Alternative medicine

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Alternative Medicine (etymological meaning: refers to methods and treatments that are not used by science based medicine (or evidence based medicine, EBM). Alternative treatments are almost always pseudomedicine. Especially it's supporters use also terms like complementary medicine, experience based medicine and integrative medicine. Complementary and alternative medicine are often called CAM.

A National Center for Complementary and Alternative Medicine NCCAM in USA defines complementary and alternative therapies as treatments which are used in place ("alternative") or together ("complementary") with conventional, established therapy. A treatment is considered established, when it's clinical efficacy has been demonstrated in prospective, randomized trials or a biological rationale establishes the treatment as reasonable. An Anglo-Australian group of researchers demonstrated with a computional model in 2009 that for some odd reason the methods which have little or no effect at all show a tendency to spread quickly.

The terms alternative medicine and complementary medicine are therefore euphemistic, as they do not offer a real alternative and are just ineffective or less effective pseudomedical methods. This also applies to the "experience based medicine" which tries to invoke anecdotal cures instead of solid proof as a positive quality.

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The appeal of alternative medicine

For the popularity of offers outside of science-based medicine various factors can be assumed. In addition to the usual arguments like "healing practitioners commit more time to patients than doctors" disappointments and distrust for conventional therapies ma play a role. Many patients and customers find pleasure in the more or less explicit criticism of mainstream medicine" or "the pharmaceutical industry" which is not uncommon in alternative medicine circles. An appeal may also result from the typical features of pseudomedical treatments, such as simple, clear explanations for the alleged therapeutic effect or lack of side effects.

Alternative medicine business in Germany

The number of CAM providers is rising in Germany. From 1993 to 2000 the number of healing practitioners rose as the most important non-medical CAM-profession by  90% (from 11/100.000 to 21/100.000 persons). The CAM-offerings of doctors rose in the same period by 125% (from 19/100.000 to 43/100.000).

Every year herbal remedies for about two billion Euros are prescribed in Germany and about nine billion Euros are spent on complimentary and alternative medical procedures (2006). Five billion Euros are paid by the patients themselves. Four billions are refunded by insurance companies. 40.000 doctors offer respective treatments. Another estimate estimates that the total turnover is about 20% of the whole Wellness industry in Germany which has an annual volume of 50 billion Euro, and would therefore be about 10 billion Euros per year. The worldwide turnover is estimated at 60 billion U.S. dollar. According to figures by the economic research company "Global Insight" the annual turnover of the spa industry is now estimated at about 73 billion Euros.

Alternative medicine business in USA

Sales figures for alternative and complementary medicine are also known from United States. The National Health Statistic Report states in an article from July 30, 2009 for 2007 that U.S- patients have spent 33.9 billion dollar for CAM services and products. Homoeopathy accounted for 3 billions, Qigong for 4 billions. Expenditure for food supplements like vitamins and minerals are not included in this sum. In 1997 between 36 and 47  billion U.S. dollars were spent on complementary medicine. Of these, 12 to 20 billion USD were paid out of the one's own pocket for complementary therapists. This is half of the sum spent out of pocket for medical services. According to a further source 27 billion dollars were spent in 2002 for complementary and alternative medical treatments by the consumers. According to a study by author McGinnis four times as much money was spent in USA in 1987 on complementary medicine than for all cancer research. In 1981 Laetrile, a then popular, ineffective, alternative cancer drug made from apricot kernels had a turnover of 2 billion U.S. dollars. In the same period 0.2 billion dollars were spent on chemotherapy. The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122 million dollars, financed by the state.

Research of Alternative medicine

Funding for research in the field of alternative medicine comes usually from private foundations in Germany, such as:

• Karl und Veronica Carstens-Foundation (27 million Euro). It sponsored 1.5 million Euro in May 2008 for an endowed chair of alternative medicine at the Berlin Charité.
• Krupp-Foundation
• Kneipp-Foundation
• Gerhard Kienle Foundation
• Erich Rothenfußer Foundation

The manufacturers of alternative medical products are also funding research in this field. German companies Bionorica and Schwabe have research budgets of 17 and 25 million Euro. While it is not possible to patent substances that occur in nature (such as plants), special techniques for preparation can be patented.

Since 1999 the National Center for Complementary and Alternative Medicine (NCCAM) has funded research on alternative medicine with 2,5 billion U.S. dollar.

Currently (2010), the "National Center for Complementary and Alternative Medicine" (NCCAM) and the "Office of Cancer Complementary and Alternative Medicine" (OCCAM) spend together 240 million U.S. dollar of taxpayers money from the NIH (National Institute of Health).

Patients of alternative medicine

The typical patient or customer can be characterized by the following attributes:

• young (30-50 years)
• higher education
• tends to be politically "left" or "green"
• relatively high income
• female

Criticism

Users of alternative medical methods refer in the question of effectiveness often only to their own experiences, which are based on a selective perception of the past. Such retrospective observations are not evident by nature. The occasional argument, Who heals is right is not sensible because causality and correlation are often confused in anecdotal experiences and reports. In other words, an illness treated with globules might just as well have gone away by itself.

The notion of a postulated and fuzzy formulated "holistic approach" (usually associated with "of body, mind and soul") remains a pure promise within alternative medicine that would be difficult to implement because of time and financial constraints (see holistic after Issels).

Potential danger

Alternative medicine involves several dangers and risks:

• rejection of effective diagnostic and therapy in favor of pseudomedicine methods without proof of effectiveness leading to protraction of the illness or appearance of avoidable symptoms
• misdiagnoses because of inadequate medical training of alternative medicine practitioners
• deterioration of therapeutic prospects due to futile pseudomedical efforts
• development of guilty feelings at failure, towards oneself or towards family members
• psychological and financial abuse through the healing supply, which often shows sect-like structure
• development of psychological dependency an addiction to the treatment
• deaths and lasting damage due to inappropriate procedures

A study by the Royal Children's Hospital in Melbourne published in December 2010 investigated 39 cases where children were hurt due to alternative medical treatments. In 30 cases a correlation between damage to the patients and the use of alternative medical therapies or the denial of prescribed medicines could be found. Four of the children died because the parents refused medical treatment. An eight-month-old malnourished infant died of septic shock because he had been set on a diet of "naturopathic" rice milk because of an alleged obstruction since his third month of life. A 10-month-old baby died also of septic shock because he was set on a restrictive diet against chronic dermatitis. A further child died after multiple epileptic seizures after the parents hat stopped the anti-epileptic drug treatment for fear of side effects and treated it with an alternative medical remedy. A fourth child suffered fatal bleeding because the parents refused treatment with clotting factors in favour of a complimentary medical treatment

Intimidation and actions against critics

Individuals or institutions that have a critical view of alternative medicine and indicate its pseudomedicinecharacter must expect personal attacks. Two women who asked critical questions at an event Helmut Pilhar about Germanic New Medicine in Frankfurt, Germany. were "accompanied home" by "bald gentlemen". The two women had to call police. A cellular therapist tried to stop a critic with a court order and from giving his assessment of cellular therapy. A further example are civil actions against the project Paralexx which led to a temporary shutdown.

The German consumer protection foundation "Stiftung Warentest" wanted to publish a book with a critical analysis and evaluation of natural and alternative medicine. The magazine "Stern" seized the opportunity to do a prior publication: Krista Federspiel, one of the two authors and her colleague Hans Weiss offered to do a undercover report on the scene and have ten natural healers give them a diagnosis. Stern offered generous payment for the report and requested a second part that should present victims of alternative methods by name. To prove that the journalists had indeed visited natural healers a photographer was documenting it. Each attended healer imputed the subject with several diseases: A total of 38 different diseases and an myriad of ailments and allergies were diagnosed and more than 130 drugs prescribed. When the report "Wunderheiler und Krankbeter" (miracle healers and patient prayers) was published in Stern 49/1991, the raised criticism was met by outrage and massive protests by healing practitioners that the editors postponed and later cancelled the second part fearing the loss of readers. The rights were returned to the autors.

In a TV-show of the German station ZDF on September 5, 2007 titled "Heilen mit dem Nichts?"(Healing with nothing?) the journalist Joachim Bublath reported about scientific findings on homoeopathy (including an analysis of the renowned journal The Lancet [4]) that questioned a possible effectiveness of this controversial method beyond placebos. This led to a call from advocates of homoeopathy to spam and ZDF shied away by deleting the websites citing the Lancet figures.

Literature

(mostly German)

• Shermer M. und Lee Traynor: Heilungsversprechen - Alternativmedizin zwischen Versuch und Irrtum, Skeptisches Jahrbuch III, Alibri, 2004, ISBN 3-932710-86-X
• Ullmann Christian: Fakten über die „andere Medizin“. Augsburg: Foitzick 2006
• Lambeck Martin, Irrt die Physik?: (2003) Über alternative Medizin und Esoterik, Beck Verlag
• Heyll Uwe, Wasser, Fasten, Luft und Licht: Die Geschichte der Naturheilkunde in Deutschland, (2006) Campus Verlag
• Singh Simon, Ernst Edzard, Trick or Treatment: The Undeniable Facts about Alternative Medicine, (2008) Random House
• Goldner C: Alternative Diagnose- und Therapieverfahren: Eine kritische Bestandsaufnahme. Alibri 2008 ISBN-10: 3865690432
• Federspiel K., I. Lackinger-Karger: Kursbuch Seele. Köln: Kiepenheuer & Witsch 1996 (544 S.)
• Beyerstein B.L.: Warum falsche Therapien zu wirken scheinen. In Shermer/Traynor (s. u.)
• Harder Bernd: Stimmt es, dass Recht hat, wer heilt? Skeptiker 2/07, 74-75
• Much Theodor: Der veräppelte Patient?: Alternativmedizin zwischen (Aber-)Glauben und Wissenschaft. Verlag: EDITION VA bENE, Klosterneuburg; 2003. ISBN-10: 3851671430
• Oepen I.: An den Grenzen der Schulmedizin. Eine Analyse umstrittener Methoden. Köln: Dt. Ärzte-Verlag 1985
• Oepen I., O. Prokop (Hrsg.): Außenseitermethoden in der Medizin. Ursprünge, Gefahren, Konsequenzen. WBG 1989
• Oepen I. (1993): Unkonventionelle medizinische Verfahren, Stuttgart.
• Oepen I., Amardeo Sarma (Hrsg.)(1998): Paramedizin - Analysen und Kommentare, Muenster.
• Oepen I., R. Scheidt: Wunderheiler heute. Eine kritische Literaturstudie. München: Zuckschwerdt 1989
• Randi J.: Flim-Flam! Buffalo: Prometheus 1982, chapter 9 (The medical humbugs)
• Siebert A.: Strafrechtliche Grenzen ärztlicher Therapiefreiheit. Berlin: Springer 1983
• Stalker D., C. Glymour (eds.): Examining holistic medicine. Buffalo: Prometheus 1985
• Ernst E.: The Desktop Guide to Complementary and Alternative Medicine. An evidence-based approach. Mosby, Harcourt Publishers Limited 2001
• R. Barker Bausell: Snake Oil Science. The Truth about Complementary and Alternative Medicine, B&T, 2007
• Weber Tobias: Christian Ullmanns „Fakten über die andere Medizin“. Skeptiker 19 (3/06) 103-106
• Margaret Thaler Singer und Janja Lalich: (1996) "Crazy" Therapies - What are they? Do They Work? San Francisco: Jossey-Bass Publishers, 1996
• Ernst E. How to get rich quickly with 'alternative' medicine Skeptical Inquirer 2009, Mar-Apr S. 57

See also: Helsana-Study

Weblinks

• http://www.faz.net/s/RubF3CE08B362D244869BE7984590CB6AC1/Doc~EFE6249A7501E4254B8EEA47E0CA266ED~ATpl~Ecommon~Scontent.html
• http://www.hauszumdolder.ch/docs/03_01_Robert_Juette.pdf
• Edzard Ernst: komplementärmedizinische Diagnoseverfahren
• http://www.gbe-bund.de/gbe10/abrechnung.prc_abr_test_logon?p_uid=gastg&p_aid=&p_knoten=FID&p_sprache=D&p_suchstring=7861::Medizin
• http://www.zm-online.de/zm/14_01/pages2/mediz1.htm
• http://www.zm-online.de/zm/15_01/pages2/mediz1.htm
• http://www.zm-online.de/zm/16_01/pages2/mediz1.htm
• http://www.zm-online.de/zm/17_01/pages2/mediz1.htm
• Der Spiegel: Alternativmedizin und Artenschutz
• blog.ebook-insel: Anthroposophie-Homöopathie-co wie verhalten sich dazu Kassen und Politiker in Deutschland
• Laborjournal: A flowchart of alternative medicine
• Sekten-Info NRW: Kriterien zur Beurteilung alternativer/komplementärer Heilmethoden