Something Thats Been Bugging Me

johnsix

You've probably notice that Ireland is swarming with Supplementary, Complementary and Alternative Medicine.
Regardless of whether they work or not.

they don't

1. We know most practitioners have no qualifications from any respected or accredited source or are in no way medically trained or licensed
2. We also know they claim to treat people who actually are ill and give medical advice.
What bugs me is: why exactly aren't they busted for practicing medicine without a license?

5uspect

Well for a start there are no side effects... or any effects really.

monkeyfudge

5uspect wrote: »

Well for a start there are no side effects... or any effects really.

There is if people use them and are under the belief that it's enough and don't get proper medical attention as a result.

johnsix

I'm sure a doctor giving you a treatment he knows doesn't work isn't exactly on the up and up either.

monkeyfudge

I actually can't find a GP in my area who doesn't also deliver alternative medicine.

They all do acupuncture and homeopathy as well.

Chiropractors are the worst though... they can really do some damage to you.

5uspect

monkeyfudge wrote: »

There is if people use them and are under the belief that it's enough and don't get proper medical attention as a result.

I fully agree with you. The most danger from these alternatives to medicine comes form the ignorance of those pushing and taking them.

johnsix

On that note: http://www.kcra.com/news/16602080/detail.html
I was more thinking more along the lines of the people who aren't actual doctors, but it is pretty scary how many GPs deal in the bull****.

monkeyfudge

I guess the GPs just see money that can be made. I suppose if they're offering it they'll also offer proper medical help if it's something serious as opposed to someone just going into one of these Dr. China places that are opening up everywhere.

Anyway.. it's not like western medicine doesn't play around with the placebo effect itself. Anti-depressants would be an example of drugs with very little chemical effectiveness.

(Oh and when they started playing dolphin sounds in the surgery that was when I had to finally move to a GP further from where I live)

johnsix

Thats the other thing that pisses me off "Its from ancient China so it must work." Same with the Native America stuff people are selling.
It not very far removed form "magic negro dust" in my opinion.

monkeyfudge

Cherokee Hair Tampons!

https://www.youtube.com/watch?v=1jfuPang3RM

johnsix

Exactly.
I'd love to see better regulation of this industry. And a bit of education wouldn't hurt, people really should know 3rd level reiki master does not equal an actual medical education.

Sapien

johnsix wrote: »

You've probably notice that Ireland is swarming with Supplementary, Complementary and Alternative Medicine.
Regardless of whether they work or not.

they don't

1. We know most practitioners have no qualifications from any respected or accredited source or are in no way medically trained or licensed
2. We also know they claim to treat people who actually are ill and give medical advice.
What bugs me is: why exactly aren't they busted for practicing medicine without a license?

I'd be interested to know what kinds of treatments you include in your

dismissal

. Few are more vituperative of, say, homeopathy than myself, but there are other treatments that many would see fit to curse in the same breath, which are far less deserving. Massage, for instance. Yoga. Meditation exercises. All dangerous quackery?

On the other hand - psychological counselling. Embraced by the mainstream, but with little evidence of therapeutic effectiveness. Should its practitioners be monitored, and sanctioned when they fail to heal, or when they replace proven medical or pharmaceutical therapies, or worsen a patient's condition?

johnsix

Sapien wrote: »

I'd be interested to know what kinds of treatments you include in your

dismissal

. Few are more vituperative of, say, homeopathy than myself, but there are other treatments that many would see fit to curse in the same breath, which are far less deserving. Massage, for instance. Yoga. Meditation exercises. All dangerous quackery?

My arguement isn't about what works and what doesn't (this time), but rather who is legally allowed give medical advice.
Yoga, Meditation etc can be theraputic, yes but not necessarily medical. But a good yoga teacher or masseuse would have the relevant qualifications or at the very least a decent amount of training.

Sapien wrote: »

On the other hand - psychological counselling. Embraced by the mainstream, but with little evidence of therapeutic effectiveness. Should its practitioners be monitored, and sanctioned when they fail to heal, or when they replace proven medical or pharmaceutical therapies, or worsen a patient's condition?

Again not about what does and doesn't work. Psychiatrists have qualifications and standards as well as years of training, not saying it isn't without it flaws. Psychiatrist have standard they can be held up to and held accountable for bad practice.

Sapien

johnsix wrote: »

My arguement isn't about what works and what doesn't (this time), but rather who is legally allowed give medical advice.
Yoga, Meditation etc can be theraputic, yes but not necessarily medical. But a good yoga teacher or masseuse would have the relevant qualifications or at the very least a decent amount of training.

Well then, of course, neither do acupuncturists nor homeopathists practice medicine. They offer supplementary/complementary medicines. I'm quite certain that if any such practitioner purported to be medically trained, and were found to be lying, they would be in a huge amount of trouble. Your question seems moot.

johnsix wrote: »

Again not about what does and doesn't work. Psychiatrists have qualifications and standards as well as years of training, not saying it isn't without it flaws. Psychiatrist have standard they can be held up to and held accountable for bad practice.

I mentioned psychologists. Psychiatrists are physicians, psychologists are not - so my question stands.

Gibs

Sapien wrote: »

On the other hand - psychological counselling. Embraced by the mainstream, but with little evidence of therapeutic effectiveness. Should its practitioners be monitored, and sanctioned when they fail to heal, or when they replace proven medical or pharmaceutical therapies, or worsen a patient's condition?

This is simply not accurate. There is overwhelming evidence in favour of both the efficacy and effectiveness of psychotherapy and psychological interventions delivered using a variety of approaches. The benefits of such interventions are considerably in excess of those provided by placebo. There are literally hundreds of well-controlled, well-designed, methodologically sound studies that consistently show the benefits of appropriate psychological interventions for the treatment of a wide array of presentations and conditions.

If you even do a cursory google you will find dozens of examples that demonstrate the robustness of this finding. Here's a 2007 Irish review of the effectiveness of psychotherapy. Just click on the "download executive summary" to see the details.

Many of the most vociferous members of the Irish Skeptics are psychologists and it is disappointing to have a lazy dismissal of the value of psychological interventions made in this forum when there is so much good quality evidence that clearly and unambiguously supports the current use and further expansion of psychology/psychotherapy.

Mahatma coat

How coulds anyone claim that Meditation and Yoga have no medical or thereputical benefit?

I know someone who had a brain haemorage a few years ago, you go and tell them that they wasted their time learnin to walk as there would have been no way that a bit of Massage and a few exercises could have done anything for them.

not to come across all hippysh but the popwer of positive thought/hope is a powerful thing, granted false hope is equally as dangerous.

as for Holistic medicines, while I agree that the actual remedies they provide are mostly a load of bollox, they fill an important gap in many cases by virtue of the fact that they have the ability to spend more time on average with patients, therefore being able to relax the patient better and acquire a fuller medical history for the MD's

Mahatma coat

How coulds anyone claim that Meditation and Yoga have no medical or thereputical benefit?

I know someone who had a brain haemorage a few years ago, you go and tell them that they wasted their time learnin to walk as there would have been no way that a bit of Massage and a few exercises could have done anything for them.

not to come across all hippysh but the popwer of positive thought/hope is a powerful thing, granted false hope is equally as dangerous.

as for Holistic medicines, while I agree that the actual remedies they provide are mostly a load of bollox, they fill an important gap in many cases by virtue of the fact that they have the ability to spend more time on average with patients, therefore being able to relax the patient better and acquire a fuller medical history for the MD's

johnsix

Mahatma coat wrote: »

How coulds anyone claim that Meditation and Yoga have no medical or thereputical benefit?

They have no more benefit than anyother from of exercise.

Mahatma coat wrote: »

as for Holistic medicines, while I agree that the actual remedies they provide are mostly a load of bollox, they fill an important gap in many cases by virtue of the fact that they have the ability to spend more time on average with patients, therefore being able to relax the patient better and acquire a fuller medical history for the MD's

Thats the thing though they don't have the training or authority to actually get a persons medical history.

agrajag

Just in further support of psychologists, The Psychological Society of Ireland do attempt to regulate the profession, albeit in a non-statutory manner. See http://www.psihq.ie/about_overview.asp

Mahatma coat

johnsix wrote: »

They have no more benefit than anyother from of exercise.

if by exercise you mean regular if not regular daily workouts scheduled and monitored for changes, then, yeah, same diference

Thats the thing though they don't have the training or authority to actually get a persons medical history.

I'd be in favour of a type of, Wholistic Nursing discipline

johnsix

Would prefer a nurse trained and accredited in actual medicine myself.

Mahatma coat

what? like a Paramedic, all I'm sayin is that theres room in the industry for a lot of those people in the Quackery side of things to get involved in the nuts and bolts real medicine side of things where they would be able to greatly benifit REAL medical profesionals

johnsix

Mahatma coat wrote: »

what? like a Paramedic, all I'm sayin is that theres room in the industry for a lot of those people in the Quackery side of things to get involved in the nuts and bolts real medicine side of things where they would be able to greatly benifit REAL medical profesionals

What possible benefit can "quackery" give actual medicine?

Sapien

Gibs wrote: »

If you even do a cursory google you will find dozens of examples that demonstrate the robustness of this finding. Here's a 2007 Irish review of the effectiveness of psychotherapy. Just click on the "download executive summary" to see the details.

The effects of psychotherapy are nearly
double those of placebos and the overall
magnitude of the effects of psychotherapy in alleviating
psychological disorders is similar to the overall
magnitude of the effect of medical procedures in
treating a wide variety of medical conditions.

The first part of that is quite clear. The second not so clear. Are we to conclude that the average effectiveness over placebo control for medical procedures is around double? That would surprise me, but then again, I have argued repeatedly that the point of the placebo effect has been massively missed. I would never deny that psychological counselling can help people, but then, homeopathy helps people.

Can you tell me how placebo is achieved in studies of effectiveness in psychotherapy?

About 1 in 10 clients deteriorate as a result of
psychotherapy.

Gibs wrote: »

Many of the most vociferous members of the Irish Skeptics are psychologists

Well that doesn't really have anything to do with anything. I am a ceremonial magician, and a vociferous skeptic. Psychologists are useful in skepticism because they understand things like pareidolia and apophenia. It doesn't follow that psychotherapy is effective, or that pschology should be exempt from skepticism.

johnsix

Sapien wrote: »

homeopathy helps people.

No it doesn't, it doesn't do dick. There are much much better ways of giving people treatment than using bull****.

Sapien wrote: »

Well that doesn't really have anything to do with anything. I am a ceremonial magician, and a vociferous skeptic. Psychologists are useful in skepticism because they understand things like pareidolia and apophenia. It doesn't follow that psychotherapy is effective, or that pschology should be exempt from skepticism.

Noone was implying that because some psychologicists are skeptical that means it is immune to skepticism.
Unlike magick and homeopathy there is evidence and experimental data to actually show the effectiveness of psychotherapy.

robindch

Sapien wrote: »

I would never deny that psychological counselling can help people, but then, homeopathy helps people.

It's quite probable that there are benefits to the extended, touchy-feely one-on-one in which alternative medical practitioners excel. At least, in the areas where placebos have been shown to be effective -- relief from pain, emotional issues and the like.

Homeopathy has never been demonstrated to have any consistent or reliable effects beyond those, to the extent that the Edzard Ernst of the University of Exeter (who holds one of the very few chairs of alternative medicine in an accredited university) has said that homeopathy is a "public health problem" and that "Homoeopathic claims are not benign, they are dangerous". More here:

http://www.telegraph.co.uk/news/uknews/2141049/%27Homeopathy-putting-lives-at-risk-with-claims%27.html

Sapien

robindch wrote: »

It's quite probable that there are benefits to the extended, touchy-feely one-on-one in which alternative medical practitioners excel. At least, in the areas where placebos have been shown to be effective -- relief from pain, emotional issues and the like.

Homeopathy has never been demonstrated to have any consistent or reliable effects beyond those, to the extent that the Edzard Ernst of the University of Exeter (who holds one of the very few chairs of alternative medicine in an accredited university) has said that homeopathy is a "public health problem" and that "Homoeopathic claims are not benign, they are dangerous". More here:

http://www.telegraph.co.uk/news/uknews/2141049/%27Homeopathy-putting-lives-at-risk-with-claims%27.html

I agree entirely. And what could be more touchy-feely, one-on-one than psychotherapy?

Sapien

johnsix wrote: »

No it doesn't, it doesn't do dick. There are much much better ways of giving people treatment than using bull****.


Noone was implying that because some psychologicists are skeptical that means it is immune to skepticism.
Unlike magick and homeopathy there is evidence and experimental data to actually show the effectiveness of psychotherapy.

Hmm. I'm sensing the giddy zeal of new-found skepticism and the overriding need to demonstrate disdain for all things not-quite science. Take a breath.

johnsix

Sapien wrote: »

Hmm. I'm sensing the giddy zeal of new-found skepticism and the overriding need to demonstrate disdain for all things not-quite science. Take a breath.

And this is relevant how exactly?

Sapien

johnsix wrote: »

And this is relevant how exactly?

Perhaps fewer of the asterisks and a little more articulation of our points. You're not the only person capable of skeptical enquiry on these boards - you don't have to scream.

johnsix

Sapien wrote: »

Perhaps fewer of the asterisks and a little more articulation of our points. You're not the only person capable of skeptical enquiry on these boards - you don't have to scream.

Wow, that's condescending.
You're making quite a lot of assumptions.

Sapien

johnsix wrote: »

Wow, that's condescending.
You're making quite a lot of assumptions.

Am I? There's a lot of that going about, I suppose.

maninasia

I work in the pharma field. I was previously very skeptical about Chinese medicine but having personally seen the effectiveness of some treatments I have changed my mind. Not only that, many of the active ingredients are under investigation as possible drug agents at this time. Of course not all treatments work and some of it is hearsay and placebo effect but there are quite a lot of treatments that work, it's no surprise since they use 1000s of different herbs in Chinese medicine. A very famous anti-malarial drug, artemisin, is from a root in China. Chinese medicine is very difficult to do a controlled blind study in the way that western medicine insists (single drug agent at one time or at most 3-4, plus you need to use the pure substance only and in precisely controlled amounts).
I pride myself in scientific thinking, I am an atheist and yet I'm aware of the fact that we can't just write off an area just because the people promoting that area are often cranks and moneygrabbers or because it doesn't follow exactly the same processes we are used to. In my experience many GPs do not use scientific or rational judgements either, rather they will promote a drug according to their deal with the pharma co., out of date knowledge, hearsay and no diagnostic testing.

5uspect

I don't think anyone really disputes that there may be some effective treatments in other traditions. The problem is the understanding and explanations provided for such cures.

As you say simple blind tests are difficult, but they shouldn't be impossible either!

davros

I don't think many skeptics would deny the usefulness of herbal medicine as an input to modern medicine. Knowing where to begin the search for a new drug is half the battle and herbalists have been able to suggest some possible starting points.

But shouldn't we regard herbalism as just one stage along the road to modern medicine? Surely it has been superseded by now.

Aspirin is always called upon to defend the herbalists' cause. But it's not really a natural product, is it? Chewing on willow bark was obviously noted to have beneficial effects but chemists ran with it, isolated the active compound and eventually formulated a related, but not identical, chemical into what we know as aspirin.

Some problems with herbalism as I see it are:

• most of it is bogus (the Wikipedia article on artemisinin, for example, mentions that Chinese medicine offered a list of 200 potential cures for malaria, only one of which was effective).
• effectiveness will never approach a properly researched modern derivative.
• even for those herbal treatments which are valid dosages vary wildly because the herbalist has no idea whether the plant he has collected actually has the active ingredient at all.
• plants can be poisonous as well as medicinal.
• because Chinese/herbal medicine is harvested from plants and animal parts it can push rare species to the point of extinction.
• the Chinese medicine industry is not above fraud. Herbal skin creams have been found to contain steroids, for example, so it's no wonder that they can benefit skin conditions.

Every few years I see an announcement from China or Hong Kong that some university has established a department to seek new drugs using Chinese medicine as a starting point. It's remarkable how little has come from these efforts.

maninasia

I agree with pretty much all your points regarding herbal medicine.
I'd just like to say a few things about the weakness of modern medicine while I am at it.

1) Drugs are given final approval according to their tests among a large group of patients, pretty much ignoring the different genetic makeup of patients. Patients routinely inject combinations of drugs, the interaction of which are unknown

2) Doctors broadly do not use diagnostic tests to do their evaluation. To me as a bioscientist this nothing short of ridiculous.

3) Doctors spend a few mins per patient and in general do not do follow up research following visit or ask for a broad history from the patient

4) Most doctors fail to keep with latest advances in research

5) Doctors diagnose as an individual rather than as a team consensus

In short there are also many valid reasons to be skeptical of modern medicine as it is practised now.

maninasia

maninasia wrote: »

I agree with pretty much all your points regarding herbal medicine.
I'd just like to say a few things about the weakness of modern medicine while I am at it.

1) Drugs are given final approval according to their tests among a large group of patients, pretty much ignoring the different genetic makeup of patients. Patients routinely inject combinations of drugs, the interaction of which are unknown

2) Doctors broadly do not use diagnostic tests to do their evaluation. To me as a bioscientist this nothing short of ridiculous.

3) Doctors spend a few mins per patient and in general do not do follow up research following visit or ask for a broad history from the patient

4) Most doctors fail to keep with latest advances in research

5) Doctors diagnose as an individual rather than as a team consensus

In short there are also many valid reasons to be skeptical of modern medicine as it is practised now.

But surely you can't suggest abandoning an ,albeit faulty, but effective style of medicine for something than not only has no scientific basis but no proven benefits (like homeopathy or acupuncture.)

maninasia

Did you see me mention anything about homeopathy or acupuncture here?
Did I say abandon modern medicine?

No I merely suggest to keep a more open mind on Chinese medicine, especially herbal based component and I also suggested that you cannot apply the same type of criteria to different areas.
Is modern western medicine the standard to be measured against? Yes.
Does it have many reasons to be skeptical of it? Yes

Gibs

Gibs wrote: »

Many of the most vociferous members of the Irish Skeptics are psychologists and it is disappointing to have a lazy dismissal of the value of psychological interventions made in this forum when there is so much good quality evidence that clearly and unambiguously supports the current use and further expansion of psychology/psychotherapy.

Sapien wrote: »

Well that doesn't really have anything to do with anything. I am a ceremonial magician, and a vociferous skeptic. Psychologists are useful in skepticism because they understand things like pareidolia and apophenia. It doesn't follow that psychotherapy is effective, or that pschology should be exempt from skepticism.

I am not suggesting that a person's profession should somehow innoculate them, their opinions or their profession from being subject to the rigours of skeptical, scientific examination. However, your analogy comparing your own profession, being a ceremonial magician, to the profession of a psychologist doesn't really make sense in this instance.

You may be a ceremonial magician, but (most) magicians don't claim that their tricks or illusions are anything more than just that - tricks or illusions. I am assuming that you don't propose that your illusions represent actual transcending of the laws of physics or what is scientifically demonstrable. :P

Psychologists on the other hand are making claims that what they do - attempting to effect/facilitate change in the psychological functioning of people - does result in real, sustainable, actual, measurable change in people.

My point in mentioning that many vociferous skeptics are also psychologists was to emphasise that properly trained psychologists are scientists (and often practitioners) and apply exactly the same scientific rigour to their work and to the kinds of treatments they offer as other scientifically trained individuals such as medical doctors, biochemists, or pharmacists. Perhaps this fact is not widely known outside of the field.

To be a qualified clinical or counselling psychologist, for example, takes many years and involves extremely comprehensive, evidence-based scientifically predicated training. Good psychological research is conducted using exactly the same research designs and protocols as other scientific research. Psychological research is published in peer-reviewed psychology journals as well as the peer-reviewed journals of other disciplines. Psychology as a discipline is often located in the science department of universities and its research methods are no different from those of other scientific disciplines.

I take all of this for granted as I work in the area myself, so when I say that many vociferous skeptics are also psychologists, I am really saying that they are also scientists and therefore think and examine information using an approach that is scientific and that relies on evidence, not assertion and anecdote and is usually in accordance with the approaches advocated by skeptics here and further afield.

My original point was made only to correct your inaccurate description of psychology as some kind of pseudoscientific profession that is conducted without due regard for the measurement of outcomes and effects. In reality, this is a completely misleading caricature. There is a huge amount of reliable, reputable and reproducible evidence, conducted using good, rigorous scientific methodology, that demonstrates that psychotherapy and psychological interventions work. They produce effects that are measurable. Not everyone benefits from psychotherapeutic input, just as not everyone benefits from medical interventions. Nevertheless, legitimate, mainstream psychology as it is practiced today, both in Universities and in clinics, is nothing like the dodgy profession that you are suggesting it is.

It is unfortunate that there is currently no legal control over the profession of psychology in this country as it allows people who don't have the appropriste training to call themselves psychologists. Statutory registration of all psychologists is on the way and should be introduced in the near future. Hopefully, that will weed out those who are not appropriately trained. I just think it's important to differentiate between psychologists who are appropriately trained and people with little or no training who call themselves psychologists.

Gibs

Gibs wrote: »

You may be a ceremonial magician, but (most) magicians don't claim that their tricks or illusions are anything more than just that - tricks or illusions. I am assuming that you don't propose that your illusions represent actual transcending of the laws of physics or what is scientifically demonstrable. :P

I think by ceremonial magician he means Magick with a k.
http://en.wikipedia.org/wiki/Ceremonial_magic

Myksyk

I think it should be mentioned that The Irish Skeptics Society was officially 'launched' at one of the Psychological Society of Ireland's Annual Conferences. Papers were presented taking a critical look at psychological practice. Members of the Irish Skeptics have (before and since this) presented papers challenging psychologists about various aspects of psychological practice. It was very much a case of examining the state of our own house before casting a critical eye elsewhere.

dennis_thompson

Hi all,

to put my two pennorth worth in....

Psychology, the scientific data I have researched to date is that 'talking therapies' are only marginally better than anti depressants, of which they only have a small benefit and even that on the suicidally depressed. (Reference to depression - not other mental states seeking psychiatric treatments!)

Homeopathy - lets just agree it has absolutely no medical effects at all, unless you are allergic to water! Placebo it's great, medicine it aint.

Herbalists, including chinese herbalists, at least they have an ingredient, unlike homeopathy. To say all herbalism is bad for you is B.S., however because it is unregulated, they do not have to have a medical degree and have no access to your medical papers it has the potential to do real harm!

In the UK they are trying to regulate this area, alternative therapies.

Prince Charles supports it 100%:D

Ok I shouldn't laugh but he has to be the biggest believer in all things alternative, perhaps in the world.

Also the regulating body has no power and it is entirely voluntary to join up.

The supposition must be by British government that if these treatments get rubber stamped by their own industry, that makes them safe:D

Maybe we Sceptics need to work insidiously from within, run in elections, get voted to the halls of power and create positive changes for the health and safety of all, in the process giving these charlatans a good kick in the doodads!:D

Anyway thats my two pennorth worth for what it's worth,

regards,

Den.

Peanut

It's more than slightly ironic that Skeptics in the field of psychology have to deal with lack of confidence in their profession, as evidenced by posts here at least.

This situation would be entirely avoidable though if the culture of emotional response and knee-jerk confrontationalism was not condoned as much as it is, throughout skeptical enquiry in general - it doesn't do anyone any favours.

robindch

"Knee-jerk confrontationalism"? Could you be a bit more specific? Who, when, where?

Zombrex

robindch wrote: »

"Knee-jerk confrontationalism"? Could you be a bit more specific? Who, when, where?

Jerk promising miracle cures to sick people with nothing more than water + My knee = confrontationalism

:cool:

Peanut

robindch wrote: »

"Knee-jerk confrontationalism"? Could you be a bit more specific? Who, when, where?

Well the first post in this thread for example?
"Why aren't they all busted"

Why not just line them up against a wall while we're at it.

Peanut

Peanut wrote: »

Well the first post in this thread for example?
"Why aren't they all busted"

Why not just line them up against a wall while we're at it.

Well at least then we'd see exactly how effective reiki and homeopathy are on treating gunshot wounds.

Peanut

King Mob wrote: »

Well at least then we'd see exactly how effective reiki and homeopathy are on treating gunshot wounds.

:cool:

I don't believe they are generally indicated by their respective practitioners for that condition, although your mileage may vary.

pH

Peanut wrote: »

:cool:

I don't believe they are generally indicated by their respective practitioners for that condition, although your mileage may vary.

Peanut

nice, had been looking for that Safari kit

robindch

Peanut wrote: »

Why not just line them up against a wall while we're at it.

Given that it's quite clear from context that "busted" was used in it's "held to legal account" sense, I think your own inflammatory and nasty comment above is a much finer example of knee-jerk confrontationalism than anything else on this thread.