For quite some time now, I have been calling it SCAM – so-called alternative medicine.
Why?
Because, if a treatment does not work, it cannot be an alternative. And if it does work, it unquestionably belongs to conventional medicine.
Some people do not like this name and the acronym even less. But how else shall we call it?
The NHI is a generally well-respected organisation; they should know! Here is what they say about the question of naming it:
We’ve all seen the words “complementary,” “alternative,” and “integrative,” but what do they really mean?
This fact sheet looks into these terms to help you understand them better and gives you a brief picture of the mission and role of the National Center for Complementary and Integrative Health (NCCIH) in this area of research. The terms “complementary,” “alternative,” and “integrative” are continually evolving, along with the field, but the descriptions of these terms below are how we at NIH currently define them.
Complementary Versus Alternative
According to a 2012 national survey, many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches that are not typically part of conventional medical care or that may have origins outside of usual Western practice. When describing these approaches, people often use “alternative” and “complementary” interchangeably, but the two terms refer to different concepts:
If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.”
If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.”
Most people who use non-mainstream approaches also use conventional health care.
In additional to complementary and alternative, you may also hear the term “functional medicine.” This term sometimes refers to a concept similar to integrative health (described below), but it may also refer to an approach that more closely resembles naturopathy (a medical system that has evolved from a combination of traditional practices and health care approaches popular in Europe during the 19th century).
Integrative Health
Integrative health care often brings conventional and complementary approaches together in a coordinated way. It emphasizes a holistic, patient-focused approach to health care and wellness—often including mental, emotional, functional, spiritual, social, and community aspects—and treating the whole person rather than, for example, one organ system. It aims for well-coordinated care between different providers and institutions.
The use of integrative approaches to health and wellness has grown within care settings across the United States. Researchers are currently exploring the potential benefits of integrative health in a variety of situations, including pain management for military personnel and veterans, relief of symptoms in cancer patients and survivors, and programs to promote healthy behaviors…
___________________________
Does that enlighten you? No, me neither.
The quoted difference between complementary and alternative medicine can only refer to the practice and not to the treatment itself. A SCAM can be used as a sole or as an add-on therapy. This simple fact renders the above-quoted distinction nonsensical when applied to a therapy.
For instance, is homeopathy an alternative medicine or a complementary one? Hahnemann condemned everyone who used it in the complementary fashion. Today many homeopaths still use it in the Hahnemannian way, but most use it as an add on to conventional medicine. The distinction suggested by NIH and used by many others is therefore simply daft.
And integrative health? Don’t get me started! That term is (as I have pointed out ever since it came into fashion) even more stupid. Integrative medicine describes a concept that, as discussed so often on this blog, is nonsensical. It is best characterised by the observation that the addition of cow pie to apple pie is not an improvement of the latter.
So, until someone comes up with a better term, I think that
SCAM
is not so bad after all.
34 Responses to So-called alternative medicine: how shall we call it?
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Couldn’t agree more.
As Sgt Wilson pointed out: “They don’t like it up ’em!”
(In a UK TV show Dads’ Army . In this context, the scamists don’t like being caught out scamming!)
In my own much acclaimed book Real Secrets of Alternative Medicine I tried being a little more courteous and coined “Camistry, practised on camees by camists.”
‘Camistry’ being ‘non-conventional healthcare modalities for which there is no plausible reproducible evidence of benefit other than as placebo responses.’
The fact remains – if a modality works, it will be ‘medicine’. NIH has spent billions on ‘research, yet no proven benefit of the modalities many want to see ‘integrated’ has been demonstated.
The camists of course are looking for business; the more respectable institutions are desperate to get on the band-waggon and are under impost from an undiscerning public; politicians want to please voters; and critical thinking is going to the wall. Doesn’t the US grate sometimes?
I am profundly shocked! It was of course Corporal Jones (played by Clive Dunn), not Sgt Wilson (played by John LeMesurier) who said, of the “Fuzzy-Wuzzies”, They do not like it up ’em, Cap’n Mainwaring! Actor Ian Lavendar is probably the only one of that inimitable cast still living. The film re-make a few years ago, though admirably cast, was lame.
I have finished “The Real Secrets”, and appreciated the neologisms. ‘Condimentary’ is very good, I think.
“Integrated” is an admission, really, that it doesn’t work on its own. Otherwise, the homeopathic hospitals would have survived and now be thriving beacons.
Apologies. Jones it was.
Actually, it occurs to me that Sgt Wilson’s main aphorism is highly relevant to CAM: “D’you think that’s wise, Sir?”
Having re-watched the series recently, it seems to me that Wilson applies that phrase as an argument against almost any action, regardless of whether this leads to success or failure.
One imagines a situation like this:
A member of the platoon is bleeding heavily from a leg wound
Mainwaring: we need to apply a tourniquet immediately
Wilson: do you think that’s wise, sir?
Is Wilson arguing against any sort of intervention here, or does he feel even when Mainwaring plans an appropriate course of action, his incompetency may actually makes things worse?
“In my own much acclaimed book” …. Richard, your pomposity and smugness are truly pathetic. You and others on this forum continue to drive a wedge between ‘conventional medicine’ and anyone who thinks or works in a different way to you. Conventional medicine is attempting to to convince the public that only a vaccine will save them from serious illness or death during this pandemic. No credit is given to the human immune system – do you remember the vital mechanism that we ALL rely on to help ward of invading pathogens. I for one am quite happy for you to continue using the ridiculous acronym SCAM… it underlines your closed minds and refusal to accept there is life outside of your intolerant bubble.
https://edzardernst.com/2020/04/how-can-i-stimulate-my-immune-system-a-systematic-review-of-clinical-trials/
Do you have the faintest idea how vaccines work?
Mike Grant,
You clearly don’t know much about either vaccines or the immune system itself.
There are two main components to the immune system – specific and non-specific immunity. The non-specific immune system is capable of mounting a rapid response tailored to the general type of infection (virus, encapsulated bacterium, fungus, parasite etc.) but not to the species or strain of the infecting organism. This response is nevertheless very sophisticated and indeed many animal species have nothing else.
The specific immune system involves the production of antibodies that bind to the surface of an infecting organism, which may be inough to inactive it, or which can signal to the many kinds of immune cells that some kind of action is required. It takes several days to ramp up production of specific antibodies, but once that has occurred the immune response becomes much more targeted and therefore more effective.
Once the infection has subsided, the system remains primed to produce antibodies against it (and also to produce targeted lymphocytes if that is a more appropriate response to a particular infection – we have reason to believe that this cell-mediated response may be important in Covid-19). So if the same infection is encountered again, the specific response is immediate and the pathogens can be dealt with before they have had a chance to become established. This is known as immune memory.
Vaccines work by tricking the immune system into producing part of the same response that an actual infection would provoke, and thereby establishing a memory of that infection so that the immune system is ready when it encounters the real thing.
The immune system is immensely complex with hundreds if not thousands of feedback loops and signalling chemicals. In order to function normally all of these components need to be kept in balance. One of the problems with Covid-19 is that in some individuals there is an inappropriate activation of some components of the immune system leading to organ damage, and this is what causes most of the fatailities, rather than the virus itself. Dexamethasone is a powerful immunosuppressive drug that can be helpful here, but clearly a great deal more research is needed to understand and harness the immune response to this virus.
If you want to read more about the immune system I can recommend “The Beautiful Cure” by Daniel Davis. In this book he gives an overview of the immune system aimed at laymen such as myself (I am a doctor but not an immunologist, but I don’t think you need to have a medical background in order to understand it, though it probably helps if you at least know what a cell is).
Dr Julian, you said: “you clearly don’t know much about either vaccines or the immune system itself” … another pompous statement. You have no idea from my short comment exactly what I do and don’t know about vaccines and the human immune system. Next time, you may wish to make a more constructive comment so how about you explain what it is I CLEARLY don’t know?
I know of many folks who are waiting for a vaccine – mostly the over 50 age group. They may have to wait many months would you agree? In the meantime, not a peep from UK Gov suggesting how more vulnerable people can help themselves by at least checking their Serum 25(OH)D level. But many GP’s dismiss that idea as you may know.
Mike Grant,
From that short quote it is hard to draw any other conclusion. Though I hope you are a bit better informed now.
This is a link to the NICE guidance on vitamin D testing:
https://cks.nice.org.uk/topics/vitamin-d-deficiency-in-adults-treatment-prevention/
It sounds as though you are suggesting that policy should lead evidence, rather than the other way round. This is always a dangerous approach when it comes to health care.
You should be aware that it is difficult to measure vitamin D levels accurately, there is no standardised way of doing it and it is not clear what the threshold for deficiency is in adults. Also an apparently low vitamin D level may not necessarily represent a deficiency but could be a marker for other disease. Finally, excess vitamin D is toxic and inappropriate supplementation can be dangerous.
You may be interested to read this recent article from The Lancet, summarising the current state of evidence supporting a possible role for Vitamin D supplementation as prophylaxis against Covid-19:
https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30268-0/fulltext
Essentially the evidence is limited and conflicting. Certainly nothing on which to base any public health policy.
They conclude:
This is something that everyone can do, without having to go to the trouble of having a blood test.
Mike Grant, can you not appreciate toung-in-cheek irony?
I ALWAYS refer to my own website as “My highly eductional and informative website”…..
And why on earth do you imagine that doctors don’t appreciate the immune system?
Mike,
The reason SCAM is used is because so many, perhaps most, of those who try to make a living from health modalities which have no reliable, plausible, reproducible evidence of any non-placebo evidence, are trying to take advantage of people who lack critical thinking, whose thinking has ‘gone awry’ (as a UK judge put it), who are in the throes of the Dunning-Kreuger effect, who are vulnerable, gullible and susceptible to the blandishments, deceipt and deception of knavish ‘practitioners’. Some of whom are, sadly, medically qualified.
All these folk have to do is come up with the evidence of non-placebo benefit, or demonstrate they are seriously trying to obtain it, bearing in mind that “extraordinary claims require extraordinary evidence.”
There is no “wedge” – not all modern scientists agree on every proposition (and science would make no progress if they did), but all scientists intend that they should agree as far as possible.
And then we have a group of ‘modalities’ and philosophies which are anachronistic, have been left behind, give a nice feeling and are nice to have, but make no substantial difference to the underlying problem (unless psychological).
I style this as ‘Condimentary Medicine’ (that’s what condiments do).
Depending on whether or not the practitioner has integrity and is honest about the nature of their practice, even condimentary medicine could be a SCAM.
So too, some modern medicine.
Which is why the treatments which do not work are weeded out as best as we can.
And what are scamists doing about their practices and belief systems?
Mike – may the Wu ever be with you.
Agreed. There is an implied criticism of actual medicine when terms such as Integrative are used. This could be taken as suggesting medicine isn’t already integrated. It clearly is. This is another way in which there is misinformation inherent in the approach of SCAMers and it’s all part of their desperate search for a shred of credibility.
There are always examples of individual and system failures by health care professionals and organisations but in the UK we have what is an excellent fully integrated health system that performs well most of the time. It is by any measure far more integrated than any scam “system”.
why do you use my 1st name in your email address?
Anti spam, if I use unique addresses on websites it help narrow down any abuse, e.g. if the address is sold. Nothing sinister or odd!
For me, when someone needs a cleaver acronym like SCAM, they have lost reliability and I cannot take them serious because they already have made up their mind and closed their mind about these therapies.
NICE!
Yes, I have made up my mind about some SCAMs – after ~30 years of full time research of them and publishing more about them than any other researcher on the planet.
Research often leads to conclusions; do you find this objectionable?
Dawkins quote time, I paraphrase… Having an open mind is good but not so open your brain falls out. Edzards mind is not closed, just convinced, that as he carefully said, that some SCAMs are not supported by any credible evidence.
Dawkins may have said that, but I think James Randi said it first (and I recommend his book Flim-Flam).
30 years of re-hashing other peoples work. Now properly do a real homeopathic proving
https://edzardernst.com/2020/03/prof-ernst-has-never-done-any-clinical-trials-true-or-false/
thank you for confirming your ignorance
Is a “cleaver acronym” something to do with Occam’s Razor?
Is that a sickle joke?
Owww!
You gotta go “owww”!
Someone has to mow down or slash through the SCAMs with the scythe of truth.
Falsehoods riven asunder by the cleaver of Fact! (Would “riven in twain” be better?)
Kim, do you know of anyone who has done more primary research into, and meta-analysis of studies on, ‘alternative’ treatment modalities than Professor Ernst? Who? No-one has more right to express conclusions than he, and no-one’s conclusions are better-informed than his.
If you know different, name names and publications.
Kim, I don’t want to be the Grammar Police, but explain how we are to take seriously the opinion of someone who writes “I cannot take them serious”.
Unless English is not your native language?
In our submission to the Charity Commission’s 2017 consultation ‘The use and promotion of complementary and alternative medicine: making decisions about charitable status’, we looked at the terms used by them and said the following:
1 Terminology
The use of the term ‘complementary and alternative medicine’ (CAM) is widespread but we submit that it is both misleading and fundamentally wrong in the contexts covered by your consultation.
The words ‘complementary’ and ‘alternative’ do not define any practice but simply describe the conditions under which some practice or other is used: if it is ‘complementary, then it is used in a manner that purportedly complements conventional treatments; if it is ‘alternative’ then it is used as an alternative to conventional treatments. We are not aware of any practice that is used exclusively as either one or the other. Any practice could be used in any situation so we do not believe CAM is a useful description of any practice.
We note that your Official Guidance 304 [3] at paragraph B1 broadly concurs with our our understanding but we believe it would be better to use a term that does not pre-suppose or anticipate whether any particular practice will be used in a complementary or alternative manner.
1.1 Complementary
There are two distinct meanings in the way ‘complementary’ is used: firstly to simply mean ‘used whilst conventional treatments are being used’ and secondly referring to something that ‘complements’ or augments a conventional treatment.
This ambiguity, we believe, is important: while the word — as in your OG 304 definition — is usually used in the first sense (particularly by those who are not the practitioner), it is also frequently used by practitioners themselves to imply that it may help the conventional treatment or help alleviate some side-effects of that conventional treatment or help with the condition itself.[4]
To avoid this problem — particularly to not give any impression that any practice could be beneficial if used alongside a conventional treatment — we believe it is best to avoid the word completely.
1.2 Medicine
The use of the word ‘medicine’ is also wrong: the particular practice may involve substances akin to medicines or they may involve homeopathic or herbal products that are registered or authorised by the Medicine and Healthcare products Regulatory Agency (MHRA), but the general meaning of the word and the sense it conveys is one of a drug that has been properly licensed and regulated, which has evidence of efficacy and where the benefit-harm balance is understood.
Various EU Directives and consequently the Human Medicines Regulations 2012 and the MHRA do use the term ‘homeopathic medicines’. However, we believe this phrase — and similarly the word ‘remedy’, as frequently used by homeopaths — are misleading terms, implying as they do, that they have medicinal or remedial effects when we understand there is no good evidence for any such effects. Such products are only considered medicines for the purposes of regulation by the MHRA because they are “presented as having properties of preventing or treating disease in human beings”,[1] not because there is any evidence they actually have such properties. We believe this is consistent with the stance of the MHRA on the evidence and the official policy of the Department of Health, as stated on the NHS Choices website.[2]
An anomaly occurs with herbal products registered by the MHRA under the Traditional Herbal Medicines Registration Scheme (THMRS), which does not require any scientific evidence of efficacy. Although this refers to herbal ‘medicines’, the EU Directive 2001/83/EC requires that any herbal product that fulfils the criteria for a full Marketing Authorisation are not permitted to be registered under the THMRS[5] thus causing consumer confusion as to what is and isn’t a medicine. We urge the Charity Commission not to contribute further to this confusion by using the term ‘medicine’ for products that do not require robust evidence of efficacy.
To avoid giving the impression that any products are or could be considered to be medicines, we suggest that this word — and similarly the word ‘remedy’ — is not used.
1.3 Therapy
The word ‘therapy’ is similarly loaded because it implies there is some therapeutic action involved in the practice in question or that it provides a therapeutic effect. The specific effects of any particular practice are the effects directly caused by the distinguishing feature of that practice. For example, specific effects of acupuncture would be any effects generated by the actual insertion of needles or their subsequent manipulation. The specific effects of homeopathy would be any effects generated by the homeopathy product itself. The non-specific effects are those effects caused by the therapeutic encounter with the practitioner, the surroundings, the expectations of both client and practitioner, etc. Many practices have many of these non-specific effects in common.
That any practice might have non-specific therapeutic effects might in some circumstances be important to someone using the services of a practitioner. However, it does not follow that the practice itself has specific therapeutic effects.
Hence, using the term ‘therapy’ for a diverse range of practices, many of which have little or no evidence of efficacy, is both pejorative and misleading.
To avoid giving the impression that any practice is or could be considered to be therapeutic, we suggest that this word is not used.
1.4 House of Lords report
The House of Lords Science and Technology Select Committee’s Sixth Report [6] tried to deal with the same issues but opted to simply use the term CAM. It did suggest ‘non-conventional’ as a term sometimes used as a descriptor. This has the advantage that it highlights the generally opposing nature to what is understood as conventional treatments and we believe that is a fundamental and appropriate descriptor for the practices with which your consultation is concerned.
…
1.7 Conclusions
We think it is vitally important to ensure neutrality in these matters and to use language and terminology that is also neutral and not loaded with any supposition that something is or could be efficacious or effective or to project any such endorsement.
We will refer to the practices that are the subject of this consultation as simply ‘practices’ and those that provide those practices as ‘practitioners’. We will refer to the member of the public to whom the practitioner provides the practice as the ‘user’. It would be inappropriate to refer to them as ‘patients’ or even ‘clients’.
In view of the fact they are situated within a paradigm that is frequently not only one that is not based on robust scientific evidence, but one that is frequently diametrically opposed to conventional treatments and well-established science and medicine, we believe that a better defining descriptor for them would be ‘non-conventional’. Another possibility is the word ‘irregular’. These are not ideal, but a good step in the right direction and we urge the Charity Commission to consider their terminology.
For the purposes of this response, we therefore will use the term ‘non-conventional practice’ (NCP) as a neutral term rather than CAM or similar and the word ‘practitioner’ to refer to a person who provides that NCP.
We believe these terms encompass all the practices covered by your consultation and sets a coherent and sensible framework of terminology.
Recommendation 1
a) We recommend the Charity Commission review its terminology and use words and phrases that are neutral and that do not imply any degree of efficacy, any degree of scientific or medical acceptance or any degree of recognition by the Charity Commission.
b) We recommend the Charity Commission not permit a charity to use the words ‘complementary’, ‘integrated’, ‘integrative’ or similar in their name, objects and activities when they are referring to NCPs.
And I am happy to continue to use CON-Med (Conventional Medicine) in these pages. Medicine that claims to heal but instead hooks people for life on expensive toxic drugs that heal nothing; the Great Con that is bankrupting and destroying life around the world.
Ach c’mon Roger, 150 years ago everyone died in agony aged 30. In countries with a decent standard of living we live longer than before, and there are far more humans on earth than ever.
My granny died at the age of 42 in 1935, leaving two little girls age 9 and 7. “Cardiac insufficiency and pleural effusion”. My mother worked out, I am sure rightly, that she probably had Rheumatic Heart Disease caused by the Rheumatic Fever she (and one of her sisters who died age 16) had earlier in life. In 1935 there wasn’t much that could be done. Today, there is.
CON-Med…. I love that, how appropriate.
Agreed: “Conventional medicine.”