Unconventional Healthcare in the Era of High-Tech Medicine : From Quackery to Credibility.
I have kind of mixed feelings sometimes on bogus/fringe health claims. I kind
of hate to see the government go too far to protect everyone from themselves;
Perhaps we need some Darwinian influence on those rejecting real medicine. And
perhaps it would save money if people do crackpot medicine instead of the
real thing. Still the ignorance of and backlash against real science and real
medicine still threaten rational people. The following is of interest:
Press Release (e-mail version)
Unconventional Healthcare in the Era of High-Tech Medicine : From Quackery to
A new Healthcare Report from Financial Times / Informa Pharmaceuticals.
US consumers spent $30 billion on alternative medicine in 1999, double the
outlay three years earlier. For their part, Europeans spent over Euro 13 billion
in the same year on herbal medicines and Euro six billion (retail prices) on
Is it not a paradox that people are losing faith in modern medicine and
pharmacology, turning instead to alternative or complementary healthcare, herbal
remedies and functional foods, at a time when both medicine and pharmacology are
at the peak of their effectiveness?
This report describes the tremendous progress in biomedicine that has provided
doctors with the tools to ease suffering rather than watch patients die. It
details the political and economic context in which medical practice has
changed, taking into account parallel shifts in ideas about medicine, their
impact on regulatory measures and the manipulation of power by parties involved
in health provision. It reaches into the past to throw light on the present. And
it looks at the genetic research that now promises to enlarge the frontiers of
These days healthcare entrepreneurs come and go, many of them amassing fortunes
before they leave the theatre of pseudo-science. There are more than 1,300
entries on the ever-changing list of therapies offered by these self-proclaimed
gurus - from absent healing and aromatherapy to healing love and healtheology,
Mahikaro and Marma Science, network spinal analysis, psionic medicine,
radiesthesia, rebirthing, vibrational medicine, Zen Alexander Technique and many
more. A broad selection of these is covered in the report, giving modern
quackery its full dimension.
"Don't forget that there is something outside that has been around for 2,000
years", advises renowned US consumer activist Ralph Nader. But the New England
Journal of Medicine voiced the concerns of the international medical community
by insisting that alternative therapies could not be allowed a free ride,
substituting assertions, speculation, and testimonials for sound clinical
evidence and following a rationale that violated fundamental scientific laws.
Since the end of the vitamin discovery period, there have been advances in
quantifying human requirements for specific nutrients and developing practical
dietary and pharmaceutical means of satisfying these requirements. Yet an
unending flood of new preliminary findings or hypotheses, born mainly of the
food industry's efforts to promote foods with specific health claims, has led to
public confusion. Journalists fixed on daily news agendas have encouraged the
hype, and the question of how best to disseminate accurate nutrition and health
information to the general public is still a matter of debate. The report
explains how to avoid the pitfalls of misrepresentation and misinterpretation.
Among the proxies for scientific evidence in the alternative therapy sector are
the ubiquitous placebo effect, a mismatch of correlation with causation and an
over-emphasis on the anecdotal. Often these are a front for misdiagnosis and the
failure of human logic. The question of why unproven therapies appear to work,
and how the mysterious placebo can be such a powerful healer, is addressed in
A regulatory approach to alternative/complementary therapies that is fast
gaining currency is the notion of a 'Third Way'. US experts consider Germany's
Kommission E monographs to be a possible model for a third category of medicines
alongside prescription and OTC products. The report examines the potential
advantages of a system that, although far from perfect, has been proposed to the
FDA as one way to tackle herbals when reviewing the contraversial DSHEA (Dietary
Supplements Health Education Act).
Germany's love affair with nature is put in its historical context. The report
describes past and present natural and holistic remedies/theories with their
roots in the German tradition, particularly homeopathy. Phrenology, Mesmerism
and Naturopathy are offered as examples of alternative practices from Europe
that have sought to undermine conventional medicine by borrowing the symbolic
capital of science. Nor is the impact of dogmatic faith and folk remedies from
the Indian and Hispano-Mexican cultures ignored.
Where their safety and efficacy are recognised by significant scientific
agreement, functional foods and herbal supplements could emerge as significant
factors in government efforts to curb national healthcare expenditure. With the
advent of genetic modification, the near future could bring crops with improved
nutritional value, peanuts or wheat without allergens, milk with reduced lactose
and foods with enhanced 'functional' components, such as tomatoes with more
lycopene. The public, however, has mixed feelings about science and technology,
associating it with improved quality of life but concerned that it will make the
world a riskier place.
Assessing the potential risks and benefits of functional foods means answering
questions about safety and efficacy: does the product actually contain the
active component and will it be effective? Is it safe at the levels likely to be
consumed? Might not the product displace traditional healthy foods from the
diet? Could people be spurred into self-treating serious medical conditions,
neglecting or delaying professional help? Communication and consultation with
the public are essential to ensure they can make informed choices from a range
of alternatives. They must be allowed access to credible information and the
chance to have their say in the development and application of science.
Can 'complementary' healthcare supply the financial magic that governments
desperately need in managing the costs of illness and ageing? The report
evaluates nutrient supplementation as a potential money-saver in today's
outcome-oriented environment. Detailed consideration is also given to the
dilemma of pharmacists in this respect, caught between the desire to turn a
profit and a professional awareness that many alternative healthcare products
may be of limited, if any, clinical value.
The report questions whether evidence-based medicine (EBM), with its emphasis on
the economic aspects of healthcare, may not be aiding the renaissance of
unconventional therapies And it surveys a range of other contributory factors,
· Genuine concern about the adverse effects of powerful drugs, allied to the
perception that conventional medicine is too harsh for chronic and
· Moves to restrain social health and welfare costs, prompting a search for
affordable means of alleviating suffering.
· Doubts over conventional medicine's ability to maintain the flow of more and
better treatment options.
· Reduced tolerance for medical paternalism.
· Increased interest in spiritualism as a replacement for disappearing
· The general public's deep-rooted preference for the 'natural' over the
· Health illiteracy, compounded by 'information age' confusion.
· The shift in emphasis from keeping people alive to keeping them fit for longer
The measure of success enjoyed by alternative theories and products has always
reflected the degree of disillusionement with the orthodox medical system of the
day. But that in itself is no proof of efficacy.
Complementary therapies, invoking nature and its universal healing powers, are
more than a current fad: they are embedded in cultural heritage and practice.
Yet mysticism should not be allowed a new lease of life in matters of health.
One scenario for the future of unconventional healthcare is to acquire
'conventional' credibility through recourse to full regulatory approvals. But
this is a less likely survival strategy for the sector than others envisaged in
the report: adaptation (evolution), democracy/diversity and the pendulum
scenario. Also examined is the current concept of integrated healthcare in a
framework of outcomes-driven therapy.
The report includes several case studies. Among them are :
· The largest. Most heartless and firmly rooted racket
· Luring the manly man full of vigour
· The stubborn resistance to new medical knowledge
We are witnessing now the reinvention of the nutrition industry around a core of
health and 'functionality'. This in turn could catalyse the strategic
realignment of other global businesses - pharmaceuticals, food and agriculture -
around biotechnology as the defining, integrative technology base. But companies
may misunderstand the nature and true potential of the emerging 'naturals'
business. Today's functional foods are just one step in the evolution of
products that will increasingly be promoted as healthier, more nutritious,
better tasting and as better insurance against disease. The long-term winners
will be those companies that learn to set their sights beyond the passing
We retain a romantic affection for the plausibility of the unproven; we warm to
the scientific underdog. Yet this can lead to adventurism with consequences that
we have not fully weighed. While it is easy to sympathise with emerging theories
of disease prevention and treatment, we must beware of having our interests
dictated by the ambitions of self-declared health priests, yellow press
journalists, drugstore cowboys and commercial mavericks. Credibility matters.
"Unconventional Healthcare in the Era of HighTech Medicine" is published by
Financial Times /Informa Pharmaceuticals in its series of Healthcare Reports.
Author : Gilbert Mertens. ISBN : 1 8606 7465 8. Price US $ 780/UK 495 Pound.
For further information contact :Dr.Fischer-Mertens@...