alternative medicine
For some time now, the research activity in and around alternative medicine has been seemingly buoyant. In each of the last 4 years, Medline listed around 2 000 articles is the category of ‘complementary alternative medicine’. This will surely look impressive to many!
Why then did I write ‘seemingly’? To comprehend this a little better, we should have some comparisons. Here are numbers of Medline-listed articles published in 2015 for a few other areas:
- Surgery: 176 277
- Psychology: 65 679
- Internal medicine: 36 998
- Obstetrics/gynaecology: 13 818
- Pharmacology: 194 322
- Paediatrics: 30 646
Now you see, I hope, why the 2 049 Medline-listed articles in the category of ‘complementary alternative medicine’ are only seemingly impressive. But what about specific alternative therapies? Here are numbers of Medline-listed articles published in 2015 for some major alternative treatments:
- Homeopathy: 181
- Herbal medicine: 1 572
- Chiropractic: 314
- Acupuncture: 1 784
- Naturopathy: 45
- Dietary supplements: 5 199
These figures are perhaps interesting but not easy to interpret. They might indicate that certain sections of alternative medicine are more open to scientific scrutiny than others. Or do they show that for some areas there are more research funds and expertise than others? I am not sure I know the answer.
If we look a little closer at the research activity in defined alternative therapies, we are bound to get disappointed. I have recently done this for homeopathy and for acupuncture and reached rather gloomy conclusions.
In the case of homeopathy the were:
- The research activity into homeopathy is currently very subdued.
- Arguably the main research question of efficacy does not seem to concern researchers of homeopathy all that much.
- There is an almost irritating abundance of papers that are data-free and thrive on opinion (my category of ‘other papers’).
- Given all this, I find it hard to imagine that this area of investigation is going to generate much relevant new knowledge or clinical progress.
And in the case of acupuncture, I stated:
- Too little research is focussed on the two big questions: efficacy and safety.
- In relation to the meagre output in RCTs, there are too many systematic reviews.
- As long as we cannot be sure that acupuncture is more than a placebo, all these pre-clinical studies seem a bit out of place.
- The vast majority of the articles were in low or very low impact journals.
- There was only one paper that I would consider outstanding.
And what about the quality of the research into alternative medicine?
Well, this is a sad and depressing tale! If you doubt it, read my previous post or indeed any of the other ~500 which I have written on this particular subject in the past.
In alternative medicine, good evidence is like gold dust and good evidence showing that alternative therapies are efficacious is even rarer. Therefore, I was delighted to come across a brand-new article from an institution that should stand for reliable information: the NIH, no less.
According to its authors, this new article “examines the clinical trial evidence for the efficacy and safety of several specific approaches—acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenosylmethionine), tai chi, and yoga—as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines.”
The results of this huge undertaking are complex, of course, but in a nutshell they are at least partly positive for alternative medicine. Specifically, the authors state that “based on a preponderance of positive trials vs negative trials, current evidence suggests that the following complementary approaches may help some patients manage their painful health conditions: acupuncture and yoga for back pain; acupuncture and tai chi for OA of the knee; massage therapy for neck pain with adequate doses and for short-term benefit; and relaxation techniques for severe headaches and migraine. Weaker evidence suggests that massage therapy, SM, and osteopathic manipulation might also be of some benefit to those with back pain, and relaxation approaches and tai chi might help those with fibromyalgia.”
This is excellent news! Finally, we have data from an authoritative source showing that some alternative treatments can be recommended for common pain conditions.
Hold on, not so fast! Yes, the NIH is a most respectable organisation, but we must not blindly accept anything of importance just because it appears to come form a reputable source. Let’s look a bit closer at the actual evidence provided by the authors of this paper.
Reading the article carefully, it is impossible not to get troubled. Here are a few points that concern me most:
- the safety of a therapy cannot be evaluated on the basis of data from RCTs (particularly as it has been shown repeatedly that trials of alternative therapies often fail to report adverse effects); much larger samples are needed for that; any statements about safety in the aims of the paper are therefore misplaced;
- the authors talk about efficacy but seem to mean effectiveness;
- the authors only included RCTs from the US which must result in a skewed and incomplete picture;
- the article is from the National Center for Complementary and Integrative Health which is part of the NIH but which has been criticised repeatedly for being biased in favour of alternative medicine;
- not all of the authors seem to be NIH staff, and I cannot find a declaration of conflicts of interest;
- the discussion of the paper totally lacks any critical thinking;
- there is no assessment of the quality of the trials included in this review.
My last point is by far the most important. A summary of this nature that fails to take into account the numerous limitations of the primary data is, I think, as good as worthless. As I know most of the RCTs included in the analyses, I predict that the overall picture generated by this review would have changed substantially, if the risks of bias in the primary studies had been accounted for.
Personally, I find it lamentable that such a potentially worthy exercise ended up employing such lousy methodology. Perhaps even more lamentable is the fact that the NIH (or one of its Centers) can descend that low; to mislead the public in this way borders on scientific misconduct and is, in my view, unethical and unacceptable.
Did you know that:
- All diseases are really just psychological conflicts.
- Conventional medicine is a conspiracy of Jews to decimate the non-Jewish population.
- Microbes do not cause diseases.
- AIDS is just a normal allergy.
- Cancer is the result of a mental shock.
These are just some of the theories of RG Hamer realized in his Germanic (or German) New Medicine.
Hamer once had a medical licence; it was revoked after he was found guilty of malpractice. Subsequently, he continued treating patients as a ‘Heilpraktiker‘. He has been in court many times, sentenced repeatedly and imprisoned at least twice. There is an abundance of information about Hamer available on the Internet (for instance here), and I am therefore not attempting to repeat it here. Yet to give a quick impression of Hamer’s mind-set, I translate what he is quoted stating: ” … I do not even believe in the holocaust…I also do not believe that man was on the moon and, much worse, that the Twin Towers were brought down by Arabs, but hardly anybody believes that today…”
Hamer’s treatments have been associated with several deaths. The most recent case has only just been reported in this article from the Austrian newspaper ‘Der Standard’. As it is in German, I will summarize the essence here:
An Italian couple apparently had refused to let her daughter’s leukaemia be treated with conventional medicine (which usually is life-saving in this condition) but insisted that she receives Hamer’s methods of cancer therapy (which are not evidence-based). They therefore took her to a Swiss clinic where she apparently received cortisol and vitamins. After the interventions of Italian doctors, the parents were forbidden to take charge of their daughter’s care. Meanwhile, however, the daughter, Eleonora Bottaro from Padova, had reached the age of 18 and was therefore legally allowed to decide about her treatments. She opted to continue the treatment in the Swiss clinic and died of her leukaemia in mid August.
Some aspects of this new case are reminiscent of the one of the Austrian, Olivia Pilhar. In 1995, this girl, then aged 6, was diagnosed with a Wilms’ tumour. The parents withheld conventional treatments from her and opted for Hamer’s methods as an alternative. When the authorities intervened, the parents took their child to Malaga where she was treated according to Hamer’s weird ideas. Following a court order, the child eventually did receive proper medical treatment and survived her disease. Her parents received a suspended prison sentence of 8 months in Austria.
Sadly, alternative medicine hosts many miracle healers like Hamer. They have in common that
- they create their own bizarre ideas about healthcare which are neither plausible nor evidence-based;
- they mix them with a rich dose of conspiracy theory;
- they tend to sue those who expose them for what they are;
- they manage to amass a sizeable following of often quite fanatical believers;
- they exploit them by selling false hope;
- they manage to create some sort of cult;
- they do financially very well with their quackery;
- they endanger the health of consumers and patients who have the misfortune to come into contact with them;
- they are undeterred by medical ethics, the law or the authorities.
These people disgust me beyond words. Yet, even in this company of rogues, Hamer is special – not least because of his rampant racism. He claims, for instance, that conventional medicine is guilty of the “most hideous crime in the whole history of mankind” and alleges that Jews have killed around two billion people with morphine, chemotherapy and radiation.
Highly diluted homeopathic remedies are pure placebos; that statement is by no means new and has been discussed here so many times that it hardly needs repeating. It follows that those who, in the face of overwhelming evidence, claim that such remedies are efficacious for any condition or symptom are misleading the public.
What, in the realm of homeopathy, could be worse?
The answer is fairly clear, I think: those who promote homeopathy for immunizations; i.e. those ‘experts’ who advocate HOMEOPROPHYLAXIS; they are clearly worse, much worse.
On this blog, I have repeatedly warned consumers of this nonsense (see for instance here, here, here, here and here), yet the Internet remains full of promotion of this dangerous quackery. Few charlatans are as despicable as the author of this recent article:
…Energy medicine is becoming more sought after and used. Homeopathy is one such form of energy medicine used by over 500 million people worldwide. Within homeopathy is the practice of a safe and natural disease prevention method called homeoprophylaxis, or “HP.”
HP involves the safe use of either diluted and potentized disease products or materials from animal, mineral, or vegetable sources to elicit an immune response in order to educate the immune system before encountering a disease. Due to the ultra-high dilution, the final product contains no molecules of the original source, rendering it completely harmless. It is energetic instead of material and operates by way of its frequency.
Energetic Medicine
This energetic frequency “educates” the immune system to recognize a disease when met in the environment and effectively mount an immune response in the most natural way. As Albert Einstein once said, “Everything is energy and that’s all there is to it. This is not philosophy. This is physics.”
Just like cell phones receive a radio frequency, interpret it, and deliver it to the user in a form that can be understood, HP delivers the energetic spectrum of a targeted disease. The human body, just like the phone, is able to receive and respond to the energetic signature and produce a beneficial response.
This signature is delivered on tiny sugar pellets, by mouth, one disease at a time, and is devoid of adjuvents, preservatives, or antibiotics of any kind. It is not grown on foreign mediums, but contains only the frequency of the disease.
This is how illness occurs in nature. Pure and simple. The developing immune system contracts a disease, mounts an immune response, resolves the illness, and is left with lifelong immunity to a specific virus. No chemicals, no confusion, no system overload! HP confers all of the benefits with none of the risks…
Is HP for Me?
With any aspect of your health, or the health of your children, it’s essential to do your homework and carefully gather all the information you can before making choices. HP is not a “replacement” for vaccination. It is a conscious method to enhance immunity that employs energetic principles. Applications for epidemics and childhood diseases are based upon sound homeopathic principles and common sense. It is utilized and appreciated by many people around the world and shown to be safe and effective…
The time will come when we recognize that trying to eliminate disease is an infantile attempt to declare superiority over other lifeforms. The human body is 9/10ths bacteria, viruses, and other organisms that live symbiotically within us. Living in harmony with these organisms is the only answer to the survival of our species. HP honours this relationship. More people are finding it as they seek a better way…
END OF QUOTE
And here are the facts about HP:
- there is no reason why it should work; it is not biological plausible,
- there is no clinical evidence that it does work,
- the stories HP-fans tell us about epidemics where HP has been employed successfully are unconvincing nonsense,
- this means that HP is not evidence-based,
- to mislead people into thinking otherwise is criminally irresponsible, in my view,
- such bogus claims could cost the lives of millions, if HP truly became wide-spread.
I cannot think of anything in the realm of homeopathy that is more irresponsible than the promotion of HP.
The ‘Deutsche Apotheker Zeitung’, a paper for German pharmacists, rarely is the most humorous of publications. However, recently they reported on a battle between the EU and the European producers of homeopathic remedies – a battle over mercury which has, I think, hints of Monty Python and the Flying Circus.
The EU already has strict regulations on the use of mercury, for obvious reasons, they apply particularly to medicines. The law in this area is now 8 years old and is about to be replaced by a new one which is even stricter. A draft has been recently published here.
The new law would prohibit all mercury in medicinal products, except for some used in dentistry. For the homeopathic and anthroposophic manufacturers, this is not good news because they have many remedies on the market that have the word ‘mercury’ on the label. Consequently, they fear that the sale of these products might be impeded or even become impossible in the EU.
„Quecksilber und Quecksilberverbindungen stellen für manche homöopathische und andere traditionelle Arzneimittel einen unverzichtbaren Bestandteil dar“ (Mercury and mercury compounds are an essential ingredient of some homeopathic and other traditional medicines) .. “Es steht keine Quecksilber-freie Alternative zur Verfügung, die als aktiver Bestandteil in der Therapie mit homöopathischen oder anderen traditionellen Arzneimitteln verwendet werden könnte“ (There is no mercury-free alternative that could be used in these medications”) wrote the Dachverband der Arzneimittelhersteller im Bereich der Selbstmedikation (AESGP) (a lobby group of the homeopathic manufacturers) in a comment adding that „Diese Produkte sind seit Dekaden auf dem europäischen Markt und gehören zum Arzneimittel-Werkzeugkoffer” (these products are on the market since decades and belong to the medical tool-kit)… and that these products contain merely tiny amounts of mercury – even the largest manufacturers of these remedies only require a few milligrams for their production.
The plea of the manufacturers therefore is for an exemption from the new law which would allow the trade of mercury-containing remedies in future. They even have the support of some health politicians; for instance Peter Liese CDU favours an exemption for homeopathic medicines. The next meeting of the EU committee on public health will vote on the matter.
Personally, I can imagine the following dialogue between the EU officials (EU) and the lobbyists of the homeopathic industry (LOHI):
EU: We are very sorry but, because of the toxicity of mercury, we will not allow any of it in medicines.
LOHI: But we have always used it and nobody has come to harm.
EU: We don’t know that, and we have to be strict.
LOHI: We appreciate your concern, but we use only very, very tiny amounts; they cannot cause harm.
EU: The law is the law!
LOHI: Actually, the vast majority of our products are so dilute that they do not contain a single molecule of the ingredient on the bottle.
EU: That’s interesting! In this case, they are not medicines and we will have to ban them.
LOHI: NO, no, no – you don’t understand. We potentise our medicines; this means that the ingredient that they no longer contain gets more and more powerful.
EU: Are you sure?
LOHI: Absolutely!
EU: In this case, we will ban not just your mercury products but all your phony remedies. Because either science is right and they are fraudulent, or you are correct and they are dangerous.
For far too many proponents of alternative medicine, belief in alternative methods seems disappointingly half-hearted. Not so for this enthusiast who invented an alternative form of resuscitation – but sadly failed.
This article explains:
A Russian woman spent more than 4 months trying to bring her dead husband back to life. How? With the help of holy water and prayer!
The retired therapist said she didn’t report the death of her 87-year-old husband because she believed she could revive him by sprinkling holy water on his body and reading prayers. The woman’s bizarre secret was revealed when she accidentally flooded the apartment below, and a neighbour forced his way into her home to turn off the water. He found the almost completely mummified husband laying on the living-room couch. Forensic pathologists determined that the man had been dead for 4 – 6 months, but found no traces of violence on his body and concluded he had died of natural causes.
Neighbours said that they did sense a strange smell coming out of the apartment, but didn’t think anything of it. The deceased had suffered a serious injury to his leg in 2015 and had been bed-ridden since then. Therefore his disappearance from public view went unnoticed. To make sure nobody interfered with her resuscitations, the woman told everyone that he was fine, but too tired for receiving guests. Even the couple’s children were asked not to visit.
The 76-year-old woman who had worked as a doctor for most of her life, became interested in the occult and obsessed with the work of Leonid Konovalov, a Russian psychic who stars in a television show where he tries to communicate with the dead. “When we started talking to the woman, it turned out that she was fascinated by alternative medicine and believed that, by sprinkling holy water on her husband, she would be able to bring him back, to revive him,” Chief investigator commented.
Is there a lesson in this story?
Perhaps this one: conviction in one’s methods might be good, but evidence is better.
As has been discussed on this blog many times before, the chiropractic profession seems to be in a bit of a crisis (my attempt at a British understatement). The Australian chiropractor, Bruce Walker, thinks that, with the adoption of his ten point plan, “the chiropractic profession has an opportunity to turn things around within a generation. Importantly, it has an obligation to the public and to successive generations of chiropractors ahead of it. By embracing this plan the profession can be set on a new path, a new beginning and a new direction. This plan should be known as the new chiropractic.”
And now you are. of course, dying to hear this 10 point plan – well, here it is [heavily abbreviated, I am afraid (the footnotes [ ] and the comments referring to them are mine)]:
- There is a need to improve pre professional education for chiropractors.
Universities or private colleges?
Chiropractic education should where possible be conducted at universities [1] and this does not mean small single purpose institutions that are deemed universities in name only. Why is this recommended? Primarily because unlike some private colleges, government funded universities insist on intellectual evidence based rigour [2] in their learning and teaching and importantly require staff to be research active. Chiropractic courses need to have an underpinning pedagogy that insists that content [3] is taught in the context of the evidence [4] and that students obtain the necessary training to question and critically appraise [5]…
Accreditation problems
Underpinning chiropractic education is program accreditation and this is also in need of review particularly where vitalistic subluxation [6] based courses have been legitimised by the accreditation process…
Hospital training
Chiropractic education should also involve specifically relevant hospital access or work experience such as hospital rounds so that students can observe patients that are truly unwell and observe the signs and symptoms taught in their theory classes. Hospital rounds would also allow chiropractic students to interact with other health providers and increase the likelihood of legitimate partnership and respect between health professions [7].
Who should teach chiropractic students?… - There is a need to establish a progressive identity.
Chiropractors need to become solely musculoskeletal practitioners with a special emphasis on spinal pain [8]. If the profession becomes the world’s experts in this area it will command the respect deserved [9]. Importantly it will not be seen as a collective of alternative medicine practitioners with a strange belief system [10]… - The profession should develop a generalised special interest.
…Chiropractic as a profession should also develop a special interest area in the health sciences that can make a worldwide contribution to other related health sciences. This could be either research based or clinically based or indeed both. Some possibilities are: the further development and refinement of evidence based practice [11], improved posture through motor control, musculoskeletal care for the aged and elderly, improving bone density or the very important area of translating research into practice via implementation science. Whatever chosen we need to develop a special interest that sets us apart as experts in a distinctive area [12]. - Marginalisation of the nonsensical elements within the profession.
As professionals chiropractors should not tolerate colleagues or leadership in the profession who demonstrate aberrant ideas. If colleagues transgress the boundaries or professionalism they should be reported to authorities and this should be followed up with action by those authorities [13]… - The profession and individual practitioners should be pro public health.
It is important to speak up openly in favour of evidence-based public health measures and to join public health associations and agencies [14]… For example, chiropractors promoting anti-vaccination views need to be countered [15]… - Support legitimate organised elements of the profession.
Practitioners should support and become involved in chiropractic organisations that are clearly ethical and evidence based [16] and add value to them…
…Regular collective professional advertising of the benefits of chiropractic for back pain, for example, is a worthy undertaking but the advertisements or media offerings must be evidence based [17]. - The profession should strive to improve clinical practice.
Chiropractors contribute to the public health by the aggregated benefit of positive outcomes to health from their clinical practices [18]… Where restrictive practice laws relating to chiropractors prescribing medication exist the profession should seek to overturn them [19]… - The profession should embrace evidence based practice.
EBP is the amalgam of best scientific evidence plus clinical expertise plus patient values and circumstances. So what could be missing from this equation? It is clear that in the opinion of a sizable minority of the profession the elements that are missing are “practitioner ideology” and “practitioner values and circumstances”. These additional self- serving and dangerous notions should not be entertained. The adoption of evidence based practice is critical to the future of chiropractic and yet there is resistance by elements within the profession. Soft resistance occurs with attempts to change the name of “Evidence-based practice” (EBP) to “Evidence-informed practice” (EIP). It is worth noting that currently there are over 13,000 articles listed in PUBMED on EBP but less than 100 listed on EIP. So why are some of our profession so keen to use this alternate and weaker term?
Hard resistance against EBP occurs where it is stated that the best evidence is that based on practice experience and not research. This apparently is known as Practice Based Evidence (PBE) and has a band of followers [20]… - The profession must support research.Research needs to become the number one aspiration of the profession. Research informs both practice and teaching. Without research the profession will not progress. Sadly, the research contribution by the chiropractic profession can only be described as seed like. Figure 1 is a comparison of articles published in the past 45 years by decade using the key words “Physiotherapy” or “Physical Therapy” versus “Chiropractic” (source PUBMED). The Y axis is the number of articles published and the X axis is the decade, the red represents physiotherapy articles, the blue chiropractic. The difference is stark and needs urgent change [21].
If the profession at large ignores research whether in its conduct, administration or its results the profession will wither on the vine [22]… - Individual chiropractors need to show personal leadership to effect change.
Change within the profession will likely only occur if individual chiropractors show personal leadership….
As part of this personal leadership it will be critical to speak out within the profession. Speak out and become a mentor to less experienced colleagues [23]…
Anyone you thinks that with such a strategy “the chiropractic profession has an opportunity to turn things around within a generation” is, in my view, naïve and deluded. The 10 points are not realistic and woefully incomplete. The most embarrassing omission is a clear statement that chiropractors are fully dedicated to making sure that they serve the best interest of their patients by doing more good than harm.
If you are free on 17 – 19 November, why not pop over to Vienna and attend the European Congress for Homeopathy? The programme looks exciting (and full of humour); here are eight of my favourite lectures:
- R G Hahn ‘Homeopathy from a scientific and sceptic point of view’
- L Ellinger ‘Homeopathy as a replacement of antibiotics and in epidemics’
- T Farrington ‘Homeopathic treatment of farm animals’
- M M Montoya ‘Evidence based medicine in veterinary homeopathy’
- S Kruse ‘Homeopathy in neonatology’
- J Wurster ‘Homeopathic treatment and healing of cancer’
- P Knafl ‘The homeopathic treatment of cancer in cats and dogs’
- E Scherr ‘The homeopathic treatment of cancer in horses’
Other presenters at this meeting include two members of my ALT MED HALL OF FAME: Dr Fisher and Prof Frass. Their contributions alone would make the journey to Vienna a memorable event, I am sure.
And why are the presentations selected above amongst my favourites?
I am glad you asked! Here are some of my reasons:
- Prof Hahn as been mentioned on this blog before. He published what some homeopaths consider a biting criticism of one of my papers. I find his arguments utterly bonkers and I tried to explain this here. In the comments section of this post, one commentator wrote: “Dr. Hahn has an interesting take on the relationship of reason and science. Perhaps the best illustration of his confused views is illustrated in a comment-dialog (in english) following a blog post by Michael Eriksson, a Swedish computer scientist living in Germany. There, the two exchange views on this matter: https://michaeleriksson.wordpress.com/2011/01/16/science-and-reason/
The following quote from Dr. Hahn’s comments in this thread I find illustrative:The question is – should we believe in scientific data or should we believe is them only if you can accept them by reason? I claim that you should trust the data, in particular if “reason” is provided by a complete outsider. The risk is very great that reason provided by an outsider is completely wrong.
Dr. Hahn reveals his denial of homeopathy’s implausibility and motivates this view by rejecting reason itself. He seems to be totally blind to the meaning of the term “reason” and presumably therefore blind to his own lack of it.
As I said, quite a curious case. Perhaps a variant of the Nobel disease?”END OF QUOTE
These considerations render the title of Hahn’s lecture more than a little humorous, in my view.
- Homeopathy as a preplacement of antibiotics could to be a special type of very dark humour. If anyone really did implement such a strategy, there would be millions of fatalities worldwide within just a few months.
- Homeopathy for animals has also been debated on this blog before. The long and short of it is that there is no good evidence that it works.
- What follows for ‘evidence-based veterinary homeopathy is simple: it is a contradiction in terms.
- Homeopathy for children is not much different; in fact, it is worse: arguably, this is child abuse.
- The last there of my selected lectures are all on cancer, a subject that we too on this blog are familiar with (see here, here, here, here and here, for instance). Where does the homeopathic obsession with cancer cone from? Have homeopaths somehow decided that, as they are so very useless at curing trivial conditions, they must now go for the life-threatening diseases?
In any case, this conference promises to be a hilarious event – full of comedy gold, hubris, and wishful thinking. I think it’s a ‘must event’ for sceptics – so hurry and book soon!
Would you like to see a much broader range of approaches such as nutrition, mindfulness, complementary therapies and connecting people to green spaces become part of mainstream healthcare?
No?
Well, let me tell you about this exciting new venture anyway!
It is being promoted by Dr Dixon’s ‘College of Medicine’ and claims to be “the only accredited Integrative Medicine diploma currently available in the UK… [It] will provide you with an accredited qualification as an integrative medicine practitioner. The Diploma is certified by Crossfields Institute and supported by the College of Medicine and is the only one currently available in the UK. IM is a holistic, evidence-based approach which makes intelligent use of all available therapeutic choices to achieve optimal health and resilience for our patients. The model embraces conventional approaches as well as other modalities centred on lifestyle and mind-body techniques like mindfulness and nutrition.”
Dr Dixon? Yes, this Dr Michael Dixon.
College of Medicine? Yes, this College of Medicine.
Integrative medicine? Yes, this cunning plan to adopt quackery into real medicine which I have repeatedly written about, for instance here, here and here.
Crossfields Institute? Yes this Crossfields Institute which promotes the Steiner/’Waldorf quackery and has Simon Fielding as the chair of trustees.
Simon Fielding? Yes, the Simon Fielding who “devoted much of his professional life to securing the recognition of osteopathy as an independent primary contact healthcare profession and this culminated in the passing of the Osteopaths Act in 1993. He was appointed by ministers as the first chair of the General Osteopathic Council responsible for bringing the Osteopaths Act into force… He is currently vice-chair of the board of trustees of The College of Medicine… In addition Simon has… served as a long term trustee on the boards of The Prince of Wales’s Foundation for Integrated Health… and was the founder chair of the Council for Anthroposophical Health and Social Care.”
You must admit, this IS exciting!
Now you want to know what modules are within the Diploma? Here they are:
- The Modern Context of IM: Philosophy, History and Changing Times in Medicine
- IM Approaches and Management of Conditions (part 1)
- Holistic Assessment: The Therapeutic Relationship, Motivational Interviewing & Clinical Decision Making in Integrative Medicine
- Critical Appraisal of Medicine and IM Research
- Holistic assessment: Social prescribing, a Community Approach in Integrative Medicine
- Managing a Dynamic IM Practice and Developing Leadership Skills
- IM Approaches and Management of Conditions (part 2)
- Independent Study on Innovation in Integrative Medicine
Sounds terrific, and it reminds me a lot of another course Michael Dixon tried to set up 13 years ago in Exeter. As it concerned me intimately, I wrote about this extraordinary experience in my memoir; here is a short excerpt:
…in July 2003… I saw an announcement published in the newsletter of the Prince of Wales’ Foundation for Integrated Health:
“The Peninsula Medical School aims to become the UK’s first medical school to include integrated medicine at postgraduate level. The school also plans to extend the current range and depth of programmes offered by including healthcare ethics and legislation. Professor John Tooke, dean of the Peninsula Medical School, said: ‘The inclusion of integrated medicine is a patient driven development. Increasingly the public is turning to the medical profession for information about complementary medicines. This programme will play an important role in developing critical understanding of a wide range of therapies’.”
When I stumbled on this announcement I was taken aback. Is Tooke envisaging a course for me to run? Has he forgotten to tell me about it? When I inquired, Tooke informed me that the medical school planned to offer a postgraduate “Pathway in Integrated Health” which had been initiated by Dr Michael Dixon, a general practitioner who had at that stage become one of the UK’s most outspoken proponents of spiritual healing and other dubious forms of alternative medicine, and for this reason was apparently very well regarded by Prince Charles.
A few days after I received this amazing news, Dr Dixon arrived at my office and explained with visible embarrassment that Prince Charles had expressed his desire to establish such a course in Exeter. His Royal Highness had already facilitated its funding which, in fact, came from Nelson’s, the manufacturer of homoeopathic remedies. The day-to-day running of the course was to be put into the hands of the ex-director of the Centre for Complementary Health Studies (CCHS), the very unit I had struggled – and even paid – to be separated from almost a decade ago because of its overtly anti-scientific agenda. The whole thing had been in the planning for several months. I was, it seemed, the last to know – but now that I had learnt about it, Dixon and Tooke urged me to contribute to this course by giving a few lectures.
I could no more comply with this request than fly. Apart from anything else, I was opposed in principle to the concept of “integration.” As I saw it, “integrating” quackery with genuine, science-based medicine was nothing less than a profound betrayal of the ethical basis of medical practice. By putting its imprimatur on this course, and by offering it under the auspices of a mainstream medical school, my institution would be encouraging the dangerous idea of equivalence – i.e., the notion that alternative and mainstream medicine were merely two parallel but equally valid and effective methods of treating illness.
To add insult to injury, the course was to be sponsored by a major manufacturer of homoeopathic remedies. In all conscience, this seemed to me to be the last straw. Study after study carried out by my unit had found homoeopathy to be not only conceptually absurd but also therapeutically worthless. If we did not take a stand on this issue, we might just as well all give up and go home…
END OF QUOTE FROM MY MEMOIR
Dixon’s Exeter course was not a brilliant success; I think it folded soon after it was started. Well, better luck up the road in Bristol, Michael – I am sure there must be a market for quackery somewhere!
The Subject of the German ‘Heilpraktiker’ has recently been the topic of one of my blog-posts. In Germany, it has been a taboo for decades, but now the ‘Frankfurter Allgemeine Zeitung’ (FAZ) have courageously addressed the problem. In today’s article, the FAZ reports that, Josef Hecken, the chair of the an organisation called ‘Selbstverwaltung im Gesundheitswesen’ (self-administration in healthcare), demands that “health-insurers should be forbidden to pay for treatments that are not supported by evidence.” Hecken, is also the chair of the Gemeinsamen Bundesausschusses, an umbrella organisation of doctors, insurers and hospitals which determines which services are paid for and which not. He stated that even paying for homeopathy out of your own pocket when treating diseases like cancer must be forbidden and stressed that “this is not about well-being but human lives.”
Hecken’s views are partly supported by Rudolf Henke, the chair of both a German doctor’s union and of the Marburger Bund, a union of hospitals: “the regulations regarding the Heilpraktiker have to be re-considered entirely… I do not believe it to be acceptable that Heilpraktiker are able to treat cancer patients.”
These remarks relate to the deaths that recently occurred in a clinic led by a Heilpraktiker. About two thirds of all German health insurers seem to pay for consultations with a Heilpraktiker. Vis a vis the fact that most of their treatments are not evidence-based, this situation seems intolerable and deeply unethical.
Hecken’s stance seems clear, rational and, in view of the popularity of homeopathy in Germany, even courageous: “The government should charge the ‘Gemeinsamen Bundesausschuss’ or another organisation with the task of conducting a meta-analysis on the evidence of homeopathy and then draw the appropriate conclusions… We have reached a point where we need a public discussion, and I am prepared to take the flack.”
