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May 23, 2006

Alternative Medicine

Bloody right too:

A GROUP of Britain’s leading doctors has urged every NHS trust to stop paying for alternative medicine and to use the money for conventional treatments.

Their appeal is a direct challenge to the Prince of Wales’s outspoken campaign to widen access to complementary therapies.

Public funding of “unproven or disproved treatments” such as homoeopathy and reflexology, which are promoted by the Prince, is unacceptable while huge NHS deficits are forcing trusts to sack nurses and limit access to life-saving drugs, the doctors say.

The 13 scientists, who include some of the most eminent names in British medicine, have written to the chief executives of all 476 acute and primary care trusts to demand that only evidence-based therapies are provided free to patients.

Their letter, seen by The Times, has been sent as the Prince today steps up his crusade for increased provision of alternative treatments with a controversial speech to the World Health Organisation assembly in Geneva.

The Prince, who was yesterday given a lesson in crystal therapy while touring a complementary health unit in Merthyr Tydfil, will ask the WHO to embrace alternative therapies in the fight against serious disease. His views have outraged clinicians and researchers, who claim that many of the therapies that he advocates have been shown to be ineffective in trials or have never been properly tested.

If as and when double blind trials are done to show that "alternative" treatments work, they then stop being alternative and become conventional, evidence based medicine. Which is as it should be. If rich idiots (or even poor idiots) wish to waste their money on healing crystals, let them do so. The rest of us can then have our tax money spent on crystals that actually work: like the lutetium oxide ones that are at the heart of an MRI scanner. (Of course, this is just me talking up my own book again. Guess who has in the past (and would like to again in the future) supplied that lutetium oxide?)

The full letter is here:

First, there is now overt promotion of homeopathy in parts of the NHS (including the NHS Direct website). It is an implausible treatment for which over a dozen systematic reviews have failed to produce convincing evidence of effectiveness. Despite this, a recently-published patient guide, promoting use of homeopathy without making the lack of proven efficacy clear to patients, is being made available through government funding. Further suggestions about benefits of homeopathy in the treatment of asthma have been made in the ‘Smallwood Report’ and in another publication by the Department of Health designed to give primary care groups “a basic source of reference on complementary and alternative therapies.” A Cochrane review of all relevant studies, however, failed to confirm any benefits for asthma treatment.

You what? Homeopaths are actually killing people by giving them sugar pills for an asthma attack? Hang the buggers for murder!

The list of signatories is pretty impressive:

Professor Michael Baum
Emeritus Professor of Surgery, University College London

and
Professor Frances Ashcroft FRS
University Laboratory of Physiology, Oxford
Professor Sir Colin Berry
Emeritus Professor of Pathology, Queen Mary, London
Professor Gustav Born FRS
Emeritus Professor of Pharmacology, Kings College London
Professor Sir James Black FRS
Kings College London
Professor David Colquhoun FRS
University College London
Professor Peter Dawson
Clinical Director of Imaging, University College London
Professor Edzard Ernst
Peninsula Medical School, Exeter
Professor John Garrow
Emeritus Professor of Human Nutrition, London
Professor Sir Keith Peters FRS
President, The Academy of Medical Sciences
Mr Leslie Rose
Consultant Clinical Scientist
Professor Raymond Tallis
Emeritus Professor of Geriatric Medicine, University of Manchester
Professor Lewis Wolpert CBE FRS
University College London

Just as an aside, I doubt there’ll be many memberships of the Royal Victorian Order offered to these guys.

 

May 23, 2006 in Health Care | Permalink

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Comments

And about time, too. This pernicious twaddle needs to be stamped out, along with religion.

Posted by: PostPunkUnkle | May 23, 2006 11:13:46 AM

Yet the BBC radio coverage today seems intent on giving equal time to the charalatns from the homeopathy lobby. Balance doesn't require giving equal time to fruitloops.

Posted by: Stephen C | May 23, 2006 12:53:25 PM

As a whole shedload of doctors have said, once a buit of alternative medecine has been proved to work, it becopmes incorporated into medecine. What's left as alternative is what doesn't work.

Posted by: dave heasman | May 23, 2006 4:57:25 PM

I think Prince Chuck is an honourable, caring & hard working man (in many ways better than we have any right to expect) but I would have barely more trust in his competence to make health policy than in that of Michael Meacher to make environmental policy.

Posted by: Neil Craig | May 23, 2006 5:20:08 PM

I think homeopathy is twaddle, but I have a huge objection to the principle that the producer (the NHS) takes your money from you (whether you want to give it to them or not) and then decides what treatments it will provide. The whole thing reeks of producer interest.

The medical unions and royal colleges have succeeded in removing competition from the market. The BMA insisted on the destruction of rival medical institutes (which kept prices down) that existed in several areas when the NHS was created.

Lest we think that medics can be relied upon to only provide scientifically justified treatments, we'd do well to examine the propensity of ENT surgeons to whip out tonsils for practically any reason. When this was discredited and the prospect of a work shortage for ENT surgeons loomed, all of a sudden thousands of children needed operations for glue ear (a condition that clears up naturally). Also look at the huge differences in attitudes to treatment between various countries (e.g. medication to treat low blood pressure is very common in Germany and uncommon here). Many common prcedures are inroduced and routinely used with very little statistical or other evidence of efficacy - often justified by claims that individual clinical professional judgement should not be compromised.

Posted by: HJHJ | May 24, 2006 8:40:24 AM


Doctors Are The Third Leading Cause of Death in the US, Causing 225,000 Deaths Every Year

This article in the Journal of the American Medical Association (JAMA) is the best article I have ever seen written in the published literature documenting the tragedy of the traditional medical paradigm.

If you want to keep updated on issues like this click here to sign up for my free newsletter.

This information is a followup of the Institute of Medicine report which hit the papers in December of last year, but the data was hard to reference as it was not in peer-reviewed journal. Now it is published in JAMA which is the most widely circulated medical periodical in the world.

The author is Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health and she desribes how the US health care system may contribute to poor health.

ALL THESE ARE DEATHS PER YEAR:

* 12,000 -- unnecessary surgery
* 7,000 -- medication errors in hospitals
* 20,000 -- other errors in hospitals
* 80,000 -- infections in hospitals
* 106,000 -- non-error, negative effects of drugs

These total to 225,000 deaths per year from iatrogenic causes!!

What does the word iatrogenic mean? This term is defined as induced in a patient by a physician's activity, manner, or therapy. Used especially of a complication of treatment.

Dr. Starfield offers several warnings in interpreting these numbers:

* First, most of the data are derived from studies in hospitalized patients.
* Second, these estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
* Third, the estimates of death due to error are lower than those in the IOM report.

If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).

Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings,with:

* 116 million extra physician visits
* 77 million extra prescriptions
* 17 million emergency department visits
* 8 million hospitalizations
* 3 million long-term admissions
* 199,000 additional deaths
* $77 billion in extra costs

The high cost of the health care system is considered to be a deficit, but seems to be tolerated under the assumption that better health results from more expensive care.

However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care.

An estimated 44,000 to 98,000 among them die each year as a result of medical errors.

This might be tolerated if it resulted in better health, but does it? Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators. More specifically, the ranking of the US on several indicators was:

* 13th (last) for low-birth-weight percentages
* 13th for neonatal mortality and infant mortality overall
* 11th for postneonatal mortality
* 13th for years of potential life lost (excluding external causes)
* 11th for life expectancy at 1 year for females, 12th for males
* 10th for life expectancy at 15 years for females, 12th for males
* 10th for life expectancy at 40 years for females, 9th for males
* 7th for life expectancy at 65 years for females, 7th for males
* 3rd for life expectancy at 80 years for females, 3rd for males
* 10th for age-adjusted mortality

The poor performance of the US was recently confirmed by a World Health Organization study, which used different data and ranked the United States as 15th among 25 industrialized countries.

There is a perception that the American public "behaves badly" by smoking, drinking, and perpetrating violence." However the data does not support this assertion.

* The proportion of females who smoke ranges from 14% in Japan to 41% in Denmark; in the United States, it is 24% (fifth best). For males, the range is from 26% in Sweden to 61% in Japan; it is 28% in the United States (third best).
* The US ranks fifth best for alcoholic beverage consumption.
* The US has relatively low consumption of animal fats (fifth lowest in men aged 55-64 years in 20 industrialized countries) and the third lowest mean cholesterol concentrations among men aged 50 to 70 years among 13 industrialized countries.

These estimates of death due to error are lower than those in a recent Institutes of Medicine report, and if the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000.

Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the US, following heart disease and cancer.

Lack of technology is certainly not a contributing factor to the US's low ranking.

* Among 29 countries, the United States is second only to Japan in the availability of magnetic resonance imaging units and computed tomography scanners per million population. 17
* Japan, however, ranks highest on health, whereas the US ranks among the lowest.
* It is possible that the high use of technology in Japan is limited to diagnostic technology not matched by high rates of treatment, whereas in the US, high use of diagnostic technology may be linked to more treatment.
* Supporting this possibility are data showing that the number of employees per bed (full-time equivalents) in the United States is highest among the countries ranked, whereas they are very low in Japan, far lower than can be accounted for by the common practice of having family members rather than hospital staff provide the amenities of hospital care.

Posted by: charles maguire | May 26, 2006 9:24:11 PM

I support the opinion of the Prince of Wales about alternative medicine and I think it's important to give money for such supplies too.Many people prefer the alternative medicine.

Posted by: Cara Fletcher | Jul 30, 2007 12:18:06 PM