Health in the News

Complementary Medicine - does it work or is it a waste of money?

As complementary and alternative medicine (CAM) has received extensive coverage in the press there have been more and more articles by sceptics and outright opponents of these forms of health care. These articles usually take the line that CAM treatments lack evidence of effectiveness or that they are an expensive indulgence. Articles like this are known in journalism as ‘knocking copy’.

Most recent of these appeared in the Times Body and Soul supplement (Saturday 10th January 2004) in which the writer argued strongly that CAM treatments should not be made available on the NHS because the evidence that they work is very flimsy.

Setting aside, for the moment, the fact that the majority of treatments in conventional medical practice have not been subjected to randomised control trials (the gold standard in medical research), to say nothing of the enormous cost of many drugs and surgical procedures, there is no question that more evidence should be accumulated about natural forms of treatment so that patients can make better informed choices. That is why I have been a Trustee of the Research Council for Complementary Medicine since it was founded in 1983 to promote and enable research into these therapies.

The RCCM (www.rccm.org.uk) has the principle aim of developing the evidence base for complementary medicine. The RCCM CISCOM database has over 85,000 references on CAM treatments and related topics. Not all are positive but a great many demonstrate the benefits of these treatments.

Often the ridicule is poured on CAM treatments because their theories do not fit conventional scientific wisdom. But it is the antithesis of good science to reject something and deprive patients of its possible benefits simply because it cannot be explained. Acupuncture and homoeopathy are prime examples of treatments that have helped thousands of people but whose mechanisms cannot be fully understood. Their benefits are, therefore, attributed to the placebo effect. (A placebo is an inactive replica of a real treatment or drug. The ‘placebo effect’ is, therefore, said to be the result of a patient’s belief in the therapy rather than any genuine effect of the real medicine) Yet there are numerous cases of successful treatment with homoeopathy or acupuncture of animals and infants who are unlikely to be made better by the power of suggestion.

Frequently the studies that are reputed to demonstrate little or no benefit of CAM treatments have been badly designed or did not apply the treatment in an appropriate way. This is not to say that many of the positive studies of CAM therapies are always of the highest quality. They can often be rather small scale (too few patients) or poorly controlled (not sufficient comparison with other treatments or no treatments). But they are often carried out with very limited funds and certainly do not have the resources available to them for large-scale trials such as those invested in the development of new drugs by major pharmaceutical companies.

The important thing about treatment is that it should be appropriate to the condition and the individual patient. It should, of course, also be safe and, fortunately, the vast majority of natural therapies are, when properly applied by trained practitioners. In other words they are not inherently dangerous (unlike many conventional drugs, which have a potential for harm, even when applied appropriately).

So the next time you see an article criticising CAM ask yourself if the writer has presented a balanced argument, or is defending an entrenched position of dogmatism, or merely airing some personal prejudices.

Roger Newman Turner
January 16th 2004