Friday, 27 July 2007

Quackwatch



Its all gone to plan and I am registered with The Motley Fool again (see previous post).

Yesterday I went to post something on the back pain forum but, instead, I found a really good link to a site devoted to exposing health fraud and quackery written by American doctors. As I mentioned before, this was the original role of the GMC but they are now too busy using our money persecuting doctors and sticking their heads up politicians backsides to do this and it seems the whole country is now wasting its money on faith healers, fad diets and food supplements with no-one interested in protecting the gullible, vulnerable or stupid from being fleeced.

There is a touch of Emperors New Clothes about it too and anyone who is prepared to say what most scientifically literate people know is the truth about food supplements or homeopathy is denounced as narrow minded or protecting their own status and interests.

This sort of quackery does blend into the sort of quackery that we see in the NHS where opinion and bullshit count for more than hard work, intelligence and experience. If you have time to read some of the articles on Quackwatch you will see that the snake-oil salesmen use much the same terminology and selective quoting of dodgy research to justify their existance. Embarrassingly, the author quotes the use of the word "holistic" as one of the giveaway signs of quackery. I used this on my uk-radiology website and have been known to describe myself as a "holistic radiologist". Obviously this is a meaningless term and I originally used it as a joke but it seems to tick all the right boxes and no-one has queried it. Somehow it conjures up a softer, gentler image of radiology than the use of Hiroshima levels of radiation justifies.

33 comments:

PhD scientist said...

Other UK-based sites worth visiting for their take on quack therapies - including those offered on the NHS - are Ben Goldacre's BadScience blog:

http://www.badscience.net/

and Prof David Colquhoun's "Improbably Science":

http://www.dcscience.net/

Ben Goldacre is a psychatrist and writer who has columns in the Guardian (weekly) and the BMJ (monthly), while David Colquhoun is a distinguished pharmacologist (FRS) and one of the authors (along with surgeon Prof Michaeal Baum and others) of the open letter to the PCTs a while back calling on them to stop spending tax money on unproven CAM therapies.

http://www.timesonline.co.uk/tol/life_and_style/health/article1827553.ece

A good introduction to David Colquhoun's take on Alternative Therapies and related Snake-Oil is in this article:

http://dcscience.net/?page_id=10

Dr Ray said...

Thank you phd scientist. I shall use those links as my sword of justice and trusty shield of truth. I have been visiting the various CAM websites and debunking some of the claims and the more ammo the better. Sorry about the mixed military metaphor.
What I would like to know is why the CAM practitioners don't require the same evidence base as conventional medicine for their claims.

PhD scientist said...

Yes, the million dollar question.

It is a mystery to everyone. But maybe...

The answer, one suspects, is "CAM is popular with the patients (holistic! works with your body!) and doesn't have many obvious adverse effects"

But of course that is not the same as "effective", or even cost-effective in terms of taking the load of mainstream services.

The other person I should have mentioned, who wages a heroic One-Professor War against non-evidence based CAM therapies is Prof Edzard Ernst down at Exeter / Peninsula:

http://en.wikipedia.org/wiki/Edzard_Ernst

(some links there, or hundreds of his papers are on PubMed)

Coming from the German-speaking medical tradition Ernst clearly started with some sympathy for CAM viewpoints, but his insistence on evidence of efficacy and safety, and insistence on pointing out when n it isn't there, has made him increasingly unpopular with the CAM crew.

PhD scientist said...

PS To last comment:

Here, for instance, is Prof Ernst in Sunday's Observer
taking chiropractors who do (over)vigourous "spinal manipulation" to task:

http://observer.guardian.co.uk/uk_news/story/0,,2175332,00.html

Dr Ray said...

Thank you again phd scientist. I don't want to upset the chiropractors too much because some at least are moving towards conventional diagnosis and treatment and are quite good at recognising patients with serious disease which they are happy to pass on to us. I am much more concerned with the cranio-sacral therapists, faith healers and suchlike, who are just the lowest of the low as far as I am concerned and just fleecing the gullible and vulnerable.

PhD scientist said...

Would agree that there are shades of daft-ness, Dr Ray. A corollary is that, for an alternative “profession” to have any sensible-ness, it has to have a regulatory body which (i) sets meaningful standards of practise (e.g. don’t treat what you can’t help, be able to recognise it and send to people who can) AND (ii) can and does discipline rogue practitioners (be accountable if you screw up). This is what happens in Germany where Mrs PhD (hospital physician) did her medical degree.

Part of the problem in the UK is that there is effectively zero regulation of most of the alternative lot, despite their increasing inroads into the NHS. And the “qualifications” they do have are meaningless if all they constitute is a degree in mumbo-jumbo, as David Colquhoun would put it.

http://dcscience.net/?p=19

For a really twenty-carat example of Alt b*!!ocks on the NHS, see this jaw-dropper on Colquhoun’s website:

http://dcscience.net/?p=34

..may be even crazier than homeopathy, which is saying something.

Dr Ray said...

Thanks for these links. As you can see I have been a little busy looking into Labour Party sleaze recently but I am looking forward to getting more involved with exposing quackery.

PhD scientist said...

Yes, have been following the coverage of the Citizens' Jury.

Bogus "consultation" processes far outweigh real ones everywhere you look, and especially in the public sector, but the one you wrote about was truly appalling. Could have been borrowed from the Stalin Handbook. Good luck helping blow the whistle.

BTW, it turns out that one of the UK's higher profile medical homeopaths, and editor of a leading CAM journal, works in your neck of the woods:

http://www.liebertpub.com/eboard.aspx?pub_id=26

http://www.spiked-online.com/Articles/0000000CAEB6.htm

Most mind-boggling is said person's endorsement of the qLink "anti-EMF pendant" here:

http://www.dailymail.co.uk/pages/you/article.html?in_page_id=1909&in_article_id=398105

..but then Cherie Blair used to wear something similar, so it must be good:
http://news.bbc.co.uk/2/hi/uk_news/politics/135844.stm

Dr Ray said...

Kim Jobst. Well fancy that. He lives just down the road and used to work at our local private hospital but I haven't seen him recently. I always thought he was doing insurance medicals. I had no idea.
You really do know your subject. Have you been on the Healthypages website and wound up the moderators yet?

I'm told the story about the Citizens Jury is in Private eye but I haven't seen it yet. The D.O.H. has admitted the bit about the cash in plain envelopes.

PhD scientist said...

Once you start looking into Alt nuttery a bit, there is so much of it about that you become an expert surprisingly quickly, Dr Ray.

I got into it originally via reading Ben Goldacre's Guardian BadScience column, which apart from raging at bad (often CAM) science also attacks the ludicrously credulous press coverage it gets. Anyway, went from cheering him on over the Saturday toast and coffee to posting on his blog and the forums.

I suppose one of the reasons some doctors and scientists (like me) get rather obsessed with this stuff is that it rather defeats the point of doing biomedical research if the public don't believe any of the results, or indeed believe in general "scientific method". It is truly jaw-dropping what crazy stuff Mrs PhD and my nice middle-class professional neighbours believe about science and health, and that includes several people with two degrees. And my students are no better. When we did a mock debate recently at my Univ we found that nearly half the bioscience Ph.D. (yes, Ph.D.) students could easily be "sold" the view that homeopathy was a seriously effective treatment for illness.

On your neighour, Kim Jobst is one of the three most high-profile medical homeopaths / alties in the UK, the others being Peter Fisher (lead consultant at the Royal London Homeopathic Hosp and the Queen's homeopath) and Prof George Lewith in Southampton.

http://www.naturalmatters.net/article.asp?article=3032&cat=85

http://www.complemed.co.uk/doctors/doctors2.htm

Peter Fisher is the one that you always see on the news, but Kim Jobst and George Lewith turn up in all sorts of places too. Apart from editing the J Alt Comp Med, Kim Jobst is now a Visiting Professor in Healthcare & Integrated Medicine at Oxford Brookes University, so he is obviously a busy man.

Peter Fisher is a particularly interesting medical homeopath since he wavers situationally from "of course homeopathy works!" bluster (see the article above) all the way to practically admitting it is all placebo, therapeutic encounter and "cultural trappings". David Colquhoun told me that when he talks to Fisher he always comes away unsure whether Fisher really believes in homeopathy at all.

Finally, re the Alt Forums, most of the BadSci blog fraternity tend to give up lurking there "undercover" after a bit, since the indefatigable conviction of the CAM-believers and anti-vaccine types grinds you down. If you want to debate / debunk them, it can be best to do it on more open "mixed audience" forums, where some of the readers might be persuadable in-betweens rather than True Believers.

For an example of how unstoppably bonkers the Hard Core ones can be, try this thread on Dr Crippen's blog - John Stone is the chief nut to look out for:

http://nhsblogdoc.blogspot.com/2007/07/letter-from-america.html

Warning, though: reading it has been known to rob people of the will to live.

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Marcela said...

It sounds to me that the author of this blogs is far too arrogant to accept that he doesn't know it all! I feel sorry for him and his friends, really.
I'm not a medical doctor but I have experienced benefits of other ways of treating an illness which are not conventional. Homoeopathy has worked wonders for me in the past. The Quackometer should come hard on this site rather than defaming people who are much more intelligent than Dr Ray or PhD Scientist!

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