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

The ‘Schwaebische Tageblatt’ is not on my regular reading list. But this article of yesterday (16/10/2018) did catch my attention. For those who read German, I will copy it below, and for those who don’t I will provide a brief summary and comment thereafter:

Die grün-schwarze Landesregierung lässt 2019 den ersten Lehrstuhl für Naturheilkunde und Integrative Medizin in Baden-Württemberg einrichten. Lehrstuhl für Naturheilkunde und Integrative Medizin

Ihren Schwerpunkt soll die Professur im Bereich Onkologie haben. Strömungen wie Homöopathie oder Anthroposophie sollen nicht gelehrt, aber innerhalb der Lehre beleuchtet werden, sagte Ingo Autenrieth, Dekan der Medizinischen Fakultät in Tübingen am Dienstag der Deutschen Presse-Agentur. «Ideologien und alles, was nichts mit Wissenschaft zu tun hat, sortieren wir aus.»

Die Professur soll sich demnach mit Themen wie Ernährung, Probiotika und Akupunktur beschäftigten. Geplant ist laut Wissenschaftsministerium, die Lehre in Tübingen anzusiedeln; die Erforschung der komplementären Therapien soll vorwiegend am Centrum für Tumorerkrankungen des Robert-Bosch-Krankenhauses in Stuttgart stattfinden. Die Robert-Bosch-Stiftung finanziert die Professur in den ersten fünf Jahren mit insgesamt 1,84 Millionen Euro, danach soll das Land die Mittel dafür bereitstellen.

«Naturheilkunde und komplementäre Behandlungsmethoden werden von vielen Menschen ganz selbstverständlich genutzt, beispielsweise zur Ergänzung konventioneller Therapieangebote», begründete Wissenschaftsministerin Theresia Bauer (Grüne) das Engagement. Sogenannte sanfte oder natürliche Methoden könnten schwere Krankheiten wie etwa Krebs alleine nicht heilen, heißt es in einer Mitteilung des Ministeriums. Wissenschaftliche Ergebnisse zeigten aber, dass sie häufig zu Therapieerfolgen beitragen könnten, da sie den Patienten helfen, schulmedizinische Therapien gut zu überstehen – etwa die schweren Nebenwirkungen von Chemotherapien mindern.

Im Gegensatz zur Schulmedizin gebe es bisher aber kaum kontrollierte klinische Studien zur Wirksamkeit solcher Therapien, ergänzte Ingo Autenrieth. Ihre Erforschung am neuen Lehrstuhl solle Patienten Sicherheit bringen und ermöglichen, dass die gesetzlichen Krankenkassen die Kosten dafür übernehmen.

Hersteller alternativer Arzneimittel loben den Schritt der Politik. «Baden-Württemberg nimmt damit eine Vorreiterrolle in Deutschland und in Europa ein», heißt es beim Unternehmen Wala Heilmittel GmbH in Bad Boll. Die Landesregierung trage mit der Entscheidung dem Wunsch vieler Patienten und Ärzte nach umfassenden Behandlungskonzepten Rechnung.

Auch hoffen die Unternehmen, dass Licht in die oft kritische Debatte um Homöopathie gebracht wird. «Wir sehen mit Erstaunen und Befremden, dass eine bewährte Therapierichtung wie die Homöopathie, die Teil der Vielfalt des therapeutischen Angebots in Deutschland ist, diskreditiert werden soll», sagte ein Sprecher des Herstellers Weleda AG mit Sitz in Schwäbisch Gmünd der Deutschen Presse-Agentur. Deshalb begrüße man den Lehrstuhl: «Es ist gut, dass Forschung und Lehre ausgebaut werden, da eine Mehrheit der Bevölkerung Komplementärmedizin wünscht und nachfragt. Es braucht Ärzte, die in diesen Bereichen auch universitär ausgebildet werden.»

Laut Koalitionsvertrag will Baden-Württemberg künftig eine Vorreiterrolle in der Erforschung der Komplementärmedizin einnehmen. Bisher gab es im Südwesten mit dem Akademischen Zentrum für Komplementäre und Integrative Medizin (AZKIM) zwar einen Verbund der Unikliniken Tübingen, Freiburg, Ulm und Heidelberg, aber keinen eigenen Lehrstuhl. Bundesweit existieren nach Angaben der Hufelandgesellschaft, dem Dachverband der Ärztegesellschaften für Naturheilkunde und Komplementärmedizin, Lehrstühle für Naturheilkunde noch an den Universitäten Duisburg-Essen, Rostock und Witten/Herdecke sowie drei Stiftungsprofessuren an der Berliner Charité.

END OF QUOTE

And here is my English summary:

The black/green government of Baden-Wuerttemberg has decided to create a ‘chair of naturopathy and integrated medicine’ at the university of Tuebingen in 2019. The chair will focus in the area of oncology. Treatments such as homeopathy and anthroposophical medicine will not be taught but merely mentioned in lectures. Ideologies and everything that is not science will be omitted.

The chair will thus deal with nutrition, acupuncture and probiotics. The teaching activities will be in the medical faculty at Tuebingen, while the research will be located at the Robert-Bosch Hospital in Stuttgart. The funds for the first 5 years – 1.84 million Euro – will come from the Robert-Bosch Foundation; thereafter they will be provided by the government of the county.

So-called gentle or natural therapies cannot cure serious diseases on their own, but as adjuvant treatments they can be helful, for instance, in alleviating the adverse effects of chemotherapy. There are only few studies on this, and the new chair will increase patient safety and facilitate the reimbursement of these treatments by health insurances.

Local anthroposophy manufacturers like Wala welcomed the move stating it would be in accordance with the wishes of many patients and doctors. They also hope that the move will bring light in the current critical debate about homeopathy. A spokesperson of Weleda added that they ‘note with surprise that time-tested therapies like homeopathy are being discredited. Therefore, it is laudable that research and education in this realm will be extended. The majority of the public want complementary medicine and need doctors who are also university-trained.’

Baden-Wurttemberg aims for a leading role in researching complementary medicine. Thus far, chairs of complementary medicine existed only at the universities of Duisburg-Essen, Rostock und Witten/Herdecke as well as three professorships at the Charité in Berlin.

END OF MY SUMMARY

As I have occupied a chair of complementary medicine for 19 years, I am tempted to add a few points here.

  • In principle, a new chair can be a good thing.
  • The name of the chair is odd, to say the least.
  • As the dean of the Tuebingen medical school pointed out, it has to be based on science. But how do they define science?
  • Where exactly does the sponsor, the Robert-Bosch Stiftung, stand on alternative medicine. Do they have a track-record of being impractical and scientific?
  • In order to prevent this becoming a unrealistic prospect, it is essential that the new chair needs to fall into the hands of a scientist with a proven track record of critical thinking.
  • Rigorous scientist with a proven track record of critical thinking are very rare in the realm of alternative medicine.
  • The ridiculous comments by Wala and Weleda, both local firms with considerable local influence, sound ominous and let me suspect that proponents of alternative medicine aim to exert their influence on the new chair.
  • The above-voiced notion that the new chair is to facilitate the reimbursement of alternative treatments by the health insurances seems even more ominous. Proper research has to be objective and could, depending on its findings, have the opposite effect. To direct it in this way seems to determine its results before the research has started.
  • I miss a firm commitment to medical ethics, to the principles of EBM, and to protecting the independence of the new chair.

Thus, I do harbour significant anxieties about this new chair. It is in danger of becoming a chair of promoting pseudoscience. I hope the dean of the Tuebingen medical school might read these lines.

I herewith offer him all the help I can muster in keeping pseudoscience out of this initiative, in defining the remit of the chair and, crucially, in finding the right individual for doing the job.

16 Responses to A new chair in alternative medicine has just been announced; will they be able to fend off pseudoscience?

  • How do they reconcile
    Ideologies and everything that is not science will be omitted.
    with
    The chair will thus deal with nutrition, acupuncture and probiotics.

    I don’t think this bodes well for medicine at the University of Tuebingen.

    • Well, nutrition is sound science. Probiotics are a real thing, we just have very little idea what a “good” biome is and even less idea of how to achieve one.

      There’s electro-accupuncture and dry needling, both of which are rather fuzzy, but they’re being used and have at least the potential for study.

      Regular acupuncture is a tough one. Crap studies always show it works; good studies always show it doesn’t. I suppose they could dedicate some time to proving it doesn’t work, but they’d be unlikely to convince anyone.

      Maybe they’ll actually do some real research and anger their sponsors. You never know.

      • yes, you never know!
        BUT
        have a look at what comes out of the other German institutions listed at the end of the announcement … and don’t hold your breath!

      • I tried to underline the “acupunture” but it did not stick.

        I have no problem with studying nutrition and probiotics. I’d argue that nutrition is not anywhere near an alternative or complimentary branch of medicine. I am sure there are a lot of dieticians who would agree with me.

        I have not been following the probiotics saga but while it looks like the alt-meds people have jumped on the bandwagon, there may be some good results that could come out of studying them. Come to think of it though, why not just consider probiotics a subset of nutritional studies?

  • Ernst, Dear fellow.

    “The funds for the first 5 years – 1.84 Euro – will come from the Robert-Bosch Foundation”

    Is that a typu? The amount seems positively homeopathic.

    https://www.bosch.com/explore-and-experience/robert-bosch-education-and-healthcare/

  • “The funds for the first 5 years – 1.84 Euro – will come from the Robert-Bosch Foundation”

    So they are providing homeopathic funding?
    Or maybe there’s a typo 🙂

    • the foundation has strong links to homeopathy (https://www.bosch-stiftung.de/en/theme/foundations-within-foundation):
      In accordance with the mandate from Robert Bosch, since its founding the foundation has viewed itself as having a duty to conduct research on natural treatments, particularly homeopathy. This research is financed from income earned on fund assets held by the Hans-Walz-Stiftung as well as from Robert Bosch Stiftung funds.

      The quality and credibility of scientific studies are of crucial importance in the current debate about the effectiveness of complementary medicine and alternative therapies. This is why a summer school dedicated to the research methods used in complementary medicine was launched in 2007 in cooperation with the Charité university hospital in Berlin and the Technische Universität München (TUM – technical university of Munich) and was offered annually until 2011. Beginning in 2012, the International Society for Complementary Medicine Research has taken over its operation.

      We support scientific work related to the history of homeopathy through the Hans Walz Scholarship, which allows scientists from around the world to come to Stuttgart to conduct research at the Robert Bosch Stiftung’s Institute for the History of Medicine (IGM). Every two years, the institute awards the Hans Walz Research Prize for research on the history of homeopathy. The prize was awarded most recently in 2017 to Dr. Alice Kuzniar for her work „The Birth of Homeopathy out of the Spirit of Romanticism”.

    • and then, there is this (https://facultyofhomeopathy.org/revalidation/):
      The Institute for the History of Medicine of the Robert Bosch Foundation (IGM) with domicile in Stuttgart was established in 1980 and is the only organization of its kind without university affiliation in Germany. Its main field of research are the social history of medicine and the history of homeopathy. The Institute is home to a library of over 40,000 volumes and the Homeopathy Archives which hold Samuel Hahnemann’s estate as well as records of national and international homeopathic organizations.

      • Compared to other German foundations (http://www.homöopedia.eu/index.php/Artikel:Stiftungen) in the field of CAM the Robert-Bosch-Stiftung has been a rather respectable organization – with exception of the Hans-Walz-Stiftung and the IGM. Hans Walz was a close colleague of Robert Bosch and like him a great supporter of homeopathy. The foundation as well as the Robert-Bosch-Krankenhaus in Stuttgart seemed to have emancipated themselves from the agenda of their founder – until now.
        Lets hope the best.

  • May I suggest that Prof Ernst is ideal for the post?

  • Prof. Autenrieth seems to be determined to find an evidence-based scientist for this chair.
    That´s good news. But let´s hope that he also finds enough reasonable colleagues to withstand the massive opposition that is to be expected from populist politicians and CAM lobbyists!

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you want to be able to edit your comment for five minutes after you first submit it, you will need to tick the box: “Save my name, email, and website in this browser for the next time I comment.”
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”


Click here for a comprehensive list of recent comments.

Categories