One in five Britons use some form of complementary or alternative medicine (CAM) each year and the figure is rising.
Broadcaster Anna Ford investigates why people are turning to CAM in a new six part BBC Radio Four series, The Other Medicine. Is there any evidence that CAM works, is it harmful and should the CAM industry, worth £1.6 billion a year, be made more available on the NHS?
Anna Ford starts her exploration in Hebden Bridge in West Yorkshire, where a centre of alternative and complementary therapies has been operating since the 1970s, when hippies set up communes on the moors. Reflexology, homeopathy, acupuncture, yoga centres, naturopathy, Alexander Technique, herbal medicine and Reiki are readily available.
Throughout the series Anna meets patients, therapists and doctors to ask them what’s driving this patient-led revolution and we hear from scientists and therapists who have tried to establish mechanisms for these therapies in formal experiments.
The Other Medicine is a co-production between the BBC and the Open University.
Programme 1. Why is it so popular?
So what makes CAM therapies popular? A former GP-turned acupuncturist, talks about patients seeking a ‘holistic approach’ – a therapy that treats the whole person and not just the presenting complaint. It’s a common selling point of many treatments, particularly homeopathy, which uses a long and detailed consultation process to formulate a specific therapy that is “unique” to each patient. Diane Seymour, a Hebden homeopath who specialises in treating children, insists that questions such as “what sort of weather do you prefer?” are relevant to treating seemingly unrelated diseases in which “everything is connected”.
Programme 2. How do we find out if they work?
There’s no shortage of people who’ll tell you that CAM works for them. But anecdote is not the same as the sort of evidence that comes from testing new pharmaceuticals in rigorous clinical trials. But are scientific trials applicable to practices such as acupuncture or spiritual healing? And what does evidence mean anyway? In this programme, we’ll examine the options open to the scientific evaluation of CAM, find out what a good trial actually involves and ask if patients actually care about the evidence behind their chosen therapy. We’ll look at new methods of studying success in medicine (like asking patients if they feel better!) and delve in to the highly charged world of research within the CAM scene.
Programme 3. If it works, does it matter how it works?
Are therapies like homeopathy or aromatherapy nothing more than elaborate placebos? If they work by some other mechanisms, what are they? And if they do work, does it really matter how they work? In the scientific world, mechanism does matter. We hear from scientists and therapists who have tried to establish mechanisms for these therapies in formal experiments, and from practitioners who explain the importance – or otherwise – of understanding the “mechanisms”.
Programme 4. First, do no harm
Hippocrates’ golden rule for healers was to “first, do no harm”. “Natural” doesn’t always mean safe – after all, opium, belladonna and digitalis are all “natural” poisons. We often hear about the dangers of CAM therapies – but are they really so dangerous? What’s being done to protect patients? How dangerous are they in comparison to orthodox medicine and are the risks being seen in terms of the benefits? Are Herbals safe and what rules govern their preparation and sale? What sorts of advice is being given to patients with cancer searching for miracle cures? We explore this complex issue in which patient safety is not always the first consideration.
Programme 5. Fit to practise
Right now, anyone can call themselves a homeopath or an acupuncturist. You can practise Reiki on patients after one weekend and become a “Master” after a few weeks of learning. GPs can practise acupuncture on patients after a short induction course. Regulation and CAM is, frankly, a joke and the people to suffer are the patients. How do you tell whether or not your therapist is fit to practise? What happens when non-medical therapists abuse their position? After decades on the fringes, Osteopathy and Chiropractic became more part of the mainstream, regulated by bodies with the power to suspend or strike people off the register. After lengthy consultation, the House of Lords published recommendations which included setting up a CAM council, to make statutory regulation of CAM a reality. First up are the acupuncturists, herbalists and controversially, traditional Chinese medical practitioners. Will this stop the infighting that has dogged these professions and finally set standards that patients can benefit from?
Programme 6. A marriage made in heaven?
In the last programme we’ll unpick the supposedly Utopian ideal painted by many of a world where all medicine is free at point of delivery – whether it’s acupuncture or keyhole surgery. Already the NHS is no stranger with CAM – University College Hospital employs a spiritual healer, the only one in the NHS – but it is still largely a piecemeal process. Patients want more – and with many doctors offering both CAM and orthodox medical treatments, it seems the tide may be turning. But is CAM ready to come to the NHS?