The UK chiropractic profession chooses a specialist in “paediatric chiropractic” for one of its leading awards

Elisabeth Davidson is a chiropractor who travels around Europe providing training on paediatric chiropractic. She was recently awarded the British Chiropractic Association’s ‘Chiropractors Chiropractor of the Year’ Award, which is voted for by members of the British Chiropractic Association (BCA). Unfortunately, misleading and unsubstantiated claims and unsuitable and unproven treatments are common in paediatric chiropractic. When someone who specialises in this area is given an award like this it serves to highlight the serious problems within the UK chiropractic profession.

In the training courses that Elisabeth provides she claims to be able to treat a whole range of childhood problems from dyspraxia to growing pains to bed wetting and even asthma. Here is an example: https://www.southwales.ac.uk/business-services/professional-development/specialist-courses/chiropractic/ Not only is there no evidence to back up these claims but there is simply no plausible mechanism by which chiropractic treatments could have any beneficial effect for any of these conditions.

As well as training in specific conditions, Elisabeth also provides training in particular techniques including Craniosacral therapy. Craniosacral therapy and the closely related cranial osteopathy are complete nonsense, have no plausible mechanism of action and no evidence of effectiveness for any condition.

The risks that are presented when an unsuspecting member of the public takes their child for treatment for these sorts of health problems by a chiropractor should not be understated. The direct risks from chiropractic treatment in children have not been adequately assessed and it’s therefore unclear the risk that these treatments present. What’s probably more important in this case though is the indirect risks, in particular delaying more suitable treatments. Some of these conditions are serious and need to be treated by a doctor with appropriate specialist knowledge, e.g. paediatrician. Some children do unfortunately die from asthma and it is totally inappropriate for a chiropractor to be trying to treat this.

The British Chiropractic Association’s ‘Chiropractors Chiropractor of the Year’ Award is voted for by chiropractors. When UK chiropractors choose someone who provides this sort of training as being worthy of an award it raises serious questions about the UK chiropractic profession as a whole. I would normally recommend against taking your child to a chiropractor but given who the profession seems to view as its leaders I actually wonder if it’s more appropriate to say that the only safe option is that nobody should visit a UK chiropractor at all.

An article in Glamour magazine highlights the many problems with osteopathy and how similar it is to chiropractic

There was a recent article in Glamour magazine that was shared by a number of osteopaths. They seemed to think it showed the benefits of osteopathy, but in reality it just serves to highlight the many problems with the beliefs that underpin the profession. For instance, the patient was apparently told “a blockage in the left side of my stomach was causing the curve in my right shoulder”. Wait, what? For some bizarre reason this osteopath thought that shoulder problems can be caused by an issue in the stomach. Not only is there no plausible reason why this could be the case but it’s also not possible for an osteopath to assess the stomach (or any other internal organ). The nonsense in this osteopathy session didn’t stop here though so let’s look at some of the other issues:

  • “My right leg is slightly longer” – This is not unsurprising as many people have some, usually small, difference in limb lengths. However, whether an osteopath (or any other professional) can accurately assess this in the clinic setting is debatable. There is also much debate about when a leg length discrepancy is sufficiently large to be of clinical relevance and require treatment. (See this paper for a detailed assessment of the issues). Leg length discrepancy is something that some osteopaths and chiropractors seem to focus their treatments on. (Just do a web search and see the large number of results). However, there is a lack of validity to the measurements used, lack of agreement on when treatment is needed and lack of evidence to support the treatments used by osteopaths and chiropractors to “correct” this issue. Buyer beware!
  • A twist in my back was reducing the blood flow to my head which was causing my headaches.” Diagnosing and treating headaches can be complicated and sometimes requires further investigations and / or onward referral to a specialist. Whilst tight neck muscles can be a cause of headaches (not usually back muscles) there is no way that an osteopath could possibly know that there was a reduced blood flow to the head or whether this could be the cause of a headache in this case. Importantly, diagnosis should also be carried out by a doctor. Osteopaths are complementary therapists, not doctors and lack the medical training to adequately diagnose headaches. In terms of treatment of headaches, the approaches used by osteopaths lack evidence of effectiveness
  • “He informed me that my lower-back and mid-back (super-sensitive areas) are experiencing spasms and pain because they have memory of the trauma 12 years ago.” This is nonsense. There may have been some long-term damage to the back that hadn’t fully healed after the previous trauma but to suggest that the back has “memory” is ridiculous. The brain has memory. The back doesn’t.
  • “Saied has a gentle approach and believes in treating the body as a whole, as there’s no point treating a specific area unless the whole body is in tune, or the pain will recur and it will be a waste of time.” Here we get an insight into some of the mistaken beliefs held by some osteopaths. There are some circumstances where a problem in one part of the body may influence other parts but to suggest that the whole body needs to be “in tune” is simply not valid. If you break your arm, it’s a safe bet that it wasn’t caused by a problem with your leg and treating your leg isn’t going to make any difference to your recovery from a broken arm! Everybody has small physical imbalances and variations such as differences between one side of the body and the other. These do not need to be “corrected”.
  • Saied would gently adjust my arms, legs, shoulders, running his fingers down my spine, that felt like nothing really was happening. But, slowly appointment, by appointment the constant agony just faded into a distant memory.” Reading this, it sounds possible that the back pain may have gone away of its own accord rather than due to the actual treatment. That is something that happens much more frequently with health problems such as back pain than most people realise. If someone is going for treatment at the same time that they improve they naturally put the improvement down to the treatment. In reality, it could just as easily be due to the condition improving on its own and the treatment may have not had any actual effect.

Similarities to chiropractic

Although osteopathy and chiropractic are different professions they have a lot more in common than they do differences. Assessing leg length difference, as discussed above, as well as other structural imbalances and “misalignments” is something that chiropractors often do as well as osteopaths. The reality is that there is little evidence to support such structural assessments as a basis for making a diagnosis or that “treating” these imbalances has any benefit. Both professions also use manual therapy (hands-on therapy) as their primary treatments. Some osteopaths and chiropractors also make use of similar nonsensical treatment approaches such as cranial osteopathy (osteopaths) and craniosacral therapy (chiropractors). In the UK there are many issues that are common to both professions.

Conclusion

There are some osteopaths (and chiropractors) who behave much like physiotherapists and use evidence-based treatments to tackle problems such as back and neck pain. Unfortunately, from what I’ve seen, osteopaths who practice in this way seem to be in a pretty small minority. Too many osteopaths have mistaken beliefs about the way the human body works and use unproven and unsuitable techniques. The article in glamour magazine highlights a few examples such as suggesting that the body needs to be “in tune” and that a blockage in the stomach could cause a curve in the shoulder. If you decide to visit an osteopath there is no way to know whether you will get one who is evidence-based or one who is fully immersed in nonsense. It’s therefore probably safer to avoid osteopathy and look elsewhere for a more suitable treatment.

Integrative Health Convention 2019: A collection of unsuitable, unproven and potentially harmful treatments

On 5th and 6th October 2019 it’s the annual Integrative Health Convention. From QiGong to Homeopathy to Reflexology to Acupuncture and many more this really is quite the collection of unsuitable, unproven and potentially harmful treatments.

The convention aims to “show you how complementary therapy, self-care, and medicine are already working together successfully to improve health outcomes, reduce workload, limit overprescribing, and manage stress and workload, as well as resulting in a possible reduction in national health spending.” On the face of it this is a worthy aim. Improving health outcomes whilst reducing workload and costs to the NHS would be great if it could be achieved. Self-care is also clearly an important part of managing many health conditions. However, it’s already used alongside medicine in conventional healthcare. All that this convention therefore offers is the addition of complementary therapy. Most complementary therapies are not effective, carry risks and are carried out by practitioners who lack adequate skills in diagnosis and treatment. It is therefore hard to see how this convention can have a positive impact on public health.

Let’s look at just a small sample of the therapies being discussed at the convention:

  • “Transforming responses to Stress with Integrative QiGong”. QiGong is a branch of Traditional Chinese Medicine (TCM). Like many aspects of TCM it is focused on the “life force” Qi (or Chi). Qi has never been shown to actually exist and therefore QiGong is highly implausible. There is no good evidence that QiGong has any health benefit.
  • “Integrating Acupuncture – Western Medical Acupuncture, Traditional Chinese Acupuncture and Future Avenues in Acupuncture”. Like QiGong, acupuncture is a branch of Traditional Chinese Medicine. It is also based on the concepts of Qi and meridians, neither of which actually exists. Acupuncture has little or no evidence of effectiveness for any health condition. The perceived benefits of acupuncture are probably due to non-specific treatment effects, e.g. the relaxing environment and attention provided by the acupuncturist rather than the actual acupuncture treatment. This has led to acupuncture being called a “theatrical placebo”.
  • “Reflexology: What is it and what is the evidence?” Reflexology is based on the
    reflexology feet
    An actual map of the feet

    mistaken belief that different parts of the feet correspond to different parts of the body. Reflexologists believe that by pressing on different parts of the feet they can bring about changes in other parts of the body. This is nonsense. Reflexology is a foot massage, nothing more, nothing less. As to the evidence, that’s very clear: It has not been shown to provide any benefit for any health condition.

  • “Homeopathy explained – How does homeopathy work & How to use it at Home?” Homeopathy is made up of many strange beliefs such as the “memory” of water and “like cures like”. It conflicts directly with many aspects of science. Homeopathy has been extensively tested and not found to be effective for any health condition. For instance, see the NHMRC report on homeopathy. Put simply, homeopathy doesn’t work and there is no plausible mechanism by which it could. Recommending people to use homeopathy at home carries a number of risks, most importantly the potential to delay more effective treatments. In some situations this could have serious consequences.

    reiki
    Does this look like a valid medical treatment?
  • “The Successful Integration of Reiki into NHS Hospitals.” Reiki is a form of energy healing in which a “universal energy” is believed to be transferred through the palms of the practitioner to the patient in order to encourage healing. It’s based on the assumptions of Traditional Chinese Medicine including the existence of Qi. Qi has never been shown to actually exist and there is no plausible mechanism by which Reiki could work. When tested in clinical trials it has not been shown to provide any health benefits. Far from being a success, any use of Reiki in the NHS would therefore be a disaster and an appalling waste of scarce NHS resources.
  • “An introduction to aromatherapy and essential oils.” Aromatherapy and essential oils are not medical treatments and have not been shown to provide any benefit for any health condition. Yes, they may be relaxing, particularly when combined with a pleasant environment, but they don’t have any medicinal properties and shouldn’t have any place in a conference about health. They also carry side effects, as does any treatment.

Conclusions

Most of the treatments being discussed at this convention are based on pre-scientific beliefs, are biologically implausible, lack evidence of effectiveness and carry risks. None of them should have any place in the treatment of any health condition.

Chiropractors should no longer be allowed to treat non-musculoskeletal conditions

I recently became aware of an international research meeting of chiropractors where they sought to “develop evidence-based patient-centered policy recommendations to inform patients, the public and decision makers about the effectiveness of using spinal manipulation to prevent or treat non-musculoskeletal disorders.” If chiropractors treating non-musculoskeletal conditions doesn’t immediately set alarm bells ringing then it should do. Let’s look into this in a bit more detail.

Spinal manipulation is the primary treatment used by most chiropractors. (It is also widely used by osteopaths as well as some physiotherapists). It is mostly used to treat back and neck pain, although the evidence of its effectiveness is pretty thin on the ground. Some chiropractors also use it to treat a wide range of conditions that have nothing to do with the spine or musculoskeletal system. They may treat anything ranging from colic to asthma to autism and even cancer. This is nonsense and there is no evidence that spinal manipulation provides any benefit for any of these conditions.

At this research meeting they set out to answer three questions:

  1. Is spinal manipulation/mobilization/ traction effective in preventing the development of non-musculoskeletal disorders in healthy individuals?
  2. Is spinal manipulation/ mobilization/l traction effective in improving disease-specific
    health outcomes of non-musculoskeletal disorders?
  3. Is spinal manipulation/ mobilization/ traction effective in maintaining overall health status or lowering the incidence of negative health outcomes of non-musculoskeletal disorders?

Based on the available evidence in all of the published literature the answer to all of these questions is a very resounding “no”. What then was the point of this meeting and what did all of these chiropractic researchers spend all weekend discussing? This is what they had to say:

“The discussions are expected to inform a consensus document on the state of the evidential basis for chiropractic.”

If this consensus document is going to be factual then I’d suggest it should read something like this:

  1. There is no plausible biological mechanism by which spinal manipulation could possibly provide any benefit for any non-musculoskeletal condition.
  2. There is no non-musculoskeletal condition for which spinal manipulation has been shown to be effective.
  3. Spinal manipulation is the primary treatment used by most chiropractors. In order to adequately protect the public it would therefore make sense for chiropractors to no longer be allowed to treat non-musculoskeletal conditions.

I suspect that the consensus document produced by this group of chiropractic researchers will look rather different to mine but which statement will be the more factually accurate? Let’s wait and see.

Former osteopath continues to mislead the public and claims that “doctors know very little about health”

In January 2018 the osteopath Mark Mathews was removed from the register of practicing osteopaths for unacceptable professional conduct. However, he continues to run his practice Reve Pavilion where he works as a “Natural Health Practitioner”. He is also the president of the charity The Sunflower Trust which makes wildly misleading claims about the suitability of their treatments for children. I’ve written about that previously here and here. On the Reve Pavilion website there are a number of misleading claims including:

  • Misleading information about other evidence-based treatments and doctors including the claim that “doctors know very little about health”
  • Treatment of conditions for which it is highly implausible that osteopathy could be of any benefit
  • Use of cranial osteopathy

Let’s look into each of these in a little more detail.

Misleading information about other evidence-based treatments and doctors

In the “Mark’s blog” section of the Reve Pavilion website it suggests that anti-inflammatory drugs, antacids and anti-histamines are harmful and that taking anti-depressants is not helpful for depression. This is misleading, doesn’t present a balanced view of the evidence and could discourage someone from taking appropriate evidence-based medical treatments. There is also a post entitled “medical doctors know very little about health”. That post is full of conspiracy theories and makes several false claims. For instance, it says that “Nearly all the background research papers that are published are sponsored by the drug industry”. Whilst it is true that pharmaceutical companies undertake a significant amount of research, there is also research that is funded by governments and charities and carried out by universities and other research organisations. He also goes on to say “The normal state of all living things is to be well given the right environment”. Is it the case that people won’t get cancer if they are “given the right environment”? Of course not! This is complete nonsense but it is perhaps not a large stretch from the beliefs of many osteopaths who claim to “restore the body to a state of balance”. It is clear that someone with such extreme views presents a risk to the public.

I should state at this point that I don’t think that Mark Mathews unreasonable criticism of doctors is representative of the osteopathic profession as a whole. He is clearly at a fairly extreme end of the spectrum in terms of his beliefs and approaches. Misleading claims and use of unsuitable treatments are widespread within the osteopathy profession but it is quite unusual for osteopaths to publically criticise doctors in such an extreme manner.

Treatment of conditions for which it is highly implausible that osteopathy could be of any benefit

In the common conditions section of the Reve Pavilion website it claims that they are able to treat a wide range of conditions including allergies, anxiety, stress, depression, insomnia and menopausal symptoms. In the “Mark’s blog” section of the website it is suggested that “functional neurology”, “natural medicine” and osteopathy treatments available at Reve Pavilion are beneficial for urinary incontinence, depression, menopausal symptoms, asthma, menstrual pain and diet problems. In reality, none of the treatments offered at Reve Pavilion have been shown to be effective for any of these conditions. There is simply no plausible mechanism by which osteopathy or any similar treatment could possibly provide any benefit for these conditions. The section on migraines and headaches suggests that the treatments on offer are suitable for all types of headaches. Osteopathy has actually not been shown to be effective for headaches in general or for migraines specifically.

Cranial osteopathy

There are two sections of the Reve Pavilion website that focus on cranial osteopathy: here and here. It claims that it is effective for a wide range of conditions including anxiety, depression, insomnia, feeling run down, sports injuries, whiplash, headaches, musculoskeletal pain, learning difficulties and behavioural difficulties. The website also suggests that “abnormal births” may cause problems that can be treated by cranial osteopathy. Finally, it claims that cranial osteopaths can feel the involuntary motion.  In reality, cranial osteopathy is a fanciful concept based on something that doesn’t exist. There is no such thing as a cranial rhythm. Unsurprisingly, it has not been shown to provide any benefit for any health condition.

Complaint to the Advertising Standards Authority

I complained to the Advertising Standards Authority (ASA) about the many misleading advertising claims made by Reve Pavilion. The response from the ASA was to refer this to their compliance team. They do this when they have already seen plenty of misleading adverts about a particular issue and have established a standard position on it. The ASA said “your complaint raises an issue which we know is a clear problem under the rules”. Although the Compliance team will not report to me directly, it will be interesting to see what happens to the advertising on the Reve Pavilion website.

Conclusions

Here is a former osteopath who continues to make wildly misleading claims about the suitability of the treatments he has to offer as well undermining doctors and evidence-based treatments. He clearly represents a significant risk to the public. The General Osteopathic Council (GOsC) have already removed him from their register for unacceptable professional conduct and so he no longer falls under their remit. There appears to be a significant regulatory problem here because he no longer falls under the GOsC as he is not an osteopath but there is no other organisation that then picks up responsibility for regulating him. He therefore seems to be able to continue to practice uncontrolled in spite of the risk he presents to the public. Any suggestions on where he could be reported to would be welcomed.

Alternative Medicine – A Critical Assessment of 150 Modalities: book review

Alternative-Medicine-a-critical-assessment-of-150-modalitiesAlternative Medicine – A Critical Assessment of 150 Modalities, written by Edzard Ernst, is a book focused on alternative medicine and sets out to provide a “comprehensive, critical yet fair summary of the evidence that is easily accessible to a lay-person”. It is split into two main parts. Part 1 looks at general issues relating to alternative medicine and part 2 goes into 150 alternative therapies and diagnostic methods. Overall, this is a very good book and anyone reading it is going to be much better informed about the (un)suitability of most types of alternative medicine than they were before starting.

In part 1 there are some real “nuggets” of information about what makes alternative medicine attractive, the problems with alternative medicine and the approaches that alternative medicine practitioners use to promote their treatments. I’ll go through each of the 6 chapters in a little more detail shortly but I’d like to whet your appetite with something I think is critically important: the indirect risks of alternative medicine. This is highlighted in section 3.2 “Alternative Medicine Is Risk-Free”. The book says “Indirect risks are not caused by the treatment per se but arise in the context in which therapy is given. If, for instance, a completely harmless but ineffective alternative treatment replaces a vital conventional one, the harmless therapy becomes life-threatening.” Personally, I think this is really important and I believe that if the general public fully understand the level of indirect risk that seeing a homeopath, chiropractor, osteopath, naturopath, acupuncturist or other alternative practitioner presents most people would never go to see one again.

The second part of the book (chapters 7-11) goes through 150 alternative therapies and diagnostic methods assessing each in turn for plausibility, efficacy, safety, cost, risk / benefit balance. It provides nice succinct summaries of many alternative therapies that you have probably heard of as well as a good number that you probably haven’t. Are you thinking about trying acupuncture, gua sha or chiropractic? Check out this section of the book first for a summary of each of these treatments and many more.

Chapter 1 Introduction

The first chapter highlights the large number of books on alternative medicine and how so many of them promote “bogus, potentially harmful treatments”. This book sets out to provide a “comprehensive, critical yet fair summary of the evidence that is easily accessible to a lay-person”. As the book itself says this is a large and challenging task. Is Edzard the right person to take this on? The book claims that he is, and I agree. He arguably has more knowledge and experience in this area than anyone else including having published more peer-reviewed articles on the subject.

This chapter also explains the way that each of the 150 modalities are evaluated and the rating system used to assess each of them in the five areas of plausibility, efficacy, safety, cost, risk / benefit balance. The rating system is deliberately simple which doesn’t allow for much subtlety:

rating scale Edzard Ernst

Personally, I think this simple approach is appropriate for the intended aims of the book – to provide information that is easily accessible for the lay-person. This is a good introductory chapter.

Chapter 2 Why Evidence?

This chapter aims to answer the questions “What is evidence?” and “Why is it important?”. To start with, this chapter tackles the notion that a patient getting better isn’t necessarily a result of the treatment they are receiving. Put another way, correlation does not equal causation. The book offers a few alternative explanations for a patient improving after treatment:

  • the natural history of the condition (most conditions get better, even if they are not treated at all)
  • regression towards the mean (outliers tend to return to the mean when we re-check them)
  • the placebo-effect (expectation and conditioning affect how we feel)
  • concomitant treatments (people often take more than one treatment when ill)
  • social desirability (patients tend to claim they are better simply to please their therapist)

I agree with all of these points. However, I think the book has lost track of its intended audience a bit here: the lay-person. Would a member of the public who has no particular experience with science be expected to understand all of the above? Take for instance “regression towards the mean (outliers tend to return to the mean when we re-check them)”. I don’t think that most people outside the science / medical community would understand the term “regression towards the mean” and even the explanation in brackets is still rather “sciencey”. Perhaps a better lay explanation would be something like: “People often go for a treatment when they are feeling at their worst. Because many conditions have fluctuating symptoms, it is likely that with time they will return to something more like their average symptoms even without treatment. ”

The book then looks at what is suitable as evidence and why it’s important. The book, correctly, suggests that controlled clinical trials are the best way of determining if a treatment caused the improvement and the treatment is therefore effective. The book acknowledges that clinical trials are not perfect (they aren’t) but they are the best way that we have of assessing treatment effectiveness.

I think that overall this chapter is more science-focused than any other. That’s understandable as explaining what evidence is and why it’s important does require some science. However, I do wonder if members of the general public without any science background might find some of what’s in here a bit difficult to follow. Overall it’s still a decent chapter but perhaps some re-wording / additional explanation would have been beneficial in some parts?

Chapter 3 The Attractiveness of Alternative Medicine

Alternative medicine is undoubtedly popular and this chapter tackles a number of the unsubstantiated claims alternative medicine practitioners make in order to sell their services:

  • Alternative medicine is effective
  • Alternative medicine is risk free
  • Alternative medicine is natural
  • Alternative medicine is holistic
  • Alternative medicine has stood the test of time
  • Alternative medicine tackles the root causes of an illness
  • Alternative medicine is inexpensive
  • Alternative medicine is a small, innocent cottage industry
  • Alternative practitioners are more human
  • Conventional medicine does not live up to its promises

I often see alternative medicine practitioners making these sorts of claims. Edzard tackles each one in turn in his book. One point that he makes is of particular importance I think. He highlights that one important reason for the popularity of alternative medicine is the failings of conventional medicine (sections 3.10 & 3.11 in the book). That makes a lot of sense. How often do we see someone who has been told that their cancer is terminal going to a “cancer clinic” that offers fake “cures”. It’s unfortunate that sometimes there just aren’t solutions available through conventional medicine. When someone is told by a doctor that there is nothing that can be done to help them it’s entirely natural that they look elsewhere as they need someone to give them hope. That’s when alternative medicine practitioners step in and offer people false hope by claiming that they can help (even though they usually can’t).

Chapter 4 The Unattractiveness of Alternative Medicine

This chapter goes through the reasons why alternative medicine is unsuitable:

  • It is not plausible
  • There is no evidence
  • The “Promised Land” for charlatans
  • Pseudo-science

The book highlights the large number of papers that have been published about alternative medicine. In most cases, those trials that are of high quality fail to demonstrate that alternative medicine is effective.

This chapter and the previous one should help members of the public to know how to spot misleading claims.

Chapter 5 Ethical Problems in Alternative Medicine

Ethics is a complex and important topic in the context of any medical treatment, including alternative medicine. This chapter highlights the numerous ethical problems with alternative medicine including informed consent, neglect, competence, truth and risk / benefit analysis. Informed consent is a particular challenge for all types of alternative medicine. For a practitioner of alternative medicine to take true informed consent they would normally have to admit that their treatments are not particularly effective and that there are other better treatments available. As the book explains this would be bad for business and means that alternative medicine practitioners have a powerful conflict of interest that keeps them from adhering to the rules of informed consent and medical ethics. The book gives a very good example of potential encounters with a chiropractor to help explain this.

Chapter 6 Other Issues

This chapter picks up on other issues relating to alternative medicine that don’t fit in the earlier chapters including patient choice, science cannot explain and integrative medicine. I think the last part of the chapter is particularly interesting as it covers what conventional healthcare professionals could say when asked about alternative medicine by a patient. The book suggest four different approaches, some better than others. One of the challenges for conventional healthcare professionals is that they often lack sufficient knowledge about alternative medicine to be able to talk about the evidence (or lack of evidence) behind them. Whilst the book is aimed primarily at the lay person it may also be helpful for conventional healthcare professionals to inform themselves about the evidence and risks of alternative medicine.

Part 2

The second part of the book (chapters 7-11) goes through 150 alternative therapies and diagnostic methods assessing each in turn for plausibility, efficacy, safety, cost, risk / benefit balance. The breadth of modalities covered here is seriously impressive. I’ve been tackling misleading claims in alternative medicine for a number of years and there were a reasonable number of therapies and diagnostic methods that I’d never heard of such as Jin Shin Jyutsu, Kirlian Photography and Eurythmy. As far as I can tell, the assessment of each of the approaches is fair and objective. In fact, I would say that on occasions the assessment is quite generous in favour of some of the alternative therapies. It is certainly not the case that every alternative therapy is criticised. Some are given a positive assessment such as St John’s Wort, Alexander Technique (for chronic low back pain) and Feldenkrais Method.

This section of the book is great for the reader to “dip into” when they want to find out about a particular therapy. It doesn’t go into any of them in great detail, and further reading would be needed here, but it serves as a great reference for a really wide range of alternative therapies and diagnostic methods.

Conclusion

Overall, I think this is an excellent book. It fills an important gap in the market to provide members of the public with objective information about a wide range of alternative medicine approaches. It should help to tackle the widespread misleading (promotional) information that exists around alternative medicine. Readers of this book will undoubtedly be much better informed about the reality of alternative medicine. I just hope the book receives the wide readership it deserves.

 

The Good Thinking Society is challenging the Professional Standards Authority’s reaccreditation of the Society of Homeopaths. Why is this important?

The Professional Standards Authority (PSA) say that they are “here to protect the public and help ensure their health and wellbeing by raising standards in the regulation and registration of people working in health and social care”. Within their activities they provide a set of accredited registers so that as a member of the public you can “choose a practitioner to meet your needs with confidence”. It would therefore be reasonable to expect that the PSA have vetted the providers of their accredited registers to ensure that the treatments their members offer to the public are suitable, effective and, most importantly, safe. However, it would appear that this is not always the case.  Some members of the Society of Homeopaths (SoH) offer a treatment called CEASE therapy. This is a treatment for autism based on the false premise that vaccinations cause autism and that this can be “cured” through a combination of homeopathy, high dose vitamin C and dietary restriction. The link between vaccines and autism has been thoroughly disproved; see this for instance, and there is no evidence that CEASE therapy provides any benefit. The PSA has acknowledged that CEASE therapy is potentially harmful and they are aware that this treatment continues to be provided by some members of the SoH. In order to protect the public, it would therefore be reasonable to expect the PSA to no longer accredit the SoH. In actual fact they have done quite the opposite and on 1st April 2019 they approved accreditation of the SoH for a further year. This decision seems to be in direct conflict with the purpose of the PSA which is to protect the public. No child with autism should be subjected to CEASE therapy and it is very good that the Good Thinking Society is challenging this decision by the PSA via judicial review.

Wider implications

The particular issue here being addressed here is protecting people with autism from being exposed to the completely unsuitable CEASE therapy. This in itself is very important. However, this judicial review potentially has wider implications. It also brings into question whether regulation in the UK actually fulfils its key function of protecting the public or instead lends legitimacy to unproven, unsuitable and potentially harmful treatments. This is important as it would appear that the current approach of the PSA (and other regulators) is not effective in protecting the public from harm from unsuitable treatments.

How can you help?

Here are a few ideas of things that you could do to support the Good Thinking Society with their judicial review:

  • Make a donation
  • Share information about the campaign on social media, such as Twitter or Facebook.
  • Raise awareness with local groups that provide support to people with autism and / or parents of children with autism such as charities or local parent carer forums.
  • Get in touch with the Good Thinking Society to find out how else you could help.