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

Yesterday, L’EXPRESS published an interview with me. It was introduced with these words (my translation):

Professor emeritus at the University of Exeter in the United Kingdom, Edzard Ernst is certainly the best connoisseur of unconventional healing practices. For 25 years, he has been sifting through the scientific evaluation of these so-called “alternative” medicines. With a single goal: to provide an objective view, based on solid evidence, of the reality of the benefits and risks of these therapies. While this former homeopathic doctor initially thought he was bringing them a certain legitimacy, he has become one of their most enlightened critics. It is notable as a result of his work that the British health system, the NHS, gave up covering homeopathy. Since then, he has never ceased to alert us to the abuses and lies associated with these practices. For L’Express, he looks back at the challenges of regulating this vast sector and deciphers the main concepts put forward by “wellness” professionals – holism, detox, prevention, strengthening the immune system, etc.

The interview itself is quite extraordinary, in my view. While UK, US, and German journalists usually are at pains to tone down my often outspoken answers, the French journalists (there were two doing the interview with me) did nothing of the sort. This starts with the title of the piece: “Homeopathy is implausible but energy healing takes the biscuit”.

The overall result is one of the most outspoken interviews of my entire career. Let me offer you a few examples (again my translation):

Why are you so critical of celebrities like Gwyneth Paltrow who promote these wellness methods?

Sadly, we have gone from evidence-based medicine to celebrity-based medicine. A celebrity without any medical background becomes infatuated with a certain method. They popularize this form of treatment, very often making money from it. The best example of this is Prince Charles, sorry Charles III, who spent forty years of his life promoting very strange things under the guise of defending alternative medicine. He even tried to market a “detox” tincture, based on artichoke and dandelion, which was quickly withdrawn from the market.

How to regulate this sector of wellness and alternative medicines? Today, anyone can present himself as a naturopath or yoga teacher…

Each country has its own regulation, or rather its own lack of regulation. In Germany, for instance, we have the “Heilpraktikter”. Anyone can get this paramedical status, you just have to pass an exam showing that you are not a danger to the public. You can retake this exam as often as you want. Even the dumbest will eventually pass. But these practitioners have an incredible amount of freedom, they even may give infusions and injections. So there is a two-tier health care system, with university-trained doctors and these practitioners.

In France, you have non-medical practitioners who are fighting for recognition. Osteopaths are a good example. They are not officially recognized as a health profession. Many schools have popped up to train them, promising a good income to their students, but today there are too many osteopaths compared to the demand of the patients (knowing that nobody really needs an osteopath to begin with…). Naturopaths are in the same situation.

In Great Britain, osteopaths and chiropractors are regulated by statute. There is even a Royal College dedicated to chiropractic. It’s a bit like having a Royal College for hairdressers! It’s stupid, but we have that. We also have professionals like naturopaths, acupuncturists, or herbalists who have an intermediate status. So it’s a very complex area, depending on the state. It is high time to have more uniform regulations in Europe.

But what would adequate regulation look like?

From my point of view, if you really regulate a profession like homeopaths, it means that these professionals may only practice according to the best scientific evidence available. Which, in practice, means that a homeopath cannot practice homeopathy. This is why these practitioners have a schizophrenic attitude toward regulation. On the one hand, they would like to be recognized to gain credibility. But on the other hand, they know very well that a real regulation would mean that they would have to close shop…

What about the side effects of these practices?

If you ask an alternative practitioner about the risks involved, he or she will take exception. The problem is that there is no system in alternative medicine to monitor side effects and risks. However, there have been cases where chiropractors or acupuncturists have killed people. These cases end up in court, but not in the medical literature. The acupuncturists have no problem saying that a hundred deaths due to acupuncture – a figure that can be found in the scientific literature – is negligible compared to the millions of treatments performed every day in this discipline. But this is only the tip of the iceberg. There are many cases that are not published and therefore not included in the data, because there is no real surveillance system for these disciplines.

Do you see a connection between the wellness sector and conspiracy theories? In the US, we saw that Qanon was thriving in the yoga sector, for example…

Several studies have confirmed these links: people who adhere to conspiracy theories also tend to turn to alternative medicine. If you think about it, alternative medicine is itself a conspiracy theory. It is the idea that conventional medicine, in the name of pharmaceutical interests, in particular, wants to suppress certain treatments, which can therefore only exist in an alternative world. But in reality, the pharmaceutical industry is only too eager to take advantage of this craze for alternative products and well-being. Similarly, universities, hospitals, and other health organizations are all too willing to open their doors to these disciplines, despite the lack of evidence of their effectiveness.

 

44 Responses to My Interview for ‘L’EXPRESS’: “Homeopathy is implausible but energy healing takes the biscuit”

  • Bien sur! Splendide!

    “It’s a bit like having a Royal College for hairdressers!”
    Except that hairdressers do cut hair – camists can’t cut the mustard!

    Bonne chance!

  • “… professionals may only practice according to the best scientific evidence available.”

    I wonder what modern medicine would look like if they are required to practice in this manner? If a MD deviates from “the best” will they be disciplined? Does a MDs personal experience no longer have any value? Or do they get a pass just because?

  • Hey guys!
    This is a blog – not an academic dissertation.

    ‘Best evidence’ is a phrase which carries with it the implication that it evidence which is the best (scientific quality) available.
    ‘Evidence-based’ accepts that some flexibility may be required, but that the treatment is at least based on the best evidence available – even if that is poor.

    Not synonyms – but synonymous implications and clear to readers of this blog.

    The problem with dealing with camists is that they constantly seek and quote ‘evidence’ which demonstrates that their preferred therapy does work, rather than critically identifying evidence showing whether it works or not.
    And so far, for SCAMS – the evidence is ‘not’.
    Or they would not be CAM!

    What’s the problem?

    • My problem with much of the “evidence” based medicine is the treatment always has a monetary motive to show efficacy. Both the test criteria and the test data can magically get skewed in favor of E V I D E N C E for efficacy…. =$$$. This is the case for any and all treatments… both evidence-based treatments and un-scientific therapies. It’s just that the players that usually have the deepest pockets to pay for RCT’s have already reaped rewards from tilting the tables in their favor. Not to say that CAM therapies wouldn’t do the same, they just don’t have the deep pockets. And I’ll admit that in many cases, neither do they have the efficacy that would support treatment for the majority. That however doesn’t prove that a significant segment of the population (be it a minority) cannot benefit from CAM treatments.

      • “the treatment always has a monetary motive to show efficacy”
        THANK YOU
        I can herewith attest to you a complete lack of understanding of clinical research.

        • @EE
          You talking to a person that has invested in “clinical research” for 29 years.

          I’m currently invested in Merck, Amgen, Gilead, Regeneron, Brystol-Meyers, AbbVie, Seattle Genetics and Zoetis. The only one I’m currently down on is Zoetis. Notice sir, no Moderna or Pfizer for me…. they’re dogs. I also own United Healthcare.

          Edzard, I’m a dummy in your opinion, but I know pharma, and I’m taking it to the bank.
          LOL

          • Moderna shares were trading at $16 this time in 2019. They hit $450 in September last year. Now at $128. I’d be happy with an eightfold return on my investment. You appear to know Pharma like you know everything else.

          • RG says: “but I know pharma, and I’m taking it to the bank.
            LOL”

            Let’s assume for a moment that you are speaking the truth i.e. you are invested in big pharma. On one hand you are screaming bloody murder at big pharma, on the other hand you are happily lining up your pockets investing in them and gleefully talking about it. You are a contridiction to yourself, RG😂 😂

          • @Talker

            Yes Talker, I’m really invested in pharma…and in a big way, and have been for a long time. It really is a love hate relationship FOR SURE ! Contradiction ? … OK, if you need to call it that. Somebody is going to own the shares, if pharma shares are a good investment, it may as well be me.

            I began many years ago investing in smaller biotech companies. I soon learned that they were riskier investments. But at that time, I had no animosity for drug developers, that came much later. After I began to learn more about how they operated, I learned of the dark side of pharma.
            Believe me, if I’d never invested in pharma, I’d never have learned as much about them as I know today. Investors need to do DD to invest wisely, it takes time and research. It involves learning the process of getting an approvable letter from the FDA, and about RCT’s, about patents, about securing sufficient funding, and the failures along the way.

            One reason small biotech firms fail is that they don’t have experience getting drugs pushed through the FDA…. hmmm. Think about that.
            So, I began looking at more established pharma firms to grow money. Over the past twenty-nine years I’ve easily invested in more than one hundred biotech/pharma companies… and some I lost money. Big pharma saved my investment capital, while small biotech produce big returns, they also get killed in the equity markets when they fail to produce a marketable product.

            I did recently lose money in Novavax, I’ll admit that, but it’s still the best covid vaccine in my opinion, and if I take another jab, I’d prefer it’s Novavax. Novavax got the product to market too late, among other issues, possibly in part because they did more comprehensive testing than the competition. Novavax had no previous experience with FDA approvals, part of the problem right there.

            Yes, I hate big pharma for the same reason I invest in them, THEY MAKE MONEY… and they do it consistently. What a terrific business model, creating customers instead of cures. Imagine, selling little pills for a hundred dollars each that cost pennies to manufacture. I didn’t think of it, but surly I can benefit from it, you can also. However, stay away from the pills, the real benefit is from capital appreciation.

          • Yes Talker, I’m really invested in pharma…and in a big way, and have been for a long time. It really is a love hate relationship FOR SURE ! Contradiction ? … OK, if you need to call it that.

            Yes, contradiction is what it is called in English language. You don’t get to change the meaning of words however you wish. Although, you seem to be doing some mental gymnastics to make yourself feel better.

            The investment strategy you described is pretty typical. Most industries would give you more or less similar returns over a 30 year time period, especially if you taking into consideration the last couple of decades of economic growth. So, no big pharma is not the golden goose that you make it seem to be.

            Yes, I hate big pharma for the same reason I invest in them, THEY MAKE MONEY… and they do it consistently. What a terrific business model, creating customers instead of cures. Imagine, selling little pills for a hundred dollars each that cost pennies to manufacture. I didn’t think of it, but surly I can benefit from it, you can also.

            Nah…big pharma returns are nothing compared to what one could get if they invested in the mob.

          • @Talker

            I believe I did say call it being conflicted if you prefer.

            It happens allot. A particular football fan might dislike a particular team and wish to see them defeated in a match. However, if the same fan believed that the said disliked team would win the match. Couldn’t that same person equally place a financial bet on the team they dislike? I’ve done it.
            I believe it’s the same with my position on Pharma.

          • RG, Do you go online and spread lies and misinformation regarding the football team that you don’t like and have betted on to improve your profits? I ask, because you do that with big pharma and mRNA vaccines by posting misinformation from the likes of Kirsch, Campbell, Mercola etc. Medical misinformation causes real harm as we have seen again and again in the past few years w.r.t vaccines and covid-19. So, no it is not the same a betting on football.

      • @RG
        So what you are basically saying is that all research in medical science is fraudulent from beginning to end, and that all reported progress in medical science is just lies in order to extract money from people.

        First of all, you DID read the banner at the top? You know, the one that says that any claim you make should be supported with evidence?

        And while we are waiting for you to make up ‘find’ said evidence, I might entertain you as well as our readers with some numbers. In the US alone, there are some 150,000 medical scientists. We can safely assume that this number well exceeds 1 million worldwide.
        So are you telling us that these 1 million people are ALL bribed to falsify their research, make up data, and continuously tell lies to the world? Or even a significant fraction of this number, say 100,000 scientists? And for many, many decades, at that?
        And then there is this: lots of scientists independently find the same results – not just when replicating original research, but also when relying on those previous results in any new research. So not would your claim mean that thousands upon thousands of scientists (many of whom chose their career in order to help humanity) are all bribed into committing fraud and lying, with the health of literally billions of other people at stake, but also that all their fraudulent trials and lies are very carefully co-ordinated and adjusted to match all those other frauds and lies. And of course that absolutely no-one in this gigantic bribe conspiracy has ever spilled the beans in all those decades that this must have been going on …

        Yeah, sounds totally plausible – for someone who believes that so-called alternative medicine really works, that is.

      • My problem with much of the “evidence” based medicine is the treatment always has a monetary motive to show efficacy

        RG,
        There is monetary motive in literally everything in life. Do you believe that everyone that works for money and every company that makes a profit is corrupt?

    • Sometimes clinical experience trumps the best scientific evidence because we are dealing with people not statistics.

      My daughter is a case where the best scientific evidence (according to one young surgeon) was to place a shunt for her hydrocephalus. However, her neurosurgeon with 40 years experience said that the best approach for my daughter was to do a cervical decompression due to the Chiari. I called another neurosurgeon and asked her view. She agreed with the decompression.

      So when I read someone state that: professionals may only practice according to the best scientific evidence available

      I have questions.

      • I think your example may be little more than one OPINION against another

        • sometimes it’s best scientific evidence vs clinical experience.

          The shunt surgeon was new in practice vs the two surgeons for the decompression with a combined experience of 60 years.

          So yes, I have hesitation when someone states: “professionals MAY ONLY practice according to the best scientific evidence available” (emphasis added).

          FWIW…the profile of the one who ended up doing the decompression surgery

          https://neurosurgery.wustl.edu/people/t-s-park-md/

          • you are talking tosh!

          • nah, you just didn’t write what you meant.

          • DC,

            Are you comparing clinical experience of surgeons with that of SCAM practitioners? Seriously?

          • RD: nope. I’m asking if a MD should be disciplined if they don’t “practice according to the best scientific evidence available”.

            EE: “… professionals may only practice according to the best scientific evidence available.”

          • DC,

            EE was talking about SCAM and you are asking him about MDs. Clearcut example of whataboutism to deflect any negative attention on SCAMs. Very typical of you. Nothing else to see here, moving on.

          • Interesting how you didn’t answer the question. Is it because there are two different bars, one for MDs and one for non-MDs?

      • Why didn’t you cure her with your chiro nonsense?

        • Because she had Chiari!
          (Gag to lighten the day.)

          Seriously – the young surgeon sought to apply the best evidence avaiable to him at the time.
          The other surgeons had more evidence (based on their experience) and that was ‘better’.
          All applied EBM.
          Simple.

          Chiro does ‘work’ to the extent that many folks experience a period of their issues and tissues being ‘better’ – but not because ‘innate intellegence’ is freed to flow, subluxations adjusted. spirits realigned.

          Chiro works (for some folks) because their emotional state is impressed by the professionalism of the chiropractor describing all these things, appearing to have some valuable insight into human anatomy, physiology and morphology, practising in a ‘clinical’ surrounding with impressive anatomical wall charts, wearing a white coat as do may MDs (originating from scientific workers), manipulating tissue with exciting cracking sounds (possibly from joints being pushed beyond their limits, possibly from cracking of the practitioner’s fingers or a palmed magician’s joke ‘cracker’ – $10 at your local party shop), and return visits indicating care, compassion and concern.

          In short – placebo responses.
          Simple.
          But unless the patient is made aware of this when giving consent, hardly ethical.

          • RR: All applied EBM.

            Yes they did. But that’s not what Ernst originally wrote:

            “professionals MAY ONLY practice according to the best scientific evidence available” (emphasis added).”

            So when is clinical experience considered the best scientific evidence when it doesn’t align with current published research?

        • Frank. Cure spina bifida, hydrocephalus, Chiari, syrinx?

          Grow up.

        • Frank Collins wrote “Why didn’t you cure her with your chiro nonsense?”

          Unfortunate one has to interview chiropractors to find a good one.

          ‘DC’ on Twenty Things Most Chiropractors Won’t Tell You

          • “it is still up to you to verify and confirm that the doctors meet your referral standards. Do your due diligence!”
            YOU ARE TAKING THE MIKEY, AREN’T YOU?

          • When a chiro, or a member of their family, has an actual medical problem, they follow this advice:
            If you have a health problem, the last person you should consult is a chiropractor

          • Back pain isn’t an actual medical problem?

            Come on Pete, think before you post.

          • @DC

            Back pain isn’t an actual medical problem?

            Yes, it is. But chiros are no better at treating back pain than physiotherapists. However, the latter are considerably cheaper than the former, and also don’t try to sell you unnecessary treatments like many chiros do.
            So in case of back pain (or in fact any musculoskeletal problem), I’d say the best advice is to consult a physiotherapist, and avoid chiropractors. This way, you will not run the risk of cervical arterial dissection (a rare but potentially deadly or severely crippling side effect unique to chiropractic treatment), and you also do not run the risk of ending up in the hands of a quack who believes not only in ‘subluxations’, but also that they can treat almost any ailment.

          • Interesting how this discussion turned to chiropractic based off a silly comment by Pete.

            Back to my question:

            I’m asking if a MD should be disciplined if they don’t “practice according to the best scientific evidence available”.

            EE: “… professionals may only practice according to the best scientific evidence available.”

          • psst Richard, this is from one of your posts:

            “First of all, you DID read the banner at the top? You know, the one that says that any claim you make should be supported with evidence?”

            I see a lot of claims here that need supporting evidence:

            But chiros are no better at treating back pain than physiotherapists.

            However, the latter are considerably cheaper than the former, and also don’t try to sell you unnecessary treatments like many chiros do.

            This way, you will not run the risk of cervical arterial dissection (a rare but potentially deadly or severely crippling side effect unique to chiropractic treatment),

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.

Subscribe via email

Enter your email address to receive notifications of new blog posts by email.

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.”

The most recent comments from all posts can be seen here.

Archives
Categories