Appeasing CAM in the NHS

The UK’s National Health Service has made some progress towards embedding evidence based clinical practice in its service delivery. But there is still some fence-sitting going on. My attention has just been drawn to current guidance on complementary and alternative medicine which is less than definitive.

Energy Medicine: Review of paper by Christina L Ross

I am indebted to Richard Rasker for the following critique of this paper:

Ross Christina L. Energy Medicine: Current Status and Future Perspectives. Glob Adv Health Med. 2019; 8: 2164956119831221

I have not included Ross’ list of references. Readers should refer to the original paper which is here. The original headings are used, and original text is italicised. The reviewer’s references are linked to sources, and listed at the end.

The General Medical Council: nice bedside manner with quacks

I have for some time been critical of the GMC’s acquiescence over doctors who practise quackery, but I’m concerned now at how it seems to be getting into bed with them. I just came across an `oncologist and professor of Chinese medicine‘ and phoned the GMC for advice as to whether they would regulate such a person – who is not apparently registered to practise in the UK. It was an odd conversation, which I have followed up with this email to the GMC:

The Charity Commission Consultation

Most readers should be aware that the Charity Commission has issued a consultation on the registration of complementary and alternative medicine (CAM) organisations as charities. This was after a five-year battle documented in other posts on this blog. In the interests of transparency I am posting my response here.

The Myth of Big Pharma

Forty years ago this year (god, can it be so long?), I joined the pharmaceutical industry. Its reputation then was little better then than it is now, various companies having weathered scandals in the previous two decades. In the 1950s Pfizer was top UK company by a long way, on the back of its tetracycline antibiotics. Oxytetracycline was promoted via golf weekends for doctors, and a dimpled ball emblazoned with the brand name Terramycin was famously brandished in the House of Commons in the late 1960s by Gwyneth Dunwoody MP. Not many years later I was working for Pfizer, and doctors still asked me for golf balls, I suspect only half in jest. In the 1960s Roche was forced to repay excessive profits from benzodiazepine anxiolytics, and of course the now long gone Distillers Company presided over the worst ever case of teratogenic damage from a drug.

Charities, Evidence and Vulnerable Minors

It’s about a year since Neon Roberts was famously spirited away by his mother to a holistic therapy refuge, in defiance of the courts, because she disagreed with the treatment options offered by his oncologist. As ever, it’s not a black and white case, and I have some sympathy with Mrs Roberts regarding one aspect at least. The story was told in a Channel 4 TV programme, which didn’t mention one important point. This was that Mrs Roberts wanted her son to be treated with proton beam therapy, among others.

I’m the Doctor – or am I?

Around the end of 2012 I was alerted  to the claims which Dr Jessica Middleton was making on her website, which she calls The Natural Doctor. A central issue was that Dr Middleton (now Dr Braid – see below) was clearly trading as a medical doctor, as evidenced by the name of her business, and the use of her medical degrees on the opening page of the site. However she does not practise anything which might be called conventional medicine, preferring to offer a wide range of diagnostics and `treatments’ which mostly lack robust evidence. I don’t intend to provide a detailed critique of what is on offer, as my purpose with this post is to explore how such a doctor is regulated. Meanwhile, I’m sure some of you will have your own views about an apparently intelligent young woman who was extensively educated in medicine, to a large extent at public expense, and now chooses not to utilise any of that training in service to the public.

Too Impressed by their own Cleverness?

This is a rather belated review of the book Tarnished Gold: The Sickness of Evidence-based Medicine, by Steve Hickey and Hilary Roberts. It was published in 2011, and my attention was drawn to it when I was asked to comment on its claims, from the viewpoint of an experienced clinical research specialist. Otherwise, I don’t think I would have heard of it, as it hasn’t made any impact in my professional field. In the event, it took me very little time to see why that is the case. The review may appear to meander back and forth between concepts, but that’s because it follows the book, which does the same. So apologies for the repetition.