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.