Saturday, 25 October 2008

Enforced Quackery: Day One

It was remarkably sensible. They students sat in with an osteopath and a homeopath. The osteopath was very respectful, a very nice friendly woman, and offered several pieces of fairly sensible advice - being exceedingly respectful towards one of the students when she found out that she was already a qualified physiotherapist.

The homeopath asked "does anyone know anything about homeopathy", and my girlfriend told her. She apparently went into quite a lot of detail about Avogadro's constant, the fact that every drop of water on the planet should already be a homeopathic remedy for everything and the fact that homeopathy just doesn't work. (To be fair, of course, as Ben Goldacre would say "it's a lot more complicate than that", but the pills don't work any better than any other sugar pills). The homeopath stood there, listened, thanked my girlfriend (I might need to come up with a codename if I'm going to keep doing this... or get her to let me use her real name) for her contribution and then went on to explain about what the various tablet do.

She told them all she'd give them some free arnica tablets next time (for general aches and pains, I believe) and offered to give a few of them medicine for various conditions if they hadn't cleared up in two weeks time, and then finished with an exhortation to "do some research about homeopathy". Her suggested source was the Society of Homeopaths website which I'm sure would offer a "Fair and Balanced" view. I'm going to give her a copy of Ben Goldacre's book,as well as a few of the better meta-analyses.

As for the (very helpful) point made in the comments about using the experience to learn about why people feel the need to go to these people for help instead of using medicine that actually works - yes, we've already talked about that - it is a good chance to see something that she probably won't get to see working in hospitals or on future ward rounds (although asking the patients tactfully why they aren't seeing a traditional doctor might be a challenge). Still, that's not the way the hospital treats it - they consider it an opportunity to watch real-life health professionals at work in the field. Also, I apologise about the comments I made about the qualifications of the psychotherapists at the Centre - I was not happy at the time, and it was unnecessary.

Anyway - the visit didn't go too badly, everyone was polite and, whilst I don't think she got much out of it, my girlfriend was slightly more happy than she expected to be - at least she got a chance to air her views. We'll see how things go next week when she'll have more contact with patients.

Tuesday, 21 October 2008

Enforced Quackery

My girlfriend is a second year medical student at a UK university (naming no names, as she seems to think she'll be punished if this gets out...) She does a module called "Medicine in Society", she has 11 full days observing real-life medical practitioners at work, more than half of her patient contact for the year. This year, she will be doing her placement at the Greenwich Natural Health Centre. Yes, it is as bad as it sounds.

Among other things, they offer "Holistic Aromatherapy", "Homeopathy", "Cranial Osteopathy", "Cranio-sacral therapy" (on reading the blurb on the website, I honestly can't see any difference between these particular two brands of woo) , and the Reiki Healing. Even when some of the treatments sound as though they might be sensible (Pyschotherapy, Relationship Counselling...) it turns out that some of the practitioners are the same people who do the Reiki healing. Although, to be fair, some of them do seem to be qualified psyhotherapists (not, note, qualified pychiatrists).

There doesn't appear to be a single person on the staff at GNH who is a qualified medical doctor (I haven't looked through the entire list, I'm willing to be corrected on this) and one woman proudly offers her qualifications as "BA Hons", "DipTch", which unless I'm mistaken is just a Bachelor's degree (in an unspecified (arts) subject) and a teaching diploma.

Anyway, that's enough trashing the place - obviously, it's a hotbed for woo, and they don't really buy into the whole "evidence-based medicine" thing. Fair enough, there's a time and a place for that sort of thing, as Ben Goldacre points out in his new book, there are probably more important things to worry about, but this is where the story gets silly.

On hearing that she was going to be sent to woo-central, and not really liking the idea, my girlfriend decided to ring up the School and ask if she could possibly be transferred to a placement where they did actual medicine. She was told in no uncertain terms that she could not, and that if she didn't attend all eleven days of woo-school, she couldn't possibly pass her second year. An extract from this conversation apparently went:

My Girlfriend: "But there's absolutely no evidence that any of it works, it's not based in science."
Office Lady: "That's a fair point, but..."

"but..."? But what? What "but..." could possibly justify forcing someone to waste 11 days and (approximately) £1000 of tuition fees on learning about treatments that can't possibly work? Possibly the scariest part about this is that the other twenty or so medical students who were sent on the same placement don't seem to have objected at all.

Anyway, today is day one of her placement. She's promised to take copious notes, and I'm going to write about them here.