Posts Tagged pulse

Ernst Praises Hahnemann?

Resident MSS Doctor and Skeptics in the Pub goer Selva shares his views on Edzard Ernst and Samuel Hahnemann…

In a recent Pulse magazine article professor of complementary medicine Edzard Ernst praised the founder of homeopathy, Samuel Hahnemann.

“In my view, Samuel Hahnemann, the German doctor who invented homeopathy about 200 years ago, is a man who should be celebrated.”

Can this be true? Surely one of the most respected proponents of evidence based medicine cannot be advocating homeopathy as a treatment.

In his article he cites the hammering homeopathy has received over the last year including the House of Commons select committee’s damning report, the BMA describing homeopathy as “witchcraft”, and my particular favourite – comedians taking the “homeopathic mickey” (sadly 10.23’s not insignificant role doesn’t get a mention).

Fortunately normal service resumes further in the article – to quote Prof Ernst:

“His primary achievement is not to have developed homeopathy. His true achievement is that, in the course of doing this, he has shown us how important non-specific effects – often also called the ‘art’ of medicine – are in terms of getting patients better. To put it bluntly, Hahnemann has taught us that patients can improve even when we give them nothing but placebos.”

This somewhat conciliatory line is admirable, but I think also provides the crack which has allowed homeopathy to be practiced for so many years as an NHS treatment. Most doctors either haven’t been aware of the implausibility of homeopathy, or have been happy for other practitioners to provide placebos to patients, in the knowledge that there is some perceived benefit. Homeopathy is often given for intractable problems, where EBM doesn’t always provide sufficient benefit. As Prof Ernst says, the act of being empathic and providing sufficient time is often enough to make the patient feel better. Read the rest of this entry »

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The Doctor Says: There May Be Trouble Ahead

Dr Selva Rasaiah is a regular at Merseyside Skeptics in the Pub. Here, in response to my support for real medicine, he takes an inside look at the NHS, and doesn’t like what he sees…

The other day, I read Marsh’s latest post ‘Real Medicine: I Wonder’ with interest – as (hopefully!) one of the “good doctors” he wrote of, I would like to report all is well within the NHS. Unfortunately I can’t. Virtually all the comments on his piece were positive about the use of conventional medicine, but an important point was raised regarding the care of osteoarthritic hip pain. Currently the options for “wear and tear” arthritis are very limited, the options being:

  1. do nothing
  2. take painkillers
  3. hip replacement surgery.

The only definitive treatment is option 3, which for most patients is a life changing procedure. Unfortunately it has a limited lifespan, and in general is only offered to more severely affected patients. As this condition can start in the 50’s or younger, we have the difficult task of informing people that they will have to put up with the pain for many years before surgery will be considered. The problem with evidence based medicine (EBM) is that it leaves lots of gaps, which CAM (complementary and alternative medicine) is more than happy to fill.

On a daily basis, we have to inform patients that their self limiting viral illness/gastroenteritis etc. will not respond to antibiotics. It is so easy to skip the explanation and just dish out the pills, but with the advent of MRSA and other drug resistant nasties, the finger is pointing more and more at “irresponsible GP’s” and their over-prescribing of antibiotics as the cause of this new epidemic. How tempting it would therefore be to prescribe a harmless placebo that might make people feel better, psychologically if not physically. There is however, something inherently dishonest about this approach that would prevent me and most of my colleagues from doing so.

However, a small – but noisy – bunch of GPs DO seem to have followed this route, and regularly post articles and comments in GP magazines. Read the rest of this entry »

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