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Alternative medicine can be scientific, say besieged academics

RMIT University’s School of Health Sciences has rejected the suggestion that it peddles pseudo-scientific quackery via its…

Spicy debate: RMIT is researching the effectiveness of ginseng in improving lung function in patients with Chronic Obstructive Pulmonary Disease. Flickr/wparadiso.

RMIT University’s School of Health Sciences has rejected the suggestion that it peddles pseudo-scientific quackery via its courses in complementary and alternative medicine (CAM).

Acting head of the school Dr Ray Myers has defended RMIT’s health science programs as “evidence-based education and practice”, citing collaboration in clinical research of CAM treatments funded by the National Health and Medical Research Council (NHMRC).

Dr Myers was speaking in the face of a campaign by a coalition of prominent medical researchers to expunge higher education of the “undisciplined nonsense” taught in CAM courses at Australia’s “somewhat lesser universities”.

The campaigning group, Friends of Science in Medicine (FSM), has about 400 signatories, including immunologist Sir Gustav Nossal and Professor Jock Findlay, chairman of the NHMRC’s Embryo Research Licensing Committee. It has written to every vice-chancellor in Australia asking for a review of their health science courses to “ensure that primacy is given to scientific principles based on experimental evidence”. The letter laments the spread of chiropractic studies to 19 Australian universities, and complains that ‘energy medicine’, ‘tactile healing’, homeopathy, iridology, kinesiology, acupuncture, and reflexology are taught “as if they were science”.

Group co-founder Emeritus Professor John Dwyer from the University of NSW said that FSM wants “vice-chancellors to ask their deans of science what’s the heck’s going on … It’s just extraordinary that such undisciplined nonsense is being taught in universities around Australia.”

“One of the complaints that we have about so-called alternative medicine is that it doesn’t strive to be tested. … modern medicine is totally devoted to doing everything we can to take this evidence-based approach and do good science and do good research into the things we do to people,” he said. “Alternative medicine doesn’t do that - it’s more than happy to rely on tradition and anecdote and it doesn’t really want to be tested.”

However, Dr Myers said that CAM research at RMIT was conducted in a thoroughly scientific manner, with the NHMRC funding clinical trials of alternative medicines. In a clinical study granted A$560,000 by the NHMRC and A$30,000 by the National Institute of Complementary Medicine, the university was collaborating with two Melbourne hospitals on a clinical study investigating the use of ginseng, a herb used in traditional Chinese medicine, for improving lung function in patients with Chronic Obstructive Pulmonary Disease (COPD), he said.

The NHMRC had also granted A$400,000 for a project in which the university was collaborating with three Melbourne hospitals on a three-year clinical trial of acupuncture for pain management in emergency departments, Dr Myers said. “The project follows the promising results of pilot studies by RMIT researchers, in which more than 1,000 patients received acupuncture treatment for acute pain relief at the emergency department of the Northern Hospital.”

The professions of Chinese medicine, chiropractic and osteopathy are government regulated, Dr Myers said, with RMIT programs in these fields meeting current professional standards and subject to external accreditation. Chiropractic and osteopathy were areas in which clinical research was limited, but RMIT’s education program incorporated the “best available evidence, while promoting further clinical research into these treatments,” Dr Myers said. “RMIT stands by its long record of evidence-based research and the high quality of its health sciences programs.”

But FSM is not buying it. “Those universities involved in teaching pseudoscience give such ideologies undeserved credibility, damage their academic standing and put the public at risk,” the group’s letter states.

The great danger, said Professor Dwyer, was that people who have chronic health problems or who have been persuaded that doctors do not have the answers are delaying the “proper investigation and treatment” of their illness by instead seeking help from therapists offering alternative medicine.

“These are dangerous delusions, and our campaign at the moment is aimed at those somewhat lesser universities, but nonetheless universities, that are offering and teaching pseudoscience as if there was an evidence base to support it, because obviously that gives credibility in the eye of the public,” Professor Dwyer said.

Citing the late CEO of Apple, Professor Dwyer said that “Steve Jobs spent a year with his cancer of the pancreas trusting homeopathic remedies, and by the time he got to the surgeons it was all over.” It is worth noting the veracity of this claim by Professor Edzard Ernst about Mr Jobs treating his cancer with homeopathy has left some struggling to find evidence for it, while others have claimed that for nine months after his diagnosis, Mr Jobs spurned what could have been life-saving surgery in favour of not homeopathy but a vegan diet and herbal remedies.

The “lesser universities” that have aroused the ire of FSM include the Australian Catholic University, Charles Sturt University, Central Queensland University, Edith Cowan University, Macquarie University, Monash University, Murdoch University, RMIT University, Southern Cross University, Swinburne University, the University of Ballarat, the University of New England, the University of Newcastle, the University of Queensland, the University of Technology Sydney, the University of Western Sydney, and the University of Wollongong. To buttress its case, FSM has gathered a list of offending courses, which includes Chinese Medicine, Wellness studies, Applied Eastern Anatomy, Clinical Science with options to study osteopathy and naturopathy, Mind/Body Medicine, and many others.

“It should be a policy that all universities, higher education institutions, should not be involved in in this woolly teaching,” Professor Dwyer said, adding that “I suspect that these are well attended, popular, money-earning courses for cash-strapped universities.”

The claims of FSM, however, ignore the evidence about CAM in higher education, said Dr Wardle, a NHMRC Research Fellow at the University of Queensland’s School of Population Health and co-director of the Network of Researchers in Public Health and Complementary and Alternative Medicine (NORPHCAM), an international group promoting clinical research in CAM.

“They’re actually not that interested in evidence, because the overwhelming evidence is that putting CAM into universities has increased the standards, decreased the fringe element, and improved public safety, so it definitely smacks of dogmatism,” said Dr Wardle, who is a naturopath.

“They love to say that there’s no such thing as complementary medicine and conventional medicine, there’s just evidence-based and non-evidence-based, but, for example, St John’s Wort for over a decade now has been shown to be equally as effective as any pharmaceutical indication for mild to moderate depression, yet there’s still a large group of doctors who refuse to integrate it simply because it’s a herbal medicine,” Dr Wardle said.

The world of CAM is not a “homogenous entity”, said Dr Wardle. “There is a lot of crap, but there’s good stuff, and treating it like it’s all the same thing is very, very fraught. Taking it out of universities runs a real risk of the fringe element getting a stronger voice in the profession.”

“There are studies from Canada, Australia, and Britain that show that CAM practitioners are less anti-vaccination when they’re university trained, and they refer more to conventional [medical] providers when things get serious if they’re university trained.”

“If you look at chiropractic courses [in universities], most of it is human physiology. Chiropractic is certainly not the dominant part of the course. If you look at naturopathy, they do learn herbal medicine and nutrition but they also learn basic health science: they learn the common language of health practice - they learn what a physio or a medical doctor or a nurse would learn. Putting it into the universities diminishes the fringe element,” Dr Wardle said. “If they [FSM] are really worried about public safety they should be not trying to exclude and ostracise them from the university sector.”

He questioned how representative FSM’s roll call of doctors really is, saying that he has just completed a survey of every rural GP in NSW and qualitative interviews with about 30. “About a third wouldn’t have anything to do with complementary medicine providers, another third were very open to it - maybe too open - and the other third if they knew a practitioner who got results they’d send people on.”

About 70 per cent of Australians use CAM and it thus makes sense for research and training to be carried out within the regulation and scientific rigour of the universities, Dr Wardle said.

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