Toronto Star “Don’t muzzle our doctors”

Tuesday, November 29, 2011

The Toronto Star recently published an article which reflected negatively on alternatives to conventional medicine. As homeopathy was included in the article I wrote to the Editor. Below is the Star’s article and my published response.

Don’t muzzle our doctors

published on November 20th, 2011

Patients walk into allergist Dr. David Fischer’s office almost every day expressing interest in trying “natural” therapies. These range from harmless diet changes to the truly bizarre, like applied kinesiology, says the Barrie physician. It’s an experience shared by other doctors. “We’re on the front line of dealing with ideas for which there is often a dearth of scientific evidence.”

Alternative medicine is booming even without much proof it works. A record 20,000 people are expected at Toronto’s Whole Life Expo at the downtown convention centre next weekend. Three-quarters of Canadians regularly use some form of natural health product, opening their wallets to spend at least $4.3 billion yearly. And the herbs and homeopathic tinctures they buy are just one facet of unconventional medicine — a thriving sector encompassing everything from acupuncture to zone therapy (supposedly stimulating the body’s organs through hand or foot massage).

Ontario’s College of Physicians and Surgeons is bending to the trend with a new policy inhibiting doctors’ criticism of unconventional therapies. In doing so it risks encouraging even broader use of dubious and potentially harmful treatments.

Make no mistake — blind trust in alternative cures can be dangerous. An unknown number of Canadians are opting out of science-based medicine to treat even deadly conditions, like cancer, with unproven “natural” approaches. Monika Hevessy, for example, convinced her 67-year-old father to skip chemotherapy after surgery last year. Instead, he responded to bowel cancer by consuming fruit juice, massive doses of vitamin C and an alternative remedy called MMS. Health Canada last year warned against using it due to toxicity.

“I don’t believe in medication,” Hevessy says, adding she trusts only “natural ways” — not Health Canada. “They want people to be on medication.” Thankfully her father, Sandor Csorgo, remains healthy and cancer-free. But others who have gone this route aren’t so lucky.

Some pay a price for postponing, rather than outright rejecting, conventional care. Apple Inc. CEO Steve Jobs died in October reportedly regretting his decision to delay cancer surgery for nine months in favour of herbal remedies and spiritual healing. That wasted precious time while pancreatic cancer spread.

The field of allergy medicine, Fischer’s specialty, is especially prone to alternative approaches. Natural practitioners using applied kinesiology, for example, check for allergy by placing a food item in a patient’s mouth or in their hand. Then they pull down on the person’s free arm to assess its strength. If this “muscle testing” shows notable weakness, the patient is deemed to be allergic.

There is no good evidence that this method works, and no sound scientific reason why it should. Yet patients come in with an interest in that, says Fischer. “I’d like to be able to tell them it’s quackery.”

He may not be in a position to say so much longer under a new policy proposed by the college of physicians and surgeons. It states that doctors are obliged to give a patient their best professional opinion on an alternative treatment goal or decision, but physicians “must refrain from expressing personal, non-clinical judgments.”

Would calling applied kinesiology “quackery” be considered a personal, non-clinical judgment? The policy isn’t clear and Fischer is uncertain. There’s a grey area here. For a physician intent on avoiding complaints to the college from headstrong complementary medicine enthusiasts, the safest thing would be to just shut up.

“They make it feel like you can’t speak about these areas without getting yourself in trouble,” says Dr. Stuart Carr, president of the Canadian Society of Allergy and Clinical Immunology.

Carr is concerned by another section of the policy that would muzzle doctors. It says that physicians unfamiliar with an alternative therapy “must indicate as much to the patient, and explain that they are consequently unable to comment on the matter.”

But there are literally thousands of these therapies on the market, from crystal healing to exotic Asian herbs. More surface each year. No one is familiar with them all.As it is, physicians scramble to keep up-to-date on scientific developments even in their own branch of medicine, says Carr, a specialist in children’s allergy and immunology.

“The rate of publications is through the roof,” he says. “So now I also have to make an effort to become conversant in all of these different unscientific approaches, or I’m not to discuss it? That’s really unfair and unrealistic.”

The college’s governing council is to consider its ill-judged guidelines at the end of this month. To give college officials some credit, the policy’s first draft was even worse, intentionally written in “value-neutral” language that set up a false equivalence between scientific medicine and alternative cures.

The college stepped back from that excess — but it needs to step further. Rather than endorsing a still-flawed policy, the council should stand up for doctors’ freedom of speech and end the ambiguity surrounding what constitutes non-clinical judgment.

There’s no denying alternative medicine is immensely popular. Patients are more independent than ever before, often researching their illness and trusting their own solutions. And a host of unconventional “natural” healers has risen capitalizing on that trust — offering unproven therapies with little validity and which, in some cases, are a menace.

The college shouldn’t seek to accommodate that trend or retreat to a neutral corner. Rather it should leave doctors free to punch hard against those peddling dubious cures and to challenge people’s comforting, but irrational, beliefs. Science-based medicine serves patients best. If doctors can’t vigorously defend it, who will?

http://www.thestar.com/opinion/editorials/article/1089492–don-t-muzzle-our-doctors#article

My Letter to the Editor

More Voices on Alternatives to Medicine

published November 28th 2011

An article such as this assumes that the only scientific medical system is the conventional one in Canada practiced by MD’s. However, conventional medicine, which advocates the use of prescription pharmaceuticals, is not the only evidence-based medical science, only the newest one on the block.

Because homeopathy is mentioned in the article in a negative light I want to share some information with your readers.

According to the World Health Organization, homeopathy is the second most widely used medical system in the world. It is not considered alternative in many parts of the world, such as India, Cuba, France, Germany and England. Homeopathy is covered under the national health care system in England and in some European countries.

Homeopathic treatment has existed throughout time: its principles—like cures like, and use the smallest dose possible—were recorded by Hippocrates, Socrates and Plato. They are mentioned in the Jewish Bible, and were practiced throughout history by such great practitioners such as Paracelsus.

In the late 1700’s, Samuel Hahnemann, a doctor and chemist, devised a systematic methodology to produce medicine which was not toxic to the patient. He incorporated the historical philosophy of homeopathy into a text which is still studied and followed today. It was in the same year that Hahnemann published his work that Edward Jenner published his findings on the use of vaccination in smallpox. Vaccination is the use of the same substance which causes the disease to prevent the disease, and that principle is commonly used in homeopathic treatment. Conventional medicine today uses the principle of “like cures like” in treatments such as amphetamines like Ritalin for ADD, or minute doses of heroin in withdrawal treatment for heroin addicts.

Homeopathy is nano-medicine. The same remedies have been used for over 200 years. The reason homeopathy is so popular and has survived alongside conventional medicine is because it works and people want it. Homeopathy is safe for everyone, including pregnant women, babies, and the elderly. Homeopathic products are regulated by Health Canada. Homeopathy is currently being regulated in Ontario and the establishment of a College is underway.

Marilyn Freedman, BA DHMHS DipGem, Homeopath, Toronto

http://www.thestar.com/opinion/letters/article/1093831–more-voices-on-alternatives-to-medicine