integrative medicine
The objective of this paper, as stated by its authors, was to develop an evidence-based clinical practice guideline (CPG) through a broad-based consensus process on best practices for chiropractic management of patients with chronic musculoskeletal (MSK) pain.
Using systematic reviews identified in an initial literature search, a steering committee of experts in research and management of patients with chronic MSK pain drafted a set of recommendations. Additional supportive literature was identified to supplement gaps in the evidence base. A multidisciplinary panel of experienced practitioners and educators rated the recommendations through a formal Delphi consensus process using the RAND Corporation/University of California, Los Angeles, methodology.
The Delphi process was conducted January–February 2020. The 62-member Delphi panel reached consensus on chiropractic management of five common chronic MSK pain conditions:
- low-back pain (LBP),
- neck pain,
- tension headache,
- osteoarthritis (knee and hip),
- fibromyalgia.
Recommendations were made for non-pharmacological treatments, including:
- acupuncture,
- spinal manipulation/mobilization,
- other manual therapy;
- low-level laser (LLL);
- interferential current;
- exercise, including yoga;
- mind–body interventions, including mindfulness meditation and cognitive behavior therapy (CBT);
- lifestyle modifications such as diet and tobacco cessation.
Recommendations covered many aspects of the clinical encounter, from informed consent through diagnosis, assessment, treatment planning and implementation, and concurrent management and referral. Appropriate referral and comanagement were emphasized.
Therapeutic recommendations for low back pain:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence.
- Exercise
- Yoga/qigong (which may also be considered “mind–body” interventions)
- Lifestyle advice to stay active; avoid sitting; manage weight if obese; and quit smoking
- Spinal manipulation/mobilization
- Massage
- Acupuncture
- LLL therapy
- Transcutaneous electrical nerve stimulation (TENS) or interferential current may be beneficial as part of a multimodal approach, at the beginning of treatment to assist the patient in becoming or remaining active.
- Combined active and passive: multidisciplinary rehabilitation
- CBT
- Mindfulness-based stress reduction
Therapeutic recommendations for neck pain:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan for maximum therapeutic effect. The following are recommended, based on current evidence.
- Exercise (range of motion and strengthening).
- Exercise combined with manipulation/mobilization.
- Spinal manipulation and mobilization
- Massage
- Low-level laser
- Acupuncture
- These modalities may be added as part of a multimodal treatment plan, especially at the beginning, to assist the patient in becoming or remaining active:
- Transcutaneous nerve stimulation (TENS), traction, ultrasound, and interferential current.
- Yoga
- Qigong
Therapeutic recommendations for tension headache:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan for maximum therapeutic effect. The following are recommended, based on current evidence:
- Reassurance that TTH does not indicate presence of a disease.
- Advice to avoid triggers.
- Exercise (aerobic).
- Spinal manipulation
- Acupuncture
- Cold packs or menthol gels
- Combined active and passive
- CBT
- Relaxation therapy
- Biofeedback
- Mindfulness Meditation
Therapeutic recommendations for knee osteoarthritis:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence:
- Exercise
- Manual therapy
- Ultrasound
- Acupuncture, using “high dose” (greater treatment frequency, at least 3 × week)
- LLL therapy
Therapeutic recommendations for hip osteoarthritis:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence6
- Exercise
- Manual therapy
Therapeutic recommendations for fibromyagia:
- Consider multiple approaches. Both active and passive, and both physical and mind–body interventions should be considered in the management plan. The following are recommended, based on current evidence:
- Exercise (aerobic and strengthening)
- Advice on healthy lifestyle
- Education on the condition
- Spinal manipulation
- Myofascial release
- Acupuncture
- LLL therapy
- multidisciplinary rehabilitation
- CBT
- mindfulness meditation
- yoga
- Tai chi,
- Qigong
The authors concluded that these evidence-based recommendations for a variety of conservative treatment approaches to the management of common chronic MSK pain conditions may advance consistency of care, foster collaboration between provider groups, and thereby improve patient outcomes.
This paper is an excellent example of a pseudo-scientific process resulting in unreliable outcomes.
- The Delphi process was conducted some 4 years ago
- Because of the truly weird inclusion criteria, the findings are based essentially on just 3 systematic reviews.
- Anyone who has ever tried to conduct a consensus excercise knows that the outcome will almost entirely depend on who is chosen to sit on the panel. So, all you have to do to obtain pro-chiro recommendations is to select a few pro-chiro ‘experts’ who then write the recommendations!
- A “best practices for chiropractic management” may sound reasonable but, looking at the therapeutic recommendation, one easily realizes that the authors cast their nets so wide that the result has little to do with what differentiates chiropractic from Physiotherapists or osteopaths.
It is therefore not surprising that the recommendations are laughably unreliable: can, for instance, anyone explain to me why “advice on healthy lifestyle and education on the condition” are recommended for fibromyalgia but not for any other condition?
This paper is, in my view, chiropractic pseudo-science at its most ridiculous!
All it really does is it tries to legitimise all sorts of therapies as part of the chiropractic toolbox. My advice to patients is to:
- consult a physio if you need exercise therapy or LLL or manual therapy or ultrasound or interferential current or TENS or cold packs or massage;
- consult a clinical psychologist if you need CBT, or mindfulness, biofeedback;
- consult a doctor if you want rehab or education or lifestyle advice or reassurance;
- etc. etc.
And please avoid chiropractors who pretend they can do all of the above, while merely wanting to manipulate your neck.
It is already 7 years ago that I listed several ‘official verdicts on homeopathy‘, i.e. conclusions drawn by independent, reputable bodies evaluationg the evidence for or against homeopathy:
“The principles of homeopathy contradict known chemical, physical and biological laws and persuasive scientific trials proving its effectiveness are not available”
Russian Academy of Sciences, Russia
“Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness.”
National Health and Medical Research Council, Australia
“These products are not supported by scientific evidence.”
Health Canada, Canada
“Homeopathic remedies don’t meet the criteria of evidence based medicine.”
Hungarian Academy of Sciences, Hungary
“The incorporation of anthroposophical and homeopathic products in the Swedish directive on medicinal products would run counter to several of the fundamental principles regarding medicinal products and evidence-based medicine.”
Swedish Academy of Sciences, Sweden
“We recommend parents and caregivers not give homeopathic teething tablets and gels to children and seek advice from their health care professional for safe alternatives.”
Food and Drug Administration, USA
“There is little evidence to support homeopathy as an effective treatment for any specific condition”
National Centre for Complementary and Integrative Health, USA
“There is no good-quality evidence that homeopathy is effective as a treatment for any health condition”
National Health Service, UK
“Homeopathic remedies perform no better than placebos, and that the principles on which homeopathy is based are “scientifically implausible””
House of Commons Science and Technology Committee, UK
Since then, there have been many more statements from similar organisations (does someone know of a complete list? if so, please let me know). One such statement is from French veterinarians: Avis 2021- 3 sur l’Homéopathie vétérinaire. Aloow me to translate the crucial passages for you:
Opinion 2021- 3 on Veterinary Homeopathy. The Report of a Working Group on Veterinary Homeopathy, an Opinion on Veterinary Homeopathy adopted in the academic session on May 6, 2021. The report ecommends that :
no medical discipline or practice claiming to be a medical discipline should be exempt from the ethical duty of testing its claims;
in this respect, clinical studies on the individual, reconciling scientific rigor and practical constraints, be explored, and in particular the N of 1 trials described in human medicine;
veterinary medicine be defined as evidence-based medicine, and not as allopathic medicine;
it is reaffirmed that veterinary medicine must above all be holistic, and that consequently the label of holistic veterinary medicine cannot be monopolized by particular practices;
homeopathy in veterinary medicine, as in human medicine, is not currently recognized nor can it be claimed as an exclusive veterinary medical activity;
institutional communication provides ongoing information on the scientific approach, evidence-based medicine and complementary medicine, tailored respectively to veterinarians, the general public and, in particular, animal keepers;
veterinary surgeons who, in the absence of recognized scientific proof of the efficacy of homeopathy in particular, wish to pursue this activity, particularly as a complementary medicine, should be fully aware of their increased responsibilities due to the current lack of scientific confirmation of efficacy;
it is possible to use homeopathic preparations, insofar as the medical decision to use a complementary and non-alternative therapy systematically requires informed consent, and does not result in a loss of opportunity by delaying the diagnostic procedure and/or the establishment of a recognized effective treatment;
that, in order to provide the information needed to obtain informed consent, a prescription for a homeopathic preparation should be accompanied, on any suitable medium, by a statement to the effect that, in the current state of knowledge, veterinary homeopathy has a contextual effect;
that the term “homeopathic medicine” be eventually replaced by “homeopathic preparation” in national and European legislation, that labelling state that “the efficacy of the preparation has not been demonstrated in accordance with current standards”, and that homeopathic preparations cannot claim the properties of vaccines or replace them, without incurring criminal sanctions;
in veterinary medicine, no university diploma in homeopathy be awarded by schools and other public establishments, and that training in homeopathy only take place within the framework of training that takes into account the realities of the scientific approach;
as part of their initial training, veterinary schools are places for debate and training in critical thinking, by offering interdisciplinary seminars on non-conventional approaches;
_____________________________
So, the next time someone claims “homeopathy has been proven to work in animals”, let’s show them what the experts think of this notion.
More reason to worry about our royal family? Apparently, Camilla (I apologise for calling her thus, as I am never entirely sure whether she is Queen or Queen Consort: Camilla, the wife of Prince Charles, will be formally known as Queen Consort now that her husband is King12. When Camilla and Charles married in a civil ceremony in 2005, it was announced Camilla would become known as Princess Consort – rather than Queen Consort – due to public sensitivity3. However, Queen Elizabeth II granted her the title of Queen Consort in February last year during the Platinum Jubilee45.) has been urged to take more time to recover after a bout of pneumonia.
At the start of November it was announced that she had been diagnosed with a ‘chest infection’ and was under doctors’ supervision. The 77-year-old Camilla was forced to withdraw from her engagements so she could rest at home. She has now revealed that she was suffering from a form of pneumonia.
It is understood Camilla’s condition was viral. She seems to be suffering significantly diminished reserves of energy following her chest infection. This led to her having to pull out of a number of events over recent weeks. Even though the lung infection has now cleared, she says she is still feeling tired. She has been advised by her doctors to take more time to recover. It was confirmed yesterday on the eve of the state visit that the Queen was also reducing her role at the glam state banquet later on Dec. 3 in light of her health.
So, is there anything special that might have triggered this unfortunate turn of events? To answer this question, I refer you to my post of 31 October this year:
… 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 Soukya International Holistic Health Centre (SIHHC), where he was also joined by his wife, 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.
… 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.
Yes, you may well ask: isn’t Ayurvedic medicine supposed:
- to strengthen the immune system,
- to fortify you against infections,
- to replenish your reserves of energy,
- to enable you to recover swiftly from infections?
Of course, I know, correlation is not causation! Perhaps the recent Ayurvedic pampering in India and Camilla’s inability to make a timely recovery from what started merely as a ‘chest infection’ are not at all linked in any way. Yet, it does seem tempting to speculate that the stay in the SIHHC with all the Ayurvedic medicine did her not a lot of good.
Whatever might be the case, I would like to take this opportunity to wish Camilla a full recovery for her condition.
It has been reported that the Dresden Higher Regional Court (OLG) examined the extent to which a doctor must inform his patient, if he/she uses so-called alternative medine (SCAM) that deviates from conventional medicine. To be precise, the case was about a detoxification therapy with so-called chelating agents. A patient had received ‘holistic treatment’ for symptoms of exhaustion with sleep disorders, headaches, concentration problems and general restlessness and became worse and worse during the course of the therapy. Eventually, he sued for compensation for pain and suffering and damages.
Initially, the patient had been treated conservatively with iron supplements. After carrying out ‘provocation test’, the doctor diagnosed a heavy metal load, which he treated with ‘elimination therapy’ in the form of an i.v. “detox therapy” (2-3-dimercaptopropane-1-sulfonate (DMPS)). The patient subsequently became increasingly unwell, leading to hospitalisation and treatment for severe thrombocytopenia with moderate liver damage.
The expert opinion obtained in the first-instance of the ensuing legal proceedings considered the cause of the patient’s complaints to be the administration of an inadmissibly excessive amount of alpha-lipoic acid during ‘detoxification therapy’. It became clear that the doctor had not properly informed the patient about this therapy and its risks.
The court considered that the basic information required under German law had not been provided. This basic information gives the patient a general idea of the severity of the procedure and the impact of the associated burdens on their lifestyle. The obligation to provide information also applies to practitioners who use SCAM. A doctor who offers SCAM must therefore clearly inform the patient that they are deviating from a conventional approach. He/she must also explain why he/she is doing this and what advantages and disadvantages the patient can expect as a result.
Detoxification therapy is indisputably such a SCAM, the costs of which are not covered by the health insurance companies. The patient must therefore not only be informed of the risks and the danger of failure of the procedure, but must also be informed that the planned therapy is not standard medical practice and that the effectiveness of the therapy is unproven.
The patient must be able to weigh up whether they want to take the risks of treatment with regard to the prospects of success in view of their state of health before the procedure. Such information was not provided in the present case. For this reason, the Regional Court awarded damages for pain and suffering amounting to EUR 15,000 for the damage to health suffered.
__________________________
On this blog, we have often discussed the problems of informed consent. Informed consent, I have previously stated, must usually include full information on:
- the diagnosis
- its natural history
- the most effective treatment options available
- the proposed therapy
- its effectiveness
- its risks
- its cost
- a rough treatment plan
Only when this information has been transmitted to and understood by the patient can informed consent be considered complete. I do understand why many SCAM practitioners do not like informed consent – it could stop many from practising: they are frequently unable to provide the required information. Yet, ALL clinicians have a moral, ethical and legal duty to obtain informed consent BEFORE starting a therapy. It is reassuring that the German court agrees.
Donald Trump has nominated Dr. Mehmet Oz, a celebrity physician known for his US television show, to lead the Centers for Medicare and Medicaid Services (CMS). Some 20 years ago, I had the pleasure to briefly meet Oz at a conference. I can honestly say that I rarely met anyone who was – in my view – oozing that much quackery as he was. Oz’s nomination has sparked (not just my but) widespread disbelief, mainly due to Oz’s long history of irresponsibly promoting even the worst forms of so-called alternative medicine (SCAM) for his own fame and fortune.
After being nominated, Oz posted a comment on X: “I am honored to be nominated by @realDonaldTrump to lead CMS. I look forward to serving my country to Make America Healthy Again under the leadership of HHS Secretary @RobertKennedyJr“
Personally, I am beginning to find Trump’s recent appointments too tiresome and ridiculous for further detailed comments. They seem to me like a deliberate provocation and an indication of the systematic destruction that Trump has in mind for his second term in office.
Instead of a comment, let me therefore show you some of the comments on the appointment that have appeared on X.
- Robert F. Kennedy Jr @RobertKennedyJr Very excited that my friend @DrOz has agreed to run CMS. Thank you @realDonaldTrump for this outstanding nomination. Welcome Dr. Oz to The Avengers. Let’s Make America Healthy Again!
- Elizabeth Warren @SenWarren Running Medicare and Medicaid for over 100 million Americans isn’t like hosting a daytime talk show. Dr. Oz is another rich guy who doesn’t care if your health care costs go up or an insurance company denies you coverage. These decisions have life and death consequences.
- Billboard Chris @BillboardChris Dr. Oz has been appointed to head Medicare and Medicaid. He needs to come out and publicly disavow this abhorrent garbage he pushed on his show about ‘transgender children.
- Michael Steele @MichaelSteele Robert F. Kennedy at HHS; now Dr. Mehmet Oz to run Medicare and Medicaid. And Republicans want to cut the social safety net to pay for renewing Trump’s tax cuts. Reality TV personalities for a Reality TV administration. Unfortunately, we live in a world where diseases are real, people are poor and reality hits many of us hard every day
- The Resistor Sister @the_resistor More like The Apprentice Administration NONE of them are qualified.
- seanmack @seanmack1025 When does Dr Doolittle get a job. I bet doctor Phil feels left out.
- Peter Morley @morethanmySLE Donald Trump’s CMS pick Dr. Mehmet Oz suggested in 2020 Lupus patients were IMMUNE to COVID if we took Hydroxychloroquine. FACT: I have Lupus & have been on this since medication since 2014 & I had Covid 3x. This man should NOT be overseeing Medicare & Medicaid!
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The bon mot that describes the situation best: If you put a clown in a palace, the clown does not become a king, but the palace turns into a circus.
Guest post by Catherine de Jong
Academic circles have reacted with surprise to the announcement on 12 November of the appointment of chiropractor Sidney Rubinstein as endowed professor at the Vrije Universiteit Amsterdam. The website of the Dutch Chiropractors Association (NCA) states:
“On 1 August 2024, Mr. Sidney Rubinstein was appointed professor by special appointment at the chair “Optimizing Management of Musculoskeletal Health” at the Vrije Universiteit in Amsterdam. In addition to his work as a chiropractor in his own practice, Rubinstein has been working at the Vrije Universiteit for a long time. In addition to treating patients, he has always focused on research and development within chiropractic and musculoskeletal (MSK) disorders.”
Chiropractic is an alternative method of treatment. There is no scientific evidence for clinically relevant positive treatment outcomes. For that reason, chiropractic is not mentioned as a treatment option in the guidelines of general practitioners and medical specialists in the Netherlands. Both the profession and the education are not recognized in the Netherlands. On the website of the NVAO (Dutch-Flemish Academic Organization, www.nvao.net), chiropractic does not appear as an accredited program. There is now plenty of research, especially case reports, on the damage that treatment by a chiropractor can cause, such as cerebral infarctions due to arterial dissection of carotid arteries due to cracking of the neck by chiropractors.
On June 20, 2008, the website of Medisch Contact (magazine of KNMG, Dutch Society of Medical Doctors) stated: “First Dutch chiropractor gets his PhD: Sidney Rubinstein will be the first chiropractor in the Netherlands to obtain a PhD today. Rubinstein states that most of the side effects of chiropractic are harmless and temporary.”
This dissertation, for which Sidney Rubinstein obtained his doctorate at VU Amsterdam, was substandard and was criticized in a letter sent to the same journal. The subsequent correspondence with, among others, the supervisor can be read here. In short, a dissertation that VU Amsterdam cannot be proud of.
The Cochrane database contains two reviews published by Rubinstein on chiropractic, or Spinal Manipulative Therapy (SMT) for acute and chronic back pain, respectively. The conclusion was the same in both cases: In summary, SMT appears to be no better or worse than other existing therapies for patients with acute/chronic low‐back pain. In a 2013 update (Spinal manipulative therapy for acute low back pain: an update of the Cochrane review. Spine 2013; 38(3): E158-77), Rubinstein comes to the same conclusion: SMT is no more effective for acute low back pain than inert interventions, sham SMT or as adjunct therapy. SMT also seems to be no better than other recommended therapies. Rubinstein himself has concluded years ago that chiropractic or SMT has no greater effect than other treatments (like standard physiotherapy), but still it needs to be researched again and again?
At the end of the news item on the NCA’s website, the truth is revealed: the NCA subsidizes half of the chair! The members of this organization (there are now more than 500 chiropractors in the Netherlands) have diligently raised the money for this chair. Since its foundation in 1896 by the grocer/magnetizer D.D. Palmer, chiropractic has had every chance to prove its usefulness, but it has not succeeded. That Rubinstein can change that situation is, of course, extremely unlikely.
This appointment is therefore in fact a political publicity stunt for a still pointless alternative treatment. It will do both the practice of Sidney Rubinstein and that of other chiropractors a lot of good that there is now a professor of chiropractic in the Netherlands.
The other half of the chair is paid for by the university. This means that public money that could have been better spent is now going to be wasted on research into an alternative treatment that we already know is useless, by a researcher who has already shown that there is no added value of treatment by a chiropractor.
A substandard dissertation and a purchased chair, but Sidney Rubinstein can call himself a professor. With the appointment of chiropractor Sidney Rubinstein as endowed professor at VU Amsterdam, the university is jeopardizing its good name and contributing to the unjustified elevation of Sidney Rubenstein’s status and his pointless method of treatment, chiropractic.
Can this appointment really be reconciled with the scientific norms and values that VU Amsterdam wants to uphold?
This study evaluated the real-world impact of acupuncture on analgesics and healthcare resource utilization among breast cancer survivors.
The authors selected from a United States (US) commercial claims database (25% random sample of IQVIA PharMetrics® Plus for Academics) 18–63 years old malignant breast cancer survivors who were experiencing pain and were ≥ 1 year removed from cancer diagnosis. Using the difference-in-difference technique, annualized changes in analgesics [prevalence, rates of short-term (< 30-day supply) and long-term (≥ 30-day supply) prescription fills] and healthcare resource utilization (healthcare costs, hospitalizations, and emergency department visits) were compared between acupuncture-treated and non-treated patients.
Among 495 (3%) acupuncture-treated patients (median age: 55 years, stage 4: 12%, average 2.5 years post cancer diagnosis), most had commercial health insurance (92%) and experiencing musculoskeletal pain (98%). Twenty-seven percent were receiving antidepressants and 3% completed ≥ 2 long-term prescription fills of opioids. Prevalence of opioid usage reduced from 29 to 19% (P < 0.001) and NSAID usage reduced from 21 to 14% (P = 0.001) post-acupuncture. The relative prevalence of opioid and NSAID use decreased by 20% (P < 0.05) and 19% (P = 0.07), respectively, in the acupuncture-treated group compared to non-treated patients (n = 16,129). However, the reductions were not statistically significant after adjustment for confounding. Patients receiving acupuncture for pain (n = 264, 53%) were found with a relative decrease by 47% and 49% (both P < 0.05) in short-term opioid and NSAID fills compared to those treated for other conditions. High-utilization patients (≥ 10 acupuncture sessions, n = 178, 36%) were observed with a significant reduction in total healthcare costs (P < 0.001) unlike low-utilization patients.
The authors concluded that, although adjusted results did not show that patients receiving acupuncture had better outcomes than non-treated patients, exploratory analyses revealed that patients treated specifically for pain used fewer analgesics and those with high acupuncture utilization incurred lower healthcare costs. Further studies are required to examine acupuncture effectiveness in real-world settings.
Oh, dear!
Which institutions support such nonsense?
- School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, 802 W Peltason Dr, Irvine, CA, 92697-4625, USA.
- School of Pharmacy, Chapman University, RK 94-206, 9401 Jeronimo Road, Irvine, CA, 92618, USA.
- College of Korean Medicine, Kyung Hee University, Seoul, South Korea.
- Integrative Medicine Program, Departments of Supportive Care Medicine and Medical Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
- School of Pharmacy, Chapman University, RK 94-206, 9401 Jeronimo Road, Irvine, CA, 92618, USA. [email protected].
- School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, 802 W Peltason Dr, Irvine, CA, 92697-4625, USA. [email protected].
And which journal is not ashamed to publish it?
It’s the BMC Med!
The conclusion is, of course, quite wrong.
Please let me try to formulate one that comes closer to what the study actually shows:
This study failed to show that a ‘real world impact’ of acupuncture exists. Since the authors were dissatisfied with a negative result, subsequent data dredging was undertaken until some findings emerged that were in line with their expectations. Sadly, no responsible scienctist will take this paper seriously.
This paper discussed the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand’s contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration.
Qualitative interviews were conducted with both Rongoā practitioners and Western surgeons. The data collected were subjected to thematic analysis to extract key themes related to the integration process, challenges faced, and the potential for mutual recognition and respect between the two healing paradigms.
The study reveals a deep respect for Rongoā Māori among Western surgeons but identifies significant systemic barriers that impede its integration. These include bureaucratic challenges and the absence of clear referral pathways. Rongoā practitioners express concerns over being overlooked within the healthcare system and highlight a lack of awareness among healthcare professionals about their practices. Despite these challenges, there is a shared interest in collaborative approaches to healthcare that respect and incorporate Rongoā Māori.
The authors concluded that their findings underscore the need for systemic changes to facilitate the integration of Rongoā Māori into mainstream healthcare, including the development of clear referral pathways and initiatives to raise awareness among healthcare professionals. The study highlights the need for a more collaborative healthcare approach that values the contributions of Rongoā Māori, aiming to improve patient care through holistic practices.
The authors also stated that Rongoā Māori, the Indigenous healing system of Māori, encompasses a holistic approach to health that acknowledges the complex interplay of cultural values, connection to wairua, tinana, tikanga, whakaora, whānau, and whenua. Despite its comprehensive approach to health and well-being, Rongoā Māori remains largely marginalized within New Zealand’s mainstream healthcare system.
I beg to differ!
A ‘healing system’ – no matter what its origin or tradition might be – does not need to be adopted into current healthcare because it is ‘holistic’ or because it ‘acknowledges the complex interplay of cultural values’. It must be considered for integration once it has been shown to be effective and safe, i.e. if it demonstrably generates more good than harm.
And has Rongoā Māori been shown to fulfill these criteria?
No!
In this case, please do the research. Until compelling evidence is available, do me a favour and stop the BS!
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?
