Thursday, 15 May 2008

Shamans, charlatans and quacks?

Prince Charles popped up on the Today Programme this morning. He seemed in jovial mood and chortled his way through an interview on using the rain forests to protect us all against climate change. HRH has long been interested in alternative issues, and is as well known for talking to his plants as for his ill-fated marriage to Diana.

Last month the Prince was in the news as a professor from Exeter university criticised guides to alternative medicine produced by the Prince's Foundation for Integrated Health. At the time the Today programme ran an interview with someone speaking for the Prince, suggesting that the important thing was that people should have information to help them make up their own minds, and that the guides presented the facts for them to consider.

CAM can be an easy target. Ben Goldacre, debunker of health myths, is not keen on it and practitioners of all its various aspects are regularly criticised on his blog. The good folk at Quackwatch also list many "alternative" therapies on their pages. A possible antidote to DR Goldacre is the NHS Alternative Medicine blog.

CAM has no Royal College or regulatory body, as as such. The Institute of Complementary Medicine exists to provide people with information on "safe and best practice" They keep a British Register of Complementary Practitioners and publish a code of ethics for practitioners.
There is also the British Complementary Medicine Association. The ICM's website has pictures of people in white coats, the BCMA has graphics of doors opening onto bright lights, but they also have a list of registered therapists and a code of conduct.
Some individual therapies have their own organisations - reflexologists, acupuncturists, Alexander teachers. How are these bodies regulated? Can they stop people from setting themselves up as practitioners without training? What training can there be? How about a postgraduate diploma in crystal therapy, complete with bibliography, continuous assessment and learners' portfolio? There are 61 complementary medicine courses available from bona fide UK universities.

There is a NLH Specialist Library for CAM. This covers the more mainstream end of things - herbal medicine, massage and art therapy. There is no section for crystals, reiki or macrobiotic diets. The NLH also offers a database of papers on alternative medicine - AMED.
Bandolier has a page of evidence on CAM. Cancer Research UK has a page of resources as does the Department of Health. Dr Foster has a search facility for finding CAM practitioners, although this only covers acupuncture, chiropractice, herbalism, homeopathy and osteopathy. Natural Standard is an American website that aims to provide "high quality, evidence based information about complementary and alternative therapies." You need to register to read anything on this site, although their blog is freely available. There is also a NHS Directory of complementary and alternative practitioners. As well as information on therapies it will tell you where to find your nearest crystal therapist. The Open University, working with the BBC, has a web resource on alternative medicine.

The Student BMJ has a basic run down of CAM issues. Further reading on this topic available in the library - natch.

CAM continues to strike up debate and controversy. It seems to me that one of the main problems is the attempt to lump together everything that is not mainstream medicine. Perhaps we need to stop thinking about CAM and think instead about the individual therapies, taking each one on its merits. More research might help. And in the end if we believe it makes us feel better, and it's not doing us harm, then why should we knock it?

With thanks to Newham Knowledge for suggesting the topic for this posting.

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