I remember talking to the wife I had just met of an old friend whom I had not seen in twenty years. She was an avid avoider of medical doctors, preferring to take her family to alternative health practitioners. Learning I was a doctor, and to my dismay, she began telling me about her fantastic homeopath, and how he had sorted out numerous problems that previous “inept” family doctors had struggled to heal. Her approach, as I have come to expect, was both provocative and accusing.
The family had just come back from a holiday in a malaria area. I asked whether they had taken prophylaxis.
I asked her how she would treat one of her children if he became sick with malaria.
“At the homeopath.”
“And cerebral malaria?” I explained what that was, and the high mortality rate.
“Still at the homeopath.”
“What if your child became ill with meningococcal meningitis, and there was a normal doctor nearby with the emergency antibiotics that would be critical in offering hope of cure?”
She wavered slightly, and I pounced.
“You would rather risk your child’s life than see a normal doctor?”
The discussion, as I anticipated, ended badly.
What is it about alternative medicine that its adherents find so compelling? What has conventional medicine lost? With the heavy burden of evidence-based medicine, and cries for proof of efficacy, legislation and regulation, why are so many people willing to put their faith in therapies that have no compelling scientific basis or evidence whatsoever?
I had got as far as this point in writing this post when I discovered a book called Bad Science written by Dr Ben Goldacre, an NHS doctor, journalist and columnist for Britain’s Guardian newspaper. I consumed it over the next two days, finding in its pages a hilarious debunking of alternative medicine (with homeopathy his primary target), bad research, unethical practice by big corporations, the dodgy qualifications and practices of health “gurus”, and the downright dangerous beliefs that irresponsible doctors have encouraged in an unsuspecting and gullible public. All done with incisive insight, brilliant logic and superb analysis. And simple mathematics. I stand in awe of the man.
You can read the book for yourself for the details, and I am not going to repeat them. Or go to his web initiative at www.badscience.net. Homeopaths, among his other targets, have got to hate him, for nothing else than suggesting those sensible enough should look for more grounded careers. In short, I share his beliefs.
But the growing shift towards alternative healthcare, despite the lack of evidence of efficacy, has to suggest worrying failures with modern medical practice. What have we doctors done wrong? Or, to put it another way, what does alternative therapy, homeopathy included, do better than we do?
For a start, I would guess these therapists spend a lot more time with their patients, in environments that themselves are therapeutic — less formal, less threatening, with nicer colours and smells.
That the pace of consultation is calmer and more methodical.
That communication is better, even if the scientific quality of the content would raise Goldacre’s eyebrows off his forehead.
That the explanations given are more people friendly (“Your fundamental frequency is out of tune with the world’s harmonic C”) even if no one else can make any sense of them!
That there is a “connection” between therapist and patient based on shared beliefs and trust.
All these points are known to enhance healing based on the placebo effect. That IS scientifically proven — Goldacre makes that point very clearly — and works for both types of medicine. So for many users these methods do “work”, and have positive outcomes, even if no better than placebo. Even if the methods, explanations and treatments are mumbo jumbo.
I suspect the following points are critical in the growing popularity of alternative methods:
1. Faith of the patient in the art, method or skill of the healer.
2. No expensive referral to specialists, and no “passing of the buck” between doctors.
3. No expensive investigations — the method is the art and is complete.
4. No need for medical insurance.
5. Time spent in the process and method of healing.
6. Listening and communication skills.
7. No prospect of hospitalisation.
8. Limited medication costs.
If I look at these points I see that modern conventional healthcare has become a frightening place for many where high costs, painful or uncomfortable interventions and uncertainty rule. That alternative healthcare, for all its unproven and mystifying claims, is a safer and less scary refuge, where “healing” is the art and process of enabling the body to heal itself.
So what have we, the conventional medical system, lost in comparison? I think it may be the knowledge of the “warm and fuzzy” things about being healers — the mind-to-mind interactions, the common purpose, the reassurance, the art of medicine. We have come to believe that every presenting complaint needs to be analysed, tested and treated, with focus on the problem rather than on the person.
You might say modern medicine is in danger of losing its soul.