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

The 13th European Congress for Integrative Medicine is about to take place online between 4 and 7 November 2021. It will host 125+ speakers presenting from around the world. The programme will cover the following topics.

Even looking at the more detailed list of lectures, I did not find a single contribution on conventional medicine (“Integrative medicine combines conventional medicine with…” [see below]) or a lecture that is remotely critical of integrative medicine. The definition of INTEGRATED MEDICINE (IM) adopted here seems similar to the US definition we recently discussed. Here is the European definition:

Integrative medicine combines conventional medicine with evidence-informed complementary medicine and therapies to achieve the optimum health and wellbeing of the patient. Focusing on a holistic, patient-centred approach to healthcare, it takes into consideration the patient’s physical and psychological wellbeing and treats the whole person rather than just the disease.

Allow me to do a quick analysis of this definition by looking at its key elements:

  • Evidence-informed: While proper medicine is BASED on evidence, IM is merely INFORMED by it. The difference is fundamental. It allows IM clinicians to use any un- or disproven so-called alternative medicine (SCAM) they can think of or invent. The evidence for homeopathy fails to show that it is effective? Never mind, IM does not need to be evidence-based, it is evidence-informed. IM physicians know homeopathy is a placebo therapy (if not they would be ill-informed which would make them unethical), but they nevertheless use homeopathy (try to find an IM clinic that does not offer homeopathy!), because IM is not EBM. IM is evidence-informed!
  • Therapies that achieve optimum health and wellbeing. This is odd because the website also states that “therapies can include anything from acupuncture, yoga, massage, aromatherapy, herbal medicine, nutrition, exercise along with many more approaches, tailored to the needs of the individual” indicating that virtually anything can be included. Anyway, “optimum health and wellbeing” seems a strange and unachievable criterion. In fact, it is nothing but a ‘bait and switch‘ salesmen’s trick.
  • Holistic: This is a little trick that IM proponents love. With it, they imply that normal medicine is not holistic. However, this implication is demonstrably wrong. Any good medicine is holistic, and if a sector of healthcare fails to account for the whole person, we need to reform it. (Here are the conclusions of an editorial I published in 2007 entitled ‘Holistic heath care?‘: good health care is likely to be holistic but holistic health care, as it is marketed at present, is not necessarily good. The term ‘holistic’ may even be a ‘red herring’ which misleads patients. What matters most is whether or not any given approach optimally benefits the patient. This goal is best achieved with effective and safe interventions administered humanely — regardless of what label we put on them.) Creating a branch of medicine that, like IM, pretends to have a monopoly on holism is grossly misleading and can only hinder this process.
  • Patient-centred: This is the same mean little trick in a different guise. They imply that conventional medicine is not patient-centred. Yet, all good medicine is, of course, patient-centred. To imply otherwise is just daft.
  • Consideration of the patient’s physical and psychological wellbeing and treating the whole person rather than just the disease: Same trick yet again! The implication is that physical and psychological wellbeing and the whole person are not all that relevant in conventional medicine where only disease labels are being treated.

Altogether, this definition of IM is unworthy of anyone with the slightest ability to think critically. I find it much worse than the latest US definition (which already is fairly awful). In fact, it turns out to be a poorly disguised bonanza of strawman fallacies combined with ‘bait and switch’ deception.

How can this be?

How can a professional organisation engage in such mean trickery?

Perhaps a look at the list of speakers will go some way towards answering the question. Have a good look, you might recognize many individuals as members of our ALTERNATIVE MEDICINE HALL OF FAME.

PS

Registration costs £ 249 (standard rate)

PPS

Perhaps I should also mention at least 4 of the many commercial sponsors of the conference:

  • Boiron
  • Helixor
  • Iscador
  • Weleda

 

 

12 Responses to The 13th European Congress for Integrative Medicine

  • Sounds like a concatenation of self-aggrandising bunk…..

  • I am frequently invited to speak at such events, but at my own expense! They must be joking.

  • Should I assume, Doctor, that you will not be delivering the keynote address?

  • Supported by Elsevier and other assorted profiteers.

  • It seems to me that, with so many wildly different and mutually contraditory One True Causes and Cures of Disease all in the same room, it shouldn’t be long before they realize that it is impossible for them all to be correct, and start debating who amonst them is right and who is wrong. And yet, these umbrella conferences are a regular recurring feature in AltMed. So how do they preserve their happy unity wherein they are right and the only one that’s wrong is “CONmed”?

    Seriously, Prof Ernst, you should go ahead and write your commencement speech anyway, in spite of the fact they’ll never allow you on-site to deliver it. (Much like Channel 4’s annual Alternative Christmas Message, gleefully rebuking the BBC and ITV’s tedious toadying to the Queen’s speech.) Your decades of detailed investigation into numerous AltMed systems puts you in the rare position of being able to assemble a detailed list of exactly which AltMed claims are mutually contraditory and why. Publish this list at the start of every big-tent AltMed conference and challenge their attendees either 1. to resolve those contradictions by figuring out amongsts themselves which of them are wrong, or 2. to explain to the rest of us why they refuse to do so.

    You will never kill AltMed with science, because AltMed is religious in nature and science cannot win against that. But set the various AltMed factions against each other, drive each one to prove false all the other AltMed systems that contradict (and thus should threaten) their own or confess their own hypocrisy, and let them pull down their own one big happy we’re-all-friends-here tent on top of themselves.

  • Hi On Monday, 1. October 2021’I was at the multi-day event “Medical Week” in Baden-Baden. All doctors for “naturopathic treatments” meet there once a year. Almost all SCAM directions are represented by the organizers. It was noticeable that even medical professors from universities, gave lectures. Of course there were also some other therapists and German naturopaths – „Heilpraktiker“ in the audience. As always, these alternative practitioners were looking for simple answers to complex questions and pathological relationships and were mostly overwhelmed by the much more complex way of thinking of doctors in the SCAM area. These complex pseudoscientific models of the doctors overwhelm the alternative practitioners, because they mostly do not have any prior training in the natural sciences. This gives doctors the halo that their SCAM models sound convincing. I have found that the way of thinking of the SCAM doctors does not differ in principle from the way of thinking of the “alternative practitioners”.

    Both professions are fundamentally unsettled by the problem that structurally arises from the division of humans into anatomically limited medical specialties. Since every specialist has little idea what the medical or ecotrophological standard is outside of the knowledge of his own specialty, the knowledge gap is filled with more or less complex magical oriented pseudoscientific systems (SCAM).

    But these pseudoscientific filling systems are, with all their ostensible complexity, always significantly more reduced than the actual scientific state of affairs in the individual medical and natural scientific fields. However, doctors and and medical specialists gain the illusion through SCAM that they are competent beyond their specialist area, simply because of the somewhat more sophisticated SCAM models.

    On the one hand, these models satisfy the model class that corresponds to their way of thinking. On the other hand, SCAM suggests a pseudo-competent ability to act in areas that go beyond their sectoral area.

    The difference to the “Heilpraktikers” is that doctors, due to their higher education, design these SCAm systems in a much more professional and differentiated manner and represent them pseudoscientifically much better. Doctors are the better magicians.

    The underlying omnipotence fantasies and the overestimating of oneself, the arrogance and above all the sense of mission to be able to save the world with it are the fundamental personality structures in both professional groups. That’s why I’m pretty sure that banning the profession of “Heilpraktikers” alone will not solve the SCAM problem. There would only be an income shift towards SCAM doctors.

    The problem with SCAM is more fundamental and has several structural causes that result from the socio-cultural circumstances of modern medicine.

    Klaus Czepan,
    Heilpraktiker and Osteopath
    I am practicing in the field of functional disorders and diseases. I am following the German AWMF and the Cochrane medical standards and the oecotrophological scientific standards in the field of evidence based medicine.

  • Modern medicine is very good in the field of acute medicine if the disease is mainly monocausal and if the pathological process allows clear algorithms in the procedure and clear allocation to medical departments. The more behavioral aspects and the more chronic and the more complex the problem becomes, the more magical, speculative processes and thought structures are used. The problem with magical speculative thinking is complex.

    The demand from the market creates the channels for corresponding therapy offers. Anything that sells is offered by any medical profession from doctors to midwives. The alternative market exists on many levels. It exists in the area of ​​esoteric healers, who are allowed to practice freely in all countries, because the jurisprudence no longer classifies them as part of medicine. It exists in the medical profession itself.

    This creates a graduated social space of action between evidence-based medicine, religious hope and the vast area of ​​relaxation and wellness. The need for general recovery exists alongside the much smaller field of the ICD 10 categories. It exists in the area of ​​wellness and it exists in the minds of many doctors and medical professions and therapists who work on an evidence-based basis. It exists next to the specialized area in which they work evidence based.

    Isn’ it like Prof Feynman stated: „I believe that a scientist looking at nonscientific problems is just as dumb as the next guy.“
    (Prof. Richard Feynman)? It is interesting that many specialists outside their specialty are quite ready to accept magically speculative views on a large scale, more or less uncritically.

    Another fundamental factor is the fact that medicine has been divided more and more into disciplines, which divide the body into delimited boxes of local or regional medical fields of action. This is one of the worst for patients in the area that, due to historical development, has not produced a specialist. That is the musculoskeletal system. Because in medicine there is no specialist for the musculoskeletal system this is a door for the Trojan horse of SCAM in medicine.

    A second major problem is that nutritional medicine is not part of basic medical training.

    A third problem is that the complexity of polymedication, especially in the field of chronic diseases and geriatrics, is not adequately dealt with in the course of studies at medical schools.

    A fourth problem is that fundamental problems of pharmacology or the pharmacological procedure in therapy are not reflected fundamentally or critically in terms of methods in the course of study.

    This leads me to the fifth problem, the training in systemic thinking as a scientific cognitive principle does not exist in medical training.

    Just as a sixth problem as there is no compulsory, method-critical training on the historically relevant areas of medical history and the history of pharmacology, which make up today’s common procedures of alternative medicine. The study subjects history of medicine in the study of doctors and the subject history of pharmacy in the training of pharmacologists are not primarily scientifically method-critical in a historical context.

    Overall, this all together shows that a good science based foundation is lacking in doctors to be able to enter this field of alternative medicine in a method-critical manner. Because of this epistemological deficit, isn’t there generally an essential part missing for a meta-level of reflection on one’s own actions in medicine?

    As a result, there is also no incentive to develop systemic, interdisciplinary therapeutic approaches on a scientific basis. The problem is particularly pronounced in the area of ​​the musculoskeletal system. Due to the historical development of the disciplines in medicine, there is no musculoskeletal specialist and this problem is one of the main reasons that magical speculative practices are spreading in medicine.

    The orthopedic surgeon for example is a surgeon who only covers the small, surgical part of the problems of the movement apparatus. As a surgeon, he is least trained to think systemically. Anesthetists or specialists in internal medicine or endocrinologists are much more inclined to think that way.

    In the area of ​​the musculoskeletal system, complaints and diseases are dealt with in different departments. Problems of rehabilitation are the part that is covered by the physiotherapist and the occupational therapist, problems of tension end up with the masseur, all of them are not trained in a complex systemic way of thinking not even in the area of the movement apparatus.

    Although there are also differences in the training of physical therapists in different states. Some countries like Netherlands integrate ecotrophological aspects into the training of the physiotherapist. But nutritional problems connected with the movement apparatus is not part of the training of orthopedic surgeons at all.

    The neurological part of diseases of the musculoskeletal system belong to the neurologist and rheumatic diseases to the rheumatologist. The rest ends up with psychosomatists, who tend to work psychotherapeutically.

    Since the problems resulting from the division of subjects are structural, the resulting problems are not recognized, one reacts to them with the same structural deficit and that is the consil. The consil remains on the epistemological level of the division of the human body. A systemic view of the kind that developed in the 1970s as a new field of ecology, strangely enough, did not develop in medicine. Instead one makes do with speculative magic. The Age of Enlightenment has stopped halfway in the field of medicine.

    May be that there is still a long way to go in medicine to accept the principle that we still know only a little about the human body and that we do not need to have a answer to every complaints. Doctors have to learn to be honest about that and to stop to pretend to always have an answer. It is as Prof. Feynman has said: „I have approximate answers and possible beliefs and different degrees of certainty about different things, but I’m not absolutely sure about anything. And there are many things I don’t know anything about. It doesn’t frighten me!“ or “It’s OK to not know, the pleasure is in finding things out!” Prof. Richard Feynman.

    This are my thoughts about speculative magic in medicine and this is my answer to those who remain unswerving in the believe to always know what to do at once without following a proper medical algorithm and standard of investigation and who would rather focus on feeling “hidden messages” or do “alternative or complementary speculative magic” or who have no problem to betray patients with every nonsense that sells.

    Science based epistemological considerations can only be successful if they grasp the systems of action in their complexity. That is why a singular ban on the German and Swiss “Heilpraktiker” or the chiropractor or the „osteopath“ (osteopathic manipulator) in England or Switzerland will never solve the problem with SCAM as long as the medical profession itself will nit solve the problems in the medical training of doctors and does not dry up the swamp at the roots in the medical profession itself.

    In my last 22 years of practice at the City of Karlsruhe Hospital Centre I have learned to reflect on medical systems and procedures in a critical way. I guess that a ban on alternative medical professions only makes sense if the structural problems that cause this problem which originate and are located in the training of medical professions and doctors and in the practice of commercial medical institutions are eliminated at the same time. A sole ban on “Heilpraktikers” is politically motivated and will only result in a shift in this market segment towards doctors who practice SCAM.

    Klaus Czepan
    Heilpraktiker and Osteopath in Germany and Switzerland

    I am practicing at the City of Karlsruhe Hospital Centre with a rational natural sciences based approach in the field of evidence based medicine for 22 years. My approach is method-critical in relation to all procedures that I have learned and in the context of which I work. My approach is essentially based on Antonovsky’s salutogenesis model with manual and oecotrophological and developmental psychology approaches.

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