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NHS doctors criticise use of alternative therapies

Discussion in 'Speaker's Corner' started by cleanbluesky, 23 May 2006.

  1. cleanbluesky

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    http://news.bbc.co.uk/1/hi/health/5007118.stm

    I think they are confusing 'evidence' with the idea that a therapy has emerged from Western scientific process, rather than outside of it. Why are they asking for cessation of alternative therapies rather than more research into them, if this were not the case?
     
  2. Rich_L

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    Figured it would be worth posting the text of the letter itself for people to have a look at as well as the media interpretation, will add opinion later but bit pushed for time atm!

     
  3. AJUK

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    I wonder how much influence the major pharmacutical companies have had in the draughting of this letter? Homeothapy and other alternative therapies are used in the NHS because they have been proven to work. That is the crux of the matter and I am sure patients are open to the idea that whatever works should be available to them, be it St Johns Wort or Herceptin. The focus shouldn't be on which therapies deserve funding but more so on which people deserve treatment.
     
    Last edited: 23 May 2006
  4. Rich_L

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    Have they? I thought that was the whole point that there was conflicting evidence from anecdotal (it works) and experimental (it doesn't) which is the whole reason for this debate!

    As an interesting aside, I know how pharmaceutical companies are often touted as these big bad companies with profits only at their hearts. Out of interest why do the companies making a killing out of selling alternative therapies somehow any different?
     
    Last edited: 23 May 2006
  5. AJUK

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    Yes, ask the patients.
     
  6. cleanbluesky

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    As they have mentioned in the 'smallwood' report, there have been studies for its effectiveness yet they have also chosen to suggest that another study somehow overrides these originals without explanation why.

    Given the existing prejudice against any knowledge that emerges without help of Western scientific or pharmeceutical control, I think such a comment is meaningless.

    And this is hypocritical...

    Considering that almost every drug has side effects, and some very popular ones have some very serious side effects I dont see the problem except perhaps such substances can't be manufactured and sold by pharmaceutical companies... and also, merely saying there are no benefits doesn't simply make it so.
     
  7. Dolph

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    Sounds like 13 doctors from the Richard Dawkins school of thought to be honest...

    I'll carry on supporting what works for individuals, rather than what a small group of people says works on a small test group then claims it applies equally to everyone.
     
  8. anarchist

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    Why? Do they have some magical properties that can't be created by massive companies like GSK, but which can be created by the smaller companies which are currently selling them?

    As Rich_L says, they are all the same, and survive based on making a profit from the products they sell.

    I think the problem is that they can't be measured and tested whereas the "normal" drugs that the NHS use have (hopefully) gone through rigorous testing and have proven results and side effects.
     
  9. anarchist

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    You mean doctors that use evidence rather than faith? Sounds like my kind of doctor ;)

    Absolutely. I have no problem with people having acupuncture or whatever for things like chronic back pain (anything which saves the government a bit of incapacity benefit ;)). Where the real problem lies is when people assume that alternative therapies can cure cancer and forego the proper treatment as a result.
     
  10. Dolph

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    I mean doctors who use a tiny amount of evidence that suits only them, irrespective of everything else, and refuse to look at the bigger picture.

    If you were having treatment that you were satisfied was giving positive results, would you be happy if a doctor said "Well, I've looked at this chap over here, it's not helping him, so it can't be helping you, you can't have it anymore"?

    I'll agree with you there, I certainly don't advocate alternative treatments as a substitute for chronic conditions such as cancer, and I don't believe the NHS offers such things, However that's also not what this letter is aimed at either.

    My mum (a former midwife medically retired after 2 slipped discs and an operation to try and correct it following an accident at work) currently gets treated by a Reflexologist as part of her methods of dealing with the pain (privately, not through the NHS). Now, when I see her, I can tell if she's been recently, the difference is that noticeable, she's in less pain, has more movement and is better in herself. I don't care what the explaination for it is, I care that it helps, and so does she.
     
  11. cleanbluesky

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    I should have been more specific... its not that GSK couldn't manufacture such things, they just couldn't brand them exclusively...

    Why? Do they have some magical properties that can't be measured by massive orgnisations like the NHS?

    The difference is that medical institution are unwilling to acknowledge many approaches that are not based on Western principles like being part of a massive recognised institution before being allowed to address health concerns, and charging lots of money for medication...
     
  12. Rich_L

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    Whilst it's a shame that the NHS can't fund everyone for exactly what works best for them, there needs to be a justification in order to spend the money before doing so. Also what's to stop another patient demanding the same treatment, or another alternative therapy with no proven benefits..or another which they read on the internet, or one that a friend of a friend told them about - where (and how) do you draw the line?
     
    Last edited: 23 May 2006
  13. cleanbluesky

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    Nothing except for the fact that NHS dont merely accept any shamanistic procedures, rather than alternative therapies demonstrable benefits... a statement which then brings us onto the question of what 'proven benefits' are - you assume that there is no way to prove effectiveness, yet perhaps it is more an idea that many are unwilling to acknolwedge effectiveness.
     
  14. anarchist

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    Sorry, what I meant was, that the effects can't be measured from what I've read, in that surveys done haven't found any proven benefits. The only evidence is anecdotal which, as I said with regard to chronic pain, is in fact the only evidence that you will ever get since it's purely down to perception on the part of the patient.

    Rich_L makes a good point though, in that the NHS has to stick to things with proven benefit or else anybody could demand anything. Where the grey area is, I guess, is what "proven benefit" exactly means in terms of metrics etc.
     
  15. Dolph

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    How does the NHS allocate drugs or treatments now? You don't go to the doctor and say "I want this operation" and get it. It's part of a diagnosis and treatment program, and that would be how I would see alternative therapies used as well.
     
  16. Rich_L

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    True, because the NHS trust has decided that the best use of their limited resources is a certain form of treatment with proven efficacy for patients with that condition. It is often not the 'best' treatment which is why you don't get the cutting-edge drugs and medical procedures on the NHS, but the treatment which strikes the right balance between cost and efficacy. Likewise a doctor can't just prescribe any drug he likes or that is effective for a condition but is again limited by what the trust has deemed are those which strike the appropriate balance between cost & efficacy.

    You then have to look at how the trust can go about finding out, and achieving that balance. Cost is the easy one, but how do you determine a treatment's efficacy when the only evidence is anecdotal? By all accounts patients often tell their doctors what they want to hear - that they're getting better, even when the evidence points in the opposite direction.

    I would add at this juncture that I'm certainly not dismissing alternative therapies, the amount of anecdotal evidence can't simply be ignored, although medically a condition may be unaltered or getting worse, something is going on which makes people seem to feel better, whether it's the placebo effect or something else we don't understand. As mentioned previously there is the issue as well that reliance on alternatives can lead to active dismissal of conventional medicine, although that in itself certainly isn't a reason to dismiss alternative therapies either.

    I guess what I'm getting at is the difficulty the trust administrators have in deciding what treatments to sanction on their limited resources. Having repeatable studies with details of efficacy on all patients, not to mention actually knowing how it works in detail is far easier to sanction than a treatment about which evidence is often anecdotal at best, seems to work for some patients and no-one knows how it works. :) However, if alternative therapies are truly as effective as they are often touted to be, I often wonder what is 'flawed' about Western scientific method that these therapies are so often deemed ineffective.

    Just my 2.5 cents :o

    *edit*
    Although from the recent court cases around Herceptin, it would appear that, on some occasions, you can go 'I want this treatment' and get it :)
     
  17. mrthingyx

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    My missus had an episode a while ago where she couldn't walk more than twenty metres without getting an appalling stitch - so much so that she really struggled doing just about anything.

    When I finally dragged her (kicking and screaming) to the doctor, her GP suggested acupuncture... one session later (carried out by the GP herself) and my wife was as right as rain: apparently the acupuncture needle freed up a muscle spasm in my wife's back.

    Does acupuncture count as an alternative therapy? Regardless, it got my missus back on her feet and that's what's important to me (as per Dolph, as usual).

    From my personal experience (based on the accidents I've had/injuries I've sustained) doctors can appear to be suspicious of anything outside of their field. Which is odd, considering the number of times they'll dole out treatment regardless of efficacy to keep patients happy (read: ritalin, antibiotics in general, prozac, etc.) or mis-diagnose and even miss key signs altogther. Sure, they aren't perfect, but considering how much they get paid... I'd expect them to be pretty close.
     
  18. anarchist

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    Yes, acupuncture is a notable exception which I mentioned earlier, as I have seen cases where chronic pain has been cured by it. Pain is very subjective anyway, except obviously where real physical damage has taken place.

    As you say, regardless of the reasons for it, it seems to work and is probably better for the patient than taking painkillers or similar.

    Pampering is often cited as a key factor in all such techniques and I think there is a lot of truth in that. GPs give patients five minutes. An acupuncture session or reflexology session can be an hour, during which time (despite pins being stuck in you!) you are basically pampered and have the total attention of the person giving you the treatment.
     
  19. wsurfa

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    Acupuncture and homepathy are rather different.

    Acupuncture has been shown to have physiological effects in single blind placebo controlled experiements, as well as patient perception. As ever placebo groups did better than control groups.

    Homeopathy has failed every large well structure double blind placebo controlled testing, even the homeopaths reject BDPC testing as 'unsuited' for testing homeopathy i.e. it doesn't work.
     
  20. anarchist

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    It's a fact that homeopathic liquids are diluted so much that there is literally none of the original supposedly healing liquid in the final solution. Of course it could leave behind it's "aura" or whatever, but that's moving into faith and away from science.