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

alternative therapist

Naturopathy is an eclectic system of health care that uses elements of alternative and conventional medicine to support and enhance self-healing processes. Naturopaths employ treatments based on therapeutic options that are thought of as natural, e. g. naturally occurring substances such as herbs, as well as water, exercise, diet, fresh air, pressure, heat and cold – but occasionally also acupuncture, homeopathy and manual therapies.

Naturopathy is steeped in the obsolete concept of vitalism which is the belief that living organisms are fundamentally different from non-living entities because they contain some non-physical element or are governed by different principles than are inanimate things. Naturopaths claim that they are guided by a unique set of principles that recognize the body’s innate healing capacity, emphasize disease prevention, and encourage individual responsibility to obtain optimal health. They also state that naturopathic physicians (NDs) are trained as primary care physicians in 4-year, accredited doctoral-level naturopathic medical schools.

However, applied to English-speaking countries (in Germany, a doctor of naturopathy is a physician who has a conventional medical degree), such opinions seem little more than wishful thinking. It has been reported that New Brunswick judge ruled this week that Canadian naturopaths — pseudoscience purveyors who promote a variety of “alternative medicines” like homeopathy, herbs, detoxes, and acupuncture — cannot legally call themselves “medically trained.”

The lawsuit was filed because actual physicians were frustrated that fake doctors were using terms like “medical practitioner” and saying they worked at a “family practice.” This conveyed the false idea that naturopaths were qualified at the same level as real doctors.

The argument from naturopaths was that they weren’t misleading anyone. “There’s not even the slightest hint of evidence that anyone has been misled — or worse, harmed,” [attorney Nathalie Godbout] said. “This mythical patient that has to be protected by naturopathic doctors — I haven’t met them yet.”

However, Justice Hugh McLellan wasn’t buying it. He said the justification for naturopaths using terms such as “doctor” and “family physician” are based on the assumption that “people are attuned to the meaning of words like “naturopathy.” Many patients might read a website or a Facebook ad out of context, he said, and fail to pick up on the difference between “a doctor listing his or her qualifications as ‘Dr. So-and-So, B.Sc., MD,’ as opposed to the listing that might include ‘B.Sc., ND [naturopathic practitioner].’”

“I see a risk here,” McLellan said, “that the words … could, in fact, imply or be designed to lead the public to believe these various naturopaths are entitled to practise medicine.”

Britt Marie Hermes, a former naturopath who now warns people about the shortcomings of the profession, said she was thrilled with the judge’s ruling: “This is a very encouraging step in the right direction toward ensuring public safety. Naturopaths are not doctors. The onus should not be on patients to vet the credentials and competency of someone holding themselves out to be a medically trained physician. Now, patients will have an easier time separating truly medically qualified physicians from naturopathic practitioners. Bravo New Brunswick!”

In view of the many horror-stories that emerge about naturopathy, I am inclined to agree with Britt:

In the context of healthcare the title ‘doctor’ or ‘physician’ must be reserved to those who have a conventional medical degree. Anything else means misleading the public to an unacceptable degree, in my view.

 

The most frequent of all potentially serious adverse events of acupuncture is pneumothorax. It happens when an acupuncture needle penetrates the lungs which subsequently deflate. The pulmonary collapse can be partial or complete as well as one or two sided. This new case-report shows just how serious a pneumothorax can be.

A 52-year-old man underwent acupuncture and cupping treatment at an illegal Chinese medicine clinic for neck and back discomfort. Multiple 0.25 mm × 75 mm needles were utilized and the acupuncture points were located in the middle and on both sides of the upper back and the middle of the lower back. He was admitted to hospital with severe dyspnoea about 30 hours later. On admission, the patient was lucid, was gasping, had apnoea and low respiratory murmur, accompanied by some wheeze in both sides of the lungs. Because of the respiratory difficulty, the patient could hardly speak. After primary physical examination, he was suspected of having a foreign body airway obstruction. Around 30 minutes after admission, the patient suddenly became unconscious and died despite attempts of cardiopulmonary resuscitation.

Whole-body post-mortem computed tomography of the victim revealed the collapse of the both lungs and mediastinal compression, which were also confirmed by autopsy. More than 20 pinprick injuries were found on the skin of the upper and lower back in which multiple pinpricks were located on the body surface projection of the lungs. The cause of death was determined as acute respiratory and circulatory failure due to acupuncture-induced bilateral tension pneumothorax.

The authors caution that acupuncture-induced tension pneumothorax is rare and should be recognized by forensic pathologists. Postmortem computed tomography can be used to detect and accurately evaluate the severity of pneumothorax before autopsy and can play a supporting role in determining the cause of death.

The authors mention that pneumothorax is the most frequent but by no means the only serious complication of acupuncture. Other adverse events include:

  • central nervous system injury,
  • infection,
  • epidural haematoma,
  • subarachnoid haemorrhage,
  • cardiac tamponade,
  • gallbladder perforation,
  • hepatitis.

No other possible lung diseases that may lead to bilateral spontaneous pneumothorax were found. The needles used in the case left tiny perforations in the victim’s lungs. A small amount of air continued to slowly enter the chest cavities over a long period. The victim possibly tolerated the mild discomfort and did not pay attention when early symptoms appeared. It took 30 hours to develop into symptoms of a severe pneumothorax, and then the victim was sent to the hospital. There he was misdiagnosed, not adequately treated and thus died. I applaud the authors for nevertheless publishing this case-report.

This case occurred in China. Acupuncturists might argue that such things would not happen in Western countries where acupuncturists are fully trained and aware of the danger. They would be mistaken – and alarmingly, there is no surveillance system that could tell us how often serious complications occur.

The Spanish Ministries of Health and Sciences have announced their ‘Health Protection Plan against Pseudotherapies’. Very wisely, they have included chiropractic under this umbrella. To a large degree, this is the result of Spanish sceptics pointing out that alternative therapies are a danger to public health, helped perhaps a tiny bit also by the publication of two of my books (see here and here) in Spanish. Unsurprisingly, such delelopments alarm Spanish chiropractors who fear for their livelihoods. A quickly-written statement of the AEQ (Spanish Chiropractic Association) is aimed at averting the blow. It makes the following 11 points (my comments are below):

1. The World Health Organization (WHO) defines chiropractic as a healthcare profession. It is independent of any other health profession and it is neither a therapy nor a pseudotherapy.

2. Chiropractic is statutorily recognised as a healthcare profession in many European countries including Portugal, France, Italy, Switzerland, Belgium, Denmark, Sweden, Norway and the United Kingdom10, as well as in the USA, Canada and Australia, to name a few.

3. Chiropractic members of the AEQ undergo university-level training of at least 5 years full-time (300 ECTS points). Chiropractic training is offered within prestigious institutions such as the Medical Colleges of the University of Zurich and the University of Southern Denmark.

4. Chiropractors are spinal health care experts. Chiropractors practice evidence-based, patient-centred conservative interventions, which include spinal manipulation, exercise prescription, patient education and lifestyle advice.

5. The use of these interventions for the treatment of spine-related disorders is consistent with guidelines and is supported by high quality scientific evidence, including multiple systematic reviews undertaken by the prestigious Cochrane collaboration15, 16, 17.

6. The Global Burden of Disease study shows that spinal disorders are the leading cause of years lived with disability worldwide, exceeding depression, breast cancer and diabetes.

7. Interventions used by chiropractors are recommended in the 2018 Low Back Pain series of articles published in The Lancet and clinical practice guidelines from Denmark, Canada, the European Spine Journal, American College of Physicians and the Global Spine Care Initiative.

8. The AEQ supports and promotes scientific research, providing funding and resources for the development of high quality research in collaboration with institutions of high repute, such as Fundación Jiménez Díaz and the University of Alcalá de Henares.

9. The AEQ strenuously promotes among its members the practice of evidence-based, patient-centred care, consistent with a biopsychosocial model of health.

10. The AEQ demands the highest standards of practice and professional ethics, by implementing among its members the Quality Standard UNE-EN 16224 “Healthcare provision by chiropractors”, issued by the European Committee of Normalisation and ratified by AENOR.

11. The AEQ urges the Spanish Government to regulate chiropractic as a healthcare profession. Without such legislation, citizens of Spain cannot be assured that they are protected from unqualified practitioners and will continue to face legal uncertainties and barriers to access an essential, high-quality, evidence-based healthcare service.

END OF QUOTE

I think that some comments might be in order (they follow the numbering of the AEQ):

  1. The WHO is the last organisation I would consult for information on alternative medicine; during recent years, they have published mainly nonsense on this subject. How about asking the inventor of chiropractic? D.D. Palmer defined it as “a science of healing without drugs.” Chiropractors nowadays prefer to be defined as a profession which has the advantage that one cannot easily pin them down for doing mainly spinal manipulation; if one does, they indignantly respond “but we also use many other interventions, like life-style advice, for instance, and nobody can claim this to be nonsense” (see also point 4 below).
  2. Perfect use of a classical fallacy: appeal to authority.
  3. Appeal to authority, plus ignorance of the fact that teaching nonsense even at the highest level must result in nonsense.
  4. This is an ingenious mix of misleading arguments and lies: most chiros pride themselves of treating also non-spinal conditions. Very few interventions used by chiros are evidence-based. Exercise prescription, patient education and lifestyle advice are hardy typical for chiros and can all be obtained more authoratively from other healthcare professionals.
  5. Plenty of porkies here too. For instance, the AEQ cite three Cochrane reviews. The first concluded that high-quality evidence suggests that there is no clinically relevant difference between SMT and other interventions for reducing pain and improving function in patients with chronic low-back pain. The second stated that combined chiropractic interventions slightly improved pain and disability in the short term and pain in the medium term for acute/subacute LBP. However, there is currently no evidence that supports or refutes that these interventions provide a clinically meaningful difference for pain or disability in people with LBP when compared to other interventions. And the third concluded that, although support can be found for use of thoracic manipulation versus control for neck pain, function and QoL, results for cervical manipulation and mobilisation versus control are few and diverse. Publication bias cannot be ruled out. Research designed to protect against various biases is needed. Findings suggest that manipulation and mobilisation present similar results for every outcome at immediate/short/intermediate-term follow-up. Multiple cervical manipulation sessions may provide better pain relief and functional improvement than certain medications at immediate/intermediate/long-term follow-up. Since the risk of rare but serious adverse events for manipulation exists, further high-quality research focusing on mobilisation and comparing mobilisation or manipulation versus other treatment options is needed to guide clinicians in their optimal treatment choices. Hardly the positive endorsement implied by the AEQ!
  6. Yes, but that is not an argument for chiropractic; in fact, it’s another fallacy.
  7. Did they forget the many guidelines, institutions and articles that do NOT recommend chiropractic?
  8. I believe the cigarette industry also sponsors research; should we therefore all start smoking?
  9. I truly doubt that the AEQ strenuously promotes among its members the practice of evidence-based healthcare; if they did, they would have to discourage spinal manipulation!
  10. The ‘highest standards of practice and professional ethics’ are clearly not compatible with chiropractors’ use of spinal manipulation. In our recent book, we explained in full detail why this is so.
  11. An essential, high-quality, evidence-based healthcare service? Chiropractic is certainly not essential, rarely high-quality, and clearly not evidence-based.

Nice try AEQ.

But not good enough, I am afraid.

Many chiropractors tell new mothers that their child needs chiropractic adjustments because the birth is in their view a trauma for the new-born that causes subluxations of the baby’s spine. Without expert chiropractic intervention, they claim, the poor child risks serious developmental disorders.

This article (one of hundreds) explains it well: Birth trauma is often overlooked by doctors as the cause of chronic problems, and over time, as the child grows, it becomes a thought less considered. But the truth is that birth trauma is real, and the impact it can have on a mother or child needs to be addressed. Psychological therapy, physical therapy, chiropractic care, acupuncture, and other healing techniques should all be considered following an extremely difficult birth.

And another article makes it quite clear what intervention is required: Caesarian section or a delivery that required forceps or vacuum extraction procedures, in-utero constraint, an unusual presentation of the baby, and many more can cause an individual segment of the spine or a region to shift from its normal healthy alignment. This ‘shift’ in the spine is called a Subluxation, and it can happen immediately before, during, or after birth.

Thousands of advertisements try to persuade mothers to take their new-born babies to a chiropractor to get the problem sorted which chiropractors often call KISS (kinetic imbalance due to suboccipital strain-syndrome), caused by intrauterine-constraint or the traumas of birth.

This abundance of advertisements and promotional articles is in sharp contrast with the paucity of scientific evidence.

A review of 1993 concluded that birth trauma remains an underpublicized and, therefore, an undertreated problem. There is a need for further documentation and especially more studies directed toward prevention. In the meantime, manual treatment of birth trauma injuries to the neuromusculoskeletal system could be beneficial to many patients not now receiving such treatment, and it is well within the means of current practice in chiropractic and manual medicine.

A more critical assessment of … concluded that, given the absence of evidence of beneficial effects of spinal manipulation in infants and in view of its potential risks, manual therapy, chiropractic and osteopathy should not be used in infants with the kinetic imbalance due to suboccipital strain-syndrome, except within the context of randomised double-blind controlled trials.

So, what follows from all this?

How about this?

Chiropractors’ assumption of an obligatory birth trauma that causes subluxation and requires spinal adjustments is nothing more than a ploy by charlatans for filling their pockets with the cash of gullible parents.

Acupressure is the stimulation of acu-points by using pressure instead of needles, as in acupuncture. The evidence for or against acupressure mirrors that of acupuncture, except there is far less of it. This is why this new trial might be important.

The aim of this RCT was to determine the effect of self-acupressure on fasting blood sugar (FBS) and insulin level in type 2 diabetes patients. A total of 60 diabetic patients were selected from diabetes clinic in Rafsanjan in Iran, and  assigned to 2 groups, 30 in the acupressure and 30 in the control-group. The intervention group received acupressure at ST-36, LIV-3, KD-3 and SP-6 points bilaterally for 5 minutes at each point in 10 seconds pressure and 2 seconds rest periods. Subjects in the control group received no intervention. The FBS and insulin levels were measured before and after the intervention for both groups.

There were no significant differences between the acupressure and control group regarding age, sex and level of education. The insulin level significantly increased after treatment in the acupressure group (p=0.001). There were no significant differences between the levels of insulin in study or control groups. Serum FBS level decreased significantly after intervention in the acupressure group compared to the control group (p=0.02).

The authors concluded that self-acupressure as a complementary alternative medicine can be a helpful complementary method in reducing FBS and increasing insulin levels in type 2 diabetic patients.

I do not want to go into the methodological details of this study; suffice to say that it was less than rigorous and that its findings are therefore not trustworthy (never mind the fact that the results are biologically implausible). Even if that had not been the case, a single study would certainly not be sufficient reason to reach the conclusion that acupressure is helpful to control diabetes. For that, I am sure, we would need at least half a dozen independent replications.

Like most people, I have several non-medical friends who suffer from diabetes. They would love nothing better than having a simple, safe and effective method applying pressure to their skin in order to manage their disease. If they read this paper, some of them might conclude that acupressure is the answer to their problems and use it to control their condition. One does not need all that much imagination to see that this could seriously harm them, or even cost several lives.

Acupressure might be virtually free of risks, but with a bit of ill advice, even seemingly harmless treatments can kill.

Alternative medicine is an odd term (but it is probably as good or bad as any other term for it). It describes a wide range of treatments (and diagnostic techniques which I exclude from this discussion) that have hardly anything in common.

Hardly anything!

And that means there are a few common denominators. Here are 7 of them:

  1. The treatments have a long history and have thus stood the ‘test of time’.
  2. The treatments enjoy a lot of support.
  3. The treatments are natural and therefore safe.
  4. The treatments are holistic.
  5. The treatments tackle the root causes of the problem.
  6. The treatments are being suppressed by the establishment.
  7. The treatments are inexpensive and therefore value for money.

One only has to scratch the surface to discover that these common denominators of alternative medicine turn out to be unmitigated nonsense.

Let me explain:

The treatments have a long history and have thus stood the ‘test of time’.

It is true that most alternative therapies have a long history; but what does that really mean? In my view, it signals but one thing: when these therapies were invented, people had no idea how our body functions; they mostly had speculations, superstitions and myths. It follows, I think, that the treatments in question are built on speculations, superstitions and myths.

This might be a bit too harsh, I admit. But one thing is absolutely sure: a long history of usage is no proof of efficacy.

The treatments enjoy a lot of support.

Again, this is true. Alternative treatments are supported by many patients who swear by them, by thousands of clinicians who employ them as well as by royalty and other celebrities who make the headlines with them.

Such support is usually based on experience or belief. Neither are evidence; quite the opposite, remember: the three most dangerous words in medicine are ‘IN MY EXPERIENCE’. To be clear, experience and belief can fool us profoundly, and science is a tool to prevent us being misled by them.

The treatments are natural and therefore safe.

Here we have two fallacies moulded into one. Firstly, not all alternative therapies are natural; secondly, none is entirely safe.

There is nothing natural about diluting the Berlin Wall and selling it as a homeopathic remedy. There is nothing natural about forcing a spinal joint beyond its physiological range of motion and calling it spinal manipulation. There is nothing natural about sticking needles into the skin and claiming this re-balances our vital energies.

Acupuncture, chiropractic, herbal medicine, etc. are burdened with their fair share of adverse effects. But the real danger of alternative medicine is the harm done by neglecting effective therapies. Anyone who decides to forfeit conventional treatments for a serious condition, and uses alternative therapies instead, runs the risk of shortening their lives.

The treatments are holistic.

Alternative therapists try very hard to sell their treatments as holistic. This sounds good and must be an excellent marketing gimmick. Alas, it is not true.

There is nothing less holistic than seeing subluxations, yin/yang imbalances, auto-intoxications, energy blockages, etc. as the cause of all illness. Holism is at the heart of all good healthcare; the attempt by alternative practitioners to hijack it is merely a transparent attempt to boost their business.

The treatments tackle the root causes of the problem.

Alternative therapists claim that they can identify the root causes of all conditions and thus treat them more effectively than conventional clinicians who merely treat their symptoms. Nothing could be further from the truth. Conventional medicine has been so spectacularly successful not least because we always aim at identifying the cause that underlie a symptom and, whenever possible, treat that cause (often in addition to treating symptoms). Alternative practitioners may well delude themselves that energy imbalances, subluxations, chi-blockages etc. are root causes, but there simply is no evidence to support their deluded claims.

The treatments are being suppressed by the establishment.

The feeling of paranoia seems endemic in alternative medicine. Many practitioners are so affected by it that they believe everyone who doubts their implausible notions and misconceptions is out to get them. Big Pharma’ or whoever else they feel prosecuted by are more likely to smile at such wild conspiracy theories than to fear for their profit margins. And whenever ‘Big Pharma’ does smell a fast buck, they do not hesitate to jump on the alternative band-waggon joining them in ripping off the public by flogging dubious supplements, homeopathics, essential oils, vitamins, flower remedies, detox-remedies, etc.

The treatments are inexpensive and therefore value for money.

It is probably true that the average cost of a homeopathic remedy, an acupuncture treatment or an aromatherapy session costs less than the average conventional treatment. However, to conclude from it that alternative therapies are value for money is wrong. To be of real value, a treatment needs to generate more good than harm; but very few alternative treatments fulfil this criterion. To use a blunt analogy, if someone offers you a used car, it may well be inexpensive – if, however, it does not run and is beyond repair, it cannot be value for money.

As I already stated: alternative medicine is so diverse that its various branches are almost entirely unrelated, and the few common denominators of alternative medicine that do exist are unmitigated nonsense.

Many people seem to be amazed at my continued activities (e. g. blog, books, lectures, interviews) aimed at telling the truth about homeopathy and other alternative modalities. They ask themselves: why does he do it? And sometimes I ask myself the same question. I certainly don’t do it because I receive any money for my work (as many of my critics have assumed in the past).

So, why?

Let me briefly offer just 7 of the most obvious reasons why I feel it is important to tell the truth about homeopathy and similar treatments:

1. The truth is invaluable

I probably do not need to explain this at all. For any responsible person the truth has an intrinsic value that cannot be doubted. In our book, we conclude that “the truth-violating nature of CAM renders it immoral in both theory and practice.”

2. Untruths make a mockery of EBM

If we accept that, in the realm of alternative medicine, it is permissible to apply a different standard than in evidence-based medicine (EBM), we make a mockery of EBM. Double standards are hugely counter-productive and not in the interest of patients.

3. The truth promotes rationality

If the proponents of a modality such as homeopathy promote concepts that fly in the face of science, they undermine rational thinking. Believing in a vital force or energy is just one of many examples for this phenomenon. Undermining rationality can have negative effects far beyond healthcare and reminds me of Voltaire’s bon mot: “Those who make you believe in absurdities can make you commit atrocities.”

4. It is ethical

Healthcare have the ethical duty to work towards patients receiving the best treatments available. If a therapy like homeopathy fails to be demonstrably effective, it cannot possibly fall into this category. Therefore, responsible healthcare professionals must help to improve healthcare by disclosing the evidence against homeopathy.

5. It might save money

The money spent on homeopathy and other ineffective alternative treatments is considerable. Disclosing the fact that they are not effective will help stopping people to waste their money on them. Telling the truth about homeopathy and similarly ineffective therapies would therefore save funds that can be used more efficiently elsewhere.

6. It might save lives

Because they usually are free of active molecules, homeopathic remedies are often seen as a safe treatments. However, homeopathy can nevertheless harm and even kill patients, if they use it as an alternative medicines in cases of severe illness. It follows that telling the truth about homeopathy’s ineffectiveness can save lives.

7. It could counter-balance the multiple lies that are being told.

We all have seen the multitude of untruths that are being told about the value of homeopathy (if you haven’t, you ought to read SCAM). The multitude of falsehoods seriously misleads many consumers into believing that homeopathy is a valuable therapeutic option for many conditions. I feel strongly that it is my moral duty as an independent expert to counter-balance this plethora of lies in order to minimise the harm it is doing.

The inventor of homeopathy, Samuel Hahnemann, was a German physician. It is therefore not surprising that homeopathy quickly took hold in Germany. After its initial success, homeopathy’s history turned out to be a bit of a roller coaster. But only recently, a vocal and effective opposition has come to the fore (see my previous post).

Despite the increasing opposition, the advent of EBM, and the much-publicised fact that the best evidence fails to show homeopathy’s effectiveness, there are many doctors who still practice it. According to one website, there are 4330 doctor homeopaths in Germany (plus, of course, almost the same number of Heilpraktiker who also use homeopathy). This figure is, however, out-dated. The German Medical Association told a friend that, at the end of 2017, there were 5612 doctors practising in Germany who hold the additional qualification (‘Zusatz-Weiterbildung’) homeopathy.

That’s a lot, I find.

Why so many?

Whenever I give lectures on the subject, this is the question that comes up with unfailing regularity. Many people who ask would also imply that, if so many doctors use it, homeopathy must be fine, because doctors have studied and know what they are doing.

My answer usually is that the phenomenon is due to many factors:

  • history,
  • regulation,
  • misinformation,
  • powerful lobby groups,
  • patient demand,
  • homeopathy’s image of being gentle, safe and holistic,
  • patients’ need to believe in something more than ‘just science’,
  • the fact that most German health insurances reimburse it,
  • political support,
  • etc.

But, in fact, the true explanation, as I have learnt recently, might be much simpler and more profane: MONEY!

A German GP gets 4.36 Euros for taking a conventional history.

If he is a homeopath taking an initial homeopathic history, (s)he gets 130 €  according to the ‘Selektivvertrag’.

So, yes, doctors have studied and know that the difference between the two amounts is significant.

In the latest issue of ‘Simile’ (the Faculty of Homeopathy‘s newsletter), the following short article with the above title has been published. I took the liberty of copying it for you:

Members of the Faculty of Homeopathy practising in the UK have the opportunity to take part in a trial of a new homeopathic remedy for treating infant colic. An American manufacturer of homeopathic remedies has made a registration application for the new remedy to the MHRA (Medicines and Healthcare products Regulatory Agency) under the UK “National Rules” scheme. As part of its application the manufacturer is seeking at least two homeopathic doctors who would be willing to trial the product for about a year, then write a short report about using the remedy and its clinical results. If you would like to take part in the trial, further details can be obtained from …

END OF QUOTE

A homeopathic remedy for infant colic?

Yes, indeed!

The British Homeopathic Association and many similar ‘professional’ organisations recommend homeopathy for infant colic: Infantile colic is a common problem in babies, especially up to around sixteen weeks of age. It is characterised by incessant crying, often inconsolable, usually in the evenings and often through the night. Having excluded underlying pathology, the standard advice given by GPs and health visitors is winding technique, Infacol or Gripe Water. These measures are often ineffective but for­tunately there are a number of homeo­pathic medicines that may be effective. In my experience Colocynth is the most successful; alternatives are Carbo Veg, Chamomilla and Nux vomica.

SO, IT MUST BE GOOD!

But hold on, I cannot find a single clinical trial to suggest that homeopathy is effective for infant colic.

Ahhhhhhhhhhhhhhhhhhh, I see, that’s why they now want to conduct a trial!

They want to do the right thing and do some science to see whether their claims are supported by evidence.

How very laudable!

After all, the members of the Faculty of Homeopathy are doctors; they have certain ethical standards!

After all, the Faculty of Homeopathy aims to provide a high level of service to members and members of the public at all times.

Judging from the short text about the ‘homeopathy for infant colic trial’, it will involve a few (at least two) homeopaths prescribing the homeopathic remedy to patients and then writing a report. These reports will unanimously state that, after the remedy had been administered, the symptoms improved considerably. (I know this because they always do improve – with or without treatment.)

These reports will then be put together – perhaps we should call this a meta-analysis? – and the overall finding will be nice, positive and helpful for the American company.

And now, we all understand what homeopaths, more precisely the Faculty of Homeopathy, consider to be evidence.

 

 

The public is often impressed by scenes shown on TV where surgeons in China operate patients apparently with no other anaesthesia than acupuncture. Such films have undoubtedly contributed significantly to the common belief that acupuncture cannot possibly be a placebo (every single time I give a public talk about acupuncture, the issue comes up, and someone asks me: how can you doubt the efficacy of acupuncture when, in China, they use it for major operations?).

Some years ago, I have myself been involved is such a BBC broadcast and had to learn the hard way that such scenes are more than just a bit misleading.

Unfortunately, the experts rarely object to any of this. They seem to have become used to the false claims and overt propaganda that is rife in the promotion of acupuncture, and have resigned to the might of poor journalism.

The laudable exception is a team of French authors of a recent and excellent paper.

This unusual article analysed a clip from the program “Acupuncture, osteopathy, hypnosis: do complementary medicines have superpowers?” about acupuncture as an anaesthetic for surgical procedures in China. Their aim was to propose a rational explanation for the phenomena observed and to describe the processes leading a public service broadcasting channel to offer this type of content at prime time and the potential consequences in terms of public health. For this purpose, they used critical thinking attitudes and skills, along with a bibliographical search of Medline, Google Scholar and Cochrane Library databases.

Their results reveal that the information delivered in the television clip is ambiguous. It did not allow the viewer to form an informed opinion on the relevance of acupuncture as an anaesthetic for surgical procedures. It is reasonable to assume that the clip shows surgery performed with undisclosed epidural anaesthesia coupled with mild intravenous anaesthesia, sometimes performed in other countries.

What needs to be highlighted, the authors of this critique state, is the overestimation of acupuncture added to the protocol. The media tend to exaggerate the risks and expected effects of the treatments they report on, which can lead patients to turn to unproven therapies.

The authors concluded that broadcasting such a clip at prime time underlines the urgent need for the public and all health professionals to be trained in sorting and critically analysing health information.

In my view, broadcasting such misleading films also underlines the urgent need for journalists to be conscious of their responsibility not to mislead the public and do more rigorous research before reporting on matters of health.

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