Unproven Therapies; why is our regulation so arbitrary?
What do we do when the ‘alternative’ to medicine doesn’t work?
I remember going to a homeopath vividly. I was about 10. I’d had a cough for a few weeks, and after waiting in the stifling enclosure of the NHS GP’s waiting room (this was in the UK) for what seemed like endless decades, we were called in to see the harried, brusque doctor. She gave me a quick once-over, asked my mother a few questions, and pushed us out the door with a prescription for cough medicine and advice to come back in a week if I wasn’t better.
Needless to say, my worried mother was less than impressed.
So we went to see a homeopath.
After the briefest of waits (we were early), we walked into the room and he sat us down. I remember being asked a dizzying array of questions, about my life, my preferences, what I liked to do in the day. More than anything, he was talking directly to me, something few doctors did at that point in my life. At the end of the consult, he looked me in the eye and said with absolute confidence:
“I will cure you”
To cut a long story short, the homeopathic medication didn’t work. Despite taking it twice a day for weeks (I loved the pills; they tasted just like sugar!), my cough persisted until eventually I got better on my own.
The real question is; why could he make that claim in the first place?
It’s been more than 200 years since Samuel Hahnemann decided that the laws of physics didn’t apply to his particular brand of medicine (spoiler; they did), and since then there has been little change in the argument against homeopathy. The two central premises of homeopathy, that like cures like and that dilution increases the potency of medication, are theoretically absurd.
And more than this, massive independent studies have been conducted worldwide, and have found literally not a single application in which homeopathy works. The absolute best quality evidence demonstrates that homeopathic medicines are nothing more than sugar pills, which comes as no surprise because most homeopathic medicine literally are nothing more than sugar pills.
So how is homeopathy regulated? In Australia, we actually have some reasonably robust regulation about what you can say to promote a complementary medicine. Essentially, you aren’t allowed to make claims that go against best evidence, and if the Theraputic Goods Administration (TGA) is notified that you are, they can force you to stop doing so and take further action if you refuse.
Notice the big problem there? If the TGA doesn’t hear about your dodgy claims, they won’t do anything to stop you. There are literally thousands of complementary medicines, and most of the bogus claims they make simply fly under the radar of an overworked public service organisation.
My homeopath lied to me. He had no place telling me that he could cure my cough, against all evidence to the contrary. He may have had the best intentions (I don’t think he was intentionally misleading) but he should’ve known better.
How many people are being lied to each day who never even realized the deceit?
Everyone has a spine. Sometimes, they have problems.
Chiropractic can’t do much for these problems. At best, the evidence shows that chiropractic is no better than standard treatments. And given the significant risks associated with chiro (including death), it’s hard to justify recommending it.
So why do we let people do just that?
And it’s not just basic spinal treatments that chiropractors recommend. Googling “chiropractor Australia” will show you a list of websites that offer chiropractic as a treatment for conditions from bedwetting to asthma, because why stop at one poorly-evidenced treatment when you can make so much more money selling loads?
In Australia, chiropractic comes under the purview of the Australian Health Practitioner Regulation Agency (AHPRA), which delegates their responsibility to the Chiropractic Board of Australia (CBA). And guess who makes up the CBA?
If you guessed chiropractors, you win a free prize*.
So whilst chiropractic is nominally regulated by an independent agency, most of this is filtered through a board composed of chiropractors. And whilst the board has come out against advertising inappropriate services, there is almost no oversight of what chiropractors do in their practices. A chiropractor engaging in unconscionable manipulation of a newborn’s spine, with no evidence that this could help in any way, was slammed earlier this year for his unethical conduct. The CBA’s response?
A temporary ban on treating children**.
Along with this wholly inadequate response, the CBA has a history of providing insufficient oversight to chiropractors; the advertising recommendations I mentioned above? They were only released a few years ago and still barely carry any force.
And whilst it’s fair to say that chiropractors are not the only practitioners to have this problem (the dentistry board has faced tons of criticism for supporting dentists despite their obvious malpractice), they are different from most mainstream medicine in that there is little evidence for anything that they regulate.
Regulation and Me
The bottom line is that the regulation is only as useful as we want it to be. Chiropractic and homeopathy aren’t poorly regulated because there is something intrinsically wrong with our system.
They’re just popular.
We’ve left it to overworked public servants to chase after treatments that are ineffective, and the end result is that you can say (and do) a lot of things that are simply not true.
You can tell a 10-year-old that you will cure his cough without fear of reprisal, because chances are no one will notice.
You could sell spinal manipulation to parents, despite the total lack of evidence that you are doing anything to help their infants.
It happens all the time, and the only reason we heard about it this year was because the chiropractor in question filmed it and put it online.
So next time you see something that doesn’t seem right, check it out. There are several resources you can have a look at (including sending me a message). If it looks like the service is doing something shifty, report it. I’ve linked throughout this article to the agencies responsible.
If we don’t hold practitioners to a higher standard, no one will.
- *Free prizes include; headaches, migraines, the sudden and uncontrollable urge to jump off a building.
- **Note; there is no evidence that chiropractic has any benefit for kids whatsoever, so a temporary ban is a bit pointless either way.