I have to be careful on this one, as my wife is convinced it works, and one of her best friends is a homeopath. Ben Goldacre, a firm sceptic on the subject of alternative medicine, put the boot in with some relish in the Guardian. Glasgow GP and FT columnist Margaret McCartney has major doubts too, but asks larger questions about how the NHS gives - or fails to give - patients the time and attention they need:
Denis MacEoin responds to Goldacre at Comment is Free. Plenty of heat and light, as you might expect, in the thread that follows the article.The bottom line, and no homeopath
with half an eye on the evidence can ignore it, is that homeopathic remedies are no better than taking a placebo. Homeopathy does not work. We should accept this and move on. However, we must not dismiss the placebo effect as well. The placebo effect – where a chemically inactive treatment produces beneficial effects – is one of the most useful, consistent, cheap, and side-effect free medical treatments we have. The problem is rather that one of the main ways we distribute the placebo effect on the NHS – via homeopathic hospitals – is expensive and unfair as only a few can benefit from it....The word “placebo” is Latin for “I shall please”. Modern healthcare pretends to care and to focus on the patient. In reality, this sometimes means nothing more than meeting targets, crunching numbers and handing out the occasional customer satisfaction questionnaire...
As a GP, I may have to leave halfway through a consultation to make an emergency house call – hardly what you would call undivided attention. The homeopath, on the other hand has the luxury of putting aside an hour for the first meeting, should they so wish, and will talk about nothing except what the patient wishes to discuss...
What’s clear then is that general practice is very efficient but that efficiency comes with a cost. The cost is in the value-added parts of the consultation, which we don’t often measure. No wonder patients perceive themselves to be in a vast and unfeeling machine. The contrast with homeopaths, who tend to see their patients often, could not be greater. No wonder also, that people seek out homeopaths instead.
This does not alter my opinion. We should still close the NHS homeopathic hospitals. But we should use the saved money to do NHS caring better.
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James Hamilton
November 26th, 2007 12:04pmPutting my "complementary practitioner" hat on for a moment... the fact that the NHS doesn't have enough time to treat everyone in the way they'd like to be treated (i.e. I can give my clients an hour or more, my GP, with hundreds of people to see, can give 5-10 minutes) is no more than it is - a problem that we'd like solved. Just because a homeopath has more time to give does not justify their claims to "treat the whole person". They're not. They're just being nice to them. That's all. And as for the placebo effect - that's something that neuroscience will catch up with in the relatively near future, and it'll be interesting to see what homeopaths cling to after that. Should homeopathy come up with something that really works,a cure for arthritis, say, then they'll face the GP's dilemma. And then we'd see how they got on - but it'll never happen, of course. I thought that CiF article replying to Ben G was an intellectual disgrace, by the way.
Louise Mclean
November 26th, 2007 3:33pmThe detractors appear to be totally uneducated about homeopathy and are lashing out in ignorance of the facts. Firstly, I doubt whether they even know that Hippocrates, the Father of Medicine, stated that there were two laws of healing: the law of opposites (allopathy) and the law of similars (homeopathy). http://homeoint.org/morrell/british/origins.htm http://www.google.co.uk/search?hl=en&q=Hippocrates+two+laws+of+healing+-+the+law+of+similars+and+the+law+of+opposites&btnG=Google+Search&meta= Secondly, noone ever mentions the Homeopathic Provings. Every new homeopathic medicine undergoes a Proving which means at least 50 people go away and must keep taking the new remedy, usually in a 30c potency, until they develop symptoms (that they never had before). All symptoms are recorded in a database. Whatever symptoms they all experience in common are recorded in the Materia Medica as being the symptoms of this new remedy. Then you get someone who is ill manifesting those particular symptoms and they are given that remedy as a cure according to the Law of Similars. It is much more scientific than modern medicine as each remedy is tested in this way. All homeopathy does is it acts as a catalyst to stimulate the body's own healing powers, which has become 'stuck' in sickness. It kickstarts the body's own healing reaction, through like for like. Thirdly the expression 'evidence based medicine'. The Evidence is the fact that millions of patients have been cured using homeopathy. As for the homeopathic hospitals which cost about £6 million - this is a drop in the ocean compared to the £70 BILLION spent on the NHS. When the NHS was formed in 1948, it was enshrined in its Constitution that as long as there were patients who wanted it, homeopathy would always be available on the NHS. There are waiting lists of patients who want it. In a study of 6500 patients at the Bristol Homeopathic Hospital 70% were better or much better - this is money very well spent and a great saving for the NHS. http://www.trusthomeopathy.org/csArticles/articles/000000/000080.htm Dana Ullman, MPH has just produced an excellent book which describes all the famous people throughout history over the past couple of hundred years who loved to use homeopathic medicine. www.homeopathicrevolution.com/ I can assure you that the Elite of this world use homeopathy but the one thing the pharmaceutical industry does not want under any circumstances, is for the masses to find out how well it works. Hence all these prejudiced stories being planted in the press.
Denis MacEoin
November 26th, 2007 8:27pmI'm sorry James Hamilton thinks my CiF piece wsa 'an intellectual disgrace'. Wasn't I brainy enough for him? I only have the equivalent of five degrees and have spent my life as a writer and lecturer, but perhaps that counts for nothing. I don't think it's the 'intellectual' thing at all. I think it's the fact that I challenge what I find to be puerile dogmatism from Ben Goldacre and others. And I worry about their ability to engage in a modest intellectual debate. Read through the comments on that thread and you'll find that a great crowd of BG supporters have gathered to cast insults, venom, sneers, vitriol, arrogance, and much more of the same on my head. Just after all that, I had a debate via e-mail with an engineer who also disagreed with me, but who wanted to understand my position better. He and I sent long e-mails back and forth for days, ended by agreeing to differ, and never once insulted or demeaned one another. That was an intellectual debate, and very enjoyable it was. What went on in that thread WAS the intellectual disgrace, and I deplore it as much for its language as for its dogmatic inability to grasp what I was arguing in the first place. My opponents insisted that a random controlled trial of, say, one homeopathic remedy would confirm that it does not work. I insist they would be wrong, simply because homeopathy is not administered like that, and that it is unscientific to test A by testing B. It is difficult to devise hard scientific testing for homeopathy (and BG's suggestion is inadequate to this purpose), but until it has been done no-one has a right to declare homeopathy invalid. To force homeopathy into the rigid frame of conventional rcts is scientific balderdash. What is needed is hard science, a strict adherence to scientific methodology and rigour — not an insistence that homeopathy be treated as something it is not. What I think we are seeing here is one of two things: the eventual acquisition of evidence that homeopathy indeed does not work; or the start of a paradigm shift in the terms set out by Thomas Kuhn. I don't think homeopathy's detractors know what a paradigm shift is, since they seem set on insisting that the current model of drug testing is unchallengeable. What takes science forward is the courage to think outside the box. It is intellectually dishonest to pretend that such is not possible