Australian Doctor online recently ran a news item about GP’s and their “CAM Creep”.
What they were saying was that because of the broad nature of general practice and consumer demand, doctors were susceptible to prescribing more CAM’s and were doing so in larger numbers.
In so doing, it was claimed that obsession with complementary and alternative medicine saw them desert evidence based practice.
The fear by some commentators is that more GP’s will drift towards misconduct.
This fear is based on 9 recent cases where doctors were disciplined for misconduct involving integrative medicine.
i2P has not had access to the background surrounding those 9 cases but would be interested to know and understand the rationale behind each case and whether the misconduct involved solely the use of CAM.
Most integrated medical practitioners belong to their own association (The Australian Integrated Medicine Association) which is multidisciplinary and includes pharmacists, dentists and other registered health practitioners.
In general terms it is hard to see where a case can be made against CAM because of its high safety level. That is not to say that there are not some isolated interactions that are of concern, but the majority of harm overwhelmingly comes from mainstream medicines in the form of drug/drug interactions and side effects.
There is a selective bias in some publications against CAM and one has recently been caught out by OHMS (a clinical nutrition research group) vilifying a CAM ingredient as a component in a drug combination or taken with a mainstream drug as part of an integrated medicine approach.
OHMS newsletter reported an instance where nicotinic acid, a member of the vitamin B group (and with 60 years of safe trouble-free use) was indicted as the cause of a side effect problem when used in combination with a mainstream drug.
Little investigation (or imagination) was required to pinpoint the mainstream drug was the problem component.
It’s also not that long ago that 10 prominent US physicians performed a biased study on Vitamin E using a toxic isomer well known for its toxicity and adverse events profile and naturally producing an adverse report. The report distinguished itself both for deliberate bias and ignorance on behalf of the physicians.
It is little wonder that GP’s embracing CAM are enjoying their interaction with happier patients who can more easily participate in their own self management of their condition, and feel benefit almost immediately.
GP’s are intelligent people and understand the scientific method.
They also have patients who are likewise intelligent and they have clinical conversations with their GP’s debating the pros and cons for CAM’s for their particular health issue.
It’s little wonder that GP’s come on board for their patients and I would state without hesitation, that there are less adverse events involved with CAM use than with mainstream drug use.
Why weren’t the same parameters applied to mainstream drugs in this particular study?
It is also hard to see how a charge of misconduct can apply just through prescribing a CAM if reasonable care has been undertaken by the GP in using the best evidence available.
If insufficient evidence is available, then judgement or referral takes place.
Judgement based on traditional evidence would seem a reasonable safeguard when employed by a doctor (or any other registered health professional).
And I have to note that most of the critics of CAM usually do not have patients and are concentrated within an influential group of medical skeptics. This group is often associated with grants from global Pharma’s for various research projects that create a reason for bias against CAM’s unreasonably, and generally with academic dishonesty.
This same group of critics also belabour pharmacies for selling CAM’s, they say, without any evidence (money being the only motive, they say).
They obviously don’t understand that consumers see CAM’s as a “need” and that the product demand is vested in consumers.
The style of the anti-CAM movement is starting to cause a reverse force slowly mobilising as various interests coalesce across the industry.
They have consumer backing as 70 percent of the Australian population now admit to taking some form of CAM on a regular basis. The demand within the pharmacy market place is genuine and is consumer driven.
With that level of consumer backing, big Pharma will fight a losing battle as consumers begin to understand the flaky type of “evidence” used to market mainstream drugs.
Pharma’s have had a long and relatively unhindered run and have been able to invest considerable sums of money for their campaigns. That money has been written off as marketing expenses which are not valid.
Government and consumer groups will gradually reinstate a true balance and the money supply will then not be available for invalid marketing exercises because it will no longer exist.
Natural substances still make a substantial contribution to mainstream medicine as they are modified and patented. The cancer industry can trace about 80 percent of its “drugs” back to originator natural molecules.
It is about time critics of CAM found some more useful and productive pursuit