THE TIMES recently published an interview with (my ex-friend) Michael Dixon, a person who has featured regularly on this blog. Here is a short passage relevant to our many discussions about homeopathy:
“Can I say on the record I’ve never studied homeopathy,” he says. “I’ve never even offered homeopathy. What I have done is said that if patients feel they’ve benefited from homeopathy, what’s the problem?”
The problem, scientists would argue, is that homeopathy undermines trust in real, evidence-based medicine. Homeopathic remedies are made by diluting active ingredients in water, often so that none of the original substance remains. Homeopathy has been banned on the NHS since 2017, because it is “at best a placebo”.
For Dixon, however, this “trench warfare” divide between alternative and conventional medicine is too binary. Even if something is scientifically impossible, as long as it helps his patients that is all that matters, Dixon says. “Many years ago, a Christian faith healer started seeing some of my patients. She made a lot of them better. I didn’t care a damn if it’s placebo — they got better,” he says.
While he thinks homeopathy can serve a purpose on the NHS, he draws a line at the “madness of some of the more wayward complementary practitioners” who will argue for using homeopathy to vaccinate children. “I would always advocate against anyone going for complementary medicine if there’s good evidence-based conventional medicine.”
Apart from
- the hilarious implication that a faith healer is NOT a “wayward practitioner”,
- the fact that, as far as I know, nobody ever claimed that Dixon studied homeopathy,
- the fact that Dixon does not understand what, according to scientists, the problems with homeopathy are,
his statements seem very empathetic at first glance.
Dixon’s key argument – if patients feel they’ve benefited from homeopathy, why not prescribe it – is an often-voiced notion. But that does not make it correct!
A physician’s duty is not primarily to please the patient. His/her duty foremost is to behave responsibly and to treat patients in the most effective way. And this includes, in a case where the patient feels to have benefitted from a useless or dangerous treatment, to inform the patient about the current best evidence. To me, this is obvious, to others, including Dixon, it seems not. Let me therefore ask you, the reader of these lines: what is the right way to act as a GP?
SCENARIO DIXON
Patient wants a treatment that is far from optimal and claims to have experienced benefit from it. The GP feels this is enough reason to prescribe it, despite plenty of evidence that shows the treatment in question has at best a placebo effect. Thus the doctor agrees to his/her patient taking homeopathy.
SCENARIO ERNST
Patient wants a treatment that is far from optimal and claims to have experienced benefit from it. The doctor takes some time to explain the the therapy is not effective and that, for the patient’s condition, there are treatments that would be better suited. The patient reluctantly agrees and the doctor prescribes a therapy that is backed by sound evidence (in case the patient resists, he/she is invited to see another doctor).
I admit that risking to lose a patient to another colleague is not an attractive prospect, particularly if the patient happens to be your King. But nobody ever said that medicine was easy – and it certainly is not a supermarket were customers can pick and choose as they please.
What do you think?
13 Responses to King Charles’s doctor: If homeopathy helps patients, what’s the problem?
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As I said before in your blog, no scam should be allowed at all in the first place. So scenario Dixon should never be an option. Scenario Ernst should not have to waste time on educatiing patients about the difference between science and fraud.
Edzard wrote
‘The problem, scientists would argue, is that homeopathy undermines trust in real, evidence-based medicine. ‘
I could just as easily say that my experiences of evidence based medicine undermined my trust in it. I went to CAM after bad experiences with EBM. I appear to be not the only one.
According to one paper 37% of CAM users used CAM because of disatisfaction with convential medicine.
https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-020-03157-2
Therefore, The problem is that 37% of us Camee, Camophile Camists would argue that EBM itself undermines trust in EBM.
We know you love your magic carpet and you make big bucks selling ghem. No need to flaunt it or justify it or us. Keep on riding and selling. No one will stop you. Good ol professor and his blog can’t make a dent in the sales.
@JK
Real medicine can’t solve every health problem. The problem here is that SCAMmers suggest that they can offer a solution where real medicine can’t. They tell people fairy tales such as ‘regular doctors just treat symptoms, but WE treat the whole person / find the root cause’ yada yada blah blah – even when they are in fact completely clueless about medicine.
SCAMmers simply bank on the fact that most ailments eventually resolve on their own, and claim success when that happens after their placebo treatment. In reality, the problems would have resolved all the same without their treatments.
It’s a bit like Trump’s election: just keep lying to people how great you are and that you will solve their problems, and lots of suckers will fall for it. And of course claim success for yourself when things get better, but blame others when they don’t.
Yes, but discomfort in the frying pan is not settled by jumping into the fire….
hear, hear!
“I could just as easily say that my experiences of evidence based medicine undermined my trust in it. I went to CAM after bad experiences with EBM”.
Yes, clearly, qualified medical doctors are not to be trusted at all, not British ones anyway, because look at Harold Shipman, and the British-born doctor currently serving a minimum 32 year jail sentence for the 2007 attack on Glasgow airport…….
Professor Ernst can be trusted, of course, as he wasn’t born in Britain.
‘JK’ wibbled: “According to one paper 37% of CAM users used CAM because…”
That is NOT what the paper states, which is:
[my emphasis and stating the bleedin’ obvious]
And yet again we see the lack of decent understanding of science among medics…Dixon really needs to go back to school and learn some basics of scientific methods.
Sadly this is very true of medics I have known for several decades: they pass science A-levels by rote learning the relevant bits (saw this in action at school), then continue rote and regurgitate through med school (saw this at university and then in many heath settings at work)and get very annoyed in ward rounds and the like when some stroppy nurse with a science degree or a psychologist pulls them up on something very basic…
true – but even more embarrassing is the lack of critical thinking skills of many medics.
Not just medics: I was horrified by this lack in many of my nursing colleagues, including nurse tutors and lecturers. I felt I was fighting a losing battle whenever I supervised a student or did some lecturing at the local nursing school/department…
It’s not for nothing that Trisha Greenhalgh had to write “How to Read a Paper” nor Jonathan Howard “Cognitive Errors and Diagnostic Mistakes”. Which, while both are excellent, is worrying in and of itself.
Just this evening in my Facebook feed, I saw an advert for something called H-Hemorrhoids Formula.
https://www.amoils.com/products/hemorrhoids?variant=39305614033027
I note that the ingredients listed as “Active” and “Inactive”, are the wrong way round!
The two “active” ingredients listed are Aesculus hippocastanum 12C and Collinsonia canadensis 12C. How has the “activity” of these two 12C preparations been demonstrated?
By contrast, the “Inactive” ingredients comprise four plant oils.
I am certain that this preparation which costs, if you please £34:95 for 11ml, would work just as well without the two 12C homeopathics.
“…Facebook feed, I saw an advert for something called H-Hemorrhoids Formula”
Arsebook, more like.