Science Calls Time On Uni Alternate Health Courses

Arguments over the status of alternative and complementary medicine are heating up. Over the weekend Logan at Gizmodo reported on the founding of Friends of Science in Medicine (FSM), and now a paper in the Medical Journal of Australia calls for universities to be more stringent about the kinds of courses they offer.

While you can't call yourself a doctor after doing an alternative medicine course, the authors of the paper (members of FSM) argue that universities offering qualifications such as Master of Health Science (Herbal Medicine) gives the sector a credibility it doesn't deserve:

Subjects such as acupuncture and chiropractic are claimed to treat a broad array of afflictions and are taught as such. The levels of evidence supporting these alternative beliefs are weak at best, and such randomised controlled trials of these therapies as exist mostly do not support their efficacy (with the exception of acupuncture for some types of pain).

As that last quote suggests, the FSM group (which has 460+ members) isn't opposed to any form of medicine other than pharmaceutical and surgical treatments, but only to those which can't demonstrate their effectiveness:

FSM supports research into alternative and complementary approaches when this is justified and accepts that modern medicine has more to do in championing an evidence-based approach to all types of care. Our educational institutions, the government and consumers should understand that pseudoscientific health treatments based on unvalidated beliefs are not compatible with the provision of sustainable quality health care.

This makes sense to me. Choosing a medical treatment which evidence doesn't support simply doesn't seem rational, especially if you simultaneously reject one that has been underpinned by repeatable, clinical testing. But I imagine that many people will disagree, especially given the fervent anti-science mentality evident in some sections of Australian society. What do you think?


Comments

    To say there is no evidence for the effectiveness of a particular treatment simply means that tests have not been done. Tests are selective.

    Acupuncture, just to take one example, has been used effectively for thousands of years. It cures things Western Medicine has no cure for. Western Medicine is in it's infancy. New drugs are made, tested for a short period and released on the market. Often these drugs are found to be harmful and removed from the market.

    Now if only we could apply the same criticism of lack of testing to the Pharmaceutical industry.

      What does it cure - where is your evidence? Anecdotes do not supply proof.

      The fact is that a wide range of CAM have been tested .... tests of efficacy are not selective at all, either a treatment works or it doesn't.

        But with Acupuncture 'the tests' have been don. It is one of the best-studied 'alternative' health therapies. The upshot from the many hundreds of studies done is that it hardly does anything, and the tiny effects it appears to have are entirely locationally nonspecific (ie. you can just shove a needle in anywhere and the same thing happens).

        The fact that something has been done for 'thousands of years' equally supports Shamanism, cliterodectomy, and numberless nutty prescientific practices. It is epistemologically irrelevant.

          Not to mention the FACT that many studies have shown that there is NO difference between the efficacy of actual acupuncture and sham acupuncture to the patient. (eg: http://www.ncbi.nlm.nih.gov/pubmed/21816787) There are many of these studies out there, even to the level of someone at home randomly jabbing the patient with no idea of what 'specific areas they are targetting' compared with a 'trained' practitioner.

          There is NO evidence this works any better than a placebo. But then you can look at the fact that sleeping tablets are coloured in different colours in different countries due to the placebo effect of that particular colour.

          There is proof of the placebo effect, there is no proof that any of these alternate therapies work any better than their placebo (chirst, just look at magic water).

          And as to studies showing a cure? Just look for any follow up studies and repeat after me, "regression to the mean".

          This stuff really makes me cross.

            Do yourself a favor, go to the nearest ABC, BBC shop and ask for the series "Alternative Medicine". Once you have watched the episode that covers Acupuncture you will understand everything. There ARE facts that placebo acupuncture works about %30 something and no one is denying that, however real acupuncture is PROVEN that works for diseases and conditions that have been scientifically tested.

              The sensational way that program was presented was completely at odds with what they were discussing in it.

              The faked open heart surgery? The fact that they stated at the begining that it was anecdotal evidence? The people in it were also on 'western' medicines at the time? Patient testimonials rather than scientific studies?

              Also the fact that in response to wide spread critisim of their bad science reporting in this series they wrote a rebuttal letter ostensibly signed by leading doctors and professors appearing in the program stating they were all happy with the way it was portrayed, only for it to come out that alot of them had not even seen the doccument, and those who new of its existense had to read it but were only asked if they were happy in the way that thier own individual segments were presented?

              Next I suppose someone will be asking me to watch "What the bleep do we know?" and to 'open my eyes'

              *sigh*

                It's like when someone tells you that you must read 'The Celestine Prophecy' and it will change your life.

      I can't claim to be an expert in these matters, but it seems to me that your argument is flawed. Firstly, your statement that acupuncture cures things modern medicine can't demonstrates the point here- your claim is anecdotal, not empirical. Secondly, your statement about drug testing makes it sound like they just give a pill to a monkey and if it doesn't die, put it to market. The reality is that Phase I, II and III testing takes years before approval is given. It's not perfect, but it's a lot better than you make it out to be. Just my opinions.

        Acupuncture works for many things, this has been scientifically proven. Due to the nature/cost of the scientific tests, they have been done on specific conditions only. In China, Japan every patient has an option to choose TCM or Western treatment. For any surgery requires full/local anesthetic, they have an option either western or acupuncture. So far, every scientific tests have proven that acupuncture works. I always approach everything with open mind.

        IMHO I do not care what operating system I use, as long as I can do the tasks that I need to do efficiently and quickly. In comparison, regardless of the nature of the disease or condition, I will go with the one that gives the best results.

        Yes no point watching a TV to get factual information on medical treatments. The best sources are articles from peer reviewed medical journals. This ensures the study is designed correctly, is ethical, and all sponsorships from drug companies etc are disclosed by the authors.

        There are plenty of studies done on acupuncture and the comments above are correct, real accupuncture was as effective as the control group (same acupuncture process but needles going in the wrong places) and both were equally effective. Interestingly both were slightly more effective in relieving pain on a self-rated pain scale (which is highly subjective) than no treatment at all. Basically acupuncture has placebo-like efficacy.

      Time for a rant...
      "To say there is no evidence for the effectiveness of a particular treatment simply means that tests have not been done."
      I'm sorry Vincent, but that statement is just not true. Evidence may well be lacking in certain cases because good studies haven't been done, but your broad statement that evidence doesn't exist because studies haven't been done is generally false.
      The plural of 'anecdote' is 'anecdotes', not 'evidence'.

        "The plural of ‘anecdote’ is ‘anecdotes’, not ‘evidence’."

        That, sir, is a brilliant sentence.

        Actually, that's a funny saying because traditionally people use 'the plural of anecdote is not data', but the original quote was actually 'the plural of anecdote is data' (emph mine).
        See the Freakonomics blog here.
        In reality, the plural of anecdote is data because when a lot of anecdote points in one direction then it indicates that something is going on. However, it isn't necessarily data to support what the people think is going on. It can be evidence of placebo effects, a particularly effective charlatan, and so on.

        Also, the whole thing about 'no evidence -> tests not being done' is a challenge because of the nature of null-hypothesis testing. For example, if you are testing the hypothesis that "real" acupuncture leads to faster reduction in symptoms of the common cold than sham acupuncture then the alternative 'null' hypothesis is that "real" acupuncture does not lead to faster reduction in symptoms of the common cold than sham acupuncture. So far, so good.

        However, then things get complicated. The ability to detect a difference between the real and sham treatment is affected by how big the difference is, the number of people in the study, the distribution of recovery in those people tested, and other things.
        If you only tested with 4 people (two in each group), then the chances of being able to detect a difference between the null hypothesis and the alternate hypothesis would be vanishingly small. In this case, a result which says that there is no detected difference between real and sham acupuncture (for the cold duration) is meaningless. The test wasn't sensitive enough to detect anything anyway. No conclusions can be drawn, except that the study author was a moron.
        Note: apart from the sample size, this isn't necessarily a bad test. One of the big problems in testing of alternative treatments (and often medical treatments too, historically, but they've mostly gotten over it) is the comparison of the prospective treatment to 'no treatment' rather than a placebo, because basically anything which people can imagine would help (or harm, see Nocebo) will serve as a placebo so show an effect if you have a large enough sample size.

        One of the problems is when the comparison isn't between acupuncture and sham acupuncture, but when the comparison is between acupuncture and cold-and-flu tablets (or something of the sort). If you have a sample size of 2 - one in each group - then you will not find a significant difference between the two treatments. If you included a 'no treatment' group you would find no difference between any of them, but if you don't then you can claim that there is no difference between the two treatments. Anyone who makes more than a cursory glance will realise it is complete nonsense, but if you can find some crackpot faux-journal to take the publication then you have a publication to say that acupuncture is as effective as cold-and-flu tablets for cold relief.

        With null-hypothesis significance testing, a challenge is knowing when to declare something isn't different. As the saying goes, absence of evidence is not evidence of absence. With a sufficiently large sample size in a well-designed study you can narrow the likely effect to be a very small band around 'no effect', and thus conclude that the treatment has no effect. This has been done for homeopathy, acupuncture, chiropractic, and a range of other alternative treatments for a range of conditions. (Note: not saying all conditions for all the things listed, although homeopathy is like a bad joke. Chiropractic may be good for a very narrow range of back problems, but probably not so much for athsma despite the persistent claims. If you know a chiropractor treating asthma, print out and hand them the meta-analysis and tell them that they are harming children and wasting health funds).

        Some good studies have been done on a range of alternative medicine treatments. Many, many bad studies have usually been done as well.

        (Note: all of this basically depends on using p-values and .05 significance levels; if you are using 95% confidence intervals then the failings are much more obvious).

        Edit: woops, followed a link and didn't realise I'd gone back in time...

        Last edited 09/04/14 10:58 am

    Vincent, the placebo effect is well known.

    Quackwatch is a useful site for keeping track of the worst health scammers: http://www.quackwatch.com/

    Here come the big pharma shills!

      'Big Pharma' supplies products for both conventional and 'alternative' therapies. Like all big business, they don't care what they sell, or to whom. They'll as happily exploit hippies who like magic homeopathic water as they will anyone else.

    I hate how "natural medicine" often gets confused with "alternate medicine" like acupuncture, hot/cold therapy, etc..

    I have had back pain all of my life and was taking panadol almost every single day just to get by on the advice of my doctor. After finding out the kind of serious damage that doing that can do (Did you know panadol is #1 cause of acute liver failure in the world? It surpasses alcohol. Think about that for a second) I decided to try some natural medicine, Ginger to be specific.

    I take anywhere from 2-4 teaspoons of ground ginger a day now and guess what, my back pain is almost completely gone.

    The only reason westernised doctors don't suggest natural medicine is because they were not taught about it because the pharmaceutical companies that taught them in university have no way of making money from natural medicine.

    Don't get me wrong, western medicine has it's uses and it is great but things like chinese medicine which has been around for thousands of years and uses natural medicine can be just as effective for some things.

      But again: one anecdote doesn't prove the point at all. (Off to search for randomised trials on ginger as pain relief . . .)

      Also, it's spectacularly lazy thinking to suggest that every single doctor in the world is in the pay of pharmaceutical companies and ignores all scientific evidence for that reason. By that line of reasoning, no-one should ever go to a doctor at all.

      "The only reason westernised doctors don’t suggest natural medicine is because they were not taught about it because the pharmaceutical companies that taught them in university have no way of making money from natural medicine"
      When a natural or alternative therapy is tested and proven to have a safety/efficacy profile that is as good or better than the incumbent therapy, it ceases to be 'alternative' and is adopted as 'medicine'. Basically, if it works, it ceases to be 'alternative' and become medicine. Unless it is as good/safe as another medicine, most health professionals will not recommend a natural remedy.

        correlation does not imply causation.

        What the???
        The alternate or supplement industry is worth billions in Australia alone! Think of Blackmores and all those other brands, they are not medicines, they sell well even though they are NOT tested by TGA or even proven to work. People are stupid and still buy them...

    In my experience most GP's will prescribe medication without applying a scientific approach to the patient in question. I understand that they are busy and they have to go on the balance of probabilities but it is this approach that has led me to be dissatisfied with mainstream GP's.

    I finally found a GP who was also qualified as a naturopath. It may be that she is quite unique but my sense is that her training in naturopathy gives her a slightly different attitude to traditional GPs. She is more consultative and more pragmatic with her approach than any GP I have ever seen before.

    I know in particular that my wife was prescribed medication for post natal depression with nothing more than a look at her case history and a discussion about how she felt. When we went to the GP Naturopath, extensive blood tests were done and it was found that she was very low in a number of vitamins as well as iodine. Supplements of these resolved the issue naturally after a very short period of time.

    Most doctors I speak to refer to the placebo effect as a defense for this, but it does seem reasonable to me that if a particular patient has extremely low vitamin levels (when compared with the rest of the population) particularly after an experience like childbirth, restoring them to normal levels is a good starting point for treatment.

      If your GP isn't doing blood work before treating for depression when someone doesn't have a clear history of depression with a similar pattern then they are not doing their job. Full. Stop.

      Psychology students at at least one university in Melbourne are taught that when they receive a referral from a GP they should (under most circumstances) ask whether blood work has been done, and if not then request the GP do it. I imagine GP training would incorporate the same recommendation.

      Edit: sorry, clicked a link - didn't realise I'd gone back in time.

      Last edited 09/04/14 10:59 am

    'friends of science in medicine' are just as bad as the catholic church during the dark ages. If something doesn't conform to their way of thinking it must be banned.

      No-one is suggesting anything should be banned. The idea is the simple commonsense one that public money should be put into therapies that are supported by evidence. That's the whole story, and should hardly be contentious.

    Enough. It is very simple. Every single properly conducted double-blind study has shown that alternative "medicine" produces results no better than the placebo effect. Every. Single. Study.
    On top of that, alternative "medicine" is based on concepts that cannot be proved as they are invented by the quack pushing that particular form of "medicine".
    As a consumer, here is a really simple test you can do. Select a set of consistent symptoms and go to two homoeopaths in different suburbs (this is important). I can guarantee you will get two entirely different "diagnoses" and be prescribed two entirely different sets of sugar pills.

      It is important to keep in mind that some herbal compounds do have effects, and have been tested. For example, St. John's wort has been tested and can be effective for the treatment of mild depression. However, it can have very unpleasant and severe side effects, and the quantities of active ingredients vary wildly between brands so the results are very unpredictable.

      You can't apply one conclusion to all alternative medicine without testing it. Test it, check whether it is indeed complete bollocks, and then discount it; but test it so you can be sure. (Note: assuming that there is at least some consistent anecdotal evidence to indicate that there may be something to look at. If it is just some crazy folk claiming that drinking your own piss cures cancer and those people who do drink their own piss have no improvement, then there is no real justification for a proper trial).

      Edit: sorry, clicked a link... didn't realise I'd gone back in time.

      Last edited 09/04/14 10:59 am

    The amount of delusion going on in these comments is amazing. Yes, modern medicine is just a big conspiracy to keep you sick so Big Pharma™ can make more money!

    Also, the moon landing was faked, Bush did 9/11, and Elvis is still alive and in hiding.

    The way the patient is cared for is just as important as what they are treated with. Don't confuse a bad doctor with a bad treatment as a lot of the detractors of medicine posting here seem to be doing. Their stories consist of: my GP was shit, saw someone else, they cared more, was cured. The only benefit a practitioner of alternative medicine brings in most cases is that highly valued patient interaction. People just want someone to talk to and someone to think that they are not dreaming it up. Most people can't accept the physiological reasons behind their pain (ie it is actually all in there head and that's perfectly fine) and are looking for someone to provide them with a 100% cures everything pill.
    At the end of the day medicine has a demonstrable effect that is shown with a vigorous evaluating system (clinical trials) and the thing curing people on alternative medicine isn't the treatment, it's the interaction with the administrator.

    Well, I just drink tap water. The local Homeopath says that water imbibes and remembers everthing it's been in contact with, so assumingly, it remembers all the tablets and medications that it's touch before reaching my lips. I'm going to live forever, or die of a water overdose...

      Water with the memory of all that faceal matter it has been exposed to. But you are forgetting it doesn't remember unless it is whacked 3 times against a leather covered board stuffed with horse hari to get it to remember.

      http://www.swissinfo.ch/media/cms/images/keystone/2006/11/keyimg20061127_7297047_5.jpg

    I understand some of the alternative medicines being disputed, but herbal medicine is the basis for modern medicine/medications. That's not to say it's better, but the blanket claims of it being useless are also incorrect. Modern medicine just gets rid of all the other substances found in the herbs (including toxins), and concentrates the active ingredient.

    Outside of Australia, natural medicine and modern medicine are combined, so the student gets training in both fields, and then uses their judgement to administer what they feel is best for the patient, often using herbs/tinctures as supportive treatments along with conventional drugs. Would be interesting to hear from one of these naturopathic doctors on this subject.

      Not to be trite, but we commonly use alternative medicines that have been scientifically validated, we can purchase them from a pharmacist and have them perscibed by doctors.... it's called medicine.

      Tim Minchin said it quite well in his poem, Storm:

      “By definition”, I begin
      “Alternative Medicine”, I continue
      “Has either not been proved to work,
      Or been proved not to work.
      You know what they call “alternative medicine”
      That’s been proved to work?
      Medicine.”

    Firstly in the interests of transparency, I would like to declare my position and background:

    I am the Program Manager - Natural Therapies, at Australasian College of Natural Therapies. I manage the courses of Western Herbal Medicine and Naturopathy, which are nationally accredited under the Health Training Package, and accredited by multiple professional associations. Prior to this position I was second in charge of the clinical degree program in naturopathy at the University of Western Sydney.

    I am a herbalist and naturopath with 17 years of clinical experience, and as well as my undergraduate qualifications I also hold Masters of Herbal Medicines from the Faculty of Pharmacy, University of Sydney.

    Most of my clinical experience has involved working alongside general medical practitioners in medical centres, in a cooperative and collaborative manner.

    I teach pharmacognosy & herbal pharmacy (which is a study of the chemistry, pharmacology and preparation of medicinal plants) and various herbal therapeutics subjects, and have approximately 15 years of educational experience.

    I served for 8 years on the Board of Directors of the National Herbalists Association of Australia (NHAA), and for a number of those years was involved in taking educational standards forward through modernising the NHAA's course accreditation standards.

    The first thing to note is that not all conventional medicine is "evidence-based" when approached from the rather narrow definition of double-blind, placebo controlled, randomised trials. Indeed many aspects of surgery are a classic example, a number of drug therapies, many psychological therapies (for which the model of double-blind placebo controlled trials is largely inapplicable), and more.

    To say that these interventions should not be practiced would be to ignore the clinical realities of effectiveness at the "clinical coal-face". Indeed many physicians I have worked with have argued that there are considerable flaws with applying the narrow evidence-based paradigm at the expense of ignoring the evidence generated in normal clinical practice. This evidence is genuine and relevant.

    Now to complementary & alternative medicine (CAM). Much of the evidence supporting legitimate CAM therapies and clinical approaches is also generated from decades, sometimes hundreds of years of clinical application - in a similar way to the foundation of conventional medicine. More recently we are also acquiring the more systematic evidence for some interventions as well.

    CAM is not some "new-age hippy" thing, but a form of health care with centuries of clinical usage. Whilst I am the first to admit that there are the fringe elements which do practice without any rationale and whose therapies are not based on any form of real evidence, to tar the entire profession with the same brush is nonsense.

    Unfortunately Prof Dwyer seems to have no real understanding of the profession, and seeks to equate all CAM practice with some kind of hocus-pocus fish slapping nonsense.

    The public understands the benefit of health disciplines such as herbal medicine and naturopathy, as evidenced by the frequency with which they consult with such practitioners. And evidence suggests that the majority of such individuals don't see a CAM practitioner instead of their doctor, but in conjunction with their doctor (just as people would see a dentist or a psychologist as well as a doctor).

    Let's stop the uninformed bashing of CAM and simply recognise that there is a place for a range of health care disciplines in this country. Let's work together to eliminate the fringe element. The NHAA has been lobbying for registration of herbalists since the 1920's - no that is not a typo, it does read the 1920's - which has never taken hold unfortunately due to governmental apathy and at times the work of a small handful of narrow minded individuals within the medical profession). Let's get behind that effort, make sure that the profession is recognised and accountable through such a national registration scheme.

    PS. A number of prominent individuals who were part of the FSM group have now distanced themselves from the "witch hunt" which Prof Dwyer seems to be advocating. That in itself is a telling fact.

      I call complete BS on all this clinical coalface bullshit. I am a psychologist, who works with MD's, and yes, we sometimes try new procedures that haven't been rigorously tested. The key word is new. If we get anecdotal evidence of success, its then subjected to proper empirical testing. If it doesn't work, it gets dumped. We also don't just pull these treatments out of our ass. We have to base them on pre-existing knowledge and theory.

      Most CAM treatments are not new. Further, they have been subjected to extensive research, and they do not work. To continue to use them at the coal face, when you must have access to extensive evidence that they don't work (after all, you teach it right) makes you either a fundamentally wicked opportunist or deeply misguided opportunist. You should thank god your not able to register, because you'd not even come close to meeting duty of care requirements and be sued to oblivion and back.

      And also - nice try calling this a witch hunt. What's a witch hunt about it - FSM is OK with any evidence based treatments being taught. All you have to do is present an actual basis for the BS you peddle.

        very well said Thom. Ian Breakspear, your arguments are flawed and lame. Snake oil salesman of the 21st century. Lets hope you never get called Dr.

        Well said, the Thom.
        Ian, the discipline of psychology goes to great lengths to test its theories and associated hypotheses empirically. What's more, if any psychologist chimed in with the silly arguments from popularity and antiquity as you did, they'd be shouted down by their own colleagues.

        I came back to this comment thread, and nearly had an apoplectic fit afer reading Mr.Ian Breakspears post.

        I swear there was foam.... rabid dog foam....

        But then I read your post Thorn and everything seemed suddenly better... Can I give you a hug please?

        "The public understands the benefit of health disciplines ..." is a ridiculous statement for anyone but a witchdoctor to make. If "the public" clamours for a treatment that "the evidence" clearly demonstrates doesn't work (e.g.. magic-water homeopathy), then the public is just wrong, and needs education. "The public" in many US States clamours for public teaching of creationism. That's no rational argument against Darwin.

        Scientists should argue for what fits the prevailing evidence. That's their proper role. It's certainly not in their remit to argue for what they think people 'want'. Leave that to marketing lobbyists and pundits.

        I'd say originally misguided opportunist but now locked into a profession so has become a wicked opportunist with a deep sense of regret and indignation combined with denial and anger.
        "How dare my career be proven to be a fraud!"

    what do you call alternative medicine that works? Medicine.

    I applaud the FSM on this initiative. Perhaps they could next focus their efforts on universities that provide theological studies next, just sayin.

    Goto love closed minded people, no one is forcing anyone to goto a doctor or a naturopath... If I have a cold I turn to vitamin C, Garlic, tissue salts or herbal remedies etc.... If I'm dying of a lung infection I will go see a doctor, no point to completely shutting out an entire system of medicine without at least trying it with an open mind.

    There are plenty of doctors who work with both conventional and alternative health care. Read Dr. Andrew Weil for what seems to me like a balanced approach to both.
    As an example of the usefulness of acupuncture, my wife had acupuncture to stimulate our daughter in the womb to turn head down in time for the birth. This was at the suggestion of her conventional medical carers who did not have a solution to this particular problem. They told us at the time that acupuncture had a fifty percent chance of stimulating the baby to turn. Left to chance the odds are a lot lower although I cannot give an exact figure. (I am not alone as I notice there is more hot Air than precise figures in most of the comments here.) In my wife's case, the acupuncture worked and our baby was delivered safely in the normal fashion. My wife happens to be a doctor and a specialist in western medicine who is prepared to look outside conventional medicine when necessary. We should be able to have both traditional or alternative medicine and modern medicine, all the while striving to improve standards in both.

    The Friends of Science in Medicine group has a mandate from God him/herself for their crusade. It is right there in their acronym. FSM.... Flying Spaghetti Monster.
    Touched by his noodly appendages!

    If you don't agree with the treatment, go somewhere else and get treatment. Don't knock those that chose to have the treatment options available.

    Haven't said that, there is no way that you can get rid of traditional medicine or any complementary medicine. It works. Full stop. Sometimes it doesn't work. Sometimes modern medicine works. Sometimes it doesn't. It works enough times that there is always going to be a demand in either system.

    What makes people who post comments about how CAM doesn't work think they are smarter than anybody else? You have a different opinion and experience to others. That is all. Full stop. Respect other people for their choice and you would probably discover, they are not stupid. They have an illness, disease, or condition that they want a solution to. They will try various treatments - and most of the time, they have already seen their GPs.

    This fight is as silly as;
    The church saying the earth was flat when it is round and slightly flattened at the poles.
    Saying women do not deserve the same rights as men.
    Homosexuals should burn in hell.
    Disabled people are less than able bodied people.

    They are just examples, but hey,......... the main difference between various medicines, are the skill of the practitioners. If you see a good GP or a great GP, you are going to get better results or care than one that doesn't give a shit. Same with all the professions.

      People can have any treatment they want. What they shouldn't do is expect the public purse to pay for treatments that don't have evidence supporting their efficacy. That is, Medicare shouldn't pay for unsupported treatments, public hospitals shouldn't offer them, and universities shouldn't teach them as part of a new medico's toolkit (though clearly they should research them). The fight isn't 'silly': it's about intelligent marshalling of public resources. It's also about the intellectual credibility of universities. Teaching crystal healing and magic-water treatments (aka homeopathy) as if they are on an evidentiary par with science-based medicine is fraudulent, and makes universities a laughing-stock.

      Huan, this has little or nothing to do with your individual choices, however loopy they might be.

      FSM have argued that, since most CAM modalities are not based on sound theory, testable hypotheses and solid empirical data, they have no place in universities and should not be publicly funded. It's about setting a standard for the use of public money. This should be uncontentious.

    Question: Would you trust a mechanic to fix your car if they couldn't explain what the problem was, why it happened and what they could do to fix it?

    I'm a medical doctor and if a patient comes to me, I diagnose their problem to the best of my ability, explain to the patient why I think it is so, draw a quick diagram, and explain the treatment.

    Any doctor who prescribes a medication or treatment should be able to explain (or at least look up) the exact function of the medication, it's physiological and pharmacological basis, or easily websearch an article from Medline / Pubmed / Cochrane which shows the data on it's usefulness. I even recommend that my patient's "Google" the diagnosis for their understanding.

    Admittedly not everyone will have the scientific basis to understand things, but modern Western medicine is transparent enough that anyone can websearch a medication or surgical procedure, then go to any library and pull out a textbook on anatomy or physiology or pharmacology and check that what the drug does agrees with the scientific understanding of the human body at this time.

    In the hospital setting the efficacy of conventional medicine is even more obvious because we treat people over hours or days, so we can see the effects of treatments. If someone has an infection, we sample and culture the appropriate body fluid, send it to the lab, the wonderful pathology people culture it and find the sensitivities, and we prescribe the appropriate antibiotics. If someone needs an anaesthetic or pain-relief the anaesthetists use medication for which we know the exact receptors the medicines work on, how long they last, how best they are delivered, and how they can be reversed, etc.

    I'd love to see alternative medicine practitioners be able to explain their treatments in such depth. Can they explain how anything works in a way that anyone with a scientific background would accept?

      And another hug for you.

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