Issue 16 / 6 May 2013

IT was good to see the public outcry last week that forced television ads marketing fish oil supplements as a means to improve children’s NAPLAN* scores to be removed.

Sometimes, the purveyors of quackery just go too far.

And, at other times, they totally get away with it.

Homeopathy certainly got a free kick on the Radio National breakfast program last week.

Ana Lamaro from the Australian Homeopathic Association received a sympathetic hearing for her argument that the federal government’s review of the private health insurance rebate for natural therapies was an attack on her discipline.

Homeopaths were concerned the government was “using the review to damage their entire profession”, said presenter Fran Kelly in her introduction.

Er, no. The government review is designed to ensure that private health insurance rebates — government subsidies, in effect — go only to therapies that can demonstrate a certain level of safety and efficacy.

The therapies under review are those not provided by an accredited health professional, which are covered by private health insurance but not Medicare. As well as homeopathy, they include iridology, aromatherapy, various kinds of massage, Buteyko, yoga and pilates.

If homeopathy can demonstrate its safety, efficacy and cost-effectiveness, it should have nothing to fear from this process.

Ms Lamaro made it clear on Radio National she believes it can do that, suggesting it was only prejudice and an “unscientific approach” that had led previous investigators to conclude anything else.

She claimed 91 randomised controlled trials had demonstrated benefits from homeopathy — which rather flies in the face of the evidence, according to a summary of Cochrane reviews on the topic published in the MJA in 2010.

“The findings of currently available Cochrane reviews of studies of homeopathy do not show that homeopathic medicines have effects beyond placebo”, wrote Dr Edzard Ernst, head of complementary medicine at the University of Exeter, UK.

Well, how could they, really? Homeopathic “medicines” are based on the dilution of substances to the point where there may not be a single molecule of the so-called active ingredient present.

I would really have to abandon any pretence at a scientific view of the universe to believe such things could work.

Homeopathy, like many alternative therapies, does seem to be particularly good at harnessing the placebo effect. A bit of hocus-pocus and time spent with a sympathetic therapist does genuinely make people feel better.

You might ask what’s the harm, given that the sugar pills and lolly water aren’t actually going to do anything on a biological level.

Well, there are bigger questions to be considered.

Homeopathic treatment costs money, which patients do not then have available for other treatments that might have offered a benefit. And there are well documented cases of patients dying after they rejected conventional medical treatment in favour of the homeopathic alternative.

There’s also the question of the effect these kinds of deceptions have on the health system generally. Do they contribute to a lack of trust in mainstream treatment? Do they undermine people’s ability to be effective managers of their own health?

Then there’s the fact that we simply can’t afford to be directing government subsidies at things that don’t work.

So, let the review take its course.

In the meantime, I highly recommend this Mitchell and Webb skit set in a homeopathic emergency department.

The remedy for a road accident victim with broken bones and internal injuries? Well, obviously it depends on the type of car that hit him. In this case, diluted essence of blue Ford Mondeo might be the solution.

Jane McCredie is a Sydney-based science and medicine writer.

* NAPLAN (National Assessment Program – Literacy and Numeracy) is the annual program of literacy and numeracy tests for primary and high school students introduced by the federal government in 2008.

 

7 thoughts on “Jane McCredie: A drop of credibility

  1. 211947@amamember says:

    Brava, Jane! I am particularly concerned by registered medical practitioners, allegedly university-trained in the natural sciences, who practise unproven, and even discredited, interventions as part of their Medicare-funded management of their patients’ problems. Some of them even sell the pills and potions to their patients. Regrettably, medical boards and their successor, AHPRA, turn a blind eye. 

  2. N1497@amamember says:

    Congratulations on a fine article.
     

  3. 316802@amamember says:

     

    There are several problems with the Natural Therapies Review.

    First, it only deals with therapies currently covered under private health insurance; not those subsidised directly under Medicare, and not those provided by AHPRA accredited health professionals.

    Thus a number of questionable practices of Chiropractors, Osteopaths and Traditional Chinese Medical Practitioners are not in scope. In addition, some “integrative medicine” medical practitioners include treatment modalities such as homeopathy in Medicare rebated consultations.

    Second, the review uses a list of “natural health” therapies provided by private health insurance funds. This includes diagnostic and treatment modalities such as “iridology”, “homeopathy” and “reflexology” as well as types of practitioners such as “naturopaths” and  “herbalists”.  The problem here is that the latter practitioners often use many of the former diagnostic and treatment modalities.

    Thus, hypothetically if “homeopathy” was found by the review to lack supporting evidence and was removed from the list of natural therapies receiving the rebate there is nothing to stop “naturopaths” from continuing to use homeopathy as part of an undifferentiated consultation that continued to be rebated (assuming “naturopaths” get up because some of their activities such as dietary and life-style advice is evidence-based). In addition, given the plethora of natural therapy organisations of varying standards recognised by private health insurance funds there is nothing to stop organisations representing homeopaths from reinventing themselves as naturopathic organisations.

  4. johndwyer says:

     

    A very good article Jane and important comments from Ken Harvey. I presented the views of Friends of Science in Medicine (FSM)  to the Natural Therpaies Review committee last week. From the discussion it was clear that “pseudosciences” such as Iridology, reflexology, healing touch, etc, could be reviewed to determine if they met the government’s requirement for “credible scientific evidence of clinical effectiveness”, Naturopathy and indeed “Natural Therapies” can incorporate a number of pseudosciences as well as sensible life style advice. Hence it will be important for the goverment to implement the committee’s decisons by specifying that within a “naturopathic” consultation, no rebate would be available for any of the pseudosciences the committee has determined do not meet the required standards. FSM has written to all the Private Insurers asking them to “abide by the umpire’s decision”. If the government withdraws taxpayers dollars following the review the Insurers should withdraw the “additional benefits” which are of no benefit at all. So far Insurers have commented that they are just giving policy holders what they want! Surely an indefensible approach since what they may wish for could actually compromise the  health of the insured.

  5. University of Sydney says:

    The pseudosciences are a form of religion – one must trust in the Deity (natural health healer), shun evil (western medicine) and have faith (believe the unbelievable) to be healed. Accordingly, if these factors be the basis of cure, Medicare rebates should perhaps extend to Tarot card readers and psychics, since their overheads and fees are much lower than other “naturopathies” and do not require the ingestion of pseudotherapeutic substances (now a billion dollar industry), unless, of course, we exclude the prophylactic eye of newt and toe of frog to be on the safe side.

  6. Department of Health Victoria Clinicians Health Channel says:

    WHAT THE…?

    The top banner on this page carries a link to “Blackmores”!

    Pot, Kettle and Black come to mind.

  7. Magnus E. says:

    Excellent points on traditional vs natural medicine.  Being in the massage industry, I do know that natural remedies can be effective, but they should be used in conjunction with and not replacements for traditional medicine.  –Magnus @ Mind & Body Inc.

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