of risk has been shown.

            According to Alan, the users of homeopathy are pretty small in numbers. Wondering if it’s worth the emotional distress to complain about it. Is there any evidence that blogs are making a difference? Is there any evidence that emotional stress has ill effects? Put them on the scale.

          • jm said:

            According to Alan, the users of homeopathy are pretty small in numbers.

            Where did I say that?

          • … no real evidence of risk has been shown.

            Even if this was right, there still remains the small issue of evidence for efficacy?
            We’re still waiting…

            https://en.wikipedia.org/wiki/Gua_sha#Health_Safety_and_Concern

          • jm said:

            A few comments up:
            http://edzardernst.com/2017/03/complementary-therapies-as-a-way-to-enhance-nursing-practice/#comment-87975

            You don’t consider fewer than 7% to be small?

            Good grief. Please try to get your head around absolute and relative values.

          • Good grief indeed – I’d love to hear how you figure less than 7% is a large number of the population in the UK.

            But first, do you have evidence that blogs are having any effect? Prove the benefit.

          • Jm, Circa 5 million is not a large number in the domains of cosmology and the SI units of science, but it is a very large number in terms of your, or anyone else’s, ability to accurately perceive, let alone accurately count.

            As Alan said: “Good grief. Please try to get your head around absolute and relative values.”

          • jm said:

            Good grief indeed – I’d love to hear how you figure less than 7% is a large number of the population in the UK.

            What on earth are you on about now? I’ve made no such claim.

            But first, do you have evidence that blogs are having any effect? Prove the benefit.

            I’ve made no such claim so I can’t fathom why on earth you expect me to provide any evidence for it. What is it about argumentation that you fail to comprehend?

          • Thanks for clearing that up, Pete.

            But I have to ask, did you really think that I meant that less than 7% of the UK population was a small group of people? Or do you suppose that I meant that it was small compared to the overall population of the UK? Either way, since you’re being so helpful, give me a hand with Alan’s statement:

            “Yet less than 7% use AYUSH (Ayurveda, Yoga & Naturoathy, Unani, Siddha, and Homeopathy) in India…
            Mind you, that’s a higher percentage than use homeopathy in the UK.”

            Now, a simpleton like me would figure that Alan is saying that the number of people using AYUSH in the UK is less than 7%. (Bear in mind…I’m not reading between the lines. I’m just going off of what he actually wrote.) Less than 7% in India, which is a higher percentage than in the UK. In my mind, that would make UK usage less than 7%. I’m sure you’ll correct me if I’m wrong there.

            Let’s figure there are some closet AYUSH users out there in the UK, bringing the number up to an even 7%.

            So, is that 7% absolute, or 7% relative?

            According to Wikipedia, the population of the UK is around 65 million. 7% of that would be about 4 ½ million. 4 ½ million people is a lot of people. Unless you compare it to 65 million, of course. Then it’s a relatively small amount of people. Somewhere around 7%, I’d guess.

            So is there evidence that blogging saves any of the 4 ½ million people from the evils of homeopathy? Or is it just the risk of emotional distress, without any proof that it has any effect? And of course the risk of carpal tunnel syndrome.

          • Alan, I never claimed you made such a claim. I don’t expect you to provide evidence, I’m simply wondering if you have any. Or is this a faith based endeavor?

          • if there ever was a bonkers discussion, this must be it!

          • Indeed, Edzard. Truly bonkers.

        • Greg, you and Iqbal do not understand the WHO strategy. It is in perfect alliance with Edzard. What it basically says is “Check if T & CM really works (Quality section beginning page 49) and kick out the non-working stuff”. This is a legitimate goal and spells the doom for TCM as it has already with homeopathy in Australia.

          As for India. 508 colleges ? That is an awful lot of money and lays to rest the claim that these medicines can not be proven due to financial restrictions. Also, India puts a lot of effort into these hypothesis so far with very few positive results. 25000 studnets admission capacity ? WHat a waste of brain.

        • You’re basing your argument on the fact that India’s central government gave approval and ‘standards’ are met? A government that turns a blind eye to caste systems, the rape and murder of women by groups of men citing ridiculous beliefs about a womans place in society? A government that ignores science and instead supports and regulates institutions of WOO cannot be taken seriously by the scientific community. They do their citizens a disservice by not protecting them from snake oil salesman peddeling garbage and supporting mythological treatments that can kill. The US Government is heading down the same WOO path – I can only hope that we someday elect a President who is a scientist and who pushes to cut off the stream of funding that supports homeopathy, naturopathy, accupunture, yoga and all the other pretend ‘health’ care.

    • @Greg on Friday 24 March 2017 at 05:39

      “I asked the question before: how did humanity survive for thousands of years before modern medicine came along? Edzard (deflect) and others (snicker snicker).

      Why don’t you people grow up and accept the diversity of existential paradigms? There appears to be an element of solipsism and narcissism in one dimensional consciousness .

      What is your response this this?”

      I’m surprised you even feel the need to ask this question because the answer is so self-evident. Nonetheless, I will try to explain in simple but not simplistic terms.

      Prior to civilisation, that is the aggregation of human beings in a specific location for extended periods, people were tribal and semi-nomadic. They ate a diet similar that of other moderate sized primates. The dual accidental developments of intelligence and an opposing thumb meant humans could manipulate their environment, including flora and fauna, more than any other species. Due the this power of manipulation, humans found that food was easier to come by when plants and animals were used for their own purposes, that is “domesticated”. The exploitation of other species, purely for their benefit, meant humans did not have to forage and ceased to be semi-nomadic.

      Having permanent settlements offered the great advantage of having idle time, time in which to think and perform activities not addressed only to survival. This led to better buildings, the use of materials not used prior, tools, a changed diet, the consumption of more meat, beer and wine, bread, among countless others. This was the development of civilisation and meant the collection of much larger groups of people together permanently. It also meant population growth with more people around with whom to reproduce. The concomitant problem of waste disposal also arose and at which humans weren’t very good.

      The constant closeness of domestic animals also meant zoonosis became a problem. While zoonotic transmission was “controlled” in smaller, nomadic groups by death of the victim, the proximity of many people meant the disease became more of an issue and killed many more.

      Well Greggy, there you have it in a nutshell. The choice for you is; do you want to go back to a situation described above, live a hard, tough, life with an early death and with high infant mortality, or appreciate what you have now and which is attributable to science?

  • Iqbal, Edzard USED to have some influence within the ruling establishment of the UK that led to adverse impacts on CAM within the national healthcare framework.

    The situation now is that he has ‘revealed’ that his position against CAM arises in connection with a vindictive mission.

    Science must be neutral, and Edzard’s song has ended. Nevertheless, the poison needs to be neutralised and those that were led to the ‘dark side’ of animosity towards natural medicine can be helped back to normality and equanimity in medical science perspectives.

    • why then do ‘BIG PHARMA’ pay me these vast amounts of money for doing this blog, publishing books, writing articles, giving lectures etc.?
      [just kidding, as I am sure you are]

    • To keep the illusion alive, homeopaths like other religious zealots need to repeat their make-believe mantra’s. Writing nonsense like this gives them the satisfaction of pretending their fantasy is real. They confirm their fantasies by verbalising wishful thoughts. Shouting “God is great” makes the believers feel better and in their minds corroborates their belief. For the same purpose homeopaths shout out: “Water has memory!”, “It works!” or “Edzard is unimportant!” or this latest gold nugget: “Edzards song has ended!” 🙂
      One may also liken them to children in a sandbox pretending to be grown-ups and playing out their fantasies.

      • Geir bibbled, “There still remains the small issue of evidence for efficacy….” Yet he closes his eyes when applying the same criterion to “modern medicine’s” IMATCH program which is in place at many hospitals and clinics around the USA to treat chronic headaches. The programs bilk $30k+ from patients and their insurers yet have at best limited evidence for their existence; but they still exist. Where is Geir’s outrage? Oh, it’s directed at paramedical disciplines. Imagine that!

        • Logos-Bios

          Bjorn’s “small issue of evidence for efficacy…” was in relation to a bodywork/massage technique. Efficacy in that case is palpable – if you’re doing a massage technique and can’t tell if you’re getting the palpable results you want…you need to quit doing bodywork. So I’m assuming Bjorn was being sarcastic.

          The IMATCH program isn’t geared for immediate, palpable results.

          • @jm

            So what! IMATCH is glomming 10’s of thousands of dollars from patients and insurers within the protective umbrella of “modern medicine” and has at best LIMITED EVIDENCE to support its use. Yet Geir and his pseudo-intellectual, anti-paramedical brethren on this site feign outrage at some complementary therapies which have not been fully countenanced by research. One simply must shake his head at the blatant hypocrisy.

          • Logos-Bios

            “Yet Geir and his pseudo-intellectual, anti-paramedical brethren on this site feign outrage at some complementary therapies which have not been fully countenanced by research.”

            So what?

          • @jm

            “So what?” you asked. Shouldn’t the criticisms by regulars on this forum about alleged lack of evidence for certain paramedical procedures also be levied at IMATCH?

          • Logos-Bios

            You’re taking this blog too seriously. Relax.

          • Two clowns having an argument; is this a Monty Python skit?

          • Nicely illustrated, Frank!

          • Hehe.. I had the same thought.

        • The L-B seems to think we are playing a pissing contest here. I must be treading on some very sore toes since it keeps butting into conversations with irrelevant, out of context and off topic blurbs at me. Would be interesting if it was clever and knowledgable.

          • Geir talks about rushing away to a beer garden and now discusses a pissing contest! What a hoot. Geir has evinced incomplete knowledge of “50 years of development within medicine” and responds to criticism of his demonstrated ignorance of same by invoking a comment referencing bodily fluids. I suggest he evacuate his bladder; perhaps his comments might increase in perspicacity…but I doubt it.

  • Edzard: but he hardly ever plays the ball, only the player.

    This is understatement hyperbole. The truth is that when I hit the ball back over the net to you, you pick it up and run off the court.

  • Edzard obviously didn’t read section 4.5.5 Paucity of evidence!! In fact I doubt he actually read the whole paper..!

  • Edzard states “I fail to understand why the lack of good evidential support for most complementary therapies did not emerge as a prominent theme. Are nurses not concerned about the (lack of) evidence that underpins their actions?”

    He obviously didn’t read this meta-analysis. Specifically section 4.5.5 “Paucity of evidence” where is discussed lack of evidence as a theme. It might help to actually read the paper before making sweeping statements about it.

  • I never thought about how nursing practices could benefit from complementary therapy. My wife was telling me about it because she’s a nurse and wants to try it out. Thanks for confirming what she was thinking so I’ll talk to her about going for it.

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