doctors
While medical experts across the world have expressed dismay at Trump’s appointment of Robert Kennedy, the ‘International chiropractors Association’ has just published this remarkable note:
Donald J. Trump made it official that he was nominating Robert F. Kennedy, Jr. to serve as the Secretary of Health and Human Services. Secretary-designee Kennedy has spent his entire career championing the health of the nation through education, advocacy, research and when needed litigation.
Among his many accomplishments are protecting the environment with Riverkeeper and the Natural Resources Defense Council His work at Riverkeeper succeeded in setting long-term environmental legal standards. Kennedy won legal battles against large corporate polluters. He became an adjunct professor of environmental law at Pace University School of Law in 1986 and founded the Pace’s Environmental Litigation Clinic which he co-directed for a decade.
It would be in the Pace Law Review that the landmark paper, “Unanswered Questions from the Vaccine Injury Compensation Program: A Review of Compensated Cases of Vaccine-Induced Brain Injury” (https://digitalcommons.pace.edu/cgi/viewcontent.cgi?article=1681&context=pelr) would be published in 2011.
Kennedy became laser focused on the autism epidemic while giving lectures on the dangers of mercury in fish, he was repeatedly approached by the mothers of children born healthy who regressed into autism after suffering adverse reactions from childhood vaccines, including their concern about the mercury-based preservative, thimerosal, being used in vaccines including the Hepatitis B vaccine given at birth. Kennedy’s approach to the issue was the same as it always, looking at the science. He assembled a team who gathered all the science and reviewed the issues with him. This resulted in the publication of the book, Thimerosal: Let the Science Speak
The Evidence Supporting the Immediate Removal of Mercury—a Known Neurotoxin—from Vaccines.
After establishing and leading the nonprofit Children’s Health Defense, last year Kennedy stepped back from the organization to throw his hat in the ring to be President. Becoming the embodiment of his uncle John F. Kennedy’s famous quote, “Ask not what your country can do for you, but what you can do for your country!”, Kennedy reached out to President Trump to form an alliance to focus on the crisis of chronic disease in the United States, and suspended his campaign to focus on the Make American Healthy Again (MAHA) Initiative.
ICA President, Dr. Selina Sigafoose Jackson, who is currently in Brazil promoting the protection of chiropractic as a separate and distinct profession stated, “Many ICA members have been supporters of Robert F. Kennedy, Jr.’s philanthropic activities and are all in on the MAHA Initiative. The Mission, Vision, and Values of the ICA align with the stated goals of the MAHA Initiative. We stand ready to provide policy proposals and experts to serve as advisors to the incoming Administration and to Secretary Kennedy upon his swearing in.”
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Perhaps I am permitted to contrast this with some health-related truths about Robert F. Kennedy, Jr. (my apologies, if the list is incomplete – please add to it by posting further important issues):
- Robert F. Kennedy, Jr. has, since about 20 years, been a leading figure of the anti-vaccine movement.
- During the epidemic, he pushed the conspiracy theory that “the quarantine” was used as cover to install 5G cell phone networks.
- He claimed that “one out of every six American women has so much mercury in her womb that her children are at risk for a grim inventory of diseases, including autism, blindness, mental retardation and heart, liver and kidney disease.”
- He wrote that, “while people were dying at the rate of 10,000 patients a week, Dr. Fauci declared that hydroxychloroquine should only be used as part of a clinical trial. For the first time in American history, a government official was overruling the medical judgment of thousands of treating physicians, and ordering doctors to stop practicing medicine as they saw fit.”
- He pushed the conspiracy theory that COVID-19 had been “ethnically targeted” to spare Ashkenazi Jews and Chinese people.”
- He claimed in a 2023 podcast interview that “There’s no vaccine that is safe and effective”.
- In a 2021 podcast, he urged people to “resist” CDC guidelines on when kids should get vaccines.
- He founded Children’s Health Defense’ that spreads fear and mistrust in science. One chiropractic group in California had donated $500,000 to this organisation.
- In 2019, he visited Samoa where he became partly responsible for an outbreak of measles, which made 5,700 people sick and killed 83 of them.
- He called mercury-containing vaccines aimed at children a holocaust. In 2015, he compared the horrors committed against Jews to the effects of vaccines on children. “They get the shot, that night they have a fever of a hundred and three, they go to sleep, and three months later their brain is gone. This is a holocaust, what this is doing to our country.”
- He repeatedly alleged that exposure to chemicals — “endocrine disruptors” — is causing gender dysphoria in children and contributing to a rise in LGBTQ-youth. According to him, endocrine disruptors are “chemicals that interfere with the body’s hormones and are commonly found in pesticides and plastic.”
- He stated “Telling people to “trust the experts” is either naive or manipulative—or both.”
- He plans to stop water fluoridation.
- He slammed the FDA’s “suppression” of raw milk.
- He said that a worm ate part of his brain which led to long-lasting “brain fog.”
- He has a 14-year-long history of abusing heroin from the age of 15. The police once arrested him for possession; he then faced up to two years in jail for the felony but was sentenced to two years probation after pleading guilty.
- He stated: “WiFi radiation … does all kinds of bad things, including causing cancer…cell phone tumors behind the ear.”
- He claimed that rates of autism have increased even though “there has been no change in diagnosis and no change in screening either.” Yet, both have changed significantly.
- He wrote: (Fauci’s) “obsequious subservience to the Big Ag, Big Food, and pharmaceutical companies has left our children drowning in a toxic soup of pesticide residues, corn syrup, and processed foods, while also serving as pincushions for 69 mandated vaccine doses by age 18—none of them properly safety tested.”
- He stated that cancer rates are skyrocketing in the young and the old – a statement that is evidently untrue.
- He authored a viral post on X: “FDA’s war on public health is about to end. This includes its aggressive suppression of psychedelics, peptides, stem cells, raw milk, hyperbaric therapies, chelating compounds, ivermectin, hydroxychloroquine, vitamins, clean foods, sunshine, exercise, nutraceuticals and anything else that advances human health and can’t be patented by Pharma. If you work for the FDA and are part of this corrupt system, I have two messages for you: 1. Preserve your records, and 2. Pack your bags.”
- He has also aligned himself with special interests groups such as anti-vaccine chiropractors.
- He stated categorically: “You cannot trust medical advice from medical professionals.”
- He said he’s going to put a pause on infectious diseases research for 8 years.
- He promoted the unfounded theory that the CIA killed his uncle, former President John F. Kennedy.
- He linked school shootings to the increased prescription of antidepressants.
- An evaluation of verified Twitter accounts from 2021, found Kennedy’s personal Twitter account to be the top “superspreader” of vaccine misinformation on Twitter, responsible for 13% of all reshares of misinformation, more than three times the second most-retweeted account.
PS
Let me finish with a true statement: The World Health Organization has estimated that global immunization efforts have saved at least 154 million lives in the past 50 years.
The BMJ just published an article entitled “Disinformation enabled Donald Trump’s second term and is a crisis for democracies everywhere“. Please allow me to show you a few excerpts from this paper:
Donald Trump did not win the 2020 election, but asserting that he did became a prerequisite for Republicans standing for nomination to Congress or the Senate to win their primaries. An entire party became a vehicle for disinformation. Trump did win the 2024 presidential election, and key to that victory was building on the success of that lie. If you control enough of the information ecosystem, truth no longer matters…
… Readers of The BMJ will recall the huge amounts of misinformation (wrong or misleading content that is unknowingly shared) and disinformation (false content that is deliberately spread) during the covid-19 pandemic, some generated or amplified by politicians. This reduced vaccine uptake, promoted ineffective treatments, and encouraged attacks on health workers. In the past, factually incorrect statements might have had only local consequences, but a lie can now circle the world in seconds. Yet the speed in which disinformation can spread is only part of the problem…
… Part of Musk’s reason for buying Twitter was to influence the social discourse. And influence he did—by using his enormous platform (203 million followers) to endorse Trump, spread disinformation about voter fraud and deep fakes of Kamala Harris, and amplify conspiracy theories about everything from vaccines to race replacement theory to misogyny. Musk’s platform is effective: his endorsement of Trump coincided with Republican leaning posts being algorithmically favoured over Democrat leaning posts. A more mundane example: after Musk published three non-evidence based posts on X that favoured one medication over another, sales of the former rose by 18% while the other fell by 11%. …
The warning signs are clear for democracies around the world. Firstly, governments must regulate social media companies more rigorously. Brazil’s victorious dispute with X shows what is possible, and a major battle between the European Commission and Musk is under way. Beyond that, we must grapple with how to hold the world’s richest people to account when they directly interfere with national and international politics.
Secondly, public health agencies must create robust surveillance systems for infodemics just as they have for epidemics. They must monitor the emergence of disinformation and counter it or, ideally, anticipate and counter (pre-bunk) it among vulnerable audiences (and build population resilience). Independent organisations that are countering disinformation are already being deliberately targeted (https://counterhate.com/). And we must accelerate research on “inoculating” people against the algorithms and content that attempt to radicalise them.
Finally, politicians and the public health community must not be afraid of calling out disinformation, and we must all support and applaud them in doing so. And moving beyond responding to false rhetoric, we must also get on the front foot and create compelling counter narratives of a better politics that can support a kinder, more inclusive, and socially just world.
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I’d like to thank the authors (Martin McKee, professor of European public health, Christina Pagel, professor of operational research, and Kent Buse, co-founder of ‘Global Health) for their courage to speak out and stand up for the truth. I am in full agreement with them and encourage all my readers to study their excellent paper in full.
Spanish colleagues and I just published an article entitled “Is Osteopathic Manipulative Treatment Clinically Superior to Sham or Placebo for Patients with Neck or Low-Back Pain? A Systematic Review with Meta-Analysis”. Here is its abstract:
The aim of this systematic review and meta-analysis was to compare whether osteopathic manipulative treatment (OMT) for somatic dysfunctions was more effective than sham or placebo interventions in improving pain intensity, disability, and quality of life for patients with neck pain (NP) or low-back pain (LBP). Methods: A systematic review and meta-analysis was carried out. Searches were conducted in PubMed, Physiotherapy Evidence Database, Cochrane Library, and Web of Science from inception to September 2024. Studies applying a pragmatic intervention based on the diagnosis of somatic dysfunctions in patients with NP or LBP were included. The methodological quality was assessed with the PEDro scale. The quantitative synthesis was performed using random-effect meta-analysis calculating the standardized mean difference (SMD) with RevMan 5.4. The certainty of evidence was evaluated using GRADEPro. Results: Nine studies were included in the qualitative synthesis, and most of them showed no superior effect of OMTs compared to sham or placebo in any clinical outcome. The quantitative synthesis reported no statistically significant differences for pain intensity (SMD = −0.15; −0.38, 0.08; seven studies; 1173 patients) or disability (SMD = −0.09; −0.25, 0.08; six studies; 1153 patients). The certainty of evidence was downgraded to moderate, low, or very low. Conclusions: The findings of this study reveal that OMT is not superior to sham or placebo for improving pain, disability, and quality of life in patients with NP or LBP.
As always, it seems important to stress that our review has several limitations. Firstly, the searches were conducted in the most relevant databases; however, some studies not indexed in these sources may have been missed. Secondly, the diverse NP and LBP diagnosis, as well as the lack of data reported by some studies, complicates the interpretation of the results and may weaken our conclusion. Thirdly, the primary studies pragmatically applied interventions based on diagnoses of various somatic dysfunctions, resulting in a high degree of heterogeneity among the treatments applied.
Despite these limitations, it is fair to say, I think, that OMT is not nearlly as solidly supported by reliable evidence as most osteopaths try to make us believe. In essence, this means that, if you suffer from NP or LBP, you best concult a proper doctor or physiotherapist.
The ‘WORLD JOURNAL OF PHARMACEUTICAL RESEARCH‘ just published a paper entitled RESEARCH TRIAL TO EVALUATE THE EFFICACY OF HOMEOPATHIC MEDICINES IN ACUTE PHARYNGITIS- AN OBSERVATIONAL STUDY. It is remarkable, in my view; please let me show you its abstract:
This observational study aims to evaluate the efficacy of homeopathic medicines in the management of acute pharyngitis. Acute pharyngitis, commonly caused by viral or bacterial infections, presents with symptoms such as sore throat, fever, and difficulty swallowing, significantly affecting patient quality of life. Despite the widespread use of conventional treatments, there is a growing interest in homeopathic remedies as a potential alternative. This trial involved a cohort of patients diagnosed with acute pharyngitis who received individualized homeopathic treatments based on their specific symptoms and constitutional type. Clinical outcomes were assessed using standardized symptom severity scales at baseline and follow-up visits. Data analysis focused on symptom resolution, patient-reported outcomes, and overall satisfaction with treatment. Preliminary results indicate a significant reduction in symptom severity and improvement in quality of life among participants receiving homeopathic interventions compared to standard care. These findings suggest that homeopathic medicines may offer a viable complementary approach to the management of acute pharyngitis, warranting further research to establish definitive therapeutic protocols and validate these observations.
Yes, you are right:
- This study cannot possibly assess the ‘efficacy of homeopathic medicines’. Its design does simply not allow this.
- The results are to be expected due to the natural history of the condition and say nothing about the ‘efficacy’ of the interventions.
Despite these obvious caveats, the authors reinforce their wrong message many times in the article; here are a few further quotes:
- According to the study, there was significant improvement in 61.67% of cases.
- Overall, our study emphasizes Homoeopathy as an effective treatment for acute pharyngitis and suggests its wider consideration in clinical practice.
- Homoeopathy provides a holistic, individualized, and safe approach to treating acute pharyngitis, with benefits such as minimal side effects, long-term health improvements, and enhanced patient empowerment, establishing it as a valuable therapeutic option for managing this common condition.
Who publishes such nonsense?
Surely not professionals with a higher degree!
Wrong! In fact, the authors are three professors:
- M.D. (Hom.), Phd, Assistant Professor- Department of Community Medicine State
Government Homoeopathic Medical College, Aligarh, Uttar Pradesh. - MD (Hom.), PhD, Associate Professor- Department of Pathology, G.C. Homoeopathic
Medical College, Lucknow, Uttar Pradesh. - M.D. (Hom.), PhD, Professor- PG Department of Homoeopathic Pharmacy S.S. Agrawal
Homoeopathic Medical College, Navsari, Gujarat.
And what does the ‘WORLD JOURNAL OF PHARMACEUTICAL RESEARCH‘ think they are doing when publishing such scientific misconduct? They think they serve Science & Mankind at the highest levels of Professional Ethical Conduct.
No, I am not kidding; here is a quote from their website:
“The Journal particularly aims to foster the dissemination of scientific information by publishing manuscripts related to current Pharmaceutical Drug Delivery and related fields. We started with a Mission to encourage contribution to Research in Sciences & Technology for achieving better future lives for all. We serve Science & Mankind at the highest levels of Professional Ethical Conduct.”
It has been reported that King Charles is on a secret trip to Bengaluru, his first visit to India since being coronated as king of the United Kingdom on May 6, 2023, at Westminster Abbey, London. Charles arrived in Bengaluru on October 27 and will be at the Soukya International Holistic Health Centre (SIHHC) in Whitefield for wellness treatment till Wednesday (30/10) night, when he is expected to fly to London.
Sources privy to his secret visit said that King Charles arrived in Bengaluru directly from Samoa, where he attended the 2024 Commonwealth Heads of Government Meeting from October 21-26. His visit to Bengaluru was strictly kept under wraps, and he was directly taken to SIHHC, where he was also joined by his wife, Queen Camilla.
According to sources, the couple’s day begins with a morning yoga session, followed by breakfast and rejuvenation treatment before lunch. After a brief rest, a second round of therapies follows, ending with a meditation session before dinner and lights out by 9 pm. They have been enjoying long walks around the campus, visiting the organic farm and cattle shed. Considering the high-profile secret visit, a high-security ring was thrown around SIHHC.
The health centre, founded by Dr. Issac Mathai, is located in Samethanahalli, Whitefield, on Bengaluru’s outskirts. This integrative medical facility combines traditional systems of medicine, including Ayurveda, Homoeopathy, Yoga, and Naturopathy, along with over 30 complementary therapies like reflexology, acupuncture, and dietetics.
Although this is his first visit as a monarch, Charles has visited the centre on nine earlier occasions and celebrated Deepavali on three occasions there. The royal couple has earlier taken wellness treatments, including anti-ageing, detoxification and rejuvenation. On November 14, 2019, the couple celebrated the then Prince Charles’ 71st birthday at SIHHC, an event that attracted a lot of publicity, unlike this visit.
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The website of the SIHHC modestly claims to be “THE WORLD’S FIRST INTEGRATIVE HEALTH DESTINATION’
As I reported in 2022, at a press conference in Goa it was claimed, that Prince Charles had been cured of COVID-19 after seeking treatment from a Bengaluru-based alternative treatment resort, SOUKYA International Holistic Health Centre’ run by a doctor Isaac Mathai. The Palace later denied that this was true.
And what about Dr. Issac Mathai? This is what he writes about himself:
A journey that began from the hills of Wayanad (northern Kerala) in 1985, started to bloom in 1998, and today is an international destination for Holistic health and wellbeing. When Dr. Issac Mathai embarked on this journey influenced by his mother, a Homeopathy practitioner who “helped people get better”, little did he know that one day he would lead a team to redefine the essence of health and wellbeing.
As a confident youngster aspiring to be an ‘exceptional Homeopathic Doctor’, Dr. Mathai encountered two key turning points in life – one, an internationally well-received research paper on integrating Yoga with Homeopathy to cure respiratory disorders, and two, learning at the Hahnemann Postgraduate Institute of Homeopathy, London.
Later he was made a Consultant Physician at the Hale Clinic in London, where he treated a number of high-profile people. This helped him establish a reputation in the holistic healing community in quick time. SOUKYA, is today, a residential holistic centre comparable to any facility in the world.
In a world that is comfortable with the conventional practice of ‘popping pills’, the world at large practices a combination of self-medication based on preconceived notions about what is wrong with individuals. In such a scenario, Dr. Issac Mathai and his team of experienced practitioners from different streams have achieved an important goal – create awareness about the possibility of prevention of adverse health conditions, rather than just addressing the symptom.
Education:
M.D. (Homeopathy),
Hahnemann Post-Graduate Institute of Homeopathy, London M.R.C.H, London
Chinese Pulse Diagnosis and Acupuncture, WHO Institute of Traditional Chinese Medicine, Nanjing, China
Trained (Mind-Body Medicine Programme) at Harvard Medical School, USA
Of the 3 institutions mentioned above, I could only find the last one: Harvard CME | Mind Body Medicine.
And under MD (Homeopathy), I found this: MD in Homoeopathy is a 3-year long postgraduate course in medicine including a year of house job, and remaining 2 years of research and study.
So, should we be concerned about the health of our King?
What do you think?
I was recently invited to give a lecture to the local medical association in Graz Austria. It was a pleasure to be in Austria again and a delight to visit the beautiful town of Graz. They had given me the following subject:
Mythen in der sogenannten Alternativmedizin [Myths of so-called alternative medicine (SCAM)]
In my lecture, I thought it prudent to relate to the situation of SCAM in Austria which is rather special:
- The seem to Austrians love the SAM; the 1-year prevalence of use is 36%!
- In Austria, SCAM is only allowed to be practised by doctors.
- Often SCAM is paid for by patients out of their own pocket.
- For many, SCAM is a question of belief.
- SCAM is being promoted by VIPs and loved by journalists; one politician even sells his own brand of dietary supplements!
- In Austria, SCAM is heavily promoted by the Austrian Medical Association who currently runs courses and issues several SCAM diplomas.
The Austrian newspaper DER STANDARD then decided to interview me on these issues. The interview has been published today, and I thought I might take the liberty of translating the central part for you:
Q: In Austria, the Medical Association offers diplomas in various alternative methods. Why is this problematic?
A: I am aware of no less than 11 such diplomas offered by the Austrian Medical Association. While in England, France or Germany, for example, homeopathy has been considerably restricted by the medical profession due to the largely negative evidence, in Austria it continues to be promoted by the medical associations. This makes Austrian medicine the laughing stock of the rest of the world. More importantly, it violates the principles of evidence-based medicine. And even more importantly, it seems to me that the Austrian Medical Association is neglecting its ethical duty towards patients for purely pecuniary reasons.
Q: But the Medical Association is only complying with the regulations.
A: The Medical Association boasts that the quality of medical care and patient safety are at the centre of its work. In view of these diplomas, this mission almost sounds like a bad joke. They claim that the diplomas comply with the regulations. But firstly, this is a question of interpretation and secondly, regulations can – I would say must – be changed if they run counter to the quality of medical care. Finally, according to its own statements, the Association is obliged to adapt the Austrian healthcare system to changing conditions. This means nothing other than that it must take account of changing evidence – for example in the field of homeopathy.
Q: And what do the many doctors who use homeopathy say?
A: They often claim that they are only following the wishes of their patients when they prescribe homeopathic remedies. This may be true, but it is certainly not a valid argument. It ignores the fact that it is a doctor’s damned duty to provide patients with evidence-based information and to treat them accordingly. After all, medicine is not a supermarket where customers can simply choose whatever they happen to like.
It should also be emphasised that the practitioners of homeopathy also earn a good living from it. The fact that there is resistance from them when it comes to prioritising evidence rather than earnings in this area is thus hardly surprising.
But of course there are also a few doctors who use homeopathy primarily because they are fully convinced of its effectiveness. I think that these colleagues should consider self-critically whether they are not violating their ethical duty to be at the cutting edge of current knowledge and to act accordingly.
Perhaps unsurprisingly, my lecture prompted a lively discussion. Those doctors in the audience who spoke were unanimously in favour of my arguments. I was later told that many of those people who are responsible for the 11 diplomas were in the audience. Sadly, none of them felt like discussing any of the issues with me.
Perhaps the interview succeeds in starting a critical discussion about SCAM in Austria?
It has been reported that Dr. Janette J. Gray of San Diego and her former medical practice, The Center for Health & Wellbeing in San Diego, have agreed to pay $3.8 million to settle allegations that they violated the False Claims Act by knowingly submitting false claims to the Medicare and TRICARE programs.
Dr. Gray and The Center claimed to operate an “alternative,” “integrative,” and “holistic” clinic, which was staffed by medical doctors, nurse practitioners, naturopathic doctors, chiropractors, acupuncturists, and mental health professionals, along with ancillary medical and administrative staff. Dr. Gray and The Center promoted IV infusion therapy, hormone/supplement therapy, and a variety of other alternative treatments.
The settlement resolves allegations that from 2012 to 2022, Dr. Gray and her practice billed Medicare and TRICARE for services that were not covered under either program by disguising the rendering provider, misrepresenting the services provided, “unbundling” services (by billing for a procedure or service in separate parts instead of a single code), or billing for services not medically necessary. In addition to paying $3.8 million to resolve the allegations, Dr. Gray will now be excluded from participating in Medicare, Medicaid, and all other Federal health care programs for five years.
“The civil settlement holds Dr. Gray and her former medical practice accountable for questionable actions that circumvented the TRICARE billing guidelines and allowed them to receive payments for services that should not have been reimbursed by TRICARE, costing American taxpayers millions of dollars,” said Bryan D. Denny, Special Agent in Charge of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DCIS), Western Field Office. “DCIS and its partners will always aggressively investigate those who defraud TRICARE, because those deceptive actions ultimately harm those defending our country and their families.”
“This investigation is proof that the FBI and its law enforcement partners remain committed to investigating and bringing to justice anyone who tries to violate the American health care system,” said FBI San Diego Acting Special Agent in Charge Houtan Moshrefi.
The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the Southern District of California; the United States Department of Health and Human Services, Office of Inspector General; DCIS; and the FBI. This matter was handled by Assistant U.S. Attorney Maritsa A. Flaherty.
The resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477). The claims resolved by the settlement are allegations only, and there has been no determination of liability.
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False Claims Act?
I had never heard of it and thus looked it up:
The False Claims Act (FCA) is a federal statute that allows the government to recover money when someone submits false or fraudulent claims for payment to the government, including Medicare and Medicaid programs. It was originally signed into law in 1863 by President Abraham Lincoln during the Civil War to combat fraud by suppliers providing substandard goods and services to the troops. The FCA allows whistleblowers to sue entities defrauding the government and recover damages and penalties on the government’s behalf.
This sounds most reasonable to me, and it begs, I think, one question: why is it not applied much more frequently in the realm of so-called alternative medicine (SCAM)?
As I live partly in France, I often report about what is going on in this country in relation to so-called alternative medicine (SCAM). Here are a few recent posts:
- France outlaws practices which expose patients to a serious health risk
- Dispute about so-called alternative medicine practitioners in France
- Homeopathy in France: going, going, gone!
- Osteopathy in France: widely accepted yet based on little more than wishful thinking
- Alleged sexual misconduct serves a blow to osteopathy in France
- Homeopathy in France: a triumph of reason over profit
- HOMEOPATHY IN FRANCE: Cure cancer with homeopathy? “Let’s get real. We are doctors.”
- Random thoughts on my first SCAM-research conference in France
In general, it seemed that France was becoming more rational in its attitude towards SCAM. But now Franceinfo reported worrying developments:
Patrick Hetzel, the newFrench Minister for Higher Education and Research seems to have a less than academic approach to science. He has in the past taken positions on the fringes of the scientific consensus, supporting, for example, the use of the treatment praised by Didier Raoult during the Covid-19 crisis, or defending homeopathy.
In October 2020, Patrick Hetzel supported an amendment to the French Social Security Financing Bill (PLFSS) aimed at ‘creating a body specifically dedicated to evaluating complementary and alternative medicines, including homeopathy, and setting a reimbursement rate’. A month later, he co-signed a bill aimed at introducing a two-year moratorium on the reimbursement rate (15%) for homeopathy, rather than delisting it, so as not to upset the industry. These proposals were rejected and homeopathy, whose effectiveness was deemed ‘insufficient’ by the French National Authority for Health (HAS), has not been reimbursed in France since January 2021. To reach its opinion, the health authority scrutinised a number of studies on nearly 1,200 homeopathic medicines. ‘There is a scientific consensus that homeopathy should not be prescribed. At best it is useless, at worst it detracts from a useful treatment’, points out Jean-Michel Constantin, President of Sfar.
At the same time, Hetzel has fought to have chronic Lyme disease recognised as a disease through a bill tabled in September 2023. However, the chronic nature of this disease remains controversial, based as it is on a ‘scientifically unproven’ hypothesis, as denounced by the French Academy of Medicine in 2017.
More recently, during the debate on the bill to combat sectarian aberrations, Hetzel spoke out against creating an offence of ‘inciting abstention from medical care’. He cited a ‘legal reason’ before offering a curious view of science: ‘When you look at how scientific advances are made, very often the paradigm shifts (…) are made by people who are in the minority. So let’s be extremely careful about trying to develop a kind of dogma that would be that of an official science. I think that’s extremely dangerous’, he warned before the Assembly.
This anti-science rhetoric has not gone unnoticed. ‘Taking part in the debate on article 4 of the bill on sectarian aberrations [finally adopted], implying that official science is totalitarianism, and leaving the choice of alternative medicines to patients who have no discernment, I find that annoying. Especially for a minister whose remit includes scientific research’, laments Pierre Ouzoulias. ‘I’m struck by the fact that every time he takes a stand, it’s with conspiracy theories. This accumulation paints the picture of someone who doesn’t understand how knowledge evolves in the world of science.’
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Let’s hope the new development does not signal a general U-turn, that the appointment of Patrick Hetzel is just a little glitch, and that France will nevertheless continue on its path towards rationality.
‘DOC Check’ just published an interesting article. Allow me to translate some passages for you:
In 2023, the German Federal Insititute for Drugs and Devices (BfArM) stated: ‘To date no homeopathic medicinal product has been authorised by the BfArM based on a study submitted by the applicant.’ So why are homeopathic medicines still covered by statutory health insurance? Jörg Windeler, then head of IQWiG (the German equivalent of NICE), gave an indication in 2019: ‘It is simply a way of attracting customers. Homeopathy is popular, and customers are more likely to go to the health insurance fund that pays for homeopathy.’ This laissez-faire attitude is expensive. And not just in terms of the cost of medicines.
If you delve a little deeper into the world of homeopathic medicine, further grey areas emerge. They concern the doctors’ fees that are charged as part of the therapy.
In Germany, the normal billing of fees by doctors follows strict rules. To rule out fraud, they are subject to a plausibility check by the health insurance. Among other things, the time profiles are checked to ensure that the practitioner is billing the number of examinations correctly. There are also fee budgets. If these are exceeded, doctors will only receive a pro rata payment for their services.
Doctors have different possibilities for homeopathic services. One popular version is the billing option that the German Central Association of Homeopathic Doctors (DZVhÄ) offers its members. In this case, the plausibility checks of the insurance are not carried out. Furthermore, the services are extra-budgetary. This is possible because the DZVhÄ has concluded selective contracts via its own management company, MGL Managementgesellschaft für Gesundheitsleistungen mbH.
Access to participation in these selective contracts is gained via a ‘homeopathy diploma’, which is awarded by the DZVhÄ after 6 weeks of training. Trainee homeopaths have to fork out around 3,000 Euros to obtain this document – but the expense is well worth it. Once a doctor has obtained the homeopathy diploma, he/she participates in the selective contract. Subsequently, the health insurance pay fixed fees beyond the hotly contested pot. Only a few rules have to be adhered to: a time frame of at least 60 minutes for an initial homeopathic history and at least 30 minutes for a follow-up session. There is no evidence that these time limits are strictly monitored.
This uniquely lax construction in the German healthcare system is a potential gateway for abuse and fee fraud. It is easy to cheat on the time used for medical histories without a plausibility check. A practitioner can even conduct the initial homeopathic history and the ‘conventional medical’ consultation in parallel. The conventional medical service could then be billed via the health insurance, the homeopathic service again via the DZVhÄ route.
We asked the DZVhÄ in an editorial enquiry whether they were aware of this problem and how they ensure that everything is carried out correctly. The association remained silent – a tactic they have been using for years. The DZVhÄ only get vocal when they suspect attacks on their business model.
It would be interesting to know the volume of fees billed in Germany via the DZVhÄ’s selective contracts. Unfortunately, these figures are difficult to determine. A homeopath receives 97 Euros for the initial consultation. If each of the approximately 7,000 members of the DZVhÄ took an initial medical history on 200 working days per year, this would translate into a fee volume of more than 130 million Euros per year. This does not include follow-up sessions and so-called ‘repertorisations’. In other words, 200 million Euros could quickly be spent of doctors’ fees. Admittedly, these figures are speculative. However, the DZVhÄ could easily clarify the matter – if only they wanted to do so.
German health politicians ignore these hidden costs of homeopathy. They like to point to the notion that ‘only’ around 22 million Euros are spend on homeopathics.
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It would be a mistake, I think, to assume that financial reasons provide the only motivations for German doctors to use homeopathy. There are, in my experience, several others:
- Some occasionally use homeopathy as a placebo for patients where they feel a placebo is the best solution.
- Some use homeopathy for patients want it.
- Some use homeopathy because they are not fully aware of what it is.
- Some use homeopathy because they are ill-informed about the evidence.
Very few German doctors who I know have ever used it because they are convinced that it is effective.
Available data suggest that general practitioners (GPs) in Germany use so-called alternative medicine (SCAM) modalities more frequently than GPs in many other countries. German researchers investigated the country differences perceived by GPs who have worked in Germany and in one of four other European countries with regard to the role of SCAM in primary care.
A qualitative study was conducted using semi-structured interviews with 12 GPs who had worked both in Germany and Italy, the Netherlands, Norway or the United Kingdom (UK; n = 3 for each of the four countries). Participants were asked how they perceived and experienced country differences regarding health system, relevance of SCAM modalities, the role of evidence-based medicine (EBM) and science, and how they handle so-called indeterminate situations. For the analysis, we followed a thematic analysis approach according to Braun and Clarke with focus on themes that cover SCAM.
Participants unanimously reported that they perceived SCAM to be more relevant in general practice in Germany compared to the other countries. The researchers identified four overarching themes in relation to the perceived reasons for these differences.
- Physicians with experiences in countries with a strong EBM and science orientation (Netherlands, Norway and the UK) considered the deeply ingrained view in national healthcare systems and GP communities that SCAM modalities are not evidence-based as the main reason for the lower use of SCAM by GPs.
- Extensive training of communication skills was cited as a reason that reduced the need for SCAM in the Netherlands, Norway and the UK.
- Differences in patient expectations and demands were perceived as a factor contributing to greater utilisation of SCAM by German GPs compared to the other countries.
- Country-specific reimbursement mechanisms were considered as a factor influencing the role of SCAM in general practice.
The authors concluded that their study results point to major differences between countries with regard to the role of SCAM in GP care. Differences in basic attitudes in the discipline of general practice, patient expectations and system conditions appear to play an important role here.
The authors comment that a remarkable finding is the very consistent narrative with regard to the Netherlands, Norway and the United Kingdom that a stronger scientific and EBM orientation is seen as the main reason for the lower utilisation of SCAM by GPs compared to Germany. I agree that this is an important and, as far as I can see, new aspect. It concurrs with my personal impression that many German doctors feel that EBM is some sort of ‘KOCHBUCH MEDIZIN’ [cookbook medicine] that limits their freedom of prescribing based on intuition and experience. This, I have always felt, is a profound misunderstanding of what EBM is about.
