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alternative health care « Previous | |Next »
July 8, 2008

In the 2006-2007 financial year, Medicare Australia paid out more than $23 million in rebates for patients who received acupuncture, chiropractic therapy and osteopathy. While only a small number of people qualify for the rebates – those with chronic conditions and with complex care needs – the cost to the public purse could rise dramatically if complimentary and alternative Medicine (CAM) becomes part of mainstream medicine as forecast by some within the medical fraternity.

More than $4.1 billion is spent nationally on CAM, with up to two-thirds of the Australian adult population using at least one product and one in four using complementary medicine services.The most frequent users are the better educated, higher-income earners, middle-aged women and people suffering with chronic and painful conditions that orthodox medicine manages poorly

Rose Shapiro's Suckers: How Alternative Medicine Makes Fools of Us All, argues that alternative medicine can jeopardise the health of those it claims to treat, that it leaches resources from treatments of proven efficacy, and remains largely unaccountable and unregulated. It is an industry (Included in alternative medicine are acupuncture, chiropractic therapy, homeopathy and herbal medicine) preying on human vulnerability, whose success makes fools of us all. The title casts consumers as gullible and practitioners as vampiric and we consumers spend billions each year on what amounts to little more than snake oil because our critical faculties are dulled by the pleasures of having someone listen to us.

Two things are notably lacking in dismissal texts such as these (another is Trick or Treatment: Alternative Medicine on Trial by Simon Singh and Edzard Ernst) that work the Enlightenment's science v religion duality. The first is an acknowledgement of the problems of funding adequate trials so that this health care, like medicine, becomes evidence-based, and, secondly, a discussion of the equivalent risks and inadequacies of conventional medicine. Though extensively tested, pharmaceutical drugs are scarcely devoid of side effects, and patient dissatisfaction with their treatment options is one of the many reasons why alternatives have become so popular.

The prevailing mechanistic model is not good at treating patients suffering from chronic illnesses that respond poorly to conventional treatments or from a constellation of symptoms that are not easily diagnosed or treated. These include 'headaches, heartaches, backaches, aching feet, fatigue, anxiety and those vague burning pains in your legs at night - and mechanistic medicine says that t there is no reliable cure for any of them'. So we ignorant consumers are obliged to put up with our headaches, backpain, heartaches and depression and stay unwell.

It is often argued that faith based medicine relies on obsolete or metaphysical concepts of human biology and physiology that have to be described as absurd. Obsolete here means not mechanistic, which means vitalism or organic. Secondly, it is argued that proponents of such concepts as vitalism or process philosophy will not subject their interventions to scientific scrutiny, suggesting that the mere attempt of critical evaluation is sufficient to chase the healing process away. So CAM is dumped in the dustbin market irrational.

Things are shifting. At an international CAM congress staged in Sydney earlier this year, the Federal Government announced more than $7 million in grants for the creation of new centres and research projects across the country. In Queensland, more than $660,000 was awarded to establishing a new clinic at the University of Queensland in a bid to integrate CAM with conventional medicine. Maybe research will be conducted to see develop evidence about which forms of alternative health care is effective.

| Posted by Gary Sauer-Thompson at 8:45 AM | | Comments (5)
Comments

Comments

It's a mistake to lump all branches of CAM together as some treatments, such as homeopathy, have never been found to have any effect other than placebo, whereas for others there is sound evidence of beneficial effects.

There is a growing body of evidence-based information on CAM. The Cochrane Collaboration, named in memory of Archy Cochrane, a Scottish doctor who first publicised the need for evidence about medical treatment, is the international clearing house for evidence on medical effectiveness.

In a recent newsletter it said, http://www.cochrane.org/newslett/ccinfo/CCInfo1May2008.txt:

"Founded in 1996 and coordinated by the University of Maryland Center for Integrative Medicine, the Cochrane Complementary and Alternative Medicine (CAM) Field has worked steadily to meet the growing demand for information about CAM therapies among both practitioners, clinical researchers, and the general public. The activities of the Field include identifying published reports of clinical trials of complementary therapies, preparing systematic reviews, training systematic reviewers, disseminating Cochrane reviews to the general public, clinical researchers and healthcare providers, and conducting research to improve systematic review methodology.

"In May 2007, after the thorough peer-review of our application, the US National Institutes of Health's National Center for Complementary and Alternative Medicine (NIH-NCCAM) awarded the Center for Integrative Medicine with a five-year 2.1 million dollar grant (Grant No. R24 AT001293) to help extend the work of the field and support other related activities...."

It is also worth noting that Edzard Ernst was trained in homeopathy as part of his medical training in Germany. His faith in its value faltered once he examined the research, much of which he personally supervised.

Last year the University of Western Sydney established a Centre for Complementary Medical Research, funded by the federal government.

You could argue that, in terms of total national health impact, CAM research is grossly under-funded, compared say, with AIDS research. But the situation is clearly improving.

Mike
I agree re your point about it being a mistake to lump all branches of CAM together. it more or less means non-medical.

Gary
I think it's a 2 way street. Orthodox medicine needs to relax its evangelical worship of empirical rigour, or at least permit less mechanistic cause-and-effect dynamics into its analysis. Alternative medicine proponents need to run more robust trials to provide at least a platform for justification of their practices. Both can learn from one another I feel.

Mike,
there sure is need for research into CAM medicine. They are concerned for having no evidence and research but they are given little help to do that research.

Luke,
fair comment.