The Austrian ‘Initiative für Wissenschaftliche Medizin‘ (Initiative for Scientific Medicine) did a great job by summarizing the non-scientific training events dedicated to pseudomedicine organized, supported or promoted by the ‘Österreichische Akademie der Ärzte‘ (Austrian Academy of Physicians), a partner of the Austrian Medical Association. They sorted them by date in descending order, listing the DFP points (points required for postgraduate education) awarded and the link to each specific event. The content of the programme of such events, if available, is also often “interesting”. The pseudomedicine methods are provided with links to psiram.com, where these methods are described in more detail.
So, restricting ourselves to the period of 20 years (2003-2023) and merely looking at a selection of all possible so-called alternative medicine (SCAM), we find in this treasure trove of quackery the following:
- Anthroposophic medicine – 218 events
- Homeopathy – 1 708 events
- Orthomolecular medicine – 645 events
- Neural therapy – 864 events
- TCM diagnostics – 1214 events
In total, thousands SCAM events were organized, supported or promoted by the Academy, and I am not aware of any national physicians’ organization that has done anywhere near as much for quackery.
On their website, the Austrian Academy of Physicians state that they were founded by the Austrian Medical Association as a non-profit organisation with the aim of promoting and further developing medical education in Austria… The aim is to lead the way in medical education issues in order to achieve continuous improvement in the medical profession. For the Academy, continuing medical education is an essential component of medical quality improvement…
This may sound alright but, in my view, it raises several questions, e,g,:
- Does the Academy believe that continuous improvement in the medical profession can be achieved by promoting, organizing or conducting such a huge amount of courses in quackery?
- Do they not know that this is the exact opposite of medical quality improvement?
- Are they aware of their ethical responsibility?
- Do they know that the promotion of quackery puts patients at risk?
- Have they heard of evidence-based education?
It is easy to criticize but less obvious to improve. In case the people responsible for postgraduate education at the Academy want to discuss these issues with me, I would therefore be delighted to do so, for instance, via a series of evidence-based lectures on SCAM.
He came to my attention via the sad story recently featured here about patients allegedly being harmed or killed in a Swiss hospital for so-called alternative medicine (SCAM). What I then learned about the doctor in charge of this place fascinated me:
Rau states about himself (my translation):
Early on, Dr Rau focused on natural therapies, in particular homeopathy and dietary changes. The healing success of his patients proved him right, so he studied alternative healing methods with leading practitioners. These included orthomolecular medicine, Chinese and Ayurvedic medicine and European holistic medicine. With his wealth of knowledge and over 30 years of experience, Dr Rau formed his own holistic theory of healing: Swiss Biological Medicine – Dr Rau’s Biological Medicine. It is based on the principles of detoxification, nutrition, digestion and sustainable strengthening of the immune system.
Career & studies:
- Medical studies at the University of Bern
- Final medical examinations in Switzerland and the USA
- Subsequent work in rheumatology, internal and general medicine
- Member of the Swiss Medical Association FMH since 1981
- 1981 to 1992 conventional physician & medical director of a Swiss spa centre for rheumatology and rehabilitation medicine
- 1983 to 1992 Doctor at a drug rehabilitation centre
- 1992 to 2019 Establishment of the Paracelsus Clinic Lustmühle as medical director and partner
- until 2020 Head of the academic network and training organisation “Paracelsus Academy”
Rau also states this:
- 2019 mit dem Honorarprofessoren-Titel von der Europäischen Universität in Wien ausgezeichnet (2019, he was awarded the title of homorary professor at the European University in Vienna)
This puzzles me because there is no such institution as the ‘Europäische Universität in Wien’. There is a Central European University but this can hadly be it?!
Now, I am intrigued and see what the ‘honorary professor’ might have published. Sadly, there seems to be nothing on Medline except 2 interviews. In one interview, Rau explains (amongst other things) ‘live blood analysis’, a method that we have repeatedly discussed before (for instance, here and here):
Darkfield microscopy shows a lot. We take 1 drop of blood and look at it under a very large-scale magnification. The blood is life under the glass. Once it’s on the glass, there isn’t oxygen or light or heat. This is a giant stress for the blood. So we see how, over a time, the blood reacts to this stress, and how the blood cells tolerate the stress. You can see the changes. So we take a drop of blood that represents the organism and put it under stress and look at how the cells react to the stress, and then we can see the tolerance and the resistiveness of these cells. Do they have a good cell-membrane face? Do they have good energetic behavior? Do they clot together? Is there a chance for degenerative diseases? Is there a cancerous tendency in this blood? We see tendencies. And that’s what we are interested in, tendencies.
Question: If you saw a cancerous tendency, what would that look like?
Rau: Cancerous tendency is a change in the cells. They get rigid, so to say. They don’t react very well.
Question: And how long does blood live outside the body?
Rau: It can live for several days. But after 1 hour, the blood is already seriously changed. For example, a leukemia patient came to my clinic for another disease. But when we did darkfield, I found the leukemia. We saw that his white blood cells were atypical. Look at this slide—the fact that there are so many white blood cells together is absolutely unusual, and the fact that there are atypical white blood cells. This shows me that the patient has myeloid leukemia. The patient had been diagnosed as having rheumatoid lung pain, but it was absolutely not true. The real cause of his pain was an infiltration of the spinal bone by these lymphocytes.
This is, of course, complete nonsense. As I explained in my blog post, live blood analysis (LBA) is not plausible and there is no evidence to support the claims made for it. It also is by no means new; using his lately developed microscope, Antony van Leeuwenhoek observed in 1686 that living blood cells changed shape during circulation. Ever since, doctors, scientists and others have studied blood samples in this and many other ways.
New, however, is what today’s SCAM practitioners claim to be able to do with LBA. Proponents believe that the method provides information about the state of the immune system, possible vitamin deficiencies, amount of toxicity, pH and mineral imbalance, areas of concern and weaknesses, fungus and yeast infections, as well as just about everything else you can imagine.
LBA is likely to produce false-positive and false-negative diagnoses. A false-positive diagnosis is a condition which the patient does not truly have. This means she will receive treatments that are not necessary, potentially harmful and financially wasteful. A false-negative diagnosis would mean that the patient is told she is healthy, while in fact she is not. This can cost valuable time to start an effective therapy and, in extreme cases, it would hasten the death of that patient. The conclusion is thus clear: LBA is an ineffective, potentially dangerous diagnostic method for exploiting gullible consumers. My advice is to avoid practitioners who employ this technique.
And what does that say about ‘honorary professor’ Rau?
I think I let you answer that question yourself.
The NZZ recently published a long and horrific report about a natural health clinic and its doctors. Here is a version translated and shortened by me; perhaps it makes a few people think twice before they waste their money and risk their health:
It is a narrow mountain road that they are racing down on this spring evening. Over the green Appenzell hills, towards Herisau hospital. Kathrin Pfister* is fighting for her life in the car. At the wheel is Thomas Rau, internationally renowned practitioner of so-called alternative medicine (SCAM) and director of his own luxury clinic, the Biomed Centre Sonnenberg. Three days later, Kathrin Pfister is dead. The most likely finding according to the experts: Pfister was injected with a drug that was not authorised in Switzerland at the time, the side effects of which killed her.
Pfister is not the only woman to have lost her life following treatment at the Sonnenberg. Other experts accuse Rau of serious breaches of duty that led to the death of a patient. Rau and another doctor are thus being investigated for involuntary manslaughter.
The events remained hidden from the public for over two years. It’s not just about one doctor, not just about one clinic. The events are politically explosive for Appenzell Ausserrhoden. The canton is the centre of alternative medicine in Switzerland. SCAM doctors are an important economic factor in Ausserrhoden. Wealthy people from all over the world fly here for therapies that most conventional doctors just shake their heads at. Treatments lasting several weeks with a hotel stay cost five-figure sums.
The 73-year-old Dr Rau is the star among Swiss alternative medicine practitioners.He describes himself as the “Mozart of medicine”. The Biomed Centre Sonnenberg is “Mozart’s” last big project. The clinic has a hotel and gluten-free vegan restaurant from the Tibits chain. Even the feather pillows are replaced with bamboo ones. All for the “detox” that Rau praises.
Kathrin Pfister’s case began in mid-April 2021, just four months after the Sonnenberg centre opened. She is actually healthy and comes to the clinic anyway; because of some digestive problems and headaches. The hospital records show that Pfister received infusions. Initially only those containing vitamin C and homeopathic remedies. Then one with artesunate, a preparation against malaria. And finally, on a Friday, Pfister was injected with a solution of alpha-lipoic acid into his bloodstream. The infusion is used in Germany for long-term diabetics with nerve damage. It was not authorised as a medicinal product in Switzerland at the time. According to the forensic experts, it was this substance that was “ultimately causally linked to the death”.
A few hours later, Pfister had severe abdominal cramps. Then pain throughout the body. The number of platelets in her blood drops dramatically. Anxiety sets in at the clinic. The intensive care doctors in Herisau and later at the cantonal hospital in St. Gallen can do nothing more. Pfister had a massive blood clotting disorder. Her liver and kidneys were no longer functioning.
Mary Anne Hawrylak meets Thomas Rau by chance at the clinic that weekend. She too is a patient, recently flown in from the USA. Hawrylak had massive side effects after infusions that Friday. “When I told him about it, he turned white as a sheet, like a ghost,” says Hawrylak. “Doctor Rau told me in horror that I had received the same infusions as ‘Kathrin’ and that he had to test my blood.” The tests showed that her blood platelet count had also dropped, says Hawrylak.
The forensic experts point to a central fact: Alpha lipoic acid can cause blood clotting disorders. They come to the conclusion that this is “most likely a lethal side effect of a drug”. The use of drugs that are not authorised in Switzerland is legal if they are authorised in a country with a comparable procedure. However, there is no real reason to inject this medication into the bloodstream of healthy people. It was authorised in Germany for diabetes patients with nerve damage. So, Pfister did not have this authorisation.
Experts refer to such applications as “off-label use”. Off-label treatments should only be carried out “on the basis of valid guidelines, generally recognised recommendations or scientific literature”. The guidelines also require that patients are given comprehensive information about off-label use. This counselling session should be documented in writing. None of this can be found in the clinic’s files. No written consent, no documented risk-benefit assessment, no reference to the risk of blood clotting disorders. The forensic experts state: “The scant documentation from the Sonnenberg Biomed Centre does not contain any corresponding information document.” The question arises as to “whether the medical treatment at the Sonnenberg Biomed Centre was carried out with the necessary medical care”.
Patient Hawrylak also says: “I was not told exactly what was in the infusions. I was never told that the medication was not authorised in Switzerland or that its use was off-label. I spoke to Dr Rau about what had happened to ‘Kathrin’ because I was worried about myself,” says Hawrylak. “He said to me: ‘I don’t think it was the infusions. I think it was the Covid vaccinations.” He only justified this with his “intuition”.
The Pfister case triggered an investigation by the public prosecutor’s office. But what hardly anyone knew at the time was that it was not the first questionable death at the clinic – not even the first in a month. Ruth Schmid*, a 77-year-old Swiss woman, had died just three weeks earlier. In this case, the forensic pathologists accused Rau: He had made mistakes that not even a medical student should have made, thus causing Schmid’s death.
Schmid was also in the clinic for a kind of cure. When she was about to leave, she began to tremble violently and had extreme stomach pains. She screamed “like an animal”, her partner said during the interrogation. Ultrasound examinations were carried out at the clinic and Rau gave Schmid painkillers, including morphine. According to the partner’s statement to the public prosecutor’s office, he asked Rau whether Schmid needed to be taken to hospital. Rau said no. Schmid stayed in the hotel room overnight. The next day – according to Rau, she had been feeling better since the previous evening – she travelled home. According to Rau’s confiscated notes, “she was to report closely” and return in four days. At home, Ruth Schmid fell into a coma-like state overnight. Admitted to Zurich University Hospital in an emergency, Schmid died there of cardiovascular failure due to septic shock.
The Zurich forensic pathologists performed an autopsy on Schmid’s body. Their findings: Schmid had suffered from intestinal paralysis. As a result, bacteria entered her body and poisoned her blood, leading to a heart attack. “From a forensic medical point of view, it is incomprehensible why the attending physician, Dr Thomas Rau, did not carry out appropriate diagnostics.” The irritation of the forensic experts is evident in almost every line. There had been several warning signs of intestinal paralysis. The forensic experts wrote: “This knowledge is taught in medical school and is considered basic knowledge in human medicine.” Rau’s behaviour was “a breach of the doctor’s duty of care”. With timely treatment, the prognosis for intestinal paralysis is excellent. The sad conclusion: Ruth Schmid did not have to die.
During questioning by the public prosecutor’s office, Rau denied any guilt. Schmid had left in “good condition”. There was no causality between what happened in the clinic and the death. The findings and conclusions of the Zurich forensic pathologists were wrong. Schmid did not have intestinal paralysis or septicaemia. He had been able to rule out intestinal paralysis because intestinal noises had been audible in the morning. The dose of morphine had been very small, so that it had had no effect. There were no indications of a serious condition. Rau testified that he had acted professionally, as would be expected of an internal medicine doctor.
In the Kathrin Pfister case, the doctors treating her also deny any culpability and question the forensic medical report. The doctor’s lawyer writes that the criminal investigation will show that there was no breach of the doctor’s duty to provide information. Alpha-lipoic acid was not responsible for the death. The expert opinion is not convincing in terms of method or content: “When analysed in depth, it contains no justification that the use of alpha-lipoic acid was in any way causal for the patient’s death.”
During the hearing on the Pfister case, Rau said that restricting the use of alpha-lipoic acid to diabetics was “a joke” and far too narrowly defined. He claimed that Pfister had polyneuropathy, a complex nerve disease. However, there is no mention of this in the files of Rau’s clinic.
The criminal investigation is ongoing in both cases. But did more happen on the Sonnenberg? A former hospital employee, who independently reported to the police, told the public prosecutor about other hair-raising incidents. During the interrogation, she testified that she had seen a young woman being carried out of the clinic extremely weak after an infusion. Days later, she had overheard parts of a telephone conversation between Rau and the patient’s angry husband which made it clear that the woman had died. The former employee also recounted a conversation with Rau’s wife, who is a trained nurse. She said that she had driven a patient to a hospital in Zurich in a private car with Rau because Rau was determined to take her to a particular specialist. The patient was so unwell that she was afraid the woman would die on the way. If this is true, Rau would have travelled past several hospitals with a seriously ill patient.
Hawrylak has one last memory of Appenzell etched in his memory. The departure. She was just leaving the clinic when Rau wished her good luck: “I could only say to him: I wish you good luck too, Doctor Rau. I think you’re really going to need it.”
*Names were altered.
As promised, here is my translation of the article published yesterday in ‘Le Figaro’ arguing in favour of integrating so-called alternative medicine (SCAM) into the French healthcare system [the numbers in square brackets were inserted by me and refer to my comments listed at the bottom].
So-called unconventional healthcare practices (osteopathy, naturopathy, acupuncture, homeopathy and hypnosis, according to the Ministry of Health) are a cause for concern for the health authorities and Miviludes, which in June 2023 set up a committee to support the supervision of unconventional healthcare practices, with the task of informing consumers, patients and professionals about their benefits and risks, both in the community and in hospitals. At the time, various reports, surveys and press articles highlighted the risks associated with NHPs, without pointing to their potential benefits  in many indications, provided they are properly supervised. There was panic about the “booming” use of these practices, the “explosion” of aberrations, and the “boost effect” of the pandemic .
But what are the real figures? Apart from osteopathy, we lack reliable data in France to confirm a sharp increase in the use of these practices . In Switzerland, where it has been decided to integrate them into university hospitals and to regulate the status of practitioners who are not health professionals, the use of NHPs has increased very slightly . With regard to health-related sectarian aberrations, referrals to Miviludes have been stable since 2017 (around 1,000 per year), but it should be pointed out that they are a poor indicator of the “risk” associated with NHPs (unlike reports). The obvious contrast between the figures and the press reports raises questions . Are we witnessing a drift in communication about the risks of ‘alternative’ therapies?  Is this distortion of reality  necessary in order to justify altering the informed information and freedom of therapeutic choice of patients, which are ethical and democratic imperatives ?
It is the inappropriate use of certain NHPs that constitutes a risk, more than the NHPs themselves!  Patients who hope to cure their cancer with acupuncture alone and refuse anti-cancer treatments are clearly using it in a dangerous alternative way . However, acupuncture used to relieve nausea caused by chemotherapy, as a complement to the latter, is recommended by the French Association for Supportive Care . The press is full of the dangers of alternative uses, but they are rare: less than 5% of patients treated for cancer according to a European study . This is still too many. Supervision would reduce this risk even further .
Talking about risky use is therefore more relevant than listing “illusory therapies”, vaguely defined as “not scientifically validated” and which are by their very nature “risky” . What’s more, it suggests that conventional treatments are always validated and risk-free . But this is not true! In France, iatrogenic drug use is estimated to cause over 200,000 hospital admissions and 10,000 deaths a year . Yes, some self-medication with phytotherapy or aromatherapy does carry risks… just like any self-medication with conventional medicines . Yes, acupuncture can cause deep organ damage, but these accidents occur in fewer than 5 out of every 100,000 patients . Yes, cervical manipulations by osteopaths can cause serious or even fatal injuries, but these exceptional situations are caused by practitioners who do not comply with the decree governing their practice. Yes, patients can be swindled by charlatans, but there are also therapeutic and financial abuses in conventional medicine, such as those reported in dental and ophthalmology centres. 
Are patients really that naive? No. 56% are aware that “natural” remedies can have harmful side-effects, and 70% know that there is a risk of sectarian aberrations or of patients being taken in by a sect . In view of the strong demand from patients, we believe that guaranteeing safe access to certain NHPs is an integral part of their supervision, based on regulation of the training and status of practitioners who are not health professionals, transparent communication, appropriate research, the development of hospital services and outpatient networks of so-called “integrative” medicine combining conventional practices and NHPs, structured care pathways with qualified professionals, precise indications and a safe context for treatment. This pragmatic approach to reducing risky drug use  has demonstrated its effectiveness in addictionology . It should inspire decision-makers in the use of NHPs”.
- Reports about things going wrong usually do not include benefits. For instance, for a report about rail strikes it would be silly to include a paragraph on the benefits of rail transport. Moreover, it is possible that the benefits were not well documented or even non-existent.
- No, there was no panic but some well-deserved criticism and concern.
- Would it not be the task of practitioners to provide reliable data of their growth or decline?
- The situation in Switzerland is often depicted by enthusiasts as speaking in favour of SCAM; however, the reality is very different.
- Even if reports were exaggerated, the fact is that the SCAM community does as good as nothing to prevent abuse.
- For decades, these therapies were depicted as gentle and harmless (medicines douces!). As they can cause harm, it is high time that there is a shift in reporting and consumers are informed responsibly.
- What seems a ‘distortion of reality’ to enthusiasts might merely be a shift to responsible reporting akin to that in conventional medicine where emerging risks are taken seriously.
- Are you saying that informing consumers about risks is not an ethical imperative? I’d argue it is an imperative that outweighs all others.
- What if both the inappropriate and the appropriate use involve risks?
- Sadly, there are practitioners who advocate this type of usage.
- The recommendation might be outdated; current evidence is far less certain that this treatment might be effective (“the certainty of evidence was generally low or very low“)
- The dangers depend on a range of factors, not least the nature of the therapy; in case of spinal manipulation, for instance, about 50% of all patients suffer adverse effects which can be severe, even fatal.
- Do you have any evidence showing that supervision would reduce this risk, or is this statement based on wishful thinking?
- As my previous comments demonstrate, this statement is erroneous.
- No, it does not.
- Even if this figure is correct, we need to look at the risk/benefit balance. How many lives were saved by conventional medicine?
- Again: please look at the risk/benefit balance.
- How can you be confident about these figures in the absence of any post-marketing surveillance system? The answer is, you cannot!
- No, they occur even with well-trained practitioners who comply with all the rules and regulations that exist – spoiler: there hardly are any rules and regulations!
- Correct! But this is a fallacious argument that has nothing to do with SCAM. Please read up about the ‘tu quoque’ and the strawman’ fallacies.
- If true, that is good news. Yet, it is impossible to deny that thousands of websites try to convince the consumer that SCAM is gentle and safe.
- Strong demand is not a substitute for reliable evidence. In any case, you stated above that demand is not increasing, didn’t you?
- Effectiveness in addictionology? Do you have any evidence for this or is that statement also based on wishful thinking?
My conclusion after analysing this article in detail is that it is poorly argued, based on misunderstandings, errors, and wishful thinking. It cannot possibly convince rational thinkers that SCAM should be integrated into conventional healthcare.
The list of signatories can be found in the original paper.
“Le Figaro” has published two articles (one contra and one pro) authored by ‘NoFakeMed’ (an association of health professionals warning of the danger of fake medicine) signed by a long list of healthcare professionals (including myself) who argue that so-called alternative medicine (SCAM) should be excluded from public healthcare. It relates to the fact that, since last June, a committee set up by the French government has been bringing together opponents and supporters of SCAM. At the heart of the debate is the question of how SCAMs should be regulated, and the place they should occupy in the realm of healthcare. Should they be included or excluded?
Here is the piece arguing for EXCLUSION (my translation):
They’re called alternative medicine, complementary medicine, parallel medicine, alternative medicine, SCAM, and other fancy words. The authorities prefer to call them “non-conventional healthcare practices” (NCSP), or “non-conventional health practices” (NCHP). The choice of terminology is more than just a parochial quarrel: it’s a question of knowing what quality of medicine we want, and whether we agree to endorse illusory techniques whose main argument is their popularity. This raises the question of how to regulate these practices. Some people want to force them into the healthcare system, hospitals, health centres and nursing homes. And they are prepared to use all manner of oratory and caricature to legitimise questionable practices.
Unconventional healthcare practices are on the up, and the number of practitioners and practices has been rising steadily since the 2000s; there are now around 400 therapeutic NHPs. But their success is often due to a lack of understanding of the philosophy behind them, and their lack of effectiveness beyond context effects. This was seen in the debate surrounding homeopathy, which lost much of the confidence placed in it as soon as it stopped to be reimbursed in France and was confronted with the work of popularising it on its own merits among the general public. The ethical imperative of respect for patients means providing them with reliable information so that they can make a free and informed choice.
This raises the question of the place or otherwise to be given to NHPs within the healthcare system. Although there are many different names for them, they are all practices that claim to relate to care and well-being, without having been proven to be effective, and based on theories that are not supported by scientific evidence. Admittedly, the evidence is evolving, and a practice can demonstrate its usefulness in healthcare. This is true, for instance, of hypnosis, whose usefulness as a tool in certain situations is no longer debated since it has become possible to measure and explain both its benefits and its limitations.
However, there is no question of legitimising the entire range of NHPs on the pretext that they are supposedly harmless. Many of them do have adverse effects, sometimes serious, either directly or because they lead to a lack of care. These effects also exist with conventional treatments, but the risks must always be weighed against the proven benefits. The risks associated with NHPs are therefore unacceptable, given their ineffectiveness.
Furthermore, there are abuses associated with NHPs, even if (fortunately!) they are not frequent. Sectarian aberrations are not systematically linked to NHPs, but here again the risk is unacceptable. In its 2021 activity report, Miviludes indicates that 25% of referrals concern the field of health, and that 70% of these relate to SCAM. The number of health-related referrals has risen from 365 in 2010 to 842 in 2015, and exceed 1,000 in 2021.
Conventional medicine is of course not immune to such aberrations, and Miviludes estimates that 3,000 doctors are linked to a sectarian aberration. But the health professional associations have tackled the problem head-on, notably by setting up a partnership with Miviludes and multiple safeguards (verification of diplomas and authorisation to practise, obligation to undergo continuing training, codes of ethics and public health codes, professional justice, declaration of links of interest, etc.). The professional associations have raised awareness of sexual and gender-based violence, universities are providing training in critical reading of scientific articles, and community initiatives are flourishing to improve public information.
We agree that the choices of our patients must be respected, and everyone has recourse to the wellness practices of their choice. But, at the same time, patients have the right when they consult a healthcare professional, a hospital or a health centre, to know that they will be looked after by healthcare professionals offering conscientious, dedicated, evidence-based care.
In view of the current challenges facing our healthcare system, the response must not be to offer more pseudo-medicine on the pretext that people are already using it. The real answer is to rely on evidence, to provide resources for more research, to continue with research, to rely on social work, not to neglect mental health, to improve disease prevention, and to keep pressure groups at bay, whether they come from pharmaceutical companies or the promoters of esoteric, costly and sometimes dangerous practices.
Tomorrow, I will translate and comment on the pro-piece that ‘Le Figaro’ today published alongside this article.
The list of signatories can be found in the origninal paper.
In Germany, two doctors, Dr. Christian Denné (from Vechta), Dr. Hans-Werner Bertelsen (from Bremen), and myself have initiated a petition. Here is my translation of its full text:
We, the undersigned, demand that the “homeopathy” training certificates be revoked. After the deletion from the further training regulations of the vast majority of state medical associations (13 out of 17), as well as the deletion from the model further training regulations (MWBO), it is no longer acceptable that medical fees are paid from the solidarity community pot for a sham therapy. The clear vote of the German Medical Association must be followed by consequences for doctors in private practice in order to avoid continuing to support the organised self-deception of a minority that clings to outdated and thus dangerous forms of medical practice.
1. Dubious cash flows – parallel shadow financing
In addition to the payments made to doctors via the associations of statutory health insurance physicians, there is a second method of cash flow that enables the doctors who bill to generate funds for “homeopathy”, bypassing any control functions of the associations of statutory health insurance physicians (plausibility checks, time profiles). The selective contracts concluded for this purpose with the participating health insurance funds, which were concluded directly by many statutory health insurance funds with the “German Central Association of Homeopathic Doctors” (DZVhÄ), above all Barmer GEK, Techniker Krankenkasse and DAK, are not suitable for building trust, but rather enable medical billing fraud due to the lack of any independent control functions on the part of the health insurance KV.
Enabling parallel billing channels while bypassing the KV’s control function means that the important instrument of billing control is boycotted because neither plausibility checks nor time profiles can be created. The Barmer GEK and Techniker Krankenkasse were informed of the criticism of the implementation of this dubious and non-transparent shadow financing. The management boards of both health insurance funds firmly rejected any interest in changing this situation, for example by cancelling the contracts concluded with the DZVhÄ.
2. Dubious therapies instead of talking medicine
It is no longer acceptable that “homeopathy” will still be used in 2023 to pay for sham therapies in a medical context with annual amounts of up to €530 per patient, while talking medicine remains remunerated with single-digit amounts. Talking medicine must no longer be associated with esotericism in order to generate medical fees. The organised self-deception of inclined sections of the medical profession must be stopped for ethical reasons.
3 Dubious social consequences and dangers
It is no longer acceptable that doctors allow themselves to be conditioned into self-deception by participating in expensive, so-called “advanced training courses” and ignore elementary scientific laws in order to fulfil the need for causality of their patient clientele. Numerous – sometimes fatal – consequences, such as missing an indicated therapeutic time window, have been documented. In addition to serious individual medical consequences, social effects such as denial of science, refusal to vaccinate, etc. are increasingly becoming a problem with far-reaching, unforeseeable consequences.
You can go to the petition here.
Carola Javid-Kistel is a German medical homeopath who states on her website that “homeopathy is a very powerful yet gentle medicine with no side effects, which accompanies me as a doctor for the rest of my life. Thanks to homeopathy, I was completely cured of my ailments…” (my translation).
She is famous in Germany – not so much for her devotion to homeopathy but for repeatedly breaking the law and evading justice.
Now, finally, the doctor from Duderstadt has been arrested. The Göttingen public prosecutor’s office confirmed that she was handed over to the German authorities by the Swiss judiciary in Constance. She has been charged with issuing false medical certificates for exemption from the obligation to wear a mask.
Carola Javid-Kistel has since been released from custody. As a condition, she had to pay 30,000 Euros bail and surrender her passport and identity card. She also had to report regularly to the Duderstadt police station.
According to the Göttingen public prosecutor’s office, the 57-year-old physician was arrested on arrival at Zurich airport. Javid-Kistel had fled to Mexico last year to avoid a criminal trial that had already been scheduled at the Duderstadt district court. She was due to stand trial there for issuing false certificates, among other things.
Further charges from the Göttingen public prosecutor’s office could include:
- Incitement to hatred, defamation and insult.
- At a rally in Herzberg, Javid-Kistel had claimed that the coronavirus measures were “worse than the Holocaust”.
- She also accused a fellow doctor in a video of “vaccinating patients sick and to death”.
- Furthermore, she is alleged to have said to police officers and officials during a search of her practice: “This is fascism, you’re all crazy.”
The date for her new trial has not yet been announced.
I just found this on ‘X’ (formerly Twitter):
We’re delighted to announce the launch of the #BeyondPills All Parliamentary Group in Westminster. Chaired by Danny Kruger MP and co-chaired by Lord Crisp, this new body aims to tackle #overreliance on pills, reducing the number of unnecessary and inappropriate prescriptions.
It turns out that I did not study the website of College of Quackery and Integrated Health as regualarly as I should have. Because there, the launch had been announced some time ago under the title ‘Beyond Pills All Party Parliamentary Group (APPG) launches to stop over-prescribing‘:
Now, in December 2023, we have an exciting development to report: the launch of the Beyond Pills All Party Parliamentary Group (APPG), in which the Beyond Pills Campaign joins forces with the former APPG for Prescribed Drug Dependence. We’re delighted to announce that the APPG’s former Chair, Danny Kruger MP, joins the new Beyond Pills APPG as Chair.
Danny Kruger said of the launch: ‘There is a natural synergy with our objectives and the APPG for Prescribed Drug Dependence is a great supporter of social prescribing, which we feel can make a valuable contribution to addressing this public and personal health crisis, both in terms of helping to prevent overprescribing and also to treating people who are suffering from the debilitating symptoms of dependence.’
The Beyond Pills Campaign now becomes a founder member of the Beyond Pills Alliance (BPA), alongside the Council for Evidence-based Psychiatry (CEP-UK). Setting up the BPA will, in the near future, give us the opportunity to invite other organisations with a similar goal of reducing overreliance on pills to join the Alliance.
The Beyond Pills APPG has the following Mission and Objectives:
MISSION: To move UK healthcare beyond an over-reliance on pills by combining social prescribing, lifestyle medicine, psychosocial interventions and safe deprescribing. As well as reducing unnecessary and inappropriate prescribing, this integrated approach will improve outcomes and reduce health inequalities.
Elsewhere, Dr. Michael Dixon, who seems to be in charge of the ‘beyond pills’ activities, explained: ‘The Beyond Pills All Party Parliamentary Group heralds a sea change in public perception and medical practice from “a pill for every ill” to recognising that there is so much that we can do for ourselves which will not only help us to heal but also stop us getting ill in the first place.’
This made me think – and eventually, I respond by writing this short ‘open letter’ to the group:
please let me begin by stating that I am all in favour of reducing over-prescribing. Who isn’t? The clue is in the name ‘over– prescribing’! Yet, at the same time, I would like to alert you to the fact that your group’s name ‘beyond pills‘ is of questionable merit.
It implies that conventional medicine consits only or predominantly of prescribing pills. My own career as a clinician – long ago now – was in physical medicine and rehabilitation, a discipline that certainly does not rely on pills. Many other areas of healthcare also do not exclusively rely on pills; take surgery or psychosomatic medicine, for instance. As for the rest of the physicians, they will, no doubt, have learnt in medical school that over-prescribing is wrong, dangerous, and not evidence-based.
By putting ‘beyond pills’ on your banner, you either disclose your ignorance of the facts, or you deliberately undermine trust in conventional medicine. Some less benevolent than I might even get the impression that you employ the ‘strawman fallacy‘ in order to push a hidden agenda.
I hope these lines might motivate you to reconsider and alter the irresponsible name of your initiative – how about ‘evidence-based medicine’?
In case anyone wants to use my ‘open letter’ on other sites or publication, I herewith grant permission to reproduce it.
The British doctor and outspoken anti-vaxer Aseem Malhotra has featured several times on this blog, e.g.:
- UK Cardiologist Dr. Aseem Malhotra receives a well-deserved award
- Dr Aseem Malhotra and Dr Steven James: candour and complacency
Now, there has been a potentially important new development in his story. The Good Law Project recently announced the following:
During the pandemic, we depended on doctors telling us how we could protect ourselves and our loved ones. We trusted their advice would be based on the most reliable and up-to-date research.
But when the British cardiologist Dr Aseem Malhotra went on television, or posted to his hundreds of thousands of followers on social media, he repeatedly claimed the vaccine was ineffective and posed a greater threat than Covid, causing “horrific unprecedented harms including sudden cardiac death” – suggestions refuted by medical experts and branded false by factcheckers.
The General Medical Council is responsible for regulating doctors in the UK and investigating those whose conduct falls short of the required standards. Despite the clear risk to public health of vaccine misinformation, it has so far refused to launch an investigation into Malhotra’s public pronouncements, originally saying that they “don’t consider that the comments or posts made by the doctor call his fitness to practice into question…” and subsequently upholding that decision after a number of doctors challenged it.
Good Law Project is supporting a doctor who is taking the regulator to the High Court over their failure to investigate whether Malhotra has breached standards. The judicial review has now been given permission to proceed by the High Court, which held that it raises an “issue of general public importance” as to how the GMC exercises its functions.
According to the claimant, Dr Matt Kneale, medical professionals “should not be using their professional status to promote harmful misinformation”.
“When doctors repeatedly say things that are incorrect, misleading and put people’s health at risk – for example by encouraging them to refuse a vaccine – the GMC must hold them to account,” Kneale said.
For the Good Law Project Executive Director, Jo Maugham, the regulator’s failure to investigate doctors spreading misinformation forms part of a wider pattern.
“What we have learned from both the pandemic inquiry and the calamitous economic consequences of Brexit,” Maugham explained, “is quite how serious are the consequences of deciding, as Michael Gove did, that we have ‘had enough of experts’.”
The council may prefer to avoid becoming embroiled in a controversy over free speech, he continued, but “its primary obligation is to protect the public – and it’s really hard to see how its stance delivers on that objective.”
Dr Malhotra is far from the only proponent of vaccine misinformation in the UK. Open Democracy revealed that anti-lockdown MPs, including Tufton Street’s Steve Baker, took large donations from a secretive group called The Recovery Alliance, which has been linked with a fake grassroots organisation that campaigned against the vaccine.
We’re working to stop misinformation from going unchallenged, and to make sure that regulators like the General Medical Council hold dangerous doctors who make unfounded claims accountable.
By helping to fund this case, you’ll be fighting for trust in the medical profession and to make sure public safety is doctors’ first priority. Any support you can give will help us make positive change.
The ‘Good Law Project’?
Who are they?
Good Law Project is a not for profit campaign organisation that uses the law for a better world. We know that the law, in the right hands, can be a fair and decent force for good. It is a practical tool for positive change and can make amazing things happen. We are proud to be primarily funded by members of the public, which keeps us fiercely independent. We want to inspire hope in difficult times by showing that you can make a difference, with the backing of good law. Our mission is to use the law to hold power to account, protect the environment, and ensure no one is left behind. You can learn more about our organisation and achievements in 2022-23 in our annual report.
You might even decide to support this splendid organization!
I hope you do.
If you assumed that the best management of a child by chiropractors is not to treat this patient and refer to a proper doctor, think again. This paper was aimed at building upon existing recommendations on best practices for chiropractic management of children by conducting a formal consensus process and best evidence synthesis. Its authors composed a best practice guide based on recommendations from current best available evidence and formal consensus of a panel of experienced practitioners, consumers, and experts for chiropractic management of pediatric patients. They thus syntheized results of a literature search to inform the development of recommendations from a multidisciplinary steering committee, including experts in pediatrics, followed by a formal Delphi panel consensus process.
The consensus process was conducted June to August 2022. All 60 panelists completed the process and reached at least 80% consensus on all recommendations after three Delphi rounds. Recommendations for best practices for chiropractic care for children addressed the following aspects of the clinical encounter:
- patient communication, including informed consent;
- appropriate clinical history, including health habits;
- appropriate physical examination procedures;
- red flags/contraindications to chiropractic care and/or spinal manipulation;
- aspects of chiropractic management of pediatric patients, including infants;
- modifications of spinal manipulation and other manual procedures for pediatric patients;
- appropriate referral and comanagement;
- appropriate health promotion and disease prevention practices.
The authors concluded that this set of recommendations represents a general framework for an evidence-informed and reasonable approach to the management of pediatric patients by chiropractors.
Whenever I read the term ‘evidence-informed’ I need to giggle. Why not evidence-based? Evidence-informed might mean that chiros are informed that their treatments are useless or even dangerous for children … but, on reflection and taking their own need for earning a living, they subsequently ignore these facts. And sure enough, the authors of the present paper do mention that a Cochrane review concluded that spinal manipulation is not recommended for children under 12, for a number of conditions, or for general wellness … only to then go on and ignore the very fact.
In doing so, the authors issue a string of self-evident platitudes which occasionally border on the irresponsible. For instance, under the heading of ‘primary prevention’, vaccinations are mentioned as the very last item with the following words:
If parents ask for advice or information about childhood vaccinations, explain that they have the right to make their own health decisions. They should be adequately informed about the benefits and risks to both their child and the broader community associated with these decisions. Consider referral to a health professional whose scope of practice includes vaccinations to address patient questions or concerns.
What that really means in practice, I fear, might be summarized like this: If parents ask for advice or information about childhood vaccinations, explain that they are dangerous, and that even D. D. Palmer recognized as early as 1894 that vaccination is ‘…the monstrous delusion … fastened on us by the medical profession, enforced by the state boards, and supported by the mass of unthinking people …’
Altogether, the ‘Clinical Practice Guideline for Best Practice Management of Pediatric Patients by Chiropractors’ is a thoroughly disreputable document. It was constructed in the way all charlatans tend to construct their consensus documents:
- convene a few people who are all in favour of a certain motion,
- discuss the motion,
- agree with it,
- write up the process
- publish your paper in a third class journal,
- boast that there is a consensus,
- stress that the motion must thereefore be ethical, correct and valuable.
Do chiropractors know that, using this methodology, the ‘flat earth society’ can easily pass a consensus that the earth is indeed flat?
I am sure they do!