I was alerted to an article in which some US doctors, including the famous Andrew Weil, promote the idea that so-called alternative medicine (SCAM) has a lot to offer for people recovering from Covid-19 infections. There would be a lot to argue about their recommendations, but today I will not go into this (I find it just too predictable how SCAM proponents try to promote SCAM on the basis of flimsy evidence; perhaps I am suffering from ‘BS for Covid fatigue’?). What did, however, strike me in their paper was a definition of INTEGRATIVE MEDICINE (IM) that I had not yet come across:
Integrative medicine is defined as healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies.
Ever since the term IM became fashionable, there have been dozens of definitions of the term (almost as though IM proponents were not quite sure themselves what they were promoting). And ever since I first heard about IM, I felt it was a thinly disguised attempt to smuggle unproven treatments into the routine of evidence-based medicine (EBM). In 2002, I published my 1st comment on the subject. In it, I warned that IM must not become an excuse for using every conceivable untested treatment under the banner of holism. Nineteen years on, this is exactly what has happened, and one definition of IM after the next is soaked in platitudes, falsehoods and misunderstandings.
So, let’s see how reasonable this new definition is. I will try to do this by briefly discussing each element of the two sentences.
- IM is healing-oriented medicine: this is a transparently daft platitude. Does anyone know a medicine that is not oriented towards healing? Healing is the process of becoming well again, especially after a cut or other injury, or of making someone well again. Healing is what medicine has always been and always be aimed at. In other words, it is not something that differentiates IM from other forms of healthcare.
- IM takes account of the whole person: This is the little holistic trick that IM proponents like to adopt. It implies that normal medicine or EBM is not holistic. This implication is wrong. Any good medicine is holistic, and if a sector of healthcare fails to account for the whole person, we need to reform it. (Here are the conclusions of an editorial I published in 2007 entitled ‘Holistic heath care?‘: good health care is likely to be holistic but holistic health care, as it is marketed at present, is not necessarily good. The term ‘holistic’ may even be a ‘red herring’ which misleads patients. What matters most is whether or not any given approach optimally benefits the patient. This goal is best achieved with effective and safe interventions administered humanely — regardless of what label we put on them.) Creating a branch of medicine that, like IM, pretends to have a monopoly on holism can only hinder this process.
- IM includes all aspects of lifestyle: really, all of them? This is nonsense! Good physicians take into account the RELEVANT lifestyles of their patients. If, for instance, my patient with intermittent claudication is a postman, his condition would affect him differently from a patient who is a secretary. But all lifestyles? No! I fear this ‘over the top’ statement merely indicates that those who have conceived it have difficulties differentiating the important from the trivial.
- IM emphasizes the therapeutic relationship: that’s nice! But so do all other physicians (except perhaps pathologists). As medical students, we were taught how to do it, some physicians wrote books about it (remember Balint?), and many of us ran courses on the subject. Some conventional clinicians might even feel insulted by the implication that they do not emphasize the therapeutic relationship. Again, the IM brigade take an essential element of good healthcare as their monopoly. It almost seems to be a nasty habit of theirs to highjack a core element of healthcare and declare it as their invention.
- IM is informed by evidence: that is brilliant, finally there emerges a real difference between IM and EBM! While proper medicine is BASED on evidence, IM is merely INFORMED by it. The difference is fundamental, because it allows IM clinicians to use any un- or disproven SCAM. The evidence for homeopathy fails to show that it is effective? Never mind, IM is not evidence-based, it is evidence-informed. IM physiciance know homeopathy is a placebo therapy (if not they would be ill-informed which would make them unethical), but they nevertheless use homeopathy (try to find an IM clinic that does not offer homeopathy!), because IM is not EBM. IM is evidence-informed!
- IM makes use of all appropriate therapies: and the last point takes the biscuit. Are the IM fanatics honestly suggesting that conventional doctors use inappropriate therapies? Does anyone know a branch of health care where clinicians systematically employ therapies that are not appropriate? Appropriate means suitable or right for a particular situation or occasion. Are IM practitioners the only ones who use therapies that are suitable for a particular situation? This last point really does count on anyone falling for IM not to have the slightest ability to think analytically.
This short analysis confirms yet again that IM is little more than a smokescreen behind which IM advocates try to smuggle nonsense into routine healthcare. The fact that, during the last two decades, the definition constantly changed, while no half decent definition emerged suggests that they themselves don’t quite know what it is. They like moving the goal post but seem unsure in which direction. And their latest attempt to define IM indicates to me that IM advocates might not be the brightest buttons in the drawer.
As though the UK does not have plenty of organisations promoting so-called alternative medicine (SCAM)! Obviously not – because a new one is about to emerge.
In mid-January, THE COLLEGE OF MEDICINE AND INTEGRATED HEALTH (COMIH) will launch the Integrated Medicine Alliance bringing together the leaders of many complementary health organisations to provide patients, clinicians and policy makers with information on the various complementary modalities, which will be needed in a post COVID-19 world, where:
- patient choice is better respected,
- requirements for evidence of efficacy are more proportionate to the seriousness of the disease and the safety of the intervention,
- and where benefit versus risk are better balanced.
We already saw this in 2020 with the College advocating from the very beginning of the year that people should think about taking Vitamin D, while the National Institute for Clinical Excellence continued to say the evidence was insufficient, but the Secretary of State has now supported it being given to the vulnerable on the basis of the balance between cost, benefit and safety.
Elsewhere we learn more about the Integrated Medicine Alliance (IMA):
The IMA is a group of organisations and individuals that have been brought together for the purpose of encouraging and optimising the best use of complementary therapies alongside conventional healthcare for the benefit of all.
The idea for this group was conceived by Dr Michael Dixon in discussion with colleagues associated with the College of Medicine, and the initial meeting to convene the group was held in February 2019.
The group transitioned through a number of titles before settling on the ‘Integrated Medicine Alliance’ and began work on developing a patient leaflet and a series of information sheets on the key complementary therapies.
It was agreed that in the first instance the IMA should exist under the wing of the College of Medicine, but that in the future it may develop into a formal organisation in its own right, but inevitably maintaining a close relationship with the College of Medicine.
The IMA also offers ‘INFORMATION SHEETS’ on the following modalities:
- Alexander Technique
- Herbal Medicine
- Tai Chi
- Yoga Therapy
I find those leaflets revealing. They tell us, for example that the Reiki practitioner channels universal energy through their hands to help rebalance each of the body’s energy centres, known as chakras. About homeopathy, we learn that a large corpus of evidence has accumulated which stands the most robust tests of modern science. And about naturopathy, we learn that it includes ozone therapy but is perfectly safe.
Just for the fun of it – and free of charge – let me try to place a few corrections here:
- Reiki healers use their hands to perform what is little more than a party trick.
- The universal energy they claim to direct does not exist.
- The body does not have energy centres.
- Chakras are a figment of imagination.
- The corpus of evidence on homeopathy is by no means large.
- The evidence is flimsy.
- The most robust tests of modern science fail to show that homeopathy is effective beyond placebo.
- Naturopathy is a hotchpotch of treatments most of which are neither natural nor perfectly safe.
One does wonder who writes such drivel for the COMIH, and one shudders to think what else the IMA might be up to.
2020 was certainly a difficult year (please note, I am trying a British understatement here). From the point of view of running this blog, it was sad to lose James Randi (1928 – 2020) who had been the hero of so many sceptics worldwide, and to learn of the passing of Frank Odds (1945-2020) who was a regular, thoughtful commentator here.
Reviewing the topics we tackled, I could mention dozens. But let me pick out just a few themes that I feel might be important.
Homeopathy continued to have a rough time; the German medical profession has finally realised that homeopathy is treatment with placebos and the German Green Party no longer backs homeopathy. In India, the Supreme Court ruled: Homeopathy must not be sold as a cure of Covid-19, and in the US improved labeling on homeopathic products were introduced. To make matters worse I issued A CHALLENGE FOR ALL HOMEOPATHS OF THE WORLD.
On this blog, I like to write about new so-called alternative medicines (SCAMs) that I come accross. Blood letting is not exactly new, but Oh look! Bloodletting is back! Many other ‘innovations’ were equally noteworthy. Here is merely a very short selection of modalities that were new to me:
- Hydrogen-rich water: the new wonder drug?
- Dr. Robin A. Bernhoft and his ‘Bioidentical Hormone Replacement Therapy’ (BHRT)
- The ‘OBERON’: revolutionary invention or dangerous con?
- Qi technology: “scientifically proven to provide EMF Protection” (edzardernst.com)
- ‘DRX9000’ for back pain: a nice little earner for chiropractors and other back pain quacks
- Vibroacoustic Sound Therapy: introducing the ‘healthy vibration of cells’ into the body
- Lakhovsky’s oscillator, the ‘cure all’ that the world forgot
Unquestionably the BIG subject (not just) in SCAM was – is and will be for a while – the pandemic. It prompted quacks of any type to crawl out of the woodwork misleading the public about their offerings. On 24 January, I wrote for the first time about it: Coronavirus epidemic: Why don’t they ask the homeopaths for help? Thereafter, every charlatan seemed to jump on the COVID bandwaggon, even Trump: Trump seems to think that UV might be the answer to the corona-pandemic – could he mean “ultraviolet blood irradiation”? It became difficult to decide who was making a greater fool of themselves, Trump or the homeopaths (Is this the crown of the Corona-idiocy? Nosodes In Prevention And Management Of COVID -19). Few SCAM entrepreneurs (Eight new products aimed at mitigating COVID-19. But do they really work?) were able to resist the opportunity. Snakeoil salesmen were out in force and view COVID-19 as an ‘opportunity’. It is impossible to calculate what impact all this COVID-quackery had, but I fear that many people lost their lives at least in part because of it.
The unavoidable consequence of the pandemic was that the anti-vaxx brigade sensed that their moment had arrived. Ex-doctor Andrew Wakefield: “Better to die as a free man than live as a slave” (and get vaccinated against Covid-19). Again the ‘charlatan in chief’ made his influence felt through the ‘Trump-Effect’ on vaccination attitudes. Unsurprisingly, the UK ‘Society of Homeopath’ turned out to be an anti-vaxx hub that endangers public health. And where there is anti-vaxx, chiropractors are seldom far: Ever wondered why so many chiropractors are profoundly anti-vax?. All this could be just amusing, but sadly it has the potential to cost lives through Vaccine hesitancy due to so-called alternative medicine (SCAM).
I happen to believe that ethics in SCAM are an important, yet much neglected topic. It is easy to understand why this should be so: adhering to the rules of medical ethics would all but put an end to SCAM. This applies to chiropractic (The lack of chiropractic ethics: “valid consent was not obtained in a single case”), to homeopaths (Ethical homeopathy) and to most other SCAM professions. If I had a wish for the next year(s), it would be that funding agencies focus on research into the many ethical problems posed by the current popularity of SCAM.
If I had another wish, it would be that critical thinking becomes a key subject in schools, universities and adult education. Why do so many people make irrational choices? One answer to this question is, because we fail to give this subject the importance it demands. The lack of critical thinking is the reason why we elect leaders who are compulsory lyers, make wrong choices about healthcare, and continue to destroy the planet as though there is no tomorrow. It is high time that we, as a society, realise how fundamentally important critical thinking truly is.
Yes, 2020 was difficult: Brexit, COVID-19, anti-vaxx, etc. But it was not all bad (certainly not for me personally), and there is good reason for hope: the globally malign influence of Trump is about to disappear, and we now have several effective vaccines. Common sense, decency and science might triumph after all.
HEALTHY NEW YEAR EVERYONE!
The authors of this review wanted to determine similarities and differences in the reasons for using or not using so-called alternative medicine (SCAM) amongst general and condition-specific populations, and amongst populations in each region of the globe.
Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a ‘risk of bias’ assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage.
A total of 231 publications were included. Reasons for SCAM use amongst general and condition-specific populations were similar. The top three reasons were:
- (1) having an expectation of benefits of SCAM (84% of publications),
- (2) dissatisfaction with conventional medicine (37%),
- (3) the perceived safety of SCAM (37%).
Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to SCAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards SCAM and satisfaction with conventional medicine were the main reasons for non-use (p < 0.05).
The authors concluded that dissatisfaction with conventional medicine and positive attitudes toward SCAM, motivate people to use SCAM. In contrast, satisfaction with conventional medicine and negative attitudes towards SCAM are the main reasons for non-use.
At this point, I thought: so what? This is all very obvious and does not necessitate an extensive review of the published literature. What it actually shows is that the realm of SCAM is obsessed with conducting largely useless surveys, a phenomenon, I once called ‘survey mania‘. But a closer look at the review does reveal some potentially interesting findings.
In less developed parts of the world, like Africa, SCAM use seems to be determined by affordability, accessibility and tradition. This makes sense and ties in with my impression that consumers in such countries would give up SCAM as soon as they can afford proper medicine.
This notion seems to be further supported by the reasons for not using SCAM. Asian consumers claim overwhelmingly that this is because they consider SCAM ineffective and unsafe.
In our review of 2011 (not cited in the new review), we looked at some of the issues from a slightly different angle and evaluated the expectations of SCAM users. Seventy-three articles met our inclusion criteria of our review. A wide range of expectations emerged. In order of prevalence, they included:
- the hope to influence the natural history of the disease;
- the desire to prevent disease and promote health/general well-being;
- the hope of fewer side effects;
- the wish to be in control over one’s health;
- the hope for symptom relief;
- the ambition to boost the immune system;
- the hope to receive emotional support;
- the wish to receive holistic care;
- the hope to improve quality of life;
- the expectation to relief of side effects of conventional medicine;
- the desire for a good therapeutic relationship;
- the hope to obtain information;
- the hope of coping better with illness;
- the expectation of supporting the natural healing process;
- the availability of SCAM.
All of these aspects, issues and notions might be interesting, even fascinating to some, but we should not forget three important caveats:
- Firstly, SCAM is such a diverse area that any of the above generalisations are highly problematic; the reasons and expectations of someone trying acupuncture may be entirely different from those of someone using homeopathy, for instance.
- Secondly (and more importantly), the ‘survey mania’ of SCAM researchers has not generated the most reliable data; in fact, most of the papers are hardly worth the paper they were printed on.
- Thirdly (and even more importantly, in my view), why should any of this matter? We have known about some of these issues for at least 3 decades. Has this line of research changed anything? Has it prevented consumers getting exploited by scrupulous SCAM entrepreneurs? Has it made consumers, politicians or anyone else more aware of the risks associated with SCAM? Has it saved many lives? I doubt it!
It has been reported that Karnataka’s Deputy Chief Minister, Dr CN Ashwathnarayan, has launched eight products, several of which fall in the category of so-called alternative medicine (SCAM), aimed at mitigating COVID-19, developed by various start-ups at Bangalore Bioinnovation Centre (BBC). Dr CN Ashwathnarayan said the launch of the products shows that Karnataka has emerged as a leading state in developing solutions to fight the COVID 19 pandemic.
Here are short descriptions of the innovations:
- Padma Vitals +: Developed by Innovator start-up Dr. Madan Gopal of Cardiac Design labs,Padma Vitals + is a centralized monitoring system for ECG, respiration, Spo2 and body temperature, which can measure the vitals continuously and the analysis sent through telemetry, with an alerting system embedded in it. The device is much needed for contactless monitoring of patients during COVID 19 Pandemic. The product has been validated at Narayana Hrudayalaya.
- Malli’s Cordytea: Developed by Dr. Moushmi Mondal from Mallipatra Neutraceuticals, this product is an Immunity booster tea prepared from medicinal mushroom – Cordyceps. The mushroom variety grown under laboratory conditions is developed by the Innovator. Cordicepin, an active ingredient is known to have anti-viral properties too. In the COVID 19 times, it will be helpful in boosting the immunity levels. The product has been patented and is approved by FSSAI.
- CD4 Shield : Developed by Dr. Vijay Lanka and his team from Stabicon, this product is a chewable tablet containing curcumin and Vitamin B12. Both the ingredients fight inflammation and infection. The product ensures activation of innate immunity by activating CD4+, CD8+ and IFN 1 to virus specific effect and has immunomodulatory properties. It also reduces cytokine storm in response to viral infection. The product is approved by FSSAI.
- BeamRoti : Developed by Dr. Srinivas from Aspartika, the product is an immunity booster chapati having mixture of herbs recommended by AYUSH ministry. The ingredients have been prepared using supercritical fluid extraction technology to ensure optimum concentration of herbal extract reaches the body. The chapatis are easy to store with good shelf life and Patent application has been filed. The product is approved by FSSAI.
- Immune booster daily drops: Developed by Dr. Srinivas from Aspartika, the product is an immunity booster drop having mixture of herbs recommended by AYUSH ministry. The ingredients have been prepared using supercritical fluid extraction technology to ensure optimum concentration of herbal extract reaches the body by mixing just one drop of the product in a glass of hot water. The product is approved by FSSAI.
- VegPhal – Fruit and Vegetable Sanitizer: Developed by Deepak Bhajantri from Krimmi Biotech, this fruit and vegetable sanitizer is prepared using edible ingredients effective against microbes and removal of pesticides. It is chorine and alcohol free.
- Water Sanitizer – Kitchen Tap: The product is developed by Ravi Kumar from Biofi and is a miniaturized version of UV purifier that can be attached to a water tap and kill 99% of microbes including viruses such as phages.
- nti-Micobial HVAC module: The product is developed by Ravi Kumar from Biofi and is a module that can be fitted to HVAC system to ensure circulating air is sanitized. This is especially useful during COVID 19 times as many enclosed spaces in which AC circulated air may be contaminated. Based on UV-silver titanium dioxide technology, the product is patented and has been validated.
Karnataka is of course a state in the south western region of India. The region has so far about one million COVID-19 cases, while almost 12 000 people have died. One would therefore very much hope that the newly launched innovations can make a difference.
But will they?
As far as the SCAM-related products (e.g. ‘immune boosters’) are concerned, I see no convincing evidence to assume that they are effective. If anyone has information to the contrary, please let me know.
But why not? They can’t do any harm!
Sadly, I am am not so sure. I see the potential for considerable harm from all the useless SCAMs that are being promoted left right and centre for protecting the public against COVID-19. Firstly, there is the financial harm of paying for products that are useless. Secondly, ineffective effords might distract from finding and adhering to efforts that are effective. Thirdly, believing in a SCAM that does not work will create a sense of false security which, in turn, renders consumers more vulnerable to catch the virus.
As always in healthcare, even harmless interventions that do not work can become dangerous, as they lead to neglecting effective measures. I shudder to think of how many deaths have been caused by the many SCAM merchants who see the current pandemic as an opportunity.
In the last few years, several individuals in Germany have, from entirely different angles, taken a fresh look at the evidence on homeopathy and found it to be desperately wanting. Independent of each other, they published articles and books about their research and insights. Here are 5 examples:
In Sachen Homöopathie: Eine Beweisaufnahme, Norbert Aust, 2013
Homöopathie neu gedacht: Was Patienten wirklich hilft, Natalie Grams, 2015
Inevitably, these individuals came into contact with each other and subsequently founded several working-groups to discuss their concerns and coordinate their activities. Thus the INH and the Muensteraner Kreis were born. So, now we have at least three overlapping groups of enthusiastic, multidisciplinary experts who voluntarily work towards informing the German public that paying for homeopathy out of public funds is unethical, nonsensical and not in the interest of progress:
- the GWUP,
- the INH
- and the Muensteraner Kreis.
No wonder then, that the German homeopathic industry and other interested parties got worried. When they realised that (presumably due to the work of these altruistic enthusiasts) the sales figures of homeopathics in Germany had, for the first time since many years, started declining, they panicked.
Their reaction was, as far as I can see, similar to their previous response to criticism: they started a media campaign in an attempt to sway public opinion. And just like before, they have taken to employing PR-people who currently spend their time defaming all individuals voicing criticism of homeopathy in Germany. Their prime targets are those experts who are most exposed to activities of responsibly informing the public about homeopathy via lectures, publications social media, etc. All of us currently receive floods of attack, insults and libellous defamations. As before (innovation does not seem to be a hallmark of homeopathy), these attacks relate to claims that:
- we are incompetent,
- we do not care about the welfare of patients,
- we are habitual liars,
- we are on the payroll of the pharmaceutical industry,
- we aim at limiting patient choice,
- we do what we do because we crave the limelight.
So, what is going to happen?
I cannot read tea leaves but am nevertheless sure of a few things:
- The German homeopathy lobby will not easily give up; after all, they have half a billion Euros per year to lose.
- They will not argue on the basis of science or evidence, because they know that neither are in their favour.
- They will fight dirty and try to defame everyone who stands in their way.
- They will use their political influence and their considerable financial power.
AND YET THEY WILL LOSE!
Not because we are so well organised or have great resources – in fact, as far as I can see, we have none – but because, in medicine, the evidence is invincible and will eventually prevail. Progress might be delayed, but it cannot be halted by those who cling to an obsolete dogma.
The above text is from a blog post I published 17 moths ago. It seems that my prediction was not wrong. Today, I saw two tweets which suggest that, in Germany, homeopathy is continuing to disappear from the realm of conventional medicine:
- Soeben erreicht mich die Nachricht, dass der Vorstand der Bayerischen Landesärztekammer in der Sitzung am 5.12. einstimmig beschlossen hat, die Zusatzweiterbildung Homöopathie aus der ärztlichen Weiterbildungsordnung zu entfernen. EINSTIMMIG!!!
- 11 von 17 Ärztekammern haben die Homöopathie gekickt. Bleiben noch 6. Die nächste Entscheidung steht in Berlin an.
I’ll translate them for you:
- I have just received the news that the Board of the Bavarian Medical Association has unanimously decided in the meeting on 5.12. to remove the additional training in homeopathy from the medical training regulations. UNANIMOUSLY!!!
- 11 of 17 medical associations have kicked homeopathy. That leaves 6. The next decision is due in Berlin.
This means that in most German counties (there is hope that, sooner or later, the other 6 will follow suit), doctors will no longer be able to train in homeopathy and use the title ‘homeopath’.
Yes, it took a while – about 200 years – but it seems that the German medical profession is finally realising that homeopathy is treatment with placebos.
The Center for Science in the Public Interest*** (CSPI) announced its agreement with Boiron to improve the labeling on the homeopathic products manufactured by Boiron and sold under the Boiron or other private label brands. The agreement covers the labeling for over 50 homeopathic products.
On Boiron’s Oscillococcinum and two similar products, Boiron will substantially increase the prominence of the words “Homeopathic Medicine” on the front of the box and the disclaimer on the back of the box that says the product’s uses have not been evaluated by the Food and Drug Administration (FDA). These changes will make it easier for consumers to identify that the products are homeopathic products, and are not FDA approved over-the-counter medicines.
For all of the other homeopathic products manufactured by Boiron, consumers will receive much more information on the packages. In addition to increasing the prominence of the words “Homeopathic Medicine,” a new disclaimer in large and contrasting font will be added to the back of the package (endorsed by the American Association of Homeopathic Pharmacists) stating: “Claims based on traditional homeopathic practice, not accepted medical evidence, and not FDA evaluated.”…
“The labeling changes that Boiron has agreed to on all the products covered by the agreement will help consumers more clearly identify that these are homeopathic products and are not FDA approved over-the-counter medicines that have been scientifically proven to be safe and effective,” said CSPI litigation director Lisa Mankofsky. “In addition, the vast majority of the covered homeopathic products will bear a disclaimer clarifying that they are based on traditional homeopathic practice, not accepted medical evidence, and not FDA evaluated. We think that consumers will find this labeling change important when choosing a remedy. We encourage other manufacturers to similarly make their labels more transparent and clear for consumers.”
Clearly a step into the right direction!
But it’s a small step only. It is a long way short of what Dylan Evans suggestied in his book ‘Placebo‘, first published in 2004:
Warning: this product is a placebo. It will work only if you believe in homeopathy, and only for certain conditions such as pain and depression. Even then, it is not likely to be as powerful as orthodox drugs. You may get fewer side-effects from this treatment than from a drug, but you will probably also get less benefit.
***The Center for Science in the Public Interest is perhaps the oldest independent, science-based consumer advocacy organization with an impressive record of accomplishments and a clear and ambitious agenda for improving the food system to support healthy eating.
In its homeland, Germany, homeopathy had a free ride for many decades. Only in the last 5 years or so, has a vocal opposition emerged of people who argue that disproven treatments should not be paid for by the public purse. Most political parties have been clever enough to pick up on the changed attitude of the German people and have thus joined more or less openly into the growing criticism of homeopathy. One noteable exception has been the German Green Party who have a long tradition of being in favour of all things alternative. Now this seems to have finally changed.
The ‘Frankfurter Allgemeine Zeitung’ (FAZ) just reported that the German Green Party no longer backs homeopathy. After many years of supporting homeopathy and other so-called alternative medicines (SCAMs) and after years of agonising about it, the party has now decided to side with reason, science and evidence. Last Sunday, on their annual party conference, the Greens have voted to back a statement according to which the German health insurers should only reemburse treatments which are “medically reasonable and justifiable and which are supported by evidence of efficacy that is scientifically proven”. Even though they did not mention it in the text, it is understood that the they meant foremost homeopathy.
The Greens rejected a suggestion to go even further and would have stated that a treatment should not be covered, if “its efficacy has not been scientifically proven to be better than a placebo.” They also did not agree to an application by the homeopathy lobby to state that would have allowed the reembursement of homeopathy.
For those of my readers who read German, here is the short article from the FAZ.
Die Grünen haben in ihrem langwierigen Streit um die Homöopathie eine Lösung gefunden. Der Parteitag billigte am Sonntag eine Formulierung, derzufolge nur noch Leistungen von den gesetzlichen Krankenkassen übernommen werden sollten, „die medizinisch sinnvoll und gerechtfertigt sind und deren Wirksamkeit wissenschaftlich erwiesen ist“. Damit gehen die Grünen auf Distanz zu Homöopathie als Kassenleistung – auch wenn die umstrittene Heilmethode in dem Text nicht ausdrücklich genannt wird.
Eine noch weitergehende Formulierung, derzufolge Leistungen, deren Wirksamkeit über den Placeboeffekt hinaus nicht wissenschaftlich bewiesen sei, explizit als Kassenleistung ausgeschlossen werden sollten, fand aber keine Mehrheit.
Today, HRH the Prince of Wales has his 72th birthday. As every year, I send him my best wishes by dedicating an entire post to a brief, updated summary of his achievements in the area of so-called alternative medicine (SCAM).
EARLY INFLUENCE OF LAURENCE VAN DER POST
Aged 18, Charles went on a journey of ‘spiritual discovery’ into the Kalahari desert. His guide was Laurens van der Post (later discovered to be a fraud and compulsive fantasist and to have fathered a child with a 14-year old girl entrusted to him during a sea voyage). Van der Post wanted to awake Charles’ mind and attune it to the ideas of Carl Jung’s ‘collective unconscious’, and it is this belief in vitalism that provides the crucial link to SCAM: virtually every form of SCAM is based on the assumption that some sort of vital force exists. Charles was impressed with van der Post that he made him the godfather of Prince William. After Post’s death, he established an annual lecture in his honour (the lecture series was quickly discontinued after van der Post was discovered to be a fraud).
CHIROPRACTIC and OSTEOPATHY
Throughout the 1980s, Charles lobbied for the statutory regulation of chiropractors and osteopaths in the UK. In 1993, this finally became reality. To this day, these two SCAM professions are the only ones regulated by statute in the UK.
THE BRITISH MEDICAL ASSOCIATION
In 1982, Prince Charles was elected as President of the British Medical Association (BMA) and promptly challenged the medical orthodoxy by advocating SCAM. In a speech at his inaugural dinner as President, the Prince lectured the medics: ‘Through the centuries healing has been practised by folk healers who are guided by traditional wisdom which sees illness as a disorder of the whole person, involving not only the patient’s body, but his mind, his self-image, his dependence on the physical and social environment, as well as his relation to the cosmos.’ The BMA-officials ordered a full report on alternative medicine which promptly condemned this area as implausible nonsense.
Six years later, a second report, entitled ‘Complementary Medicine – New Approaches to Good Practice’, heralded U-turn stating that: “the demand for non-conventional therapies had become so pressing that organised medicine in Britain could no longer ignore its contribution“. At the same time, however, the BMA set in motion a further chapter in the history of SCAM by insisting that it was “unacceptable” to allow the unrestricted practice of non-conventional therapies, irrespective of training or experience.
THE FOUNDATION OF INTEGRATED HEALTH
In 1993, Charles founded his lobby group which, after being re-named several times, ended up being called the ‘Foundation for Integrated Health’ (FIH). It was closed down in 2010 amidst allegations of money laundering and fraud. Its chief executive, George Gray, was later convicted and went to jail.
In 2001, Charles worked on plans to help build a model hospital of integrated medicine. It was to train doctors to combine conventional medicine and SCAMs, such as homeopathy, Ayurvedic medicine and acupuncture, and was to have around 100 beds. The prince’s intervention marked the culmination of years of campaigning by him for the NHS to assign a greater role to SCAM.
In 2001, Charles published an editorial in the BMJ promoting his ideas around integrative medicine. Its title: THE BEST OF BOTH WORLDS. Ever since, Charles has been internationally recognised as one of the world’s most vociferous champions of integrated medicine.
In 2004, Charles publicly supported the Gerson diet as a treatment for cancer. Prof Baum, an eminent oncologists, was invited to respond in an open letter to the British Medical Journal: ” …Over the past 20 years I have treated thousands of patients with cancer and lost some dear friends and relatives to this dreaded disease…The power of my authority comes with knowledge built on 40 years of study and 25 years of active involvement in cancer research. Your power and authority rest on an accident of birth. I don’t begrudge you that authority but I do beg you to exercise your power with extreme caution when advising patients with life-threatening diseases to embrace unproven therapies.”
THE SMALLWOOD REPORT
In 2005, the ‘Smallwood-Report’ was published; it had been commissioned by Charles and paid for by Dame Shirley Porter to inform health ministers. It stated that up to 480 million pounds could be saved, if one in 10 family doctors offered homeopathy as an “alternative” to standard drugs for asthma. Savings of up to 3.5 billion pounds could be achieved by offering spinal manipulation rather than drugs to people with back pain. Because I had commented on this report, Prince Charles’ first private secretary asked my vice chancellor to investigate the alleged indiscretion; even though I was found to be not guilty of any wrong-doing, all local support at Exeter stopped which eventually led to my early retirement.
WORLD HEALTH ORGANISATION
In a 2006 speech, Prince Charles told the World Health Organisation in Geneva that SCAM should have a more prominent place in health care and urged every country to come up with a plan to integrate conventional and alternative medicine into the mainstream. Anticipating Prince Charles’s sermon in Geneva, 13 of Britain’s most eminent physicians and scientists wrote an “Open Letter” which expressed concern over “ways in which unproven or disproved treatments are being encouraged for general use in Britain’s National Health Service.” The signatories argued that “it would be highly irresponsible to embrace any medicine as though it were a matter of principle.”
TRADITIONAL CHINESE MEDICINE (TCM)
In 2007, the People’s Republic of China recorded the visit of Fu Ying, its ambassador in London at the time, to Clarence House, and announced that the Charles had praised TCM. “He hoped that it could be included in the modern medical system . . . and was willing to make a contribution to it.”
In 2009, the Prince held talks with the health Secretary to persuade him to introduce safeguards amid a crackdown by the EU that could prevent anyone who is not a registered health practitioner from selling remedies.
In the same year, Charles urged the government to protect SCAM because “we fear that we will see a black market in herbal products”, as Dr Michael Dixon, medical director of the FIH and Charles’ advisor in SCAM, put it.
UK HEALTH POLITICS
In 2009, the health secretary wrote to the Prince suggesting a meeting on the possibility of a study on integrating SCAM in England’s NHS. The Prince had written to Burnham’s predecessor, Alan Johnson, demanding greater access to SCAM in the NHS alongside conventional medicine. Charles stated that “despite waves of invective over the years from parts of the medical and scientific establishment” he continued to lobby “because I cannot bear people suffering unnecessarily when a complementary approach could make a real difference”.
In June 2014, BBC NEWS published the following text about a BBC4 broadcast entitled ‘THE ROYAL ACTIVIST’ aired on the same day: Prince Charles has been a well-known supporter of complementary medicine. According to a… former Labour cabinet minister, Peter Hain, it was a topic they shared an interest in. He had been constantly frustrated at his inability to persuade any health ministers anywhere that that was a good idea, and so he, as he once described it to me, found me unique from this point of view, in being somebody that actually agreed with him on this, and might want to deliver it. Mr Hain added: “When I was Secretary of State for Northern Ireland in 2005-7, he was delighted when I told him that since I was running the place I could more or less do what I wanted to do. I was able to introduce a trial for complementary medicine on the NHS, and it had spectacularly good results, that people’s well-being and health was vastly improved. And when he learnt about this he was really enthusiastic and tried to persuade the Welsh government to do the same thing and the government in Whitehall to do the same thing for England, but not successfully,” added Mr Hain.
In October 2015, the Guardian obtained the infamous “black spider memos” which revealed that Charles had repeatedly lobbied politicians in favour of SCAM.
THE COLLEGE OF MEDICINE
In 2009, it was announced that the ‘College of Integrated Medicine’ (the successor of the FIH) was to have a second base in India. In 2011, Charles forged a link between ‘The College of Medicine’ and an Indian holistic health centre. The collaboration was reported to include clinical training to European and Western doctors in Ayurveda and homoeopathy and traditional forms of medicine to integrate them in their practice. The foundation stone for the extended campus of the Royal College known as the International Institution for Holistic and Integrated Medicine was laid by Dr Michael Dixon in collaboration with the Royal College of Medicine.
In 2020, Charles became the patron of the College of Medicine which, by then, had re-christened itself ‘College of Medicine and Integrated Health’. The College chair, Michael Dixon, was quoted stating: ‘This is a great honour and will support us as an organisation committed to taking medicine beyond drugs and procedures. This generous royal endorsement will enable us to be ever more ambitious in our mission to achieve a more compassionate and sustainable health service.”
DUTCHY ORIGINALS DETOX TINCTURE
In 2011, after the launch of Charles’ range of herbal tinctures, I had the audacity to publicly criticise Charles for selling the Duchy Herbals detox tincture which I named ‘Dodgy Originals Detox Tincture’.
In 2016, speaking at a global leaders summit on antimicrobial resistance, Prince Charles warned that Britain faced a “potentially disastrous scenario” because of the “overuse and abuse” of antibiotics. The Prince explained that he had switched to organic farming on his estates because of the growing threat from antibiotic resistance and now treats his cattle with homeopathic remedies rather than conventional medication. As some of you may be aware, this issue has been a long-standing and acute concern to me,” he told delegates from 20 countries “I have enormous sympathy for those engaged in the vital task of ensuring that, as the world population continues to increase unsustainably and travel becomes easier, antibiotics retain their availability to overcome disease… It must be incredibly frustrating to witness the fact that antibiotics have too often simply acted as a substitute for basic hygiene, or as it would seem, a way of placating a patient who has a viral infection or who actually needs little more than patience to allow a minor bacterial infection to resolve itself.”
In 2017, Charles declared that he will open a centre for SCAM in the recently purchased Dumfries House in Scotland. Currently, the College of Medicine and Integrated Health is offering two-day Foundation Courses at this iconic location. Gabriel Chiu, a US celebrity cosmetic and reconstructive surgeon, and his wife Christine, joined the Prince of Wales as he opened the integrated health and wellbeing centre on the Dumfries House Estate in East Ayrshire in 2019. As he unveiled a plaque, Prince Charles said: “I’m so glad that all of you have been able to get here today, particularly because I could not be more proud to see the opening of this new integrated health centre at Dumfries House. It’s something I’ve been wanting to do for the last 35 years. I’m also so proud of all the team at Dumfries House who built it, an all in-house team.”
Generations of royals have favoured homeopathy, and allegedly it is because of this influence that homeopathy became part of the NHS in 1948. Homeopathy has also been at the core of Charles’ obsession with SCAM from its beginning. In 2017, ‘Country News’ published an article about our heir to the throne stating that Prince of Wales has revealed he uses homeopathic treatments for animals on his organic farm at Highgrove to help reduce reliance on antibiotics, the article stated. He said his methods of farming tried wherever possible to ‘‘go with the grain of nature’’ to avoid dependency on antibiotics, pesticides and other forms of chemical intervention.
In the same year, it was revealed that UK farmers were being taught how to treat their livestock with homeopathy “by kind permission of His Royal Highness, The Prince Of Wales”
In 2019, the Faculty of Homeopathy announced that His Royal Highness The Prince of Wales had accepted to become Patron of the Faculty of Homeopathy. Dr Gary Smyth, President of the Faculty of Homeopathy commented, “As the Faculty celebrates its 175th anniversary this year, it is an enormous honour for us to receive the Patronage of His Royal Highness The Prince of Wales and I am delighted to announce this news today.” Charles’ move amazed observers who saw it as a deliberate protest against the discontinuation of reimbursement of homeopathy by the NHS.
In 2020, Charles fell ill with the corona-virus and happily made a swift recovery. It was widely reported that his recovery was due to homeopathy, a notion denied by Clarence House.
Happy Birthday Charles
Governments and key institutions have had to implement decisive responses to the danger posed by the coronavirus pandemic. Imposed change will increase the likelihood that alternative explanations take hold. In a proportion of the general population there may be strong scepticism, fear of being misled, and false conspiracy theories.
The objectives of this survey were to estimate the prevalence of conspiracy thinking about the pandemic and test associations with reduced adherence to government guidelines. The survey was conducted in May 2020 as a non-probability online survey with 2501 adults in England, quota sampled to match the population for age, gender, income, and region.
Approximately 50% of this population showed little evidence of conspiracy thinking, 25% showed a degree of endorsement, 15% showed a consistent pattern of endorsement, and 10% had very high levels of endorsement. Higher levels of coronavirus conspiracy thinking were associated with less adherence to all government guidelines and less willingness to take diagnostic or antibody tests or to be vaccinated. Such ideas were also associated with
- general vaccination conspiracy beliefs,
- climate change conspiracy belief,
- a conspiracy mentality, and distrust in institutions and professions.
Holding coronavirus conspiracy beliefs was also associated with being more likely to share opinions.
The authors concluded that, in England, there is appreciable endorsement of conspiracy beliefs about coronavirus. Such ideas do not appear confined to the fringes. The conspiracy beliefs connect to other forms of mistrust and are associated with less compliance with government guidelines and greater unwillingness to take up future tests and treatment.
The authors also state that the coronavirus conspiracy ideas ascribe malevolent intent to individuals, groups, and organisations based on what are likely to be long-standing prejudices. For instance, almost half of participants endorsed to some degree the idea that ‘Coronavirus is a bioweapon developed by China to destroy the West’ and around one-fifth endorsed to some degree that ‘Jews have created the virus to collapse the economy for financial gain’.
The survey did not include questions about so-called alternative medicine (SCAM). This is a great shame, in my view. We know from previous research that people who adhere to conspiracy theories feel strongly that SCAM is being suppressed via some sinister complot by the establishment. Moreover, we know that SCAM enthusiasts tend to believe in vaccination conspiracy theories. One might therefore expect that proponents of SCAM are also prone to conspiracy beliefs about coronavirus.
When reading some of the comments on this blog, I have little doubt that this is, in fact, the case.