Around
400 high profile doctors, medical researchers and scientists recently joined
forces to form lobby group Friends of Science in Medicine (FSM) in order to
have "alternative medicine" degrees removed from Australian
universities.
Chiropractic, osteopathy, Chinese medicine,
naturopathy, iridology, kinesiology, reflexology, homeopathy and aromatherapy
are some of the courses on their blacklist.
The issue has had significant media coverage,
but one question has failed to be properly answered.
Why is a group of prestigious doctors and
scientists who have the backing of the most profitable industry in the world
according to Fortune 500 – the pharmaceutical industry – targeting a few
poorly-funded natural medicine courses?
The official line of the group is that these
"alternative medicines" are making Australia look bad and
"trashing" the universities' reputation. But is that really the
reason? With all the countries and all the universities in the world that
provide alternative medicines?
A similar move was made in the UK recently –
the British will no longer be able to study certain natural medicine degrees –
this does not include chiropractic or osteopathy – at publicly-funded
universities from this year. Yet natural medicine has been utilised across Asia
and Europe for thousands of years.
The United States and Canada are pioneers of
chiropractic as we see it today, providing university courses long before they
were ever offered in Australia. Also, nearly 85 per cent of US medical schools
offer elective courses in alternative medicines.
According to the World Health Organisation
(WHO), 80 per cent of the world's population relies on natural therapies. The figures
in Australia are much the same.
So
why Australia? What is FSM so worried about?
The group seems to be particularly concerned
about an increase in chiropractic courses after it was announced recently that
Central Queensland University would be offering a new chiropractic science
degree. The move could also be partly to do with the ruling in 2010 that all
chiropractors in Australia may use the title 'Doctor'.
FSM has accused what it labels as Australia's
"lesser" universities that offer alternative medicine courses of
"putting the public at risk".
However, this is a difficult notion to fathom
when you compare the tiny number of injuries inflicted on natural medicine
patients compared to the hundreds of thousands of deaths recorded each year due
to medical errors.
WHO estimates that one in 10 hospital
admissions leads to an adverse event while one in 300 admissions leads to
death. WHO puts medical errors as among the top 10 killers in the world.
According to the US's Institute of Medicine, preventable medical errors kill
98,000 people in the US alone each year and injure countless more.
One of the group's biggest complaints,
according to FSM co-founder Emeritus Professor John Dwyer from the University
of NSW, is that natural medicine "doesn't strive to be tested". He
says that modern medicine is "totally devoted" to taking an
"evidence-based approach" and "do good science and do good
research into the things we do to people".
The argument that modern medicine is
evidence-based as opposed to other types of medicine is an argument that is
often used by medical lobbyists, and tends to be generally accepted by the
public. However, according to a report by a panel of experts assembled by the
prestigious Institute of Medicine, "well below half" of medical care
in the US is based on or supported by adequate evidence.
According to the report, between 1993 and 2004
there was a more than 80 per cent increase in the number of medications
prescribed to Americans. The panel believes this boom in pharmaceuticals is
outpacing the rate at which information on their effectiveness can be
generated. "If trends continue, the ability to deliver appropriate care
will be strained and may be overwhelmed," the report concluded.
What FSM fails to recognise is that natural
medicine courses taught at universities incorporate a much higher level of
evidence-based studies, such as health science and human physiology, than if
they were to be taught outside of a university.
The Australian universities that have been
criticised have all defended their courses, saying they are very much evidence
and science-based.
In naturopathy, for example, on top of herbal
medicine and nutrition, students also learn the same things that a
physiotherapist, medical doctor or nurse learn. As well as chiropractic
studies, chiropractors study biology, physiology, neuroscience, anatomy and
pathology, for example. These are all scientific studies.
Acting head of RMIT's Health Sciences School
Dr Ray Myers has defended its programs as "evidence-based education and
practice", saying clinical research of natural medicine treatments are
funded by the National Health and Medical Research Council (NHMRC).
If FSM really was so worried about public
safety they would not be trying to exclude natural medicine from universities
where they are taught with much more of a medical focus. Graduates of these
courses are much more likely to refer patients to medical doctors when
necessary.
As Nick Klomp, dean of the science faculty at
Charles Sturt University, points out, thousands of practitioners already
provide alternative medicine and they are very much in demand. "I could
ignore them or I could train them better," he said. "We actually
create graduates who are much better health care providers. It's all about
evidence based, science based."
The other question to ask is just how
representative the group is of Australian doctors. Dr Wardle, a NHMRC Research
Fellow at the University of Queensland's School of Population Health conducted
a survey of every rural GP in NSW and found a third did not refer to
alternative medicine providers, a third were incredibly open to it, and a third
would refer patients to practitioners that they knew achieved results.
The Australian Medical Association president
has withdrawn his support from the lobby group. A number of researchers and doctors
have also pulled out of FSM reportedly saying they were not aware of the full
picture.
Many Australian medical doctors recognise
their limits and refer to natural providers when necessary. However, others
continue to believe that modern medicine – which is only 100 years old – is the
only way of curing pain.
Natural therapies have been used for more than
10,000 years, and so they deserve a place in society, in Australian
universities, and even in modern medicine. According to Australian trauma and
general surgeon Dr Valerie Malka, former director of trauma services at
Westmead Hospital, while modern medicine is revolutionary when it comes to
surgery, particularly in emergencies, for pretty much everything else,
traditional, natural or alternative medicine is much more effective.
She says in particular, modern medicine is
completely unable to treat or cure chronic illness. Rather than focusing on
symptom control, natural medicines work on the body's ability to heal the cause
of the illness while modern medicine suppresses the body's healing mechanism
with drugs that attack the body's natural defence mechanisms, throwing the
immune system out of whack.
Dr Malka believes the attack on natural
medicine has more to do with the threat to modern medicine's power base as well
as its "unhealthy relationship" with the "trillion-dollar
pharmaceutical industry".
This is not the first time natural medicines
have been attacked by the medical industry.
Alternative healthcare professionals such as
chiropractors, naturopaths, and midwives have been targeted by the American Medical
Association (AMA) for nearly a century, in spite of a federal court injunction
against the AMA in 1987 for illegally trying to create a monopoly in the
healthcare market.
Up until 1983, the AMA had held that it was
unethical for MDs to associate with "unscientific practitioners" and
they labelled chiropractic "an unscientific cult". They also had a
committee on "quackery" which challenged what it considered to be
unscientific forms of healing. Five chiropractors including Chester Wilk sued
the AMA, claiming that the committee was established specifically to undermine
chiropractic.
Wilk won the case, with Judge Susan
Getzendanner ruling that the AMA had engaged in an unlawful conspiracy in
restraint of trade "to contain and eliminate the chiropractic profession,"
also saying that the "AMA had entered into a long history of illegal
behaviour".
If you look at the history of attacks on
natural healthcare providers over the last 100 years, it is difficult not to
associate this attack by FSM as the latest attempt to influence the public into
believing that natural medicine is, as it says, "quackery" by
spreading propaganda that most of the time is simply not true.
"It's just extraordinary that such
undisciplined nonsense is being taught in universities around Australia,"
Mr Dwyer has said.
Why does this group feel that it has the right
to talk this way about natural medicines that are ages old and used by 80 per
cent of people across the world?
If FSM really was concerned about patient care
and safety in Australia, then perhaps it would investigate medical practices
which, unfortunately, seriously injure and kill thousands of people every year,
rather than target natural medicine.
Sarah Schwager
The Drum Opinion
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