Doctors skewer sCAMmers

Rolfe said:
There was an article along that general line in this week's Scotland on Sunday. The writer stated she wasn't pro-SCAM (though I do seem to remember some woo-ish columns in the past), but took exception to the paternalism.

Her thesis was entirely based on the belief (probably at least partly correct) that SCAM fulfils a psychological need. I feel a letter coming on, asking whether in that case doesn't she agree that investigating how that psychological need might be addressed more cost-effectively than by invoking magic sugar pills and hand-waving, that surely it should be questioned whether it was ethical to lie to patients about the objective effects of said sugar pills and hand-waving, and has she not considered all the false learning going on, teaching health-care providers the pseudoscience alleged to be behind these purely psychological effects.

Probably too late now, I didn't see the article till this evening.

Rolfe.
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There's also problems with assessing psychological needs, and determining which should be met using public money. I mean, I feel a psychological need to go to the gym, listen to music, eat nice food etc. (some of which may also bring more physical benefits than CAM...) If we're going to allow prescription of sugar pills to be publically funded, then surely there's a good argument to extend provision for other psychological needs :D
 
At one point didn't GPs prescribe things like "food"? I'm thinking things like Guinness and Baked Beans - or is that an urban myth?
 
emails to MP and MSP gone.
More letters when I get home.

Mind you- let's not lose sight of the fact that some doctors- not just consultants- ARE smug, self-satisfied pillocks who think patients are complete morons. Precisely the great advantage many alt med scammers have is that they act like real, decent, concerned people. Many of them are not acting- they genuinely are concerned people.
They just have their facts wrong.
 
antihippy said:
At one point didn't GPs prescribe things like "food"? I'm thinking things like Guinness and Baked Beans - or is that an urban myth?
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Pretty sure they did 'prescribe' guinness at times (at least, apparently my mum was told to drink a regular glass when pregnant) though not sure if the beer was paid for or not :D I think there've also been trials with GPs 'prescribing' exercise for overweight patients.

Those practising CAM often claim to be focused on the whole person, to take into account lifestyle, etc. I guess if they want NHS funding they'll need to stay relatively close to a medical model, though - after all, if we're talking about publically funding lifestyle changes, there's many ways to bring far more health benefits than taking sugar pills.
 
Soapy Sam said:
Mind you- let's not lose sight of the fact that some doctors- not just consultants- ARE smug, self-satisfied pillocks who think patients are complete morons. Precisely the great advantage many alt med scammers have is that they act like real, decent, concerned people. Many of them are not acting- they genuinely are concerned people.
They just have their facts wrong.
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There's another point of view I've heard on this which I think is at least as valid.

Doctors are told to be open with their patients, to present them with all the options, to be honest about the probabilities of a treatment being successful, and to involve them in the decision-making process. Many patients don't respond well to this.

SCAMmers on the other hand are frequently paternalistic, dictatorial and very very certain. Yes, what they say is positive, and how! Yes, I can cure you, I understand more about this than the doctor, just do as I say. Who wouldn't prefer that to being told the unvarnished truth and then asked to decide which treatment option you want to go for?

Rolfe.
 
Watching very closely as this unfolds, from down here in oz.
Now is the time to show strength in numbers.
Hope you are all writing to your MPs and newspaper editors.
Keep up the good fight!
 
Rolfe said:
There was an article along that general line in this week's Scotland on Sunday. The writer stated she wasn't pro-SCAM (though I do seem to remember some woo-ish columns in the past), but took exception to the paternalism.
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What could be more paternalistic than lying to patients? Why don't people see this argument? Scientific medicine is not saying to patients "look, trust us we are doctors", it's saying "Look, don't just take our word for it, this is what science tells us". In terms of telling patients the truth, doctors are no more than the messengers. Thus, in time-honoured fashion we 13 are getting shot at.
 
Soapy Sam said:
emails to MP and MSP gone.
More letters when I get home.
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Great - anyone else have anything to report?

Mind you- let's not lose sight of the fact that some doctors- not just consultants- ARE smug, self-satisfied pillocks who think patients are complete morons. Precisely the great advantage many alt med scammers have is that they act like real, decent, concerned people. Many of them are not acting- they genuinely are concerned people.
They just have their facts wrong.
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And many priests enjoy the company of choirboys, some scientists fake their results, ministers lie to their parliaments, etc etc. Yes of course there are some right b*****ds with medical degrees - I have known a few. But ALL homeopaths are telling their patients stuff that is no more than fairy stories. I don't think that being misguided but genuine is much of an excuse.
 
Emails sent to local MP and AMs.

The cost of providing these placebos on the NHS really annoys me. From next week I'll have copies of the final accounts of two NHS trusts to work on (as an external auditor). I've not worked at either before, but I know one is currently looking at a several million pound deficit this year. It's not strictly within my remit (nothing to do with me at all, in fact), but I'll find out next week if either are offering SCAM services. Then point out an easy cost-saving measure.
 
antihippy said:
Having not seen the show...

I would be surprised if Phil Hammond was being entirely serious. I'll see if I can get a tape of the show to watch (bit torrent anyone?). He has always struck me as being quite a ... ummm cynical person so perhaps his joke has been taken incorrectly?
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He did start out making a joke about the whole matter - "sticking shatzus in one's qigongs" or something to that effect.

However, he ended by stating in all seriousness that CAM filled a need and was probably cost effective. This provoked the hearty round of applause from the audience - which rather dismayed me, as the target audience for "Have I got News for you" is usually comprises intelligent, sharpwitted and slightly cynical beings.
 
Asolepius said:
Yes, I was also rather disappointed with Phil Hammond. But then in the last 2 days or so I have been equally disappointed with Ben Goldacre and Richard Smith (ex-editor of BMJ). Some of the critics clearly have not read the letter.
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Regards Richard Smith, it seems that he’s missed the point. In citing various procedures that are no longer used (radical mastectomies, tonsillectomies, prepping for childbirth) in support of his argument that most medical interventions have a weak evidence base, he seems to have forgotten that those are good examples of medical science working as it should, i.e., discarding what has been found to be ineffective or unnecessary – which is exactly what should happen to most sCAM since medicine should be striving to build a stronger evidence base, not a weaker one.

Here’s his full commentary:
http://commentisfree.guardian.co.uk/richard_smith/2006/05/richard_smith_on_quack_medicin.html

Letters going out to MPs, etc., shortly.
 
Talking of The Grauniad here's a very depressing little puff-piece written by a "health editor" in which she lets Peter Fisher's inane assertions go without comment;

http://www.guardian.co.uk/uk_news/story/0,,1784265,00.html

Just to show how really on the ball she is;

"The dilution varies. Dr Fisher picks up one labelled 6c - that is, 600 parts water to one part active substance. Another is 9c - 900 parts water."

No. That would be 10^12 parts and 10^18 parts water. D'oh!!
 
Peter Fisher is not above muddying the waters when it suits him. When he was on the Horizon programme, he explained about "like cures like" by explaining that we all know how when chopping an onion our eyes water, therefore homoeopaths would use a preparation of onion for conditions involving streaming eyes, such as a cold. Not a word about whether I felt resentment towards my wife or a sharp pain in my left leg, after taking a 30C preparation of onion, you note!

Rolfe.
 
The same stupid mistake appeared in May 24th's paper when an article with the same ly-line told us in a dise panel that homeopathy is "administering a tiny amount of whatever is deemed to be causing the illness, diluted maybe 100 times with water"

Now that's just wrong on so many levels. It's isopathy not homeopathy, though it would be rare ever to get them to admit anything so absolute as a "cause" and the dilutions are more typically 1 in 10^100 not 1 in 100.
 
I do wonder how many of those bureaucrats who prop up homoeopathy on an almost reflex basis (Hockey, for example) actually think this is what it's all about - if they think about it at all. Which is why it's important that any serious attempt to get people like that to examine the issue has to incorporate a correct explanation, however brief.

Sorry, the information that the VMD is about to modify the Veterinary Medicines Regulations so as to explicitly make it legitimate within the cascade for a vet to prescribe "grandfathered" homoeopathic remedies is really quite depressing me right now.

Rolfe.
 
Just sent this to the Grauniad

Naughty Guardian. Twice in a week, Sarah Boseley "Health Editor" has thoroughly misrepresented the dilution principles underlying homeopathy and made it seem almost sensible as a result (Saturday 17th May 2006, http://www.guardian.co.uk/uk_news/story/0,,1784265,00.html). Contrary to her statements, 6C and 9C do not represent 1 part in 600 or 900, but 1 part in 1,000,000,000,000 and 1,000,000,000,000,000,000 respectively. Previously, on Wednesday 24th May, we were informed that remedies are "diluted maybe 100 times with water". No. A single step in the preparation may be a 100-fold dilution, but remedy preparation typically involves 10's or even 100's of such steps, so that if we were to regard this in the ordinary chemical sense then the dilution factors are beyond astronomical.

Homeopaths don't mind admitting that there is not a single molecule of source material in most of their remedies. They talk about 'traces' of 'energy' or water's mysterious 'memory', but it is more accurate to say that in making a homeopathic remedy the original substance is completely washed away by successive quantities of water. If homeopathy were true then yesterday's coffee cups would contain powerful homeopathic essence of coffee and could pose untold dangers to us all.

Homeopathy consists of giving water drops or sugar pills to patients. The reason why trials find it so hard to show any effect beyond placebo is because there is none. It really is high time that we moved on from this silly subject, but sadly the advocates of homeopathy cannot relinquish its comforting fantasies and comfortable livelihoods.
 
Great letter Monkey!
A good example for letters to the editor ... consice and straight to the point, high fact-to-emotion ratio, and a strong appeal to common sense at the end.
 
Got a reply from my MP...

Asolepius said:
Of course there's more to come, a lot more, and you are all part of it. MPs are now demanding the govt to reveal how much it spends on sCAM. Get those emails out to your own MPs. Here are some suggested questions:

1. Why does the NHS Direct website provide misleading information about CAM? For orthodox treatments it includes links to evidence sources such as Bandolier and ClinicalEvidence.com, but curiously these are missing for all the CAM entries.

2. Why does the NHS allow unconnected organisations to use its logo and style on their websites? Examples are the NHS Alliance and NHS Trusts Association, both of which carry copious misinformation about CAM. The NHS Trusts Association site has just been reloaded with even more rubbish, and seems to exist solely to promote CAM.

3. When is the DoH going to refer CAM to NICE? They agreed to do this 6 years ago and still nothing.

4. Why is the govt funding the Prince's Foundation to send out information which avoids any consideration of evidence - even when this was part of the original conditions for the funding?

5. What has gone wrong with the regulation of chiropractic, when it's the leading cause of strokes in the under 45s?

6. Why is the govt obsessed with patient choice but cares nothing for making that an informed choice?

7. Why is the government allowing university courses in fictional disciplines in our universities? How can one possibly be a Bachelor of Science in homeopathy?

That's for starters. I'll keep track of how it's going so PM me if you like with what you have done. A word of warning - do your own research and use your own words. We are all free agents.
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I wrote to my MP with these questions (Nick Clegg, Lib Dem for Sheffield) and he passed them on to the DoH. I've now received their reply. It doesn't answer many of the questions (surprise, surprise!) and I'll make the whole response available if anyone wants it, but I'll quote from their first paragraph.


The evidence base for CAM is different from traditional medicine but NHS Direct works closely with the National Electronic Library for Health, in developing its content, including CAM. NHS Direct is careful when presenting material on this area and always acknowledges when information is not supported by research....
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There's more but doesn't really answer anything. They do say the NHS Alliance and NHS Trusts Association doesn't use the NHS logo and I have to admit I couldn't find it.
 
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