Reality-Based Medicine:0 Naturopathy: 1

The Ontario Government has reversed course and embraced bad medicine: It’s going to give naturopaths prescribing privileges.

I’ve been blogging about Bill 179 and naturopathy for some time now. When the Health Professions Regulatory Advisory Council (HPRAC) recommended the Ontario government legislate a significant expansion of practice for naturopaths, health professionals dedicated to science-based health care were understandably concerned, and many contacted the Ontario Ministry of Health and Long Term Care during the consultation period. And in what appeared to be a victory for reality-based medicine, Bill 179 expressly omitted any expansion of scope for naturopathy.

It was clear the naturopaths were not going to let this pass without challenge, with British Columbia recently giving naturopaths prescribing rights. In June, I blogged that naturopaths had launched a write-in campaign to government that distorted the basis of naturopathy, omitting mention of prescientific practices like homeopathy and acupuncture.

Should We Maintain an Open Mind about Homeopathy?

No.

It is considered unethical for modern medical practitioners to sink to this kind of deception that denies the patient his or her autonomy. Secondly, by opening the door to irrational medicine alongside evidence-based medicine, we are poisoning the minds of the public. Finally, if we don’t put a brake on the increasing self-confidence of the homeopathic establishment, they will cease to limit their attention to self-limiting or nonspecific maladies.

More, from Michael Baum and Edzard Ernst, writing in this month’s American Journal of Medicine, here.

 

The Physics of Homeopathy – Finally Explained!

This has to be seen to be believed. It’s the physics of homeopathy – as explained by a an optometrist who dabbles in homeopathy.  Watch it – but I take no responsibility for the brain cells that will rupture upon viewing.

We discovered a few days ago that even the light reflecting off Saturn can made into a remedy.  When groups lilke naturopaths claim that homeopathy is science, what does this say about their ability to provide reality-based health care? And why do  pharmacists continue to enable this antiquated practice by selling homeopathic products in pharmacies?

Go read the Science-Based Medicine post for a dissection of the “science” in this presentation.

Autism Quackfest Hits the Media

It was bound to happen. And I’m glad to have done my part. I’ve been blogging since August about the questionable judgment of the SickKids Foundation for their support of rank pseudoscience at the upcoming AutismOne Conference, Changing the Course of Autism.

It’s now a national story in Canada. Tom Blackmore, of the National Post, weighs in today: Controversial autism conference got funds from Sick Kids

A branch of Toronto’s renowned Hospital for Sick Children is being criticized for funding an autism conference whose organizers champion the discredited belief that childhood immunization causes the neurological disorder.

The event – to start on Saturday at the University of Toronto medical sciences building – also includes presentations that some experts are calling unproven science, promoting such alternative treatments for autism as homeopathy and hyperbaric oxygen chambers.

Organized by the American group AutismOne and Austism Canada, the meeting has received $5,000 in funding from SickKids Foundation, the hospital’s fundraising wing.

Blogs designed to expose practitioners of dubious science have railed against the event for the past two months, questioning why a respected health-care institution would offer its support to a group that considers vaccination of children a health risk.

“The name of Sick Kids is worth more to them than the money: it is a stamp of legitimacy,” Scott Gavura, a Toronto pharmacist who runs the Skeptic North blog, said in an interview on Monday.

“Sick Kids hospital has some of the world’s most renowned autism researchers. I suspect most of them would not be thrilled by the fact that SickKids Foundation is supporting this conference.”

The full story is here.

As I blogged about this last week over at the Skeptic North blog, with content this dubious,  you’d expect science-based organizations to stay far, far away. Sadly, the SickKids Foundation, with their “neutral stance” towards pseudoscience, is a confirmed sponsor. And now they’re facing well-deserved scrutiny.

The Post also has a nice piece on the role that bloggers played: Blogs raise the alarm on autism conference. Skeptic North, Respectful Insolence, and Sandwalk are all mentioned. Science-Based Pharmacy isn’t mentioned…but that’s OK. I’m happy to see some well-deserved publicity for Skeptic North and its team of writers.  (The Post says I run the Skeptic North blog – that’s incorrect. To be clear, Steve Thoms is Skeptic North’s editor).

I’m pleased to see the media questioning the propagation and sponsorship of pseudoscience. As I blogged about earlier this week, the antivaccination rhetoric is peaking, with the arrival of the H1N1 vaccine. Why the SickKids Foundation would support anti-vaccination organizations, that will only lead to more sick kids, continues to escape me.

Homeopathy Harnesses the Power of Saturn

As I’ve blogged before, homeopathy is a pre-scientific practice without any basis in reality. Nevertheless it continues to be embraced by non-scientific practitioners like naturopaths and homeopaths.

One of the underlying principles of homeopathy is the “proving”. The proving is the process by which a homeopathic remedy’s “profile” is evaluated.  The proving determines which remedy will be appropriate for which symptoms.

From Wikipedia:

At first Hahnemann used material doses for provings, but he later advocated proving with remedies at a 30C dilution, and most modern provings are carried out using ultradilute remedies in which it is highly unlikely that any of the original molecules remain. During the proving process, Hahnemann administered remedies to healthy volunteers, and the resulting symptoms were compiled by observers into a “Drug Picture”. The volunteers were observed for months at a time and made to keep extensive journals detailing all of their symptoms at specific times throughout the day. They were forbidden from consuming coffee, tea, spices, or wine for the duration of the experiment; playing chess was also prohibited because Hahnemann considered it to be “too exciting”, though they were allowed to drink beer and encouraged to exercise in moderation. After the experiments were over, Hahnemann made the volunteers take an oath swearing that what they reported in their journals was the truth, at which time he would interrogate them extensively concerning their symptoms.

Proving is part of the homeopath’s curriculum. For example, the Canadian College of Naturopathic Medicine offers lectures on proving methodology.

So what substances can be proved? Pretty much anything can be a homeopathic remedy. Raccoon fur is one example.  Even the light reflecting off Saturn can be “proven”. As described in this month’s International Homeopathic Internet Journal:

The remedy was made by exposing powdered milk sugar to a powerful telescope in Boston, Massachusetts while it was focused on the planet Saturn during April 2009. The remedy was triturated to a 3C on July 25, 2009 by a group of 7 people in Buffalo, New York. Six of the 7 ground and scraped the milk sugar while one person took notes.

Please read the rest of “proving”. Go and read it now. I’ll wait.

This is the basis of homeopathy, and how remedies are selected. Any wonder why it was discarded by evidence-based health professionals? In the United Kingdom, the House of Commons Science and Technology Committee recently admitted that the rules drawn up to regulate homeopathic medication are based on “no scientific evidence”.  In light of the facts about homeopathy, many pharmacists (myself included) are puzzled why the Leslie Dan Faculty of Pharmacy at the University of Toronto is delivering a continuing education conference with a homeopathy manufacturer as a sponsor, and homeopathy on the agenda.  Homeopathy has no role in pharmacy practice: Its presence in  pharmacies is an embarrassment to the profession.

H1N1 Antivax Paranoia

All my illusions that Canada is free of anti-vaccination zealots (antivaxxers) disappeared this week as the H1N1 vaccine was approved in Canada. After starting an H1N1 information page on Facebook (please join) it’s been an ongoing challenge to respond to the antivaccine comments – comments that are incorrect and often deliberately misleading. This is quite time consuming, so my schedule for posts on this blog has been delayed.

I’ve also been blogging at the new SkepticNorth blog on topics that aren’t purely pharmacy related. This week I blogged about the role of naturopaths in the Canadian healthcare system, as well as quackery on campus (U of T, I’m looking at you). So please check out those posts. And please follow the SkepticNorth blog – I’m one of a number of bloggers covering Canadian topics. We appreciate your support.

Back to H1N1, here’s a few credible resources that I highly recommend you consult. If you are a science-based health professional, I’m asking you to roll up your sleeves…get the vaccine, and then help correct the misinformation that’s spreading on the web.

Blogs to follow:

Science-Based Medicine – superb posts, virtually every anti-vax argument is debunked here

Effect Measure - blog written by public health scientists, covers the reality of the pandemic in detail

Other important resources:

Public Health Agency of Canada – for Canadian info, including weekly H1N1 updates

Centers for Disease Control – the American source of H1N1 information

Canadian Immunization Guidelines – outlines in detail the rationale for vaccines, the safety monitoring process, and more.

Consumer Reports Swine Flu Information page – details the variety of swine flu scams out there

Public Health Agency of Canada’s Guidance on the H1N1 Vaccine – for health professionals, details the proper use of the Canadian vaccine.

War on Science – A fantastic series that appeared in Wired magazine that details how anti-science, anti-vaccine sentiment is hurting us all.

I’m asking all of you to speak up for science and reason. Address antivaccination comments and emails with redirection to reputable sources of information. Don’t forward paranoid emails about swine flu or the vaccine. Don’t recommend ineffective or unproven therapies. Call out fearmongering when you see it. This is going to be a long flu season – let’s fight it with science, not paranoia.

Does Bio-Fen Plus “Stop Hair Loss”?

A recurring topic at Science-Based Pharmacy has been the sale of “natural health” products in the pharmacy that lack evidence of efficacy and/or safety. Over the next few weeks I’d like to examine this state of affairs, and put the question to you, the readers of this blog: What level of regulation is appropriate for “natural health products” and other products sold in the pharmacy?  And what standard of safety and efficacy do you expect to see in products sold in the pharmacy? Do you hold pharmacies to a different standard, compared to locations like health food stores?

To kick off the discussion, we’ll consider a few “natural” products with specific health claims that are openly advertised on the Canadian market, and sold in Canadian pharmacies. We’ll look at the claims, the evidence, and the context – that is, how the current regulatory framework impacts on their availability, and the claims they make. The Canadian Health Food Association warns that Health Canada’s standards may keep many “natural” products off Canadian shelves:  Is this a good, or a bad thing for Canadians?  (If you’re not Canadian, this discussion is relevant to any jurisdiction with some form of public health protection.)

What’s Happening to Pharmacy Continuing Education at the University of Toronto?

A few weeks ago I blogged about an upcoming “Natural Health Products” symposium that’s being held at the University of Toronto’s Leslie Dan Faculty of Pharmacy.  The agenda raises a number of skeptical red flags, including topics like the efficacy of herbals for H1N1,and natural health products for menopausal symptoms (which I’ve called the power of placebo). The last presentation is the most questionable, with topics like “adrenal fatigue” as a consequence of chronic pain (adrenal fatigue is not an accepted medical condition). The biggest giveaway that this program may not be science-based is the mention of homeopathy as a “treatment option” for chronic pain.

Hi, I’m your flight attendant. Your prescription is ready.

Sorry, the doctor is busy "flying the plane"...can I help you with your prescription?

Last week, the Ontario Medical Association (OMA) managed to insult pharmacists, nurse practitioners, and flight attendants with a petty, fear-mongering campaign about prescribing rights and patient safety.  What’s the problem? Pharmacists and nurse practitioners are about to receive prescribing privileges, as part of Bill 179. And to the OMA, this is a turf war.

“Having these roles filled by non-medical personnel is like having a member of a flight crew fly an airplane”

- Dr. David Bridgeo, Chair of the OMA’s Family and General Practice Section

Note the reference to pharmacists and nurse practitioners as “non-medical personnel”.  To the OMA, unless you’re a physician, you’re not medical personnel.

So they liken pharmacists to the flight crew. Let’s look at the OMA’s vision of health care a little more closely.

In the OMA’s world, the pilot (the physician) is at the front of the plane, flying to the destination. They’re clearly in control, and they want you to know it. The pilot is never visible, and is indifferent to, and not distracted by, the ongoing needs of the passengers (the patients, presumably). Every patient goes to the same destination the same way, and it’s the pilot’s job to get them there. And they’ll get you there – but don’t ask to see them, because they’ve locked themselves in the cockpit, behind a bulletproof door.

Introducing Skeptic North

A new Canadian blog, Skeptic North, launches today. Skeptic North is Canada’s first pan-Canadian skeptical blog, where a large pool of contributors will be writing about science, education, and critical thinking. I’ll be joining the fray, and continuing my documentation of health pseudoscience.

You might be asking – what do you mean by skeptic? Well, Skeptic magazine gives the following definition:

Skepticism is a provisional approach to claims. It is the application of reason to any and all ideas — no sacred cows allowed. In other words, skepticism is a method, not a position. Ideally, skeptics do not go into an investigation closed to the possibility that a phenomenon might be real or that a claim might be true. When we say we are “skeptical,” we mean that we must see compelling evidence before we believe.

Skeptic North bloggers have very diverse backgrounds, but we’re all committed to critical thinking and promoting a scientific viewpoint among Canadians. I’ll be blogging over at Skeptic North every few weeks. Content there will generally be out-of-scope of Science-Based Pharmacy. So while I plan to write about health topics, I’ll usually cover topics unrelated to pharmacy practice. Topics that apply to both audiences may show up on both blogs.

Check out my first Skeptic North post, where I look at health advice in the pages of Canada’s biggest women’s magazine, Chatelaine. And add Skeptic North to your RSS reader or bookmarks.