survey
So-called alternative medicine (SCAM) remains widely used worldwide, yet longstanding concerns persist regarding the balance and reliability of the evidence presented in SCAM journals. This investigation examined long-term trends in publication practices within leading SCAM journals, with particular attention to changes in publication types and the prevalence of positive versus negative study outcomes as indirect indicators of potential publication bias.
The authors conducted a complete census of articles published in four leading SCAM journals at two contemporary time points (2018 and 2023), replicating the design and classification framework of a seminal 2001 analysis covering 1995 and 2000. Articles were categorised by publication type, subject area, and author-reported study outcome (positive, negative, or inconclusive, corresponding to the “open” category used in the original 2001 study). Descriptive analyses were used to compare trends over time and with earlier findings.
The total number of published articles increased substantially between the earlier and contemporary periods. The proportion of empirical studies, particularly clinical trials, rose over time. However, the prevalence of positive outcomes also increased markedly, with positive findings accounting for over 80% of published articles in the contemporary period, compared with 49% in the earlier study. Negative and inconclusive outcomes remained relatively infrequent.
The authors concluded that despite growth in publication volume and a shift toward empirical study designs, SCAM journals continue to exhibit a pronounced predominance of positive outcome reporting. These findings suggest that longstanding concerns regarding publication bias in SCAM publishing have not diminished over time and appear to have intensified, with selective publication and related reporting and dissemination practices plausibly contributing to the observed patterns. This has important implications for research integrity and evidence-based decision-making in medical practice.
It is great to see that our past research [the 2001 study mentioned above is one of my team] is being continued. It is less great, of course, to learn that the SCAM-bias continues and might even be on the increase. The reasons why there are so few negative results in SCAM journals might be complex. Two possible clues are:
- The quality of SCAM research tends to be low, and poor quality research tends to generate positive findings, particularly if it is conducted by pseudo-researchers who abuse science for confirming their beliefs rather than for testing hypotheses (see also the ALTERNATIVE HALL OF FAME on this blog).
- If nonetheless a high quality study emerges in SCAM – which, of course, does happen every now and then – it tends to produce a negative result and is likely to get published in a good quality journal rather than in one of the dodgy SCAM journals.
As I have often noted, the end-effect is bad for all concerned: SCAM and SCAM journals are slowly becoming the laughing stock of science. Consequently, nobody takes them seriously. If one day an effective therapy should emerge, we all might faile to notice. In a nutshell: publication bias harms us all!
This AI-verdict made me wonder: Who is for and who against the critical evaluation of so-called alternative medicine? And I asked a follow-up question:
Can you try to quantify this and give me % figures who is against a critical evaluation of alternative medicine, who is for it, and who is neutral. Can you do this for 1. the general population, 2. proponents of alternative medicine and 3. skeptics?
Here is the reply I got from Gemini:
To quantify these dynamics accurately, we have to look at large-scale sociological data on public attitudes toward science, peer-reviewed medical data (such as surveys by Pew Research, YouGov, and the European Commission), and the behavioral patterns of online discourse.
When it comes to a “critical evaluation” (meaning scientific testing to prove if a therapy works beyond a placebo), the groups break down along very distinct ideological lines. Here is how the percentages estimate across your three requested demographics:
Breakdown of Attitudes Toward Critical Evaluation
1. The General Population
The broader public is largely pragmatic, but a major chunk is passively open to alternative therapies without strictly demanding clinical trial proof.
- Against Critical Evaluation (~15% – 20%): These individuals hold a strong distrust of mainstream pharmaceutical companies and medical institutions. They believe alternative medicine operates on a different “energy” or “holistic paradigm” that standard science is fundamentally incapable of or biased against measuring.
- For Critical Evaluation (~35% – 45%): This group highly values evidence-based medicine, expects consumer safety protection, and agrees that if a therapy claims to cure an illness, it should prove it under a microscope or in a randomized controlled trial.
- Neutral / Passive Consumers (~40% – 50%): This is the massive middle. They don’t track clinical trials, but they will try acupuncture for back pain or take turmeric if a friend recommends it. They view alternative medicine through a lens of “well, it can’t hurt to try,” evaluating it based on personal anecdotes rather than scientific data.
2. Proponents of Alternative Medicine
This group includes dedicated practitioners, wellness influencers, and avid consumers of Complementary and Alternative Medicine (CAM).
- Against Critical Evaluation (~70% – 80%): The vast majority actively resist standard scientific evaluation, often viewing figures like Edzard Ernst as hostile prosecutors rather than objective evaluators. They argue that randomized controlled trials are “too reductionist” to capture holistic healing or claim that clinical science is rigged by corporate interests.
- For Critical Evaluation (~5% – 10%): A small minority of CAM practitioners (often in fields like medical acupuncture or osteopathy) welcome rigorous trials, hoping to find a mechanism of action that will grant them mainstream medical legitimacy and insurance coverage.
- Neutral (~10% – 15%): These are individuals who focus strictly on the individual client experience. They don’t care about data or institutional pushback either way; their attitude is simply “if my client says they feel better, that is the only science I need.”
3. Skeptics & Pro-Science Advocates
This demographic comprises secular organizations, evidence-based medical professionals, and science communicators who actively follow work like Ernst’s.
- Against Critical Evaluation (<1%): Virtually non-existent in this group, as evaluation is their core tenet. The only micro-fraction here might be extreme fringe elements who feel certain alternative therapies are so fundamentally absurd (like breatharianism) that evaluating them is a waste of scientific funding.
- For Critical Evaluation (~90% – 95%): The overwhelming majority. They strongly defend the stance that there is no such thing as “alternative” medicine—there is only medicine that has been proven to work and medicine that hasn’t. They view critical evaluation as an ethical necessity for patient safety.
- Neutral (~5%): A tiny sliver who may agree with the premise of science but feel indifferent about fighting the cultural battle against wellness trends, preferring to let people believe what they want as long as it isn’t directly killing them.
The Reality of the “Viral Sharing Power”
The Disparity: While alternative health advocates outnumber skeptics in raw volume and content creation—churning out high-yield, emotionally comforting narratives—the pro-science corrections achieve highly concentrated “viral bursts.”
When a prominent alternative health claim is cleanly and definitively debunked by data, it provides a highly shareable, “gotcha” piece of content for the large, silent neutral majority and the highly active skeptic network. A data-driven correction acts as a high-utility intellectual tool, allowing regular people to cut through multi-million dollar wellness marketing, which is why a single well-structured critique can match or outpace the reach of thousands of individual wellness posts.
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I know, there are good reasons for being cautious about such AI analyses. Yet, unless someone can point me to more reliable data, I will go with this one – not least because it coincides with my own experience and also because I quite like its findings.
Might this be a fitting task for AI?
Let’s see; I gave ‘Gemini’ the following task: “Give me a list of the 10 biggest charlatans in the field of alternative medicine + a short explanation why they are generally considered to be charlatans”
Here is the response:
The term “charlatan” is highly subjective and often used by critics to describe individuals who promote medical treatments that lack scientific evidence or conflict with established biology. While many practitioners in alternative medicine are viewed by their followers as pioneers, they are often labeled charlatans by the scientific community due to claims of “miracle cures,” the rejection of conventional data, or the sale of unproven products.
The following list includes ten figures who are frequently cited in skeptical and medical literature as major examples of this phenomenon:
1. Kevin Trudeau
Trudeau is perhaps the most famous modern example of a medical “hawker.” He authored Natural Cures “They” Don’t Want You to Know About, a book that alleged a massive conspiracy between the FDA and pharmaceutical companies to hide cures for cancer and other diseases.
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Why labeled a charlatan: He was repeatedly sued by the FTC for making false claims and was eventually sentenced to 10 years in prison for criminal contempt related to his deceptive infomercials.
2. “Dr. Sebi” (Alfredo Bowman)
Despite not being a medical doctor, Bowman gained a massive following by claiming he could cure AIDS, cancer, and diabetes through a strictly alkaline diet and herbal supplements.
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Why labeled a charlatan: He claimed that all disease is caused by “mucus” and that his “African Bio-Mineral Balance” could eliminate it—a claim with no basis in human physiology. He was successfully sued by the New York Attorney General for practicing medicine without a license.
3. Andrew Wakefield
A former physician, Wakefield is the primary source of the modern anti-vaccine movement. In 1998, he published a fraudulent study in The Lancet suggesting a link between the MMR vaccine and autism.
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Why labeled a charlatan: His study was found to be based on manipulated data and unethical treatment of children. He was subsequently stripped of his medical license, but he continues to profit from anti-vaccine activism.
4. Belle Gibson
An Australian wellness influencer, Gibson built a massive brand claiming she had cured her terminal brain cancer through diet, exercise, and alternative therapies.
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Why labeled a charlatan: It was eventually revealed that she never had cancer. She also admitted to withholding thousands of dollars in promised donations to various charities.
5. Joseph Mercola
Mercola is an osteopathic physician who runs one of the most profitable “alternative health” websites in the world. He has frequently promoted homeopathic remedies and criticized standard medical practices like vitamin K shots for newborns.
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Why labeled a charlatan: He has received multiple warning letters from the FDA for selling unapproved and misbranded products, such as “thermography” as a superior replacement for mammograms (which it is not).
6. Stanislaw Burzynski
A physician in Texas, Burzynski has spent decades selling “antineoplastons” as a cure for various cancers at his private clinic.
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Why labeled a charlatan: Despite over 40 years of operation, he has never produced a peer-reviewed, Phase III clinical trial proving his treatments work. Critics argue he exploits desperate patients, charging them hundreds of thousands of dollars for unproven therapy.
7. Robert O. Young
The author of The pH Miracle, Young popularized the idea that “acidosis” is the cause of all disease and that an “alkaline diet” can cure everything from obesity to Stage IV cancer.
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Why labeled a charlatan: In 2016, he was convicted of practicing medicine without a license. It was revealed that one of his “patients,” a woman with breast cancer, paid him thousands for intravenous baking soda treatments before she ultimately died.
8. Hulda Clark
Clark was a naturopath who claimed that all diseases (including cancer and HIV) were caused by parasites and could be cured by a device she invented called the “Zapper,” which used low-voltage electricity.
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Why labeled a charlatan: Her claims were entirely unscientific; she believed “electronic frequencies” could kill parasites instantly. She eventually died of multiple myeloma (a blood cancer), a disease her own device supposedly could have cured.
9. Matthias Rath
A German physician, Rath has aggressively promoted high-dose vitamin therapy as a cure for HIV/AIDS and heart disease.
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Why labeled a charlatan: He ran advertisements in South Africa discouraging people from using antiretroviral drugs, claiming vitamins were a safer alternative. This campaign is estimated to have led to thousands of unnecessary deaths.
10. Gwyneth Paltrow (Goop)
While Paltrow is an actress, her lifestyle brand Goop has become a central hub for “luxury” alternative medicine, selling items like “Jade Eggs” for vaginal health and “Body Vibes” stickers.
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Why labeled a charlatan: Goop has been forced to pay settlements for making unsubstantiated medical claims. Critics argue the brand uses “wellness” as a shield to sell pseudo-scientific products to wealthy, health-conscious consumers.
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I have to say, this list disappoints me: hardly any of the above individuals would have appeared on my personal list of the 10 biggest charlatans!
Will I disclose my personal list?
No, I don’t think so.
We all know, I think, what homeopaths say about homeopathy. We also know what everyone else says about it. And the two set of opinions could not be more different. In this context, it might be interesting to learn what writers have to say about the subject. Here is a list of quotes from the non-medical, non-scientific literature (I am sure there are many more; if you know some, please let me know):
Boyd, W. (Restless, 2006)
“She had a small leather case of homeopathy remedies, Nux Vomica, Pulsatilla, Arnica, that she treated like a traveling reliquary.”
Coetzee, J.M. (Elizabeth Costello, 2003)
“He is a believer in homeopathy, in the healing power of water, in the memory of water. He is a man of the eighteenth century, really.”
Cunningham, M. (The Hours, 1998)
“She has tried everything: homeopathy, psychotherapy, prayer. She is a woman who lives in the hope of a miraculous adjustment.”
Enright, A. (The Gathering, 2007)
“My mother had a great belief in homeopathy, which is just a way of saying she had a great belief in nothing at all, provided it came in a very small bottle.”
Franzen, J. (The Corrections, 2001)
“Enid was deep into a phase of homeopathy, convinced that a decillionth of a gram of honeybee sting would cure her husband’s tremors.”
Márquez G.G. (“Serenade: How My Father Won My Mother”, 2001)
“…devoted his talent as an autodidact to a science on the decline: homeopathy.”
Hustvedt, S. (The Blazing World, 2014)
“He was the kind of man who treated his neuroses with homeopathy and his physical ailments with intense, silent resentment.”
McEwan, I. (Solar, 2010)
“He had no time for homeopathy, which he considered a form of witchcraft for people who were too polite to carry crystal wands.”
O’Farrell, M. (Instructions for a Heatwave, 2013)
“She kept a kit of homeopathy in her bag, tiny glass vials of white pills that looked like the breath of ghosts.”
Self, W. (How the Dead Live, 2000)
“Lily’s faith in homeopathy was such that she believed if she diluted her own death enough, she might eventually become immortal.”
St. Aubyn, E. (At Last, 2011)
“He had reached that stage of desperation where even homeopathy seemed like a robust and evidence-based option.”
H.G. Wells (Tono-Bungay, 1909)
“By the time my uncle had taken to homeopathy, I realized that his faith in science was of a very elastic kind.”
George Bernard Shaw (Preface to The Doctor’s Dilemma, 1906)
“I have a faith in homeopathy that would make a Harley Street physician shudder, though I suspect it rests less on evidence than on temperament.”
Thomas Mann (The Magic Mountain, 1924)
“He spoke of homeopathy with a curious mixture of irony and conviction, as though the less there was of it, the more there must be.”
Aldous Huxley (Eyeless in Gaza, 1936)
“She placed her trust in homeopathy, preferring infinitesimal certainties to the gross invasions of modern medicine.”
Doris Lessing (The Golden Notebook, 1962)
“She was experimenting with diets and homeopathy, as if the body might be coaxed into sanity by gentler means.”
Margaret Atwood (Cat’s Eye, 1988)
“My mother believed in homeopathy, in small doses and invisible forces, which seemed to me another way of saying she believed in hope.”
Zadie Smith (White Teeth, 2000)
“He dabbled in homeopathy, convinced that the less substance there was, the more profound the cure.”
David Lodge (Therapy, 1995)
“I tried homeopathy for a while, but it seemed to require a belief in something so small it might not exist at all.”
Hilary Mantel (Giving Up the Ghost, 2003)
“Homeopathy offered the promise of healing without intrusion, a whisper of cure rather than a command.”
Martin Amis (The Information, 1995)
“He regarded homeopathy as a joke that had somehow outlived the punchline.”
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It seems to me that, when it comes to homeopathy, the writers tend to agree with the scientists.
Aaron Siri is an American lawyer and anti‑vaccine activist. He has become a key figure in contemporary US vaccine‑policy debates, largely through his legal challenges and close ties to health‑policy critics such as Robert F. Kennedy Jr. His following five central claims about vaccines are a mix of selective quoting, misrepresentation of studies, and appeal to legal‑style rhetoric:
- Vaccines cause chronic illness
Siri’s central “smoking‑gun” claim rests on an unpublished Henry Ford Health‑system analysis allegedly showing that vaccinated children have far higher rates of chronic illness than unvaccinated children. Vaccinated children in this dataset had far more health‑care visits than unvaccinated children, so more conditions were diagnosed in them regardless of whether vaccines caused them. This is a textbook example of detection bias, but not evidence of causation. Moreover, the study has not passed peer review; its reported disease prevalences are inconsistent with known epidemiology. It is therefore widely seen as methodologically unsound.
- Vaccines were never properly tested against proper controls
Siri argues that many childhood vaccines have not been tested in inadequately-powered, placebo‑controlled trials. When an effective vaccine exists, medical ethics oppose using placebos in new trials, as that would deny protection to a control group. Moreover, his claim that older vaccines (e.g., tetanus–diphtheria–pertussis) “lack adequate controlled trials” is misleading because earlier trials were designed for different standards and later observational data, post‑licensure surveillance, and large‑scale cohort studies have filled the gaps. In other words, he exploits technical‑sounding language to imply a hiatus of evidence, when in reality the evidence base is broader and more heterogeneous than he portrays.
- The CDC/WHO inflates how many lives vaccines have saved
Siri has attacked the WHO’s estimate that vaccines have saved around 154 million lives, calling it “corruption of science”. The 154‑million figure comes from a modelling exercise [like most “lives‑saved” statements in public health]. It depends on assumptions but is based on vaccine‑coverage and mortality‑trend data, but it is not fabricated. Siri’s rebuttals focus on rhetorically dismissing the exercise as “advertising” rather than engaging its assumptions or proposing alternative, better‑validated models. His claim that this number is “corrupt” thus rests polemic than but not on a coherent technical critique of the underlying epidemiological models.
- Exploiting the 1986 Vaccine Injury Act and “lack of liability”
Siri blames the 1986 National Childhood Vaccine Injury Act for reducing oversight and downplaying risk, arguing that liability protection “corrupts” safety monitoring. Yet the law was designed to protect manufacturers from financially ruinous litigation and to create a dedicated federal compensation program for proven injuries, not to forbid safety monitoring. The US has multiple surveillance systems (VAERS, VSD, CISA) and expert advisory bodies (ACIP, NVAC) that continuously review vaccine safety. Siri’s critique thus conflates legal strategy with scientific oversight, implying that the absence of mass torts proves lax monitoring.
In conclusion, Siri’s vaccine claims are mostly built on:
- one deeply flawed, unpublished observational study,
- selective readings of older vaccine‑trial designs,
- unwarranted dismissal of WHO‑level modelling, and
- a legal framing that conflates liability shields with absence of safety science.
Epidemiologists, infectious‑disease specialists and other experts rightly regard Siri’s arguments as misrepresenting or misapplying biostatistics and failing to meet standards for causal inference. It would be a serious mistake to follow them!
Dr. Dean Patterson, a consultant cardiologist in Guernsey, has been dismissed from his partnership at the Medical Specialist Group (MSG) following his public concerns about potential links between COVID-19 vaccines and myocarditis. Patterson had described as a notable rise in myocarditis. He claimed local figures of 5 cases in 2020 (pre-vaccine rollout), 25 in 2021, and 22 in 2022. Moreover, numbers declined as vaccinations tapered, he stated emphasizing that he was not anti-vaccine but sought open scientific debate and that other healthcare professionals feared reprisal for raising safety signals.
Speaking to ITV Channel in 2024, he said: “People think I must have come to this conclusion just like that, but I haven’t. It’s been running on guts, instinct at first, not being quite happy, trying to speak to people, then hoping to prove myself wrong. I think the scientific debate has been stifled. People and doctors have been threatened and lost their jobs, I’ve had nursing staff at the hospital contact me and say they can’t speak out because of disciplinaries.”
Eventually,Guernsey authorities commissioned an independent review by the Royal College of Physicians in late 2024 to check Patterson’s patient data for vaccine-related cardiac risks. The review found no substantiation for the scale of concerns Patterson had voiced. However, it uncovered unspecified “issues” that prompted MSG’s internal probe on patient safety grounds. Patterson had not treated MSG patients since February 2025, yet remained a partner until March 2026, when MSG ended his tenure after parallel internal processes concluded, separate from but informed by a still ongoing UK General Medical Council (GMC) investigation. The GMC had imposed a 12-month interim suspension of his license in February 2026, which Patterson is appealing, barring him from UK or Guernsey practice in the interim.
The MSG’s dismissal announcement on March 19, 2026, centred on patient safety and the review’s lack of support for his claims, without detailing specific allegations amid the GMC fitness-to-practise case. Local media framed it as a sacking tied to his vaccine critique, highlighting tensions over suppressed debate. MSG assured continuity via other cardiologists, reassigning patients, while the full review, precise issues, and the GMC outcomes all remain undisclosed.
The way I see it, this story might be a textbook example of confirmation bias. Confirmation bias is the tendency to listen more often to information that confirms our existing beliefs. Through this bias, people tend to favor information that reinforces the things they already think or believe.
It happens to us all: you drive your car through town and have to stop twice at a red light; subsequently you get the feeling that most trafic lights see you coming and turn red to annoy you. In fact, you only notice the red lights and forget about the many green ones that you passed.
Patterson seemed to have noticed one or two unusual cases which sensitised him to find more that seemed similar. Clinicians’ judgements are often biased in this way. In other words, the story could serve as a reminder that we need proper science rather than huntches to guide our decisions.
Tons of research (mostly surveys) exist on the reasons why some people – between 20 and 60% – use so-called alternative medicine (SCAM). But these people are often the minority, and few of us ask why the majority do NOT employ SCAM. The research that does exist suggests that people decline SCAM for a variety of inter‑related reasons. It also suggests that non‑use is often a rational, deliberated position grounded in both experience and reason.
Satisfaction with conventional medicine
Across different conditions and populations, the most frequently cited reason for not using SCAM is that conventional treatment is perceived as sufficient. In an oncology sample, for example, 76% of non‑users reported that they saw “no need” for SCAM because standard therapy was considered adequate. Similar findings emerged in gastroenterology and primary‑care cohorts, in which effective conventional treatment was the single most common reason for non‑use, and many non‑users stated that they would only consider SCAM if standard treatments turned out to be ineffective.
Good health
Good self‑rated health also predicts SCAM non‑use. Population surveys consistently show that SCAM use is higher among those with chronic conditions, poorer functional status, or unresolved symptoms, whereas people who feel generally healthy are less likely to seek any additional, especially out‑of‑pocket, interventions. In that sense, non‑use is often an epiphenomenon of a relatively positive health trajectory: people tend to look beyond biomedicine only when they experience persistent suffering, side‑effects, or perceived medical failure.
Lack of good evidence of effectiveness
For many non‑users of SCAM, the absence of convincing scientific evidence is central. They perceive SCAM modalities as “unproven” or “insufficiently tested” and prefer interventions that have been evaluated in rigorous randomized trials, meta‑analyses, and regulatory assessment. A recent scoping review of SCAM identified “insufficient scientific evidence” as one of the most frequently reported barriers to use across multiple settings. In an Egyptian survey, almost 80% of non‑users reported “insufficient information and evidence to prove effectiveness” as a main reason for avoiding SCAM, and nearly three‑quarters stated that they were “not convinced” by it.
Safety concerns
Safety concerns are closely tied to this evidence gap. Non‑users often highlight the lack of robust regulation of SCAM products and practitioners, worries about adulteration or contamination of herbal preparations, and the risk of interactions with prescription medicines. In cancer cohorts, substantial proportions of non‑users explicitly mention fears of fraud and of harmful interactions between SCAM and chemotherapy or other oncological treatments. These concerns are reinforced by data documenting variable product quality and under‑reporting of adverse events in the SCAM sector, which for some patients strengthens the perception that, in the absence of solid evidence and oversight, the safest option is non‑use.
Money
Even among people who are in principle open to SCAM, structural barriers can make uptake impractical. Economic factors are salient: in most healthcare systems, SCAM services are not reimbursed or are only partially covered and therefore require substantial out‑of‑pocket payments. US survey data have shown that SCAM users incur meaningful additional financial burden, and that out‑of‑pocket spending on SCAM can be associated with self‑reported financial distress. For those on lower incomes, this cost gradient effectively acts as a barrier to ever starting SCAM.
Time
Time and access constraints constitute further deterrents. Many SCAM modalities require repeated sessions, travel, and scheduling flexibility, which can be difficult for people in full‑time employment or with caregiving responsibilities. A scoping review identified limited availability of services, a shortage of qualified professionals, logistical difficulties in reaching SCAM practitioners, and lack of public provision as recurrent obstacles to use, particularly in rural or underserved regions. When an intervention demands substantial time investment and travel, while its efficacy is uncertain and it is not covered by insurance, non‑use becomes a straightforward opportunity‑cost calculation.
Physician stance
Physician stance plays a powerful role in shaping decisions. Patients often look to their primary care physicians or specialists as gatekeepers of legitimate treatment options; when doctors do not recommend SCAM, or express doubts about it, patients tend to refrain from using it. Reviews of physician attitudes suggest that many are cautious about SCAM because of concerns about evidence, safety, and the risk that some patients might replace effective conventional treatment with unproven SCAMs. This caution, whether expressed explicitly or implicitly, contributes to the social norm that poorly evidenced therapies lie outside the mainstream of responsible care.
Lack of knowledge
Lack of knowledge about specific SCAM modalities is another consistent reason for non‑use. The National Health Interview Survey showed that “not knowing enough” about practices such as acupuncture, chiropractic, natural products, and yoga was commonly endorsed as a reason for never having tried them, even among individuals with back pain that might otherwise motivate experimentation. Meta‑analyses and scoping reviews corroborate “insufficient knowledge” and “inadequate information” as personal barriers across diverse settings.
Worldview
Finally, the decision not to use SCAM is also shaped by broader worldviews. Studies mapping attitudes underlying SCAM use and non‑use suggest that commitment to a scientific, reductionist understanding of illness, trust in biomedicine, and low levels of “holistic” or spiritual health beliefs predict lower SCAM uptake. Non‑use of SCAM thus reflects an active alignment with the epistemic norms of evidence‑based medicine and a preference for treatments that are conceptually compatible with biomedical explanations of disease.
Conclusions
Users of SCAM tend to score relatively high in intuitive thinking, while non-users of SCAM tend to score higher in analytical thinking. People who do not use SCAM are often employing a cautious, risk‑averse strategy. They prefer treatments that have demonstrable effectiveness beyond placebo and safety within regulated systems, particularly when their health is reasonably good, and they see little to gain from investing scarce time and resources in therapies they regard as weakly evidenced, commercially driven, or ideologically suspect. Non‑use, then, is a principled stance grounded in satisfaction with conventional care, skepticism about unproven claims, and a desire to minimise both medical and financial risk. In a word: non-use of SCAM seems to be a sign of prudence, common sense and an ability to think critically.
References
Astin, J. A. (1998). Why patients use alternative medicine: Results of a national study. JAMA, 279(19), 1548–1553.
Li, J., Verhoef, M. J., Best, A., Otley, A., & Hilsden, R. J. (2005). Why patients use or do not use complementary and alternative medicine: A qualitative study exploring beliefs about conventional medicine and CAM in patients with inflammatory bowel disease. Canadian Journal of Gastroenterology, 19(9), 567–572.
Lindeman, M. (2011). Biases in intuitive reasoning and belief in complementary and alternative medicine. Psychology & Health, 26(3), 371–382.
Najibi, S. M., Sarikhani, Y., Hajimonfarednejad, M., Nimrouzi, M., & Hashempur, M. H. (2025). A scoping review of the barriers and facilitators in the use of traditional, complementary, and integrative medicine: Insights for health policy development. Journal of Health, Population and Nutrition, 44(1), 188
Paepke, D., et al. (2020). Prevalence and predictors for nonuse of complementary and alternative medicine in cancer patients. Journal of Cancer Research and Clinical Oncology, 146 (8), 2157–2166.
Rosenberg, E. I., et al. (1998). A review of the incorporation of complementary and alternative medicine by mainstream physicians. Archives of Internal Medicine, 158(21), 2303–2310.
I have often voiced my concerns that some SCAM practitioners are against vaccinations, particularly homeopath, naturopaths and integrative medicine doctors. It seems, that many go even further and commit lucrative anti-vax fraud. Now, a shocking story seems to confirm that my concerns were justified.
A joint investigation by NDR, WDR, and the Süddeutsche Zeitung (SZ) has uncovered a network of suspected fraud involving measles vaccinations in Bavaria. Health authorities currently suspect at least 27 medical practices of issuing false medical exemptions or recording vaccinations in certificates that never actually took place.
Since the Measles Protection Act came into effect in Germany in 2020, parents must prove their children are vaccinated against measles to attend daycare or school. The only exception is for children who cannot be vaccinated for medical reasons, which must be documented by a doctor. This legal requirement has inadvertently created a market for “courtesy” certificates and forged documents.
A prominent figure in the report is the German physician Andreas Sönnichsen, who practices in Salzburg, Austria. Sönnichsen charges €240 for a one-hour consultation and openly admits to issuing general certificates of vaccine inability to any parent who requests one. His justification is that, because measles infection rates in Germany were low in 2025 (three cases per million inhabitants), he believes the risk of vaccine side effects outweighs the risk of the disease. However, health experts point out that unvaccinated children pose a severe risk to infants under nine months who are too young for the shot.
Due to a sharp rise in suspicious certificates, approximately 40 health offices in Bavaria and neighboring regions have formed the “Measles Protection Network.” They share information and maintain a list of 27 suspect practices, nearly all of which belong to homeopaths, natural health practitioners, or “integrative” doctors.
A significant criminal case involves a physician from the Landshut district, Volkhard P. He is accused of documenting 1,290 measles vaccinations without actually administering them. Investigators noted several “red flags”:
- He is not a pediatrician but certified many childhood vaccinations.
- Patients traveled over 100 kilometers to see him.
- Vaccination booklets were empty except for the two required measles entries.
Blood tests on children supposedly vaccinated by such doctors have repeatedly shown a total lack of antibodies, confirming that no immunization occurred.
Despite the efforts of local health offices, the report highlights major gaps in enforcement. In Bavaria, health offices are instructed to merely “take note” of vaccination records during school entry exams rather than conduct a standardized verification of authenticity. The Bavarian Ministry of Health maintains that the primary responsibility for checking records lies with school principals and daycare directors. However, these administrators are often overwhelmed and lack the training to identify fraudulent certificates.
While the Federal Ministry of Health notes that the Measles Protection Act has slightly increased vaccination rates, it currently has no plans to tighten the law, leaving the responsibility of oversight to individual states. Consequently, a significant portion of this fraud likely remains undetected, posing a continuing risk to public health.
The objective of this study was to explore the nature of retraction notices associated with so-called alternative medicine (SCAM) focused journals. Data related to retractions in SCAM journals were extracted from the Retraction Watch Database for the period 2000-2025.
The analysis found that there were 902 notices associated with 42 SCAM journals. Overall, the percentage of retractions relative to all papers published in the named journals is low (<1%) however a single journal was responsible for 84% of retractions. The majority of these retractions occurred in 2023 as the result of a wider publisher investigation into paper mills and sham peer-review. Similar to other studies, retraction was rarely due to a single cause but reflected a mix of data integrity concerns, peer-review issues, evidence of plagiarism and other issues. The average time between original publication and retraction was 19 months (mode 10 months) with 98% of publications having multiple authors. The main country of origin of authors of retracted works were China, India and South Korea.
The authors concluded that published peer-reviewed literature is used in a range of ways, as the foundation for future studies, incorporated in systematic reviews, clinical decision-making and in training of practitioners and clinicians. While this study has demonstrated that retractions in the complementary and alternative medicine literature is generally at a lower level, any evidence of publication integrity breach is a concern and should be cause for ongoing monitoring.
The way I see it, there are several problems with this study and its conclusion.
1. Do we know that SCAM journals are as willing to retract papers as are other journals? The answer, I am afraid, is NO!
2. Retraction Watch compiles retractions by monitoring publisher websites, publisher metadata, and community tips, but not all publishers report or label retractions consistently. In other words,
Retraction Watch relies on a mix of automated checks and manual curation, but it still can’t catch every retraction, especially from smaller or inconsistent sources. This means that we have no evidence that retractions from SCAM journals were fairly represented in the sample investigated in this study.
In view of this, the conclusions need to be re-formulated, I fear:
In the sample analysed for the present survey, retractions in the SCAM literature might be at a lower level than in the non-SCAM literature. This observation could be due to more than one phenomenon and requires independent replication.
This study aimed to distinguish between the usage of complementary medicine and alternative medicine, often jointly referred to as CAM. Furthermore, the analysis focuses on the role of religion, healthcare system satisfaction and the country of residence.
The analysis uses data of the International Social Survey Programme 2021 “Health and Health Care II” (ISSP 2021) to estimate the prevalence of complementary medicine and alternative medicine. A nested logistic regression model was applied to distinguish between no medicine use, conventional medicine, complementary medicine and alternative medicine.
The findings indicate the following:
- Complementary medicine is significantly more prevalent than alternative medicine, though substantial cross-country differences are observed.
- While religious affiliation alone does not show a significant relationship with CAM usage, individuals who attend religious services regularly are more likely to use CAM in a complementary manner, alongside conventional medicine.
- Individuals who are dissatisfied with the health care system also are more likely to use both complementary medicine and alternative medicine.
- Higher levels of education are negatively associated with the use of alternative medicine.
- Younger individuals are more likely to use CAM and specific alternative medicine, compared to older age groups.
- Being female is consistently associated with a higher chance of CAM usage overall.
The authorsconcluded that treating complementary and alternative medicine as distinct reveals different prevalence rates and influencing factors. Religion, satisfaction with the healthcare system, education, age, and gender play varying roles depending on whether CAM is used alongside or instead of conventional medicine. Cross-country differences point to cultural and health system influences. For public health, distinguishing between complementary and alternative use can support more targeted strategies to promote safe integration and reduce risks from substituting conventional treatment.
Complementary medicine is defined as medicine being used alongside conventional medicine; alternative medicine is defined as medicine being used instead of conventional medicine. This distinction is problematic, if not impossible. One and the same therapy can be used in an alternative fashion today and in a complementary way tomorrow. One and the same therapy will often be used in an alternative fashion for one condition and in a complementary way for another. In other words there are no alternative medicines as distinct from complementary medicines. There are merely distinct ways of using these therapies.
In turn this means that the above paper set out from a flawed premise. But perhaps it nevertheless generated some interesting findings? Let’s look at the points listed above:
- This has been noted many times before.
- This has been noted many times before.
- This has been noted many times before.
- This is invalid because of the points above.
- This has been noted many times before.
- This has been noted many times before.
My conclusion: much of the research into so-called alternative medicine is hardly worth the paper that it is printed on.
