This Sunday at 10am I’ll be giving a lecture called Defending Homeopathy in the 21^st Century for the Homeopathic Medical Association. There is no doubt that homeopathy needs defending in the UK at the moment as the attacks on it, while lacking innovation, have been relentless and vicious with little space granted to us in the media to defend ourselves.

The drivel written about homeopathy has been so egregious that I feel it is not only necessary to refute what has been said but also to explain what exactly homeopathic doctors do.

Our opponents repeat one mantra: “The medicines cannot work because they are placebo.” Then they say that ‘good results’ obtained by homeopaths must therefore be purely due to placebo and meta-analyses confirm this etc. etc. They focus on the pills and impossible dilutions and choose to eschew homeopathic philosophy completely.

What you never hear described is the homeopathic process – ie. what happens when you consult a homeopathic doctor.

• Do homeopathic doctors examine you?
• Do homeopathic doctors ever use ordinary medicines such as antibiotics?
• Do homeopathic doctors believe in surgery?
• Do homeopathic doctors believe in vaccination?

The answers are “YES to all of the above.”

So how about these questions?

• How then do homeopathic and their orthodox colleagues differ?
• What do homeopathic doctors do that conventional doctors do not?
• What questions do homeopathic doctors ask you that orthodox doctors don’t?
• What is the purpose of these questions?
• What can I expect when I consult a homeopathic doctor?
• How much time will a homeopathic doctor spend with me?

For the answers to these questions watch the vodcast please.

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For many years the high ground on happiness has been held by the gurus of positive affirmations and mantras. Books and films by the thousands extolled the value of ‘postive thinking’. But has there been any evidence that these bestsellers actually made anyone any happier – apart from their authors and publishers of course?

Now some interesting research from Canada shows that people with low self esteem asked to repeat positive affirmations about themselves felt worse after doing so! Interestingly people who had good self-esteem, felt a bit better after doing so. In other words self-help books about ‘postive thinking’ might well make happy people a bit happier.

Paradoxically the study goes on to show that subjects felt somewhat better after thinking negative thoughts about themselves. Now this really is evidence for the efficacy and methodology of Provocative Therapy which is the cutting edge in the clinical application of reverse psychology. You won’t catch a provocative therapist saying too many complimentary things to their patients or ‘encouraging’ positive thoughts – that’s for sure!

I also came across an absolutely fascinating study into the causes of happiness. The men studied longitudinally (that means the study started with the intention of looking at their lives over a long period of time) over 70 years, starting when all 268 of them they were healthy, well-adjusted young sophomores at Harvard University in 1937. Their lives were monitored by the brilliant director of the 72 year study – George Vaillant. You can see Vaillant in the video that accompanies the article. This is one of the most authentic and meticulous studies into what makes us happy ever conducted. And the answer is Good Food,  Fine Wine and Great Sex! No, I’m only joking. Read the article to learn more about what makes men happy. As for what makes women happy – I’m too old to begin a 70 year longitudinal study. So any bright young things out there who want to follow the lives of 300 women for the next 70 years – this is your chance!

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In my last post, I warned that anybody using ‘lack of evidence’ as a club with which to bash homeopathy or other well-established complementary medical approaches exclusively – will be visited by the Pie Man.

The Pie Man exists purely to bring closer to the attention of these critics that a mere 13% of commonly used conventional interventions are backed by solid evidence. His job is simply to deliver a pie produced by the British Journal of Medicine’s handbook, Clinical Evidence – as orthodox a medical publication as you can hope to find on the planet.

It is perhaps no coincidence that the first (free) delivery of the pie goes to Professor Edzard Ernst (Chair of complementary medicine, University of Exeter) who was extensively quoted in both the BBC’s health column Scrubbing Up and the widely read GP journal Pulse.

In Scrubbing Up he attacks ‘Integrated Medicine’ (the use by doctors of alternative approaches alongside orthodox medicine) and uses lack of evidence to attack and ridicule this combined approach which attempts to make available to patients the ‘best of both worlds’ in medicine.

Who decides what therapy is “appropriate”? The doctor? The patient? The healer? And on what basis?

Medicine does not work like this; treatments cannot be based on opinions about appropriateness, they are based on evidence of effectiveness and safety.

And again in the article in Pulse he is quoted (among other attacks on complementary approaches) as saying:

Why not use only the many CAM treatments that are backed by good evidence?

….I submit that using unproven or disproven treatments in routine general practice is unethical (GMC ethics code) and is likely to lower the standard of care.

But why does he not simply say: ‘Why not use only those treatments that are backed by good evidence’? It appears that he feels that it his duty as a Professor of Complementary Medicine to use lack of evidence exclusively to attack complementary and alternative medicine (CAM) and not his duty as a doctor to demand its implementation in conventional medicine! Worse than this, much of what he writes leaves the impression with the reader that all or at least most of commonly used orthodox medical interventions are indeed based on good evidence. Unfortunately for him this is simply not true and there is definitely evidence to quite the contrary. Professor Ernst has professed his love of evidence in medicine so it’s obviously vital that he acquires knowledge of such important scientific evidence. He is obviously unaware of vital evidence about the effectiveness and safety of conventional medicine. This information is succinctly represented in the pie and thus the Pie Man is instructed to bring the pie closer to Prof. Ernst’s attention.

The Pie Man is proud to announce that his first free delivery is to Professor Edzard Ernst.

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Wow – Talk about empowering patients! Now there is going to be an NHS website where you can rate your GP. This fantastic and innovative idea should certainly keep doctors on their toes. They should introduce this in cricket too. The crowd, rather than the TV umpire/referees sitting in their ivory towers sipping sherry, should be the ones who decide whether the batsman is out or not. I’ve known cricket fans who are so knowledgeable that they can make an lbw decision from any seat in the grandstand.

To those who say that patients could vote with their feet and choose another doctor I say this: Why deprive patients of the schadenfreude of being able to name and shame their doctors on the internet? People could even organise orchestrated campaigns against particularly annoying GPs. All patients should be encouraged to take a stopwatch to all consultations to time the exact length of their appointments. This will enable the British public to identify the fastest GP in the NHS!

The British Medical Association is churlish to be critical of this brilliant idea of letting patients rate doctors. Many patients have accurately rated surgeons for decades by the neatness of their scars. What’s wrong with that? Or perhaps we should have all NHS operations recorded and shown on the internet so that patients can be comprehensively informed when it comes to choosing a surgeon.

On a lighter note, people could actually rate those awful jokes told by NHS surgeons in theatre. Modern technology could help us find not only the best surgeon on the NHS but the funniest one too! Or the least funny one, or the most sycophantic response to a bad joke… When it comes to rating doctors, it seem the possibilities are limitless.

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