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Complementary Medicine

 

Doctors used to be deeply sceptical about complementary medicine: no plausibility, no science, no credibility, and so on. Today this is changing. Many patients are so fond of this or that alternative treatment that their physicians have had to slowly accept (some of) it. To say that the UK medical profession has fully embraced complementary medicine would, however, be several steps too far. Most doctors remain somewhat doubtful, but at least an openness has set in that allows constructive dialogue.

For 15 years, my team has researched complementary medicine in the most rigorous fashion we could. This effort has resulted in over a thousand papers in the peer-reviewed literature - far too much for anyone to read. We have therefore also published several books summarizing the current state of affairs, which consider all the evidence available as well as looking at our own research.

In our most recent book, the Oxford Handbook of Complementary Medicine, we state bluntly what can be shown to work for what condition and what not. Those who think that complementary medicine is all a bit of make-believe will be surprised to see that many treatments are, according to reliable trial data, demonstrably effective for certain conditions. Here are a few examples:

Massage therapy reduces anxiety
Devils claw, a herbal remedy, eases back pain
African plum, a herbal remedy, reduces the symptoms of benign prostatic hyperplasia
Green tea can reduce the cardiovascular risk
Hawthorn, a herbal remedy, is effective for chronic heart failure stages I and II
Ginkgo biloba, a herbal remedy, slows the clinical decline in dementia
St Johns wort, a herbal remedy, reduces mild to moderate depression
Complementary medicine may slowly be getting accepted by the medical establishment, but it is clearly not driven by it. There is no doubt that it is the patient who takes most interest in the subject. The daily press is consequently full of articles on the subject; and there are, without exaggeration, millions of websites on it. Several independent assessments of the quality of this information have painted a very bleak picture indeed.

To put it bluntly, your patients are being brainwashed on a daily basis to believe that complementary medicine is the best thing since sliced bread. The truth is, however, very different: okay, some of these treatments work, but most are not sufficiently researched to be sure, and many are demonstrably ineffective or even dangerous.

With the field being mostly patient-driven, I have attempted to help put the record straight with a book aimed at laypeople, cowritten by Simon Singh. In 'Trick or Treatment? Alternative Medicine on Trial', we make an honest attempt to explain in some detail to the layperson why it is so very important for healthcare to be based on evidence. In doing this, we evaluate the evidence of four complementary treatments in detail acupuncture, chiropractic, herbal medicine, and homeopathy. We also evaluate more than 30 further modalities more briefly.

As the climate changes further, more and more of us will become more and more open to the claims made for complementary medicine. But while there is a greater amount of constructive dialogue in the field, it is still clouded.

I find that an air of political correctness, for example, makes it harder and harder to get the clear point across that homeopathy is based on nonsensical assumption, and that the trial data fail to show that it works beyond a placebo effect.

Health is far too important to be obstructed by belief or political correctness. It will therefore continue to be vital that researchers such as myself speak out on what the most reliable evidence shows, whether in favour of a treatment or not.

 

Professor Edzard Ernst MD PhD FRCP FRCPEd is director of the Complementary Medicine Group at the Peninsula Medical School, Exeter

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