It embarrass me that the chiropractic profession is so inept at rebuting Edzard Ernst. He reminds me of those holocaust deniers who attended a conference in Tehran last week. They were given media coverage because their ideas are so preposterous it sells newspapers. The BBC showed us some orthodox Jews who were attending the conference like that should justify putting it on television.
The frightening thing is Ernst seems to have more credibility than the people the chiropractic profession sent out to rebut him last time he commented on chiropractic. Ernst is a trained medical doctor who gets away with describing himself as an authority on chiropractic because our experts are so in awe of the biomedical model they can not take him on.
Thousands of people visit chiropractors every day. The get a far more comprehensive examination than they will get from the vast majority of GP surgeries. They wont have to wait six months for a physio. They wont develop cardiovascular disease from the side effects from Vioxx and other medications. Despite our training, Ernst gives massage (which can be learned in a few weekends) the thumbs up for back pain, but not chiropractic.
It is only 16 years ago on February 7 1990, since the United States Court of Appeals ruled that the American Medical Association was guilty of engaging in an illegal boycott of the chiropractic profession.
Chester Wilk DC devoted 14 years of his life to prove that the American Medical Association(AMA) had deliberately conspired to "destroy" the chiropractic profession. Chester Wilks decision to fight back finally brought to an end an illegal campaign by the medical establishment to limit the publics right to a free choice in health care.
Every chiropractor needs to get “Medicine, Monopolies and Malice”( Chester Wilk) this Christamas and read it.
The book is only £10.99 from Amazon. It is estimated the US medical establishment spent $20,000,000 defending their right to destroy chiropractic.
After the case was won Chester Wilk states onpage 185 “ We had won the lawsuit, but total victory for our cause would come only when the lingering effects of the lengthy boycott were completely eliminated. Incredibly, even after it lost the suit the AMA still managed to put out negative propaganda about chiropractic, although now they were more discrete. For example only a year later the AMA came out with a publication called ‘Readers Guide to Alternative Health Methods’, with the subtitle ‘An analysis of more than 1000 reports on unproven, disproven, controversial, fraudulent, quack or otherwise questionable approaches to solving health problems’ . Even after the trial the book had a section on chiropractic" Guess what? Edzards Ernsts new book The Desktop Guide To Complementary And Alternative Medicine: An Evidence Based Approach, also has a section on chiropractic, he was promoting it in theDaily Mail last week.
For years chiropractors have wallowed in Wilk’s victory but failed to take on board his final message. Despite this victory “our profession still has the job of educating and redirecting the thinking in the minds of many people as to what really constitutes rational, safe and effective health care. We won in the legal arena now we need to win in the public arena.”
While the chiropractic profession is so divided and chiropractors are unable to respect honest approaches to health care, that are merely different from their own, we are doomed to fail in the public arena.
"Complementary medicines are useless and dangerous, says Britain’s foremost expert"
By BARBARA ROWLANDS 12th December 2006
A lot of complementary medicine is ineffective, and some positively dangerous. Meanwhile, alternative treatments that promise to cure cancer ‘are downright irresponsible, if not criminal’.
These are the views not of an old-school doctor dismissive of alternative therapies, but of Professor Edzard Ernst, Britain’s first professor of complementary medicine and, you would have assumed, its greatest champion.
There is a booming market for complementary medicine, and it’s not only the public who are turning to alternative remedies. Last week it was revealed that 60 per cent of Scottish doctors prescribe their patients homeopathic or herbal remedies.
Professor Ernst is not yet convinced by homeopathy, either. Its effectiveness has neither been proved, nor ruled out, he says.
‘Miracle’ cures and ‘anecdotal’ evidence mean nothing to him. But if a therapy passes scientific muster – which usually means it has been shown to be effective in a double-blind placebo-controlled study – he gives it the thumbs up.
Acupuncture gets the thumbs up. It’s good for pain, particularly back pain, though it has nothing to do with mysterious energy flows, as many therapists claim. ‘Acupuncture works in a physical way: it’s nothing to do with yin and yang,’ he says.
Massage, too, gets the Ernst thumbs up. It has ‘considerable potential’ for treating conditions such as constipation, back pain, anxiety, depression and stress.
Herbal medicines – though not all of them – also pass muster because their success in treating a number of specific conditions has been demonstrated.
But most therapies don’t come up to scientific scratch. In a series of articles for the trade publication Independent Nurse, reprinted on the publishers’ website healthcarerepublic.com, he gives most the thumbs down.
These include spinal manipulation, particularly chiropractic. He says there is little evidence that spinal manipulation, practised by osteopaths and chiropractors, is any more effective than other remedies, such as exercise, and indeed it carries the risk of dangerous side-effects, including strokes.
Nor is there any reliable evidence that flower remedies (which are made from extracts of plants and flowers) generate clinical effects that differ from placebo – or a dummy remedy – says Ernst. And the same goes for reflexology, which he says shouldn’t be used to diagnose illness.
Hardly surprising, then, to discover that Professor Ernst is the most vilified player in the complementary world. Mention his name in a room full of practitioners
Nand you can feel the mercury plummet. Ron Bishop, chair of the British Acupuncture Council, concedes that Ernst is unpopular with his members because he produces results with which they don’t agree.
‘He did a trial and found that acupuncture didn’t help people stop smoking. If you’re an acupuncturist working with people trying to stop smoking, every day you get good results and help people stop smoking. We think that’s a bit unfair on what our members do.’
Nor do they like the professor’s view that complementary medicine could be dangerous. He was the first to draw attention to Chinese herbs mixed with dangerous substances, the potential danger of ‘high velocity’ thrusting in spinal manipulation and ill-placed acupuncture needles.
‘A lot of interest groups were very puzzled because, surely, complementary medicine was, by and large, very safe, and mainstream medicine was where you had side-effects,’ says Ernst, who is professor of complementary medicine at the Peninsula Medical School at the universities of Exeter and Plymouth.
‘But when we did our research we found a lot of surprises – and since we started our work 13 years ago, various things have been banned from the market because they are so unsafe.’
Practitioners argue his time could be better spent campaigning for regulation in complementary medicine to drive out the charlatans.
On paper, Professor Ernst, now 58, looked the perfect candidate for the first professorial post in complementary medicine.
He previously held the chair of physical and rehabilitation medicine at the Medical Faculty of Vienna – a high-status position with 120 people under him and a salary to match – and as well as his medical qualifications, he is a trained homeopath, acupuncturist, massage therapist and spinal manipulator.
But in 1993 Ernst turned his back on status and cash to take up the Exeter post. It has, he says, taken him over ‘body and soul’.
Since then, his department has published well over 1,000 research papers and tested a hugely diverse number of therapies, making it the most productive research unit in the world in this field.
Professor Ernst and his colleagues have produced the weighty Desktop Guide To Complementary And Alternative Medicine: An Evidence Based Approach – the second edition was published in June.
‘Putting science into complementary medicine is like mixing fire and water,’ he acknowledges.
‘But it is the only way ahead. Complementary medicine has always come and gone in waves, so historically, you need science to establish an evidence base, because if you have that, it won’t go away.
‘If you don’t have that base, it may flourish under Prince Charles, but it will be short-lived. So in a way, I think I am the biggest champion of complementary medicine.’
Others might argue that the Prince of Wales deserves that mantle. But, says Prof Ernst, Prince Charles is ‘amazingly resistant to the scientific approach – and if he keeps rejecting the scientific testing of complementary medicine, then the therapies he has spent much of his life championing could disappear under his reign’.
Practitioners accuse Professor Ernst of trying to shoehorn therapies which are individually tailored to the patient into the straitjacket of a double-blind randomised placebo-controlled trial – the gold standard for conventional medicine.
In such a trial, a drug and a placebo pill are distributed at random to selected patients. Neither patient nor scientist knows who gets what. The code is broken only at the end and the results analysed.
Practitioners question how a treatment such as homeopathy or acupuncture, which treats the ‘whole’ person not just the symptom, can be subjected to such a study.
Ernst concedes that the ‘bog-standard’ randomised clinical trial is sometimes not completely suited to a number of treatments, but says he and his team work hard to find new ways of testing different therapies.
‘There are ways of doing clinical trials,’ he says, ‘where you can have the full spectrum of individu-alisation, holism and so on. You need to think a bit more – it’s a challenge.