CAM ignorance

[Capsid]

This article reports that doctors want more information about CAM.

85% of GPs feeling they don't have enough knowledge and information on the safety and efficacy of complementary medicines and welcoming more guidance

I read that as saying "bring it on", let's properly test these products like we do conventional medicines then we can really judge their role in the treatment of patients.

Yet of course the real reason is not to test but to gain wider acceptance and promoting CAM as the unsung hero especially with the backing of the Prince of Wales Foundation for Integrated Medicine (got to be good then).

This could be a good thing if CAM products are properly tested for safety and efficacy and not just because 63% want to see it available on the NHS. The campaign is for talking about CAM not testing them though so I remain pessimistic.

 

[Anders]

Ofcourse they gonna test for safety. And the result will be perfect, a big A! Then they will forget about the effiency tests, and no one, but us skeptics, will give a damn!

 

[Asolepius]

This article reports that doctors want more information about CAM.

I read that as saying "bring it on", let's properly test these products like we do conventional medicines then we can really judge their role in the treatment of patients.

Yet of course the real reason is not to test but to gain wider acceptance and promoting CAM as the unsung hero especially with the backing of the Prince of Wales Foundation for Integrated Medicine (got to be good then).

This could be a good thing if CAM products are properly tested for safety and efficacy and not just because 63% want to see it available on the NHS. The campaign is for talking about CAM not testing them though so I remain pessimistic.

It all depends on what is meant by `information'. There is a massive politically-driven effort going on to dilute the rigour required in sCAM clinical research - see the Clinical Governance Project. This makes really nauseating reading. The idea is to include all sorts of rubbish in the accepted `evidence'. Randomised clinical trials, which are de rigeur for any orthodox drug, are roundly criticised in this document. Here we have people (and I make no apology for saying this again) who have advanced academic degress in medicine, topped off with OBEs, yet do not understand science as taught at GCSE level. Actually my perception of all this has changed. I used to think that sCAM was being pushed by people who were honest but misguided. The further I dig into this, and learn about the personalities behind it, the more I realise that they are mostly dishonest. sCAM is being pushed for political and commercial reasons, and has nothing to do with health care benefit. But this is a bigger thing than just health care. If we give up caring about truth and evidence, where does this take society?

 

[Rolfe]

Re: Re: CAM ignorance

If we give up caring about truth and evidence, where does this take society?

Bang alongside you there, Les.

I've been obsessing about this "the public is paying for the NHS so it should get what it wants" thing. What is the NHS for? To provide healthcare free at the point of need, that's what. And the word "necessary" wasn't actually stated, but it is implied in all sorts of ways.

Where do we go if we simply allow people to demand anything they want? Supposing I was suffering from severe burns. My distress is compounded by the fact that I spend most of my waking hours obsessing about how much pain I'm in. I find that playing computer games makes me feel much better, because it takes my mind off the whole thing, and my mood is considerably lightened. So can I have a Game Boy or a fancy computer-games system on the NHS?

This isn't a silly question. There has been research into the use of computer games (especially involving an ice and snow environment) in helping people cope with the pain of severe burns. It looks very promising. But should we be dishing out computer-games systems free just to help people cope psychologically with convalescence or a debilitating illness?

This seems to me to be a very similar point to much of the alt-med advocacy. It doesn't have any therapeutic usefulness as such, but it might help keep the patient amused. If we'd look askance at a request for free computer games consoles, I think we should apply an even more jaundiced eye to requests for alt-med just because patients seem to enjoy the process.

And look what a slippery slope you get on when you start prescribing by patient demand. Every new experimental drug will be demanded, even if it's not yet through its clinical trials, and even if the cost is enormous (well, the enormous cost of alt-med doesn't seem to be a deterrent). Patients will demand things that make them feel better in the short term, even if the long-term risks might make the drug contra-indicated. (After all, what do we even know about the long-term effects of most alt-med?) Do we simply give in to the heroin or the Valium addict's requests for a prescription?

That report (so far as I've followed the jargon-ridden, sesquipedalian, obfuscatory claptrap, that is mostly by reading the translations posted here) seems to assume that the patient can just have what he or she wants. Have they even thought about where that attitude would lead the health service in general? Hey, I want a face-lift!

It seems to me that the report is predicated on an extremely questionable premise that has not been thought through at all. Much more needs to be discussed about this idea of pandering to patient whim, regardless of efficacy, safety or cost. Where did the authors get the idea that this was the ground rule? Shouldn't it be challenged?

And by the way, the language, my dears! Impenetrable, and probably deliberately so. I've just spent some time reading the Shipman Inquiry Report, and a better example of clear, jargon-free and lucid explanation would be hard to find. Of course, the estimable Dame Janet understood what she was talking about, and wanted other people to understand too. I think the alt-med advocates are interested in putting as many barriers in the way of comprehension as humanly possible.

Rolfe.

 

[Asolepius]

Re: Re: Re: CAM ignorance

There has been research into the use of computer games (especially involving an ice and snow environment) in helping people cope with the pain of severe burns. It looks very promising. But should we be dishing out computer-games systems free just to help people cope psychologically with convalescence or a debilitating illness?

Interesting point. There was an item on BBC Today the other morning, about a scheme in the West Country to prescribe books instead of medicines for psychiatric illness. I kid you not, the patient will get a prescription for a book from the doctor, who will take it along to the library to be dispensed. We are told that all the books have been selected on the basis of evidence of effectiveness. Hmm... double-blind trials? ISTR the medic concerned was called Dr Paul Farrand.

 

[Asolepius]

I just looked up Farrand P on Medline. Yes, it's the right chap - psychologist, based in Plymouth, and guess what? Only 6 publications since 1995, and nothing on books.