Radio: The Other Medicine
Authors: Kristina Fister
Journal: BMJ (2004)

One in four UK residents regularly uses complementary and alternative therapies, spending a total of more than £1bn ($1.8bn; €1.4bn) a year. This six part series aims to explore this “other medicine”—why so many people are attracted to it, what is the evidence, if any, that it works, how it can affect our health and wellbeing, and whether it will ever become fully integrated with NHS care.

Presenter Anna Ford speaks to patients and practitioners, researchers and scientists, sceptics and believers, and we even witness her own sessions with alternative therapists (she is, her therapist tells her, apparently suffering from post-menopausal yin deficiency). But Ford restricts herself to only a few personal comments, mostly letting us hear from her guests. And there are almost as many different messages as there are interviewees.

For those of us who believe in the principles of evidence based medicine, there is little choice but to apply the same criteria to other healing methods. Many epidemiological studies of alternative treatments come from teams lead by Edzard Ernst, who in 1993 came from Vienna to London to become Britain's first professor of complementary medicine (at Peninsula Medical School). Professor Ernst tells us: “A lot of people 10 years ago and some people even today would say that science shouldn't touch complementary medicine because it will destroy it, complementary medicine cannot be squeezed into the straitjacket of a clinical trial and so forth. I think that's just a cliche—a tired cliche on top of it.”

However, the alternative camp repeatedly claims that diagnosis and treatment are an individual thing in complementary medicine, and that a randomised controlled trial “simply isn't the appropriate tool for finding out if therapy works or not.” The episodes that had been broadcast so far as the BMJ went to press (which can all be heard again on the website and downloaded as transcripts) have almost equated scientific methodology with randomised controlled trials. However, quality observational studies can provide evidence too, and are probably more appropriate study designs for research in complementary medicine.​medicine.




Figure 1



Yin up: presenter Anna Ford

Credit: MARK ST GEORGE/REX




Former BMJ editor Richard Smith tells Ford, “You can get any rubbish published, just go down and down and down and down the food chain [of medical journals],” reminding us again of the great need for critical appraisal skills among doctors. Dr Smith also says that researchers in complementary medicine are in “a bit of a catch 22” position because they have difficulties getting the funds to do research.

George Lewith, a researcher in complementary and alternative medicine at the University of Southampton, believes that “it's all about this battle, this process of who owns health.” Political economics, the cost of medicine, and the power of monopolies, all addressed in this series, certainly play a role in untangling the Gordian knot of traditions of healing.

I have had various personal and professional experiences of both traditional and complementary medicine. In general it seems to me that complementary therapists are better at reaching out to patients' souls than conventional doctors, and this may be where their success lies. One reason for this might be that complementary therapists are able to dedicate more time to a particular patient, but I fear that that is not the only reason.