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Welcome to the May 2012 homepage edition of i2P-Information to Pharmacists. Rollo Manning has been having some time out having staples removed from the site of his open heart surgery.He is now at home recuperating in Darwin, having arrived home last Friday, beating a cold and hasty retreat from Canberra.We all wish him a speedy recovery and hopefully, he will be fit enough to contribute by next month.
This month, Pharmedia discusses the toll that is taken when someone complains about you to an authority without good cause. Well, the good news is that you can now take action to protect yourself if such a complaint is made, and that may even include action for defamation. Read about a recent case involving two doctors, with Mark Coleman drawing on personal experience to illustrate.

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The Universities (and others) Respond to FSM

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	Mark Coleman articles by this author...
Mark is a semi-retired pharmacist.

"First do no harm" is the first law of orthodox medicine.
CAM practitioners embrace this law and are proud of the fact that their version of medicine causes minimal damage when compared to some of the practices of orthodox medicine.
Drug damage compared with alternate medicine damage is like comparing "chalk with cheese".
So what's all the fuss about?
The Friends of Science in Medicine (FSM) have certainly attracted a lot of media attention with their campaign to eliminate university training (and degrees) to a wide segment of complementary and alternate medicine (CAM) sciences.
CEO of FSM, Loretta Marron, said in a recent posting to the i2P site:

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“Government funded 'Faith healing' has no place in medical or health related degrees.
The real questions that no-one who supports quackery is prepared to answer are:

"Should tertiary institutions be teaching homeopathy, iridology, tactile healing, reiki, reflexology, kinesiology, 'fundamentalist' chiropractic and 'energy medicine' as belief systems?"

"Should they be indoctrinating 17 year olds (as first year students) that "innate intelligence", qi, meridians and chakras as a fact?"& "Should we be paying for these services in our health funds?"

If it is 'allied health' (such as hypnotherapy and massage) call it that, instead of CAM, which is an umbrella that covers all sorts of nonsense.

Of course test herbal remedies in universities but why not put "Trick or Treatment" (Ernst & Singh) as a text for all health students (some universities are already doing so) - so that students can learn about CAM from Prof Edzard Ernst the first Chair of CAM in the world, instead of from texts full of mumbo-jumbo."

The above questions are valid and do need to be answered. Certainly the various terminologies and descriptions need to be agreed and sorted.
But the debate triggered by FSM is too narrow in its focus and should embrace all players in the health industry – including those areas that are well-financed and politically well-connected.

That begs the next question – which person or body of persons could adjudicate on the various issues (which range from “snake oil” and faith healing, to downright medical fraud - and who would be at sufficient arms-length to avoid contamination from any powerful lobby group under instruction from Big Pharma, or their first cousins, orthodox medicine.

In essence, FSM has shot itself in the foot because its membership is overwhelmingly from orthodox medicine, including academics that have a close relationship with Big Pharma.
Unless it broadens its membership base to include a more representative membership (including science representatives from the CAM disciplines and consumer groups) it will be seen as elitist and dictatorial.
Another person lodging comment on the i2P site, Dr J Cowley, said:

"I do find the recent attempt by these medical academics to influence Universities re alternative medicine degrees quite astounding. It confronts the very basics of freedom of knowledge. And it makes these signatories look like a totalitarian outfit that wants to stop certain knowledge and disciplines of knowledge. They claim they are protecting consumers, because consumers want the right to choose. I have spent 30 years listening to consumers and seeing the changes-and the big reason they go to alternative medicine is they don't trust the medical theorists."

I could not help but think of that other famous totalitarian group that started off under different circumstances, and surprisingly included health in its basic philosophy i.e. Hitler's Nazi Party.
It also developed as elitist and dictatorial.

The following is from a reference site I found on the Internet:

“Hitler's Nazi theory also claimed that the Aryan race is a master race, superior to all other races, that a nation is the highest creation of a race, and great nations (literally large nations) were the creation of great races. These nations developed cultures that naturally grew from races with "natural good health, and aggressive, intelligent, courageous traits." The weakest nations, Hitler said were those of impure or mongrel races, because they have divided, quarrelling, and therefore weak cultures.”

Follow the link below for more background and make your own comparisons and assumptions as to which areas of health wear the "mongrel race" tag.

http://www.nazism.net/about/ideological_theory/

There are many CAM practitioners who regard themselves as friends of science in medicine and stand ready to defend that concept. Many have felt the contempt from orthodox practitioners who look down on them from a superior height and dump on them at every opportunity.
And legitimate allied health practitioners have also experienced this venom.
Few would feel encouraged to join the FSM organisation unless there was a major shift in policy and approach.

But what of the universities themselves?

Why would they accredit subjects that were not science-based?

A response to FSM was published recently in the New York Times (I couldn't find an Australian reference) which stated:

http://www.nytimes.com/2012/02/06/world/asia/australian-universities-defend-alternative-medicine-teaching.html

“Such universities have asserted that their courses are legitimate.

Macquarie University, which is in Sydney and offers bachelor’s and master’s degrees in chiropractic science, said it offered rigorous, high-quality courses.

“Our chiropractic science students are well trained in the fundamental relevant sciences (physiology, anatomy, biochemistry, biophysics, radiology, etc.) together with units in chiropractic methods and clinical practice,” the university said in a statement. “Our students are taught to understand that science proceeds only on the basis of evidence. We are confident that our graduates have been taught those techniques that are known through science to be beneficial.”

Nick Klomp, dean of the science faculty at Charles Sturt University, in Wagga Wagga, New South Wales, said while Friends in Science in Medicine made some valid points, the degree offered at his university, a bachelor of health science (complementary medicine), was based on science.

He said the course was designed to impart evidence-based science to people who already had a qualification, like a diploma, in alternative health care. The course includes such subjects as biology and physiology.

“They’re all subjects that are already mainstream, hard health science subjects,” Mr. Klomp said.

He said that thousands of practitioners were already providing alternative medicine and that there was much demand for their services.

“I could ignore them or I could train them better,” Mr. Klomp said, adding that a majority of the university’s students were already practicing. “We actually create graduates who are much better health care providers. It’s all about evidence based, science based.”

Murdoch University, in Perth, said it was committed to the promotion of research-led teaching and evidence-based practice across all disciplines, and that its School of Chiropractic and Sports Science was “established to be consistent with that approach.”

“Students are taught the science-practitioner model and our aim is to produce graduates who are critical thinkers,” the university said in a statement. “This enables them to distinguish between fad and genuine innovation in the discipline as practitioners, intelligent consumers of research and promoters of the scientific method. A clear distinction is made in all of our courses between areas for which the evidence is clear and those in which the science has not caught up with accepted practice and where sufficient evidence has yet to be accumulated.”

Universities Australia, which represents the country’s universities, said in a statement that the schools were “self-accrediting institutions with the autonomy and capacity to ensure the quality and relevance of the courses they offer.”

So it looks like the debate is going to be long and arduous and the real underlying agendas have yet to be fully understood.

The Bachelor of Health Science Degree offered by the universities is a stepping-stone to all the major health disciplines- pharmacy, medicine and nursing – so you have to scratch your head to understand what FSM is about.

Certainly qualifications obtained outside of a university might be questioned, but if they become university accredited at a later date then at least they have the basic building blocks to provide a professional service .

The broad-stroke approach by FSM needs to be tailored to a more rational policy.

The “big fish” that need to be fried will be found in a totally different direction, and if FSM decides to head that way, they are likely to get my full support.

Until then, I will assume that FSM has been constructed to protect a closed medical monopoly to create an expensive health monoculture. Orthodox medicine has already lost its way by selling its soul to Big Pharma. CAM practitioners do provide a genuine alternative and patients are marching with their feet because they get good and compassionate service.

Orthodox medicine needs to realise that it needs to be competitive in all of its service provision – otherwise patients will continue to march with their feet.

This is the real issue!

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