Download Lectures on Biostatistics (1971). Corrected and searchable version of Google books edition
Download review of Lectures on Biostatistics (THES, 1973).
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Hot off the press The Prince’s Foundation for Integrated Health (FIH) has been spreading misinformation about medicine since 1993. It has featured often on this blog. Now it has closed its doors. |
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An announcement has appeared on the FIH website
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30 April 2010 The Trustees of The Prince’s Foundation for Integrated Health have decided to close the charity. |
The announcement goes on
"Whilst the closure has been planned for many months and is part of an agreed strategy, the Trustees have brought forward the closure timetable as a result of a fraud investigation at the charity."
"The Trustees feel that The Foundation has achieved its key objective of promoting the use of integrated health. Since The Foundation was set up in 1993, integrated health has become part of the mainstream healthcare agenda, with over half a million patients using complementary therapies each year, alongside conventional medicine. . . "
While the immediate precipitating cause may have been the fraud (see below), the idea that the Foundation "has achieved its key objective of promoting the use of integrated health" seems like a ludicrous bit of make-believe. Well, make-believe is something with which the Foundation was quite familiar. At a time when university courses in quackery are vanishing like the snow in springtime, they can hardly believe that their aims have been achieved. But I guess one could not expect them to say "sorry folks, we were wrong all along".
The 2010 Conference is cancelled too
Judging by the quality of the 2009 conference, which I analysed at length last year, the cancellation of the 2010 conference is very welcome news (except perhaps to a few sycophants looking for honours).
What next? A College?
The rumour is that a “College of Integrated Medicine” may arise from the ashes of FIH. Or even, heaven forbid. a Royal College of Integrated baloney. Since universities seem to be deciding that it isn’t sensible to teach myth as truth, i is not unlikely.
“Prince Charles’s aide at homeopathy charity arrested on suspicion of fraud“
This headline, of an article in the Guardian, by Robert Booth, was not entirely unexpected.
The parlous state of the accounts at the Prince’s Foundation for Integrated Health has been documented already at
Gimpy’s blog.
“An aide in Prince Charles’s campaign for wider use of complementary medicine in the NHS was arrested at dawn today on suspicion of fraud and money-laundering at the prince’s health charity.
A 49-year old man, understood to be a former senior official at the Prince’s Foundation for Integrated Health, was taken into custody at a police station in north London. He was arrested alongside a 54-year-old woman, who was being held at the same address.
The arrests follow a police investigation into £300,000 unaccounted for in the books of the charity, of which the Prince is president.”
More news will appear here, as it comes in.
Follow-up
Other posts on this topic appeared rapidly.
The Guardian 30 April. Robert Booth Prince of Wales’s health charity wound up in wake of fraud investigation
Dr Aust’s Spleen 30 April In memoriam. In which Dr Aust gets a bit poetic
Quackometer 30 April. Prince’s Foundation for Integrated Health Closes. Prince Charles’ Toad Eaters are no more.
Followed by the rest of the mainstream media.
Edzard Ernst 1 May 2010, in the Indepenndent. Better than any journalist. Why alternative medicine wins from the foundation’s demise. Read it! Here are some quotations.
“I therefore think that the FIH has become a lobby group for unproven and disproven treatments populated by sycophants.”
“The FIH has repeatedly been economical with the truth. For instance when it published a DoH-sponsored patient guide that was devoid of evidence. They claimed evidence was never meant to be included. But I had seen a draft where it was and friends have seen the contract with the DoH where “evidence” was an important element. “
“I hope that, after the demise of FIH, the discussion about alternative medicine in the UK can once more become rational. I also hope that Prince Charles has the greatness of selecting advisers who actually advise rather than “Yes Men” who are hoping to see their names on the next Honours List. “
1 May 2010. According to Martin Delgado, in the Daily Mail, the people who were arrested on suspicion of fraud were accountant George Gray and his wife. Gray was Finance Director and acting Chief Executive of FIH. About as senior as you can get.
Gray spent two weeks (two weeks?) at Diabetes UK in 2004 before becoming finance director at the Leadership Foundation For Higher Education.
63 Responses to The end of the Prince’s Foundation for Magic Medicine
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Hoo-bloody-ray !
Brilliant.
O frabjous day! Colquhoun! Callay!
Excellent piece of news amongst all the election piss and wind.
I would love to feel I had a hand in it, but whatever the mechanism, the outcome justifies a celebration. But watch out, the Lewith and Holgate show is poised to take up the reins – the College of Obfuscated Medicine.
Woo hoo!
As I commented over at the Quackometer, I’m working on an epitaph. So far I’ve got:
[…] from FIH’s Dr Micharl Dixon and Edzard Ernst) From Nature (with comment from Edzard Ernst) From David Colquhoun’s blog (with updates promised) Google collection of news […]
Majikthyse or DC or someone,
“But watch out, the Lewith and Holgate show is poised to take up the reins – the College of Obfuscated Medicine.”
Can someone provide some background on this scheme?
Hmmm… “… as a result of a fraud investigation at the charity”.
Wouldn’t if be sweet if the “fraud” had nothing to do with the money, if you see what I mean ?
🙂
Prmomoters of fraudulent woo wound up for fraud?
It’s karma, obviously. 😉
The FIH did immeasurable damage. Not only did it divert attention from delivering effective mainstream NHS services, it posed the idea, now slavishly endorsed by academic institutions like Westminster University, that it was possible to create a Frankenstein monster called “Integrated Medicine”. A confused eclectic entity composed of severly rationed hard pharmacological-based medicine, combined with touchy-feely mysteries of the east almost entirely devoid of evidence. Much of the Foundation for Integrated Health, under Michael Fox’s leadership, advocated & rationalised the diversion of scarce NHS funds into altmed on purely consumerist grounds: ie people said they wanted it. I expect a lot of blokes would like free beer on the NHS but that doesn’t justify misuse of taxpayers’ money.
There’s nothing wrong with people spending their own money however they like. If they want to pamper themselves with an aromatherapy massage, or share their woes with a sympathetic acupuncturist, that’s up to them. Caveat emptor. If they want to dangle spoons from the end of their nose in the belief it’s good for their inner balance, then fine. It is part of their right to personal freedom to make that choice, and to make mistakes. But do we really want the state involved in controlling, regulating, and thereby endorsing the darlings of the women’s magazines feature writers?
Ironically, the FIH has done immeasurable damage to many alternative health organisations. Most have been ticking along nicely running a list of members and providing perfectly satisfactory self-regulation. Their ‘soft’ ethos was appropriate to the kind of people providing the various personal services. As soon as FIM/FIH emerged, they were sucked into a very aggressive process by which, in return for buckets of money, they were expected to sign up for regulation in a “one-size fits all” approach. In 2007, many CAM therapists, especially in aromatherapy, reflexology and Reiki were appalled at the new dictatorial approach, involving compulsory Continuing Professional Development, irrelevant National Occupational Standards, and the general Big-Brother tone coming from the Dept of Health. The nanny-state said it was supposed to be about “protecting the public”, but people were never in danger from these therapists in the first place. It was actually about control.
Most CAM practitioners see this bureaucracy as an tiresome irrelevance, sold to them on the basis they would gain NHS work from it, but it meant that the way that CAM is taught and practised changed forever. It has become more mechanistic and tick-sheet driven, and the pressure is on to further “biomedicalise”. The irony is that the attractiveness of CAM therapies were that they were not formulaic, and impersonal, as is the perception of the NHS sausage-machine. In fact the world of most alternative therapists originally had little to do with the paradigm of science. If it made people feel good, and people were happy to voluntarily pay for this, then research and statistics would do little to add to the real appeal of CAM. What FIH has done is try to wrap up incommensurable paradigms up in the same container, so that we get the worst, not the best, of both worlds. Which is what politicians have been doing for years – treating taxpayers as idiot consumers – and seling them a flashy brand that claims to “wash whiter”, but is actually no more than an ill-thought out attempt to fudge issues in a populist way while gaining control over the last few personal freedoms we have.
[…] di averne anticipato la chiusura prevista di lì a poco (? in luglio doveva ospitare una megaconferenza) quale risultato di un’indagine per frode. Pochi giorni fa, un assistente del principe era […]
I think we need a new word here. May I propose “Schadenfraude” as the not at all guilty pleasure one feels at the misfortune of woo-peddlers?
@csrster
Well the Freude bit is fine. I can’t say I’m feeling much Schade.
A few personal thoughts from Dudeistan (formerly ‘malucachu’, but had to re-register).
Conventional medicine seem to me to be like Swiss cheese, i.e. solid, but full of holes. Luckily most patients with serious conditions don’t fall through these holes.
Attempting to fill the holes with alternative quackery may be tempting – particularly if consumers like this sort of thing – but if it dumbs down healthcare then it should be seen as a serious threat.
My own perception of alternative practitioners and fans of Integrated Health Care is that they intellectually lazy and attention seeking.
[…] what a shame. The Sultan of Woo’s Foundation for Magic Medicine shuts […]
Intellectually lazy. Attention seeking. Hmm. A rather grand assumption. I still can’t work out where I fit in. With ‘conventional’ academic validation plus ‘conventional’ medical qulaifications plus ‘alternative’ certification (from the recognised authority) as well as considerable work/life experience in healthcare. How come you are so clever? Please, tell me, as I would like to know how best to serve my patients.
Recognised authority?
I am as concerned as many others here aboout the standards operating in some centres offering ‘alternative medical’ qualifications. The lack of a cohesive approach, combined with a general ignorance from patients and potential practitioners, has led to an explosion of courses, offering all sorts of dubious certificates. I am very unhappy with this – not because I am being protectionist about my own practice (I see enough patients to keep my head above water) but, for the protection of the public as well as the integrity of practice. Given that the level of scepticism about acupuncture is pretty high, it would make sense to have tighter controls over what it constitutes and form a group of practitioners who are, at least, educated to a standard that would allow some concensus on how best to develop the practice within accepted limits as well as the established ontology and epistemology. If training/education does not respect this process, then the whole body of knowledge becomes fragmented, and standards of practice cannot be maintained. I trained at the college where this approach has been in place since it’s inception, with a qualification recognised by the British Acupuncture Council. Now, I realise that makes no sense to some of you but, within the field, this is the gold standard. Or at least, it used to be; because of the recent upsurge in Mickey Mouse courses as well as the influx of organisations like Dr and Herbs et al, as well as a totally disorganised government response to the House of Lords ruling over 10 years ago, the BAcC seems to have lost it’s grip. So, I only say ‘recognised authority’ because the BAcC IS the recognised authority in this country, even though I have some misgivings about how it exercises that authority. My training esablishment does not offer BSc’s on the grounds that it is hard to establish the ‘scientific’ element within the confines of most ‘scientific’ paradigms operating in HE in the west. Nevertheless the BAcC does insist that a LicAc means a minimum of 3000 hours study, as well as supervised clinical practice and periods of interning before the licence to practice is issued. Of course this will be little comfort to those of you who believe acupuncture to be a load of crap but, I am on this site for healthy debate, and only offer the above to clarify my position. I mean, it’s not as if I am asking anyone to accept a recognised authority or serious study in hopi ear candles; rather I AM asking to engage in intelligent open discussion and merely claim I have the credentials to do so, even if at a very rudimentary level. I would like to be informed, not ridiculed. That’s all.
There is weak evidence to support non-meridian acupuncture as a pain modulator or anti-emetic.
As I am sure you are aware, although by no means proven, there are interesting theories pertaining to endorphin activation and effects on the autonomic nervous system.
On the other hand, Chinese meridian medicine is in my humble opinion quasi-religous mumbo jumbo nonsense which has no scientific basis at all, however well trained some of its practitioners may be.
The fact that patients find acupuncture satisfying is either because of a placebo effect or weak neurohormonal responses to the needles (i.e. the precise insertions sites being largely irrelevant).
What we see in the West as so called traditional acupuncture was largely codified by Mao Tse-Tung in the mid 20th century.
For some interesting scientific basic science research into acupuncture look at the work carried of Dr Thomas Lundberg at Uppsala University, Sweden.
Dudeistan. Thank you for those comments. I do not ask that you understand acupuncture, as you are neither informed nor qualified enough to make the conceptual leap required. I am aware of many, many studies that suppport/refute acupuncture. As I am aware of many studies that support/refute medical practice in the conventional field. That’s normal intellectual practice. Lundbergs work is only one of a huge number that have not established the ‘science’ of acupuncture. It is very difficult to research acupuncture within the dominant paradigm used here (I know, I teach research, and not to acupuncturists) and part of the difficulty in generating evidence is how to do so without compromising the integrity of either discipline. As a nurse with many years practice, I think I am quite capable of working out if I have made a patient feel better by my mere presence, or with smoke and mirrors. What is your history in clinical practice? FYI the type of acupuncture I practice is NOT the Maoist TCM. Oh no, I needed something weird so went for the 5 elements (I’ll wait while you change your pants).
cf Avoided Cranium for a slightly more insightful opinion.
Dr Lundberg’s research provides interesting basic science evidence in favour of acupuncture, not the other way around.
@Isobelmat
Your mention of the British Acupuncture Council as a “recognised authority” is a good example of the self-contained, self-referencing arguments that seem to underlie a lot of alternative medicine internal pseudo-logic.
As an example, for the uninitiated, the argument might go that people get sluggish and obese because they are full of “Damp”. This “Damp” is some form of pathogenic substance that we can’t see, isolate or chemically analyse. They also tell us the “Spleen” gets rid of “Damp”, so if the “Spleen” is weak, then “Damp” will build up in the body. Guess what adversely affects the ability of the “Spleen” to transform “Damp”? Too much of food & drink that are themselves “Damp”, which are things like cold beer, pizzas, milk, cream etc. So the circular logic, based on an unrecognisable organ and an invisible substance, shows that the reason that people get fat from drinking too much beer, and eating too many pizzas and cream cakes, is not because their calorific intake is too high for their exercise regime, but that because their “Spleen” couldn’t do it’s job properly because of the “Damp”. You can’t prove it, but it’s there they tell us, just like we used to think that an invisible substance called phlogiston ( http://en.wikipedia.org/wiki/Phlogiston_theory ) exists inside all combustible materials that when released makes things burn. Thanks to the scientific pursuit of Lavoisier we know that the old alchemist’s phlogiston theory was just wrong, a logical and scientific cul-de-sac. Primitive Chinese theories of non-existent pathogens are just as much a blind-alley and just as useless in a world where we do actually know better.
But back to the British Acupuncture Council. It has no authority. It’s just a member-interest group. It was cobbled together in the 90s to represent the interests of a handful of small schools doing courses in acupuncture. But who were these schools? They weren’t part of any orthodox educational programme or oversight. They were founded by enthusiastic individuals who were riding the late 60s hippie wave of interest in transcendental meditation, eastern philosophies and anti-materialism/science. They were set up by people who got on this bandwagon with their own western take on poorly misunderstood bits of oriental folk medicine. Each school taught some different version of acupuncture based on the idiosyncracies or bias of its founder. Arguments between proponents of the different schools continue today as each tries to lay claim to being the true authentic voice of Chinese acupuncture. Take one example – a bloke, J. Worsley. who started up a”5 Element” school. This is derived from a mish-mash of stuff he picked up while travelling in Korea, Japan and Taiwan. Virtually none on the main ideas he made up can be found in any Japanese or Chinese classical texts, and yet its practitioners call themselves “classical”, presumably because it makes them sound more authentic. One could just as easily start up a new Martial Arts School based on the mysterious style of the Flying Wombat, and claim it had been passed on to you by a 300 year old Tibetan monk from Shangri-la. There’s no proof of efficacy, no documented classical sources, transcripts of teachings, nothing. Just the cult of the individual. As time passed, like most schools, the curriculum includes more stuff so that it becomes acceptable to Universities to hand out bogus degrees. But the core-source of this stuff still remains unvalidated and outside the normal reference-grid of orthodox society.
Schools like this then create a member-interest group like the British Acupuncture Council to try to get more work for its members, primarily by getting the state to introduce “acupuncture” (whatever that means) as part of the NHS. So rather than competing in the open-market with all the other foot-rubbers, Hopi ear candlers, shamans and charlatans, they want the tax-payer to give them a job for life via the NHS. Graduates from the cartel of schools who set up the British Acupuncture Council get automatic membership of it, so it is hardly an objective measure as to the worth, or validity of their indoctrination into circular woo-logic. It certainly does not make them an ‘authority’, and it’s loose talk like this which confers an undeserved respectability on these sort of self-appointed quangos.
Many NHS nurses, GPs and physiotherapists practice acupuncture for pain relief.
I have no problem with this, for two reasons: (i) the acupuncture is usually just one component of a treatment programme, and (ii) there is evidence to supports its use within the context of neurophysiological theories of pain relief, albeit the evidence is weak and by no means supported by a plethora of gold standard clinical studies.
However, it does worry me when NHS professionals adopt traditional theories of Chinese medicine in their every day practice, for some of the very reasons that Avoided Cranium describes above.
Only a fool would suggest that conventional medicine has everything sewn up and is evidence based in every domain, but at least it is trying.
“part of the difficulty in generating evidence is how to do so without compromising the integrity of either discipline. ”
Sorry, isobelmat, but that’s just utter cobblers.
It’s perfectly easy to test acupuncture. This has nothing to do with “paradigms”, which is usually the first line advanced in a futile argument saying surveys and anecdotes should be counted where blinded trials fail to show any effect.
The thing that makes acupuncture trickier than, say, homeopathy to test is that it involves a physical intervention so is relatively harder to blind successfully. But relatively good methods are available to do this.
Talk of conflicting “paradigms” is just a coded way for SCAMsters to avoid drawing the very simple conclusion that their beloved form of magic therapy does not work.
Ironically, I am prepared to concede that some forms of acupuncture may have some benefit in certain conditions, but as when one sees its advocates pushing this “paradigms” rhetoric it typically means they have swallowed the whole bag of silliness.
And, by the way, a “recognised authority” that cannot manage to distinguish objective evidence from flummery certainly deserves recognition for its incompetence.
Thank you. Firstly, I agree that the BAcC is not the same type of body that governs my status as a nurse, I have no beef with that. Second, I also agree that it was put together from a variety of self-interested bodies in order to try and get a cohesive approach to acupuncture. If you note from my post, I am not fully enamoured with the BAcC but, at least there is (was) an attempt to do what many people here are asking for – provide an organisation that protects patients as well as practitioners via a sort of discipline. In that, it is no different from any of the other self-monitoring organisations (such as the NMC, GMC et al). That is a common complaint about the so-called professionalisation of many groups. Whether they have been successful in this aim is a moot point. It is, however, the closest we have to a validating body. Membership is NOT automatic. I, for instance, am not a member. If I wanted to be one, I would have to go through a series of checks to enter, and be subject to CPD and all the other features these authorities demand. Like the NMC.
Lundbergs work would appear to endorse acupuncture but, the basis for this is not in keeping with acupuncture principles and, although we may jump up and down with glee at a ‘real’ scientist saying yes, it does rather miss the point (no pun intended).
Many nurses, GPs etc practice sticking needles into selected points without a clear diagnosis that would fit the use of the technique. They are not acupuncturists because, as is pointed out, needles only form part of the practice of Chinese medicine. If their treatments are only partially successful that’s because the diagnosis is wrong. As it is in conventional medicine – the diagnosis is the thing. If you don’t understand the diagnostic process then you sure as hell won’t understand the treatment. Nor can you properly research it.
Oh dear spare me that “protecting the public” rubbish. It only provides a means to expel a dodgy acupuncturist from the membership, who are then perfectly free to continue working as you do. Statutory regulation does just the same, shutting the stable door after the horse has bolted. Statutory regulation for other people who work with the public, like taxi-drivers and hairdressers would be an equally silly idea, but at least they provide a verifiable end-result for the money you pay them.
Check your facts Isobel – any new graduate from the approved cartel of colleges is eligible for automatic membership of the BAcC, so long as they are willing to pay the fees.
And I see you conclude with another example of circular logic. To paraphrase, you say if sticking needles in people doesn’t make them better, it’s because the diagnosis is wrong. What if the diagnosis is ‘right’, but sticking needles in doesn’t actually work? Whether the ‘correct’ diagnosis is “Damp in the Lower Jiao” or “Heart Fire Ascending”, it is completely irrelevent if the “treatment”, whether colonic irrigation, hot-stones or skin-pricking, doesn’t do anything better than placebo or spontaneous symptom-remission.
Yes, you are right. Anyone from the cartel of colleges IS eligible to apply for membership, but, that is no different from other, more conventional systems. I am not a member because I do not believe the BAcC is discerning enough, having bought into a host of, as I say, Mickey Mouse courses and not being clear enough in trying to form a group of practitioners who are able and willing to allow the practice to be held up for open scrutiny. As a practitioner, I stand and fall by my own merits, and am exposed to legal and public investigation without the ‘benefit’ of an organisaton that has diluted it’s initial principles. So, dodgy is as dodgy does. However, although I am guilty of putting my CV forward in an attempt to help some of you realise we are not all numpties, this is not a discussion about me and my motives. Most medical practitioners in this country will say that diagnosis is crucial, treatment is easy. If the treatment is wrong then the diagnosis is wrong. That is an axiom of medicine. I am not arguing the rights and wrongs of Chinese medical diagnosis here (why would you understand that?). Just state a principle.
Isobelmat
I turned up for duty at a prestigious orthopedic NHS institution in southern England in November 1996. 15 years qualified, I thought I was the dog’s bollocks.
Trained in medical acupuncture, amongst many more orthodox therapies, it took only three months of sensible challenges by various specialists (medical, nursing and allied professionals) for me to realize that I was a well meaning care bear, but nevertheless a very misguided clinician (in all therapeutic spheres, not just acupuncture).
I have prevaricated over acupuncture for ten years and I am persuaded it has some merit. Not due to any animistic concepts of Chinese medicine, but because it may act as a subtle pain reliever for patients suffering chronic pain.
The problem I had pre 1996, is that all my peers where health care professionals that had spent a small fortune attending flaky guru-led courses and who had no exposure to sound clinic reasoning or robust research methodology (quantitative and qualitative).
From everything you have documented in this debate, I suspect you are intelligent clinician who has the ability to stand back and criticize your own clinical reasoning, divorced from ‘recognised authorities’.
I may be wrong in my analysis of Chinese acupuncture. Everything I may have said so far may be utter bollocks. But then again, I might just be on to something.
Badlyshavedmonkey.
I didn’t invent paradigms. They just is. Sorry your paradigm does not accommodate the paradigm. You are 100% right. Paradigmmatic thinking does not work, is incompatible. So, when ‘scientists’ say acupuncture does not work, they argue from their own paradigm, ignorant of the reality that it is a paradigm, i.e., ‘objective truth’. And I have to conclude that your assertion that a paradigm is merely a copout is correct; all paradigms are based on assumptions which lead to a revision of those assumptions which turn the original paradigm on it’s head. All we humans have in attempting to understand our world is paradigms.
@isobelmat
“most medical practitioners in this country will say that diagnosis is crucial, treatment is easy. If the treatment is wrong then the diagnosis is wrong. That is an axiom of medicine. “
Yeah but we’re not talking about medicine here, we are talking about theories based on half-baked third-hand derivations of primitive Asiatic folklore as interpreted by a handful of self-appointed British-born gurus.
You say you are a paediatric nurse but trained in “5- Element” acupuncture. So no doubt you are used to treating patients for “possession”? This is an important part of the invented “5-Element” school of acupuncture which explains certain disassociative mental states exist as a result of being possessed by external evil forces. Obviously as a rational society, we in Britain are appalled by recent stories of West African children being accused of possession and sorcery where they are tortured with blood-letting and having chilli-peppers rubbed into their eyes to drive out the evil spirits. 2000 years ago or less, people used to think that disease was caused by demons or evil spirits, and in Chinese medicine the release of blood was (and still is sometimes) an important part of the needling therapy. But in the 21st Century a treatment for possession – ie an exorcism – is still part of the absurd baggage that 5-Element Worsley picked up from the far east and taught it as part of a system of “medicine”. These days Five Element practitioners generally don’t like to talk about this voodoo part of their diagnostic toolkit and tend to put a modern-day gloss on the practice of needling 7 specific points to release ‘dragons’ that chase away the evil spirits that supposedly cause the illness. I wonder if the diagnosis of “possession” and rationale for treatment is really something you would want to explain to the Nursing & Midwifery Council?
As I said, diagnosis is the thing, the treatment follows. Thank you for outlining (clumsily) a diagnostic term in 5 element acupuncture. Thank you, too, for aligning it to a different diagnostic, from a different culture. Your ability to make huge leaps in understanding and conceptualise the unseeable, imagine the impossible, is astonishing. And here’s me assuming you are a digital thinker! Yes, years of paediatric nursing and Health Visiting has, indeed, shown me practices that are horrifying. However, I am at a loss to know when I would be called to account to the NMC for my acupuncture practice. Just as I would not be called to account for my nursing practice at the BAcC. That’s the problem with regulation and such like – it leads to narrow approaches and misunderstandings and muddled thinking. If I needed to account for my practice and rationale for treatment in a court of law, I’d be very happy to do so. I am not a ‘voodoo’ practitioner. My “half-baked third hand derivative of Asiatic folklore interpreted by British born gurus” is very familiar to a number of my patients, who are Asiatic, and they are pleased to find it here in the UK. Now, having told you at length my background and what I believe are the credentials to make the statements I do, perhaps you could tell me yours? Such as, what credentials do you have to comment with such authority on diagnostic principles and treatments? How come you feel able to comment on my practice as a nurse as well as my practice as an acupuncturist?
Isobelmat, now you are beginning to worry me.
@Isobelmat “If the treatment is wrong then the diagnosis is wrong. That is an axiom of medicine”
What?
Oh, Dudeistan. I thought I was already worrying you! My mistake.
“you are neither informed nor qualified enough to make the conceptual leap required”
Leap of faith, right?
This – and your other obfuscatory talk of paradigms, diagnoses and research – is all basically trying to set up double-standards which do not exist. It’s a staple of CAM.
You keep on making appeals to authority too. You should not be so trusting in your judgement; we humans are highly fallible, hence the need for experimental science, which removes confusion about paradigms.
What exactly are you trying to argue for at this point? I realise you’re not trying to apologise for the whackier forms of CAM, but you seem to feel your own CAM practise is much better, when the high quality and relevant evidence is, as Dudeistan said, that accupuncture has a weak non-specific effect that is irrelevant to meridian-theory.
Does even tame acupuncture pass risk-benefit and cost-benefit thresholds?
So why did you decide to get training in acupuncture in the first place? And why do you practise it now?
A Licentiate in traditional Chinese acupuncture takes 3 to 5 years and costs a small fortune. Having invested time, money and hours and hours of study, it is no surprise that graduates will defend their practice and philosophy tooth and nail.
Yes, it does take money and time to do the LicAc. So did my Masters and I expect my upcoming PhD will be the same (even with ESRC help). Still, learning stuff does not necessarily mean needing to defend it tooth and nail. I just enjoy learning stuff. However, it does mean that I make every attempt to use what I have learned in ways that benefit both myself and others. I hope to learn stuff on this site. Thanks for acknowledging that a LicAc does, at least, involve some effort – however misguided.
Teige. I didn’t realise words like paradigm, diagnosis and research were obfuscatory. Having spent a long time in both academe and clinical practice I have, perhaps, become guilty of using esoteric terminology that is not meaningful to those outside those spheres. I apologise. When I have time I shall happily answer your questions vis a vis my decision to study acupuncture. Meanwhile, as you wait with bated breath, thank you for asking.
“I make every attempt to use what I have learned in ways that benefit both myself and others”
I’m pretty sure that’s about half right.
Yes. Half right, not all wrong. Namaste.
“I didn’t invent paradigms. They just is. Sorry your paradigm does not accommodate the paradigm. You are 100% right. Paradigmmatic thinking does not work, is incompatible. So, when ’scientists’ say acupuncture does not work, they argue from their own paradigm, ignorant of the reality that it is a paradigm, i.e., ‘objective truth’. And I have to conclude that your assertion that a paradigm is merely a copout is correct; all paradigms are based on assumptions which lead to a revision of those assumptions which turn the original paradigm on it’s head. All we humans have in attempting to understand our world is paradigms.”
Isobelmat, I’m afraid you’ve moved from cobblers to plain silliness.
Please explain what defines acupuncture as being outside the paradigm of empirical science.
If an efficiently blinded trial shows acupuncture does not work for a certain medical condition are you prepared to accept that objective evidence and revise your view of its efficacy for that condition?
Isobelmat, I understand the work load involved in doing a complementary medicine degree. A dam site more useful and intensive than any crappy arts degree. Still, must fly, I have a differential diagnosis exam to revise for.
I think Isobelmat thought that if she could persuade the scientists here that a a representative of the alternative medicine brigade didn’t seem so daft as might be expected, then maybe there was some merit in Chinese medicine, exorcism and demonology after all. I think she has unwittingly confirmed all our suspicions about the sloppy thinking behind altmed advocates. With the arguments being put forward, some might go further, and wonder about her grasp on reality.
While it is true that Chinese medicine belonged in a cultural, cosmological and philosophical paradigm of its own, it is certainly not a medical paradigm that is of equal validity to western medical science. The point about paradigms is that one paradigm replaces another, they don’t just branch off and co-exist alongside each other! The paradigm of the Flat Earthers is not of equal validity to that of Spherical Earthers. The fact that we do not live on a flat earth is easily tested by flying on the same bearing until you end up where you started from. Flat-Earth was a reasonable working assumption but we know better now. It’s just the same with the primitive superstitions underlying Chinese Medicine – it’s has been replaced by a better paradigm.
As much as I have reservations about Wikipedia, I will quote one bit on Kuhn:
“A common misinterpretation of paradigms is the belief that the discovery of paradigm shifts and the dynamic nature of science (with its many opportunities for subjective judgments by scientists) is a case for relativism: the view that all kinds of belief systems are equal, such that magic, religious concepts or pseudoscience would be of equal working value to true science. Kuhn vehemently denies this interpretation and states that when a scientific paradigm is replaced by a new one, albeit through a complex social process, the new one is always better, not just different. “
I don’t mind if people want to dabble in alternative medicine, so long as they do no harm, , but I do object when they start using dumbed-down postmodern relativism to claim that what they do is as valid or efficacious as orthodox western medicine. I’d suggest their syllabus should include “Fashionable nonsense: postmodern intellectuals’ abuse of science.” by Alan Sokal before they are even allowed to touch a needle.
http://www.physics.nyu.edu/faculty/sokal/
As much as I disagree with Isobelmat’s arguments, I admire her tenacity in defending her views on a discussion list largely populated by scientists!
However, I believe she has also clearly demonstrated how futile it is to try and create a ‘middle ground’ between scientific orthodoxy and alternative mumbo jumbo.
Given that there is so much effort needed to root out ineffective practices within modern medicine itself, do we really have time for alternative therapies which are about as plausible as fairies at the bottom of our gardens?
Has she gone away? That’s a shame.
@Avoided Cranium: “I think she has unwittingly confirmed all our suspicions about the sloppy thinking behind altmed advocates. With the arguments being put forward, some might go further, and wonder about her grasp on reality.”
She also typifies another pattern I have seen repeatedly: the non-doctor who has some training in an allied field, but then wants to play doctor by getting ‘trained’ in one of these self-referential SCAM therapies, which offers much of the power and kudos accorded to doctors without placing them under an equivalent set of obligations.
@BSM
Spot on with that observation. As well as the white coats, stethoscopes and other trappings of doctoral status, they also get to “diagnose”. As the (sadly missed) NHS Blog Doctor used to say, if nurses want to play at being doctors, maybe they should have gone to medical school, instead of trying to slip in through the backdoor without the proper foundational training.
I wouldn’t limit this ‘lets play doctor’ role to nurses and allied professionals. I am sure you would agree that there are plenty of private individuals who see themselves as grand burghers of their communities by selling snake oil.
Didn’t I mention attention seeking earlier on?
What was I saying about PPIs?
May 10 (Bloomberg) — AstraZeneca Plc’s Nexium, Pfizer Inc.’s Protonix and Takeda Pharmaceutical Co.’s Prevacid, ulcer drugs also prescribed for indigestion, were linked to a higher risk of bone fractures in older women and to a diarrhea-causing infection, two studies found.
The drugs belong to a family of treatments known as proton pump inhibitors, approved to treat ulcers, acid reflux disease and erosive esophagitis, in which stomach acid causes pain or damage to the esophagus. The medicines have U.S. sales of $13.9 billion annually, according to an editorial accompanying the studies published today in the Archives of Internal Medicine.
The medicines are often prescribed for heartburn and indigestion, which are unapproved uses in people who don’t have ulcers or acid reflux, Mitchell Katz, director of the San Francisco Department of Public Health, wrote in the editorial. Previous studies have estimated between 53 percent and 69 percent of these drugs are taken for inappropriate reasons, the editorial said.
“The problem here is this is a medicine that has serious side effects and 60 to 70 percent of people who are taking it don’t need to be taking it,” Katz said in a telephone interview on May 7. “What will happen once the average person knows about the side effects of these medicines is they’ll say they don’t want to take this.”
Fracture, Infection Risk
Older women who took the medicines had 25 percent more risk of fractures than those who didn’t, according to one study published in the journal. A second report found that people taking the drugs daily had 74 percent more infections with Clostridium difficile, a bacterium that can cause severe diarrhea.
@Dangerous
Everyone agrees that it’s wrong for drugs to be prescribed if they aren’t needed or aren’t effective. It is a poor reflection on the prescribers if the numbers you give are right. There is nothing in the least controversial about that.
It also has nothing to do with the topic of this post. Please try to stick to the topic. I virtually never censor comments, but you are tempting me sorely. This post is about the Prince’s Foundation.
@DC
I think if you ask any one with half a brain whether they are concerned about the fact that the FIH has gone bust or the fact that Ernst’s going next year then they would say so what. As a clinical pharmacist, the fact that we issued 33 million scripts last year for PPIs et al in England is something we should be “bothered about”.
Your campaign against natural medicine is starting to look petty and narrow minded when compared to the bigger issues. Sad that that an excellent American news organisation like Bloomberg produces balanced and well informed articles on important health issues. Shame the same cannot be said about the BBC and Guardian.
@Dangerous Conventional
Aren’t there other blogs/forums that deal directly with your issue of prescribing? What you argue has considerable merit, but it has little to do with alternative medicine.
The fact that you post what you do on this forum seems to me to simply be an attack on DC and the like minded souls who contribute to this discussion list.
By all means contribute, but can you stick to the topic?
Did you miss me? I see you have been asking if I take sugar. I have been busy, doing spells and suchlike, so have not been able to get back on here. Oh! I have missed you. Before I go any further let me just say the following: 1) I am not on here to ‘convince’ anyone. If that had been my aim then I really deserve to be considered a guillible fool 2) I never wanted, want or aspire to, being a doctor. If I had, I would have been one. I was tempted, for a moment in the past, to engage with the FIH but, I found their thinking to be exactly the type of muddled middle ground thinking complained about in this post. Just as in care homes for the elderly, nurseries at al, Alt Med is prone to people jumping on a sort of band wagon and attracting individuals who really are not clinicians in any way. I, too, would like to have the chance to explore what works and what does not, and not for money or kudos. The only way is to join forces, stop squabbling and start to understand how it may be possible to work together for the common good. It may take time and it won’t be easy but – I’m up for it. Or perhaps I AM a guillible fool, after all.
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