Consumer Health Digest #10-33
Your Weekly Update of News and Reviews
August 19, 2010
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
UK homeopathy controversy rages on. In February, The House of Commons Science and Technology Committee issued a 275-page report that examines the British Government's policies on providing homeopathy through the National Health Service (NHS) and the licensing of homeopathic products by the Medicines and Healthcare products Regulatory Agency (MHRA). [House of Commons Science and Technology Committee. Evidence Check 2: Homeopathy. Feb 8, 2010 ] The report debunks many of homeopathy's common claims and places homeopathic research in proper perspective. It concludes:
- The Government's position on homeopathy is confused. On the one hand, it accepts that homeopathy is a placebo treatment. This is an evidence-based view. On the other hand, it funds homeopathy on the NHS without taking a view on the ethics of providing placebo treatments. We argue that this undermines the relationship between NHS doctors and their patients, reduces real patient choice and puts patients' health at risk. The Government should stop allowing the funding of homeopathy on the NHS.
- Placebos should not be routinely prescribed on the NHS. The funding of homeopathic hospitals—hospitals that specialize in the administration of placebos—should not continue, and NHS doctors should not refer patients to homeopaths.
- It is unacceptable for the MHRA to license placebo products—in this case sugar pills—conferring upon them some of the status of medicines. Even if medical claims on labels are prohibited, the MHRA's licensing itself lends direct credibility to a product. Licensing paves the way for retail in pharmacies and consequently the patient's view of the credibility of homeopathy may be further enhanced. We conclude that it is time to break this chain . . . the MHRA should withdraw its discrete licensing schemes for homeopathic products.
- If the MHRA is to continue to regulate the labelling of homeopathic products . . . we recommend that the tests are redesigned to ensure and demonstrate through user testing that participants clearly understand that the products contain no active ingredients and are unsupported by evidence of efficacy, and the labelling should not mention symptoms, unless the same standard of evidence of efficacy used to assess conventional medicines has been met.
In July, the UK Department of Health issued a response which acknowledged that "the evidence of efficacy and the scientific basis of homeopathy is highly questionable" but the products should remain available "to provide patient choice." [Secretary of State For Health. Government Response to the Science and Technology Committee report 'Evidence Check 2: Homeopathy'. July 2010]
Professor Michael Baum, one of the leaders of the scientific community's effort to de-legitimize homeopathy in the UK, expressed astonishment about this decision. in a comment in The Lancet, he stated:
Using this kind of logic, why not offer astrology on the NHS to help women decide when to induce labour? It beggars belief that a modern NHS that prides itself on evidence-based medicine should fly in the face of the Science and Technology Committee, which concluded that homeopathy is nothing other than an elaborate placebo and involves deceiving the patient every time it is prescribed. [Baum M. Homeopathy waives the rules. The Lancet 376:577, 2010]
Evidence Check 2: Homeopathy is one of the most insightful reports on homeopathy ever published. The full text is available online.
Chiropractic attrition rate examined. A newly published study has found that the 10-year attrition rate for California chiropractors rose from 10% for graduates licensed in 1970 to a peak of 27.8% in 1991 and remained between 20% and 25% from 1992 through 1998. The study was done by examining data from the California Department of Consumer affairs to see how many chiropractors held active licenses ten years after their initial licensure. The reasons for license loss include a move to another license jurisdiction, personal illness or disability, employment in other professions/jobs, disciplinary action against the license for improper behavior, retirement and death. The authors believe that the attrition rate is related to a drop in the number of potential patients per chiropractor causing a drop in income. [Foreman SM. Stahl MJ. The attrition rate of licensed chiropractors in California: an exploratory ecological investigation of time-trend data. Chiropractic & Osteopathy 18:24, 2010] The American Chiropractic Association has estimated that the average (mean) net income for all chiropractors in 2000 was $81,500, which was $5,000 less than the comparable figure for 1996 and $20,000 less than the comparable figure for 1989. U.S. government census figures indicate that between 1992 and 2007, reported income from chiropractic clinics nationwide rose from $5.9 million to $10.0 billion. Since the number of chiropractors has increased and these numbers are not adjusted for inflation, they show that the individual chiropractic income in terms of real dollars has dropped sharply. These findings add to the evidence that many students who enter the field of chiropractic will be unable to earn a living.
This page was posted on August 22, 2010.