King Charles
Charles III is about to pay his first visit to France, his second visit to any state. Earlier this year, he has already visited Germany. Originally, France had been first on his list but the event was cancelled in view of the violent protests that rocked the country at the time. Now he is definitely expected and the French are exited. I am currently in France and have been asked to give several interviews on the king’s love affair with so-called alternative medicine (SCAM).
The French have long been fascinated by our royal family which seems a bit odd considering what they did to their own. Now that Charles and Camilla are about to appear with an entourage of about 50 servants between them, the press is full with slightly bemused reports and comments:
Since childhood, Charles has been accustomed to a luxurious, gilded life, which is reproduced on every trip outside the royal palaces, to ensure maximum service, comfort and security… The new king always travels with his private secretary, Sir Clive Alderton, his press advisor, his steward, his doctor, his personal valets, his security guards, and his private chauffeur, Tim Williams… And, of course, his regular osteopath to relieve his lower back. Since he’s had a lot of falls playing polo, Charles regularly suffers from back pain…”.
Really, just an osteopath?
What about all the other SCAM-practitioners whose businesses Charles so regularly supported in the past:
- · Acupuncture
- · Aromatherapy
- · Ayurveda
- · Chiropractic
- · Detox
- · Gerson therapy
- · Herbal medicine
- · Homeopathy
- · Iridology
- · Marma massage
- · Massage therapy
- · Pulse diagnosis
- · Reflexology
- · Tongue diagnosis
- · Traditional Chinese Medicine
- · Yoga
Will they not be disappointed?
I do wonder who Charles’ osteopath and doctor are. Are they competent? I am sure they both must be well-informed and evidence-based experts. If that is the case, they will have, of course, told Charles that osteopathy is hardly an optimal solution for an injured back.
In any case, now I am concerned about the royal back and therefore urgently recommend that HIS MAJESTY reads some of my previous posts on the subject, e.g.:
- Manual therapy (mainly chiropractic and osteopathy) does not have clinically relevant effects on back pain compared with sham treatment
- Spinal manipulative therapy for older adults with chronic low back pain fails to generate convincing results
- NICE no longer recommends acupuncture, chiropractic or osteopathy for low back pain
- The Effects of Yoga, Naturopathy, and Conventional Medical Treatment in Managing Low Back Pain
- Chronic non-specific low back pain: comparing cognitive functional therapy and movement system impairment (MSI)-based treatment
- Cognitive functional therapy for chronic low back pain
- Meditation for Chronic Low Back Pain Management?
Let’s hope all goes well here in France, and please let’s not be so akward as to ask about the environmental aspects – we all know how worried Charles truly is about not just his health but also the health of the planet – of moving such an entourage for a two-day visit.
PS
Charles flew in a private jet from London to Paris and took his Bentley with him.
King Charles III is an enthusiastic, albeit uncritical proponent of so-called alternative medicine (SCAM). Does that boost his popularity in the general population? Or does it have the opposite effect? I am not aware of reliable data on this issue, yet I suspect it is neither here nor there. So, his waning popularity is probably caused by other factors.
A survey of more than 2,000 adult Brits found that overall, 62% want to keep the monarchy and 59% of people thought Charles was “personally doing a good job”.. At first glance, this looks not too bad for Charles and William but a more detailed analysis is far less optimistic: among 18 to 24-year-olds, only 30% say the monarchy is “good for Britain”. This “remarkable difference between generations”, demonstrates that younger people are much less supportive on remaining a monarchy and more sceptical about the Royal Family representing good value for money.
A decade ago, the same YouGov tracking survey found 17% preferred an elected head of state, which in this latest survey has risen to 26%. On the question whether Britain should continue to be a monarchy or be replaced with an elected head of state, the poll found:
- 62% wish no change,
- 26% want an elected head of state,
- 11% don’t know.
On the question whether the Royal Family is good value for money, 75% of the over-65s believe they are, but only 34% of 18 to 24-year-olds feel the same. And while 80% of the over-65s want Britain to stay as a monarchy, that figure falls to 37% for the 18 to 24-year-olds. There is also less support for the royals in Scotland or Wales than in England, where London has higher levels of people against the monarchy than elsewhere in the country.
Historian and royal commentator Ed Owens says the lack of support among the young should “certainly be of concern” to the Royal Family. But he says it will be difficult for the royals to turn this around, when many of the factors are outside their control. Dr Owens says opposition to the monarchy is part of a wider sense of “disenchantment” for younger generations about issues such as unaffordable housing, stagnant wages and student debt. “The system doesn’t seem to be working for them, so why should they celebrate an institution that seems to be at the heart of that system?” says Dr Owens.
Graham Smith, chief executive of the anti-monarchy campaign Republic, said the survey showed a “general trend of falling support, and that younger people will not be won back to the monarchist cause. Sooner rather than later we’ll see support for the monarchy fall below 50%.”
When the 1st edition of my book about about Charles’ (at the time, he was still ‘Prince of Wales’) love affair with SCAM came out, it was reviewd by the Daily Mail. They courageously asked Charles’ press office for a comment on it. A Clarence House spokesperson then told the journalist: ‘The Prince of Wales believes in combining the best of evidence based, conventional medicine with an holistic approach to healthcare – treating the whole person rather than just the symptoms of disease and taking into account the effects on health of factors such as lifestyle, the environment and emotional well-being.’ I know this is not all that meaningful and just a (fairly daft and uninformed) formular for getting rid of a tedious request, yet – for what it’s worth – it does not indicate that, in the realm of SCAM, Charles is all that open to change. More recent activities of King Charles seem to support this impression.
With regards to his overall popularitiy in the UK, this might mean that Charles will continue to lose the support of skeptics, while gaining the one of SCAM enthusiasts.
And the net result of this?
I fear it will almost be negligible.
The autum seems to be the season for awards. I recently mentioned the ‘Gloden Plank‘ and now The Skeptic announced the Ockham Awards – the annual awards celebrating the very best work from within the skeptical community. The awards draw attention to people who work hard to promote skepticism. The Ockhams honour outstanding campaigns, activism, blogs, podcasts, and other contributors to the skeptical cause.
Nominations for the 2023 Ockham Awards are now open! Simply complete the nomination form to submit your nominations.
The Rusty Razor is an entirely different award. It recognises individuals or organisations who have been prominent promoters of unscientific ideas within the last year. Last year’s Rusty Razor went to the Global Warming Policy Foundation, set up in 2009 by climate change denier Nigel Lawson. The Foundation has published several reports downplaying the threat of climate change.
Previous Rusty Razor winners included
- Dr Mike Yeadon for his anti-vaccination BS,
- Dr Didier Raoult for his promotion of hydroxychloroquine as a treatment for COVID-19,
- Andrew Wakefield for his ongoing promotion of anti-vaxx misinformation,
- Gwyneth Paltrow for her pseudoscience-peddling wellness empire, Goop.
The awards are, as always, based on the nominations received from the skeptical community. This is your chance to see your skeptic hero and your most prolific charlatan regognised.
So, what are you waiting for? Submit your nominations now!
Nominations will close on September 9th. Winners will be chosen by the editorial board of THE SKEPTIC, and the winners will be announced at QED in Manchester on September 23rd.
I was asked by NATURE to provide a comment on the WHO Traditional Medicine Global Summit: Towards health and well-being for all which is about to take place in India:
The First WHO Traditional Medicine Global Summit will take place on 17 and 18 August 2023 in Gandhinagar, Gujarat, India. It will be held alongside the G20 health ministerial meeting, to mobilize political commitment and evidence-based action on traditional medicine, which is a first port of call for millions of people worldwide to address their health and well-being needs.
The Global Summit will be co-hosted by WHO and the Government of India, which holds the presidency of the G20 in 2023. It will be a platform for all stakeholders, including traditional medicine workers, users and communities, national policymakers, international organizations, academics, private sector and civil society organizations, to share best practices and game-changing evidence, data and innovation on the contribution of traditional medicine to health and sustainable development.
For centuries, traditional and complementary medicine has been an integral resource for health in households and communities. It has been at the frontiers of medicine and science laying the foundation for conventional medical texts. Around 40% of pharmaceutical products today have a natural product basis, and landmark drugs derive from traditional medicine, including aspirin, artemisinin, and childhood cancer treatments. New research, including on genomics and artificial intelligence are entering the field, and there are growing industries for herbal medicines, natural products, health, wellness and related travel. Currently, 170 Member States reported to WHO on the use of traditional medicine and have requested evidence and data to inform policies, standards and regulation for its safe, cost-effective and equitable use.
In response to this increased global interest and demand, WHO, with the support of the Government of India, established in March 2022 the WHO Global Centre for Traditional Medicine as a knowledge hub with a mission to catalyse ancient wisdom and modern science for the health and well-being of people and the planet. The WHO Traditional Medicine Centre scales up WHO’s existing capacity in traditional medicine and supplements the core WHO functions of governance, norms and country support carried out across the six regional Offices and Headquarters.
The Centre focuses on partnership, evidence, data, biodiversity and innovation to optimize the contribution of traditional medicine to global health, universal health coverage, and sustainable development, and is also guided by respect for local heritages, resources and rights.
A cross-regional expert panel will advise on the Summit’s theme, format, topics and issues to address. All updates will be posted here and on the forthcoming webpages for the First WHO Traditional Medicine Global Summit.
In case you are interested, the programme can be seen here.
And my comment? I am afraid, it was not very encouraging. I doubt that Nature will publish it in full. So, allow me to show you my unabridged comment:
The increasing demand for fertility treatments has led to the rise of private clinics offering so-called alternative medicine (SCAM) treatments. Even King Charles has recently joined in with this situalion. One of the most frequently offered SCAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility.
This study evaluated the scope of information provided by SCAM fertility clinics in the UK. A content analysis was conducted on 200 websites of SCAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on:
- the efficacy,
- the risks,
- the success rates
of acupuncture for infertility.
The authors concluded that this situation has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment.
The authors are keen to point out that their investigation has certain limitations. The study only analysed the information provided on the clinics’ websites and did not assess the quality of the treatment provided by the clinics.
Therefore, the study’s fndings cannot be generalized to the quality of the acupuncture treatment provided by the clinics.
Nonetheless the paper touches on very important issues: far too many health clinics that offer SCAM for this or that indication operate way outside the ethically (and legally) acceptable norm. They advertise their services without making it clear that they are neither effective nor safe. Desperate consumers thus fall for their promises. In the case of infertility, this might result merely in frustration and loss of (often substantial amounts of) money. In the case of serious disease, such as cancer, this often results in premature death.
It is time, I think, that this entire sector is regualted in a way that it does not endanger the well-being, health, or life of consumers.
Charles has a well-documented weakness for so-called alternative medicine (SCAM) – not just any SCAM but predominantly the type of SCAM that is both implausible and ineffective. Therefore, nobody can be all that surprised to read in THE TIMES that he has decided to use SCAM for helping women who have difficulties getting pregnant.
If one really wanted to employ SCAM for this aim one is spoilt for choice. In fact, there are only few SCAMs that don’t claim to be useful for this purpose.
A recent review, for instance, suggested that some supplements might be helpful. Other authors advocate SCAMs such as acupuncture, moxibustion, Chinese herbal medicine, psychological intervention, biosimilar electrical stimulation, homeopathy, or hyperbaric oxygen therapy.
Yes, I know! The evidence for these treatments is lousy, and I would never issue a recommendation based on such flimsy evidence.
Yet, the SCAM project at Dumfries House, the Scottish stately home Charles restored in 2007, offers acupuncture, reflexology, massage, yoga, and hypnotherapy for infertile women.
REFLEXOLOGY for female infertility?
Reflexology, also called zone therapy, is a manual treatment where pressure is applied usually to the sole of the patient’s foot and sometimes also to other areas such as the hands or ears. According to its proponents, foot reflexology is more than a simple foot massage that makes no therapeutic claims beyond relaxation. It is based on the idea that the human body is divided into 10 zones each of which is represented on the sole of the foot. Reflexologists employ maps of the sole of the foot where the body’s organs are depicted. By massaging specific zones which are assumed to be connected to specific organs, reflexologists believe to positively influence the function of these organs. While reflexology is mostly used as a therapy, some therapists also claim they can diagnose health problems through feeling tender or gritty areas on the sole of the foot which, they claim, correspond to specific organs.
Reflexology is not merely implausible as a treatment for infertility, it also boasts of some fairly rigorous trial evidence. A clinical trial (perhaps even the most rigorous of all the trials of SCAM for female fertility problems) testing whether foot reflexology might have a positive effect on the induction of ovulation stated that “the results suggest that any effect on ovulation would not be clinically relevant”.
So, as so often before in the realm of SCAM, Charles has demonstrated that his lack of critical thinking leads him to the least promising options.
Well done, Your Majesty!
Last September, THE GUARDIAN published an article about the HEAD OF THE ROYAL MEDICAL HOUSEHOLD. I did not know much about this position, so I informed myself:
The royal household has its own team of medics, who are on call 24 hours a day. They are led by Prof Sir Huw Thomas (a consultant at King Edward VII’s hospital [the private hospital in Marylebone often used by members of the royal family, including the late Prince Philip] and St Mary’s hospital in Paddington, and professor of gastrointestinal genetics at Imperial College London), head of the medical household and physician to the Queen – a title dating back to 1557. Thomas has been part of the team of royal physicians for 16 years and became the Queen’s personal physician in 2014. The role is not full-time and does not have fixed hours or sessions but Thomas is available whenever he is needed. Thomas received a knighthood in the 2021 new year honours, and was made Knight Commander of the Royal Victorian Order (KCVO) – a personal gift of the monarch. At the time of the honour, in an interview with Imperial College London, he said it had been a “busy couple of years in this role,” adding that he felt “very grateful to have been recognised for my service to date”. Thomas added that being the Queen’s personal physician was a “great honour” and “a very enjoyable and rewarding role”. He said: “The nature of the work is interesting because you see how a whole different organisation, the royal household, operates. You very much become part of that organisation and become the personal doctor to the principal people in it, who are patients just like other patients.” …
In previous generations the royal doctor has caused controversy. When the Queen’s grandfather King George V was in his final hours, Lord Dawson, the royal doctor with personal responsibility for the 70-year-old monarch issued a bulletin, declaring: “The King’s life is moving peacefully towards its close.”
In 1986, four decades after Lord Dawson’s death, his diaries were made public – revealing that he had administered a lethal dose of morphine and cocaine to relieve the King’s pain, but also to ensure that the death could be announced in the morning edition of the Times, rather than “less appropriate evening journals”.
__________________________
During the last few days, it was difficult to escape all the hoo-hah related to the coronation, and I wondered whether Charles has replaced Prof Thomas in his role as HEAD OF THE ROYAL MEDICAL HOUSEHOLD. It did not take long to find out. There even is a Wiki page on the subject! It provides a list of the recent heads:
List of Heads of the Medical Household
The Head of the Medical Household was first appointed in 1973.
- 1973–1981: Sir Richard Bayliss, KCVO MD FRCP MRCS
- 1981–1989: Sir John Batten, KCVO MD FRCP
- 1989–1993: Sir Anthony Dawson, KCVO MD FRCP[1]
- 1993–2005: Sir Richard Thompson, KCVO DM PRCP
- 2005–2014: Professor Sir John Cunningham, KCVO BM BCh MA DM FRCP
- 2014–2022: Professor Sir Huw Thomas, KCVO MBBS MA PhD
- 2022 – to present: Dr Michael Dixon, LVO, OBE, MA, FRCGP, FRCP
Yes, Michael Dixon! I am sure this will be of interest. Michael Dixon used to be a friend and an occasional collaborator of mine. He has featured prominently in my memoir as well as in my biography of Charles. In addition, he has been the subject of numerous blog posts, e.g.:
- Today, integrative medicine is about to make history, says Dr. Michael Dixon
- My (most forgettable) paper with Dr Michael Dixon
- Boosting immunity against coronavirus? Dr Michael Dixon’s infinite wisdom on the pandemic
- Dr Michael Dixon seems to support homeopathy as a treatment for cancer
- Should homeopathy be blacklisted in general practice? Dr Michael Dixon’s profoundly misleading comments
- Johrei healing and the amazing Dr Dixon (presidential candidate for the RCGP)
- Dr Dixon’s safe herbal medicine
- Remember the ‘Foundation for Integrated Health’? Here is a good summary of its infamous history
- Prince Charles becomes patron of the ‘College of Medicine and Integrated Health’
- Uncharitable charities? The example of ‘YES TO LIFE’
- A treasure trove of fallacies, falsehoods and deceptions
I am sure that many of my readers would like to join me in wishing both Michael and Charles all the best in their new roles.
Social prescribing (SP) has been mentioned here several times before. It seems important to so-called alternative medicine (SCAM), as some enthusiasts – not least King Charles – are trying to use it as a means to smuggle nonsensical treatments into routine healthcare.
SP is supposed to enable healthcare professionals to link patients with non-medical interventions available in the community to address underlying socioeconomic and behavioural determinants. The question, of course, is whether it has any relevant benefits.
This systematic review included all randomised controlled trials of SP among community-dwelling adults recruited from primary care or community setting, investigating any chronic disease risk factors defined by the WHO (behavioural factors: smoking, physical inactivity, unhealthy diet and excessive alcohol consumption; metabolic factors: raised blood pressure, overweight/obesity, hyperlipidaemia and hyperglycaemia). Random effect meta-analyses were performed at two time points: completion of intervention and follow-up after trial.
The researchers identified 9 reports from 8 trials totalling 4621 participants. All studies evaluated SP exercise interventions which were highly heterogeneous regarding the content, duration, frequency and length of follow-up. The majority of studies had some concerns about the risk of bias. A meta-analysis revealed that SP likely increased physical activity (completion: mean difference (MD) 21 min/week, 95% CI 3 to 39, I2=0%; follow-up ≤12 months: MD 19 min/week, 95% CI 8 to 29, I2=0%). However, SP may not improve markers of adiposity, blood pressure, glucose and serum lipid. There were no eligible studies that primarily target unhealthy diet, smoking or excessive alcohol-drinking behaviours.
The authors concluded that SP exercise interventions probably increased physical activity slightly; however, no benefits were observed for metabolic factors. Determining whether SP is effective in modifying the determinants of chronic diseases and promotes sustainable healthy behaviours is limited by the current evidence of quantification and uncertainty, warranting further rigorous studies.
Great! Regular exercise improves physical fitness.
But do we need SP for this?
Don’t get me wrong, I have nothing against connecting patients with social networks to improve their health and quality of life. I do, however, object if SP is used to smuggle unproven or disproven SCAMs into EBM. In addition, I ask myself whether we really need the new profession of a ‘link worker’ to facilitate SP. I remember being taught that a good doctor should look after his/her patients holistically, and surely that includes mentioning and facilitating social networks for those who need them.
I, therefore, fear that SP is taking something valuable out of the hands of doctors. And the irony is that SP is favoured by those who are all too quick to turn around and say: LOOK AT HOW FRIGHTFULLY REDUCTIONIST AND HEARTLESS DOCTORS HAVE BECOME. WE NEED MORE HOLISM IN MEDICINE AND THAT CAN ONLY BE PROVIDED BY SCAM PRACTITIONERS!
A “null field” is a scientific field where there is nothing to discover and where observed associations are thus expected to simply reflect the magnitude of bias.
This analysis aimed to characterize a null field using a known example, homeopathy (a pseudoscientific medical approach based on using highly diluted substances), as a prototype. The researchers identified 50 randomized placebo-controlled trials of homeopathy interventions from highly cited meta-analyses. The primary outcome variable was the observed effect size in the studies. Variables related to study quality or impact were also extracted.
The mean effect size for homeopathy was 0.36 standard deviations (Hedges’ g; 95% confidence interval: 0.21, 0.51) better than placebo, which corresponds to an odds ratio of 1.94 (95% CI: 1.69, 2.23) in favor of homeopathy. 80% of studies had positive effect sizes (favoring homeopathy). The effect size was significantly correlated with citation counts from journals in the directory of open-access journals and CiteWatch. We identified common statistical errors in 25 studies.
The authors concluded that a null field like homeopathy can exhibit large effect sizes, high rates of favorable results, and high citation impact in the published scientific literature. Null fields may represent a useful negative control for the scientific process.
The paper is perhaps not the easiest to comprehend but once you got the idea, you will agree with me that it is BRILLIANT. I warmly recommend it to all fans of homeopathy – in fact, if I could I’d offer it to King Charles as a present for the coronation.
Its authors are among the most prominent medical epidemiologist of our time with affiliations that speak for themselves:
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
- 2Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
- 3Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA; Department of Medicine, Stanford University, Stanford, CA, USA; Department of Biomedical Data Science, Stanford University, Stanford, CA, USA; Department of Statistics, Stanford University, Stanford, CA, USA.
It is, of course, a pity that the article is behind a paywall – but fortunately, the senior author, John Ioannidis, published his email address together with the abstract: [email protected]. So, if you have trouble understanding the point of the analysis, I suggest you ask for a reprint to get your head around it. I promise it’s worth it.
It has been reported that King Charles refused to pay Prince Andrew’s £ 32,000-a-year bill for his personal healing guru. The Duke of York has allegedly submitted the claim to the Privy Purse as a royal expense having sought the help of a yoga teacher.
However, the claim has reportedly been denied by the King, who is said to have told Andrew the bill will need to be covered using his own money. It comes after sources claimed Andrew has been using the Indian yogi for a number of years for chanting, massages, and holistic therapy in the privacy of his mansion. The healer has reportedly enjoyed month-long stays at a time at the £30 million Royal Lodge in Windsor.
Previously, the Queen seems to have passed the claims. But now Charles is in control. A source said: “While the Queen was always happy to indulge her son over the years, Charles is far less inclined to fund such indulgences, particularly in an era of a cost-of-living crisis. “Families are struggling and would rightly baulk at the idea of tens of thousands paid to an Indian guru to provide holistic treatment to a non-working royal living in his grace and favour mansion. This time the King saw the bill for the healer submitted by Andrew to the Privy Purse and thought his brother was having a laugh.”
________________________
Poor Andrew!
How is he going to cope without his guru?
Will he be able to recover from the mysterious condition that prevents him to sweat?
Will his ego take another blow?
How will he be able to afford even the most basic holistic wellness?
How can Charles – who knows only too well about its benefits – be so cruel to his own brother?
Should I start a collection so that Andrew can pay for his most basic needs?
____________________________
Yes, these are the nagging questions and deep concerns that keep me awake at night!
PS
I have just been asked if, by any chance, the yoga teacher is a 16-year-old female. I have to admit that I cannot answer this question.
