Homeopaths seem to dislike our critique of integrative medicine

Our ‘Memorandum Integrative Medicine‘ seems to be causing ripples. A German website that claims to aim at informing consumers objectively posted a rebuttal. Here is my translation (together with comments by myself inserted via reference numbers in brackets and added below):

With drastic words and narrow-mindedness bordering on ideology (1), the Münster Circle, an association of opponents to complementary therapies such as homeopathy (2), takes issue with the treatment concept of integrative medicine in a memorandum (3). By integrative medicine physicians understand the combination of doctor-led medicine and doctor-led complementary medicine to a meaningful total concept with the goal of reducing side effects and to treating patients individually and optimally (4). Integrative medicine focuses primarily on chronic diseases, where conventional acute medicine often reaches its limits (5)In the memorandum of the Münsteraner Kreis, general practitioner Dr. Claudia Novak criticizes integrative medicine as “guru-like self-dramatization” (6) by physicians and therapists, which undermines evidence-based medicine and leads to a deterioration in patient care. She is joined by Prof. Dr. Edzard Ernst, Professor Emeritus of Alternative Medicine, who has changed from Paul to Saul with regard to homeopathy (7) and is leading a veritable media campaign against proponents of treatment procedures that have not been able to prove their evidence in randomized placebo-controlled studies (8). The professor ignores the fact that this involves a large number of drugs that are used as a matter of course in everyday medicine (9) – for example, beta-blockers or other cardiological drugs (10). “Like the devil fears the holy water” (11), the Münsteraner Kreis seems to fear the concept of integrative medicine (12). The vehemence coupled with fear with which they warn against the treatment concept makes one sit up and take notice (13). “As an experienced gynecologist who has successfully worked with biological medicine as an adjunct in his practice for decades, I can only shake my head at such narrow-mindedness”, points out Fred-Holger Ludwig, MD (14). Science does not set limits for itself, but the plurality of methods is immanent (15). “Why doesn’t Prof. Ernst actually give up his professorial title for alternative medicine? That would have to be the logical consequence of its overloud criticism of established treatment concepts from homeopathy to to integrative medicine”, questions Dr. Ludwig (16).

The concept of integrative medicine is about infiltrating alternative procedures into medicine, claim the critics of the concept, without mentioning that many naturopathic procedures have been used for centuries with good results (17) and that healthcare research gives them top marks (18). “Incidentally, the scientists among the representatives of the Münster Circle should know that it is difficult to capture individualized treatment concepts with the standardized procedures of randomized, placebo-controlled studies (19). Anyone who declares the highest level of evidence to be the criterion for approval makes medicine impossible and deprives patients in oncology or with rare diseases, for example, of chances of successful treatment (20). Even there, drugs are used that cannot be based on high evidence, tested in placebo-controlled studies, because the number of cases is too low (21),” notes Dr. Ludwig .

1. Ideology? Evidence is not ideology, in my view.
2. We are an association of multidisciplinary experts advocating a level playing field with sound evidence in all areas of healthcare.
3. The actual memorandum is not linked in this text; does the author not want his readers to form the own opinion?
4. In our memorandum, we offer various definitions of integrative medicine (IM), none of which is remotely similar to this one.
5. No, IM is usually being promoted in a much wider sense.
6. This term does not appear in our memorandum.
7. I am not aware that I changed from Paul to Saul with regard to homeopathy; I know that I was led mostly by the evidence.
8. I feel flattered but don’t think that my humble work is a ‘media campaign’.
9. True, I do not pretend to understand all areas of medicine and tend to be silent in the ones that I lack up-to-date expertise.
10. Is he really saying that beta-blockers are not evidence-based?
11. The holy water comparison from a homeopath, who arguably makes a living from dishing out ‘holy water’, made me laugh!
12. It is most revealing, I think, that he thinks our motivation is fear.
13. Splendid!
14. FHL is the author of the article, and it is thus charmingly naive that he cites himself in this way
15. I somehow doubt that he understands what he is expressing here.
16. I find this rather a bizarre idea but I’ll think about it.
17. Argumentum ad traditionem.
18. Those that get ‘top marks’ belong to evidence-based medicine and not to IM.
19. Here the author reveals that he does not understand the RCT methodology and even fails to know the trial evidence on homeopathy – RCTs of individualised homeopathy are possible and have been published (e.g. this one).
20. If he really believes this, I fear for his patients.
21. Pity that he does not provide an example.

To understand FHL better, it is worth knowing that he claims to treat cancer patients with conventional and homeopathic medicine. He states that this approach reduces side effects – without providing evidence, of course.

Altogether, FHL does not dispute a single fact or argument from our memorandum. In fact, I get the impression that he never actually read it. To me, it feels as though he merely read an article ABOUT the document. In any case, his critique is revealing and important, in my view. It demonstrates that there are no good arguments to defend IM.

So, thank you FHL!