Friends of Science in Medicine
Open request to all health care insurers regarding pseudoscientific interventions
Friends of Science in Medicine was established in late 2011 to promote the importance of healthcare provision being underpinned by good science. We are now supported by more than one thousand of Australia’s leading scientists, clinicians and consumer advocates. Many in the international scientific community have added their support.
On 4 March 2016, the Hospitals Contribution Fund of Australia Limited (HCF) wrote to chiropractors notifying them that they would no longer tolerate a range of interventions lacking a strong evidence-base. FSM applauds this HCF initiative. We ask you to follow their lead.
The Australian Health Practitioners Regulation Agency (AHPRA) was set up in 2010. Its primary role is to 'protect the public' by "ensuring that only health practitioners who are suitably trained and qualified to practise in a competent and ethical manner are registered". However, they have failed to stop thousands of registered practitioners from promoting belief-based interventions to our most vulnerable patients.
The registration of chiropractors legitimises their interventions.The majority target young families, claiming to be able to treat a wide range of childhood illness and disorders. Following FSM's urging, the Chiropractic Board of Australia (CBA) published, and distributed to their registrants on 7 March 2016, a statement on 'Inappropriate claims of benefit' for advertised regulated health services. This statement rejects the relationship between manual therapy and "general wellness and/or benefit a variety of paediatric syndromes and organic conditions [as they] are not supported by satisfactory evidence." While this might see some chiropractors disciplined for inappropriate advertising, it may have little impact on their promotion/advocacy of useless interventions which could continue to attract your rebates which in turn would legitimise the practices in the eyes of your insured.
There are also no sound scientific data to support the use of acupuncture and 'Osteopathy of the Cranial Field (OCF)' in the treatment of children. The lead of the CBA has not yet been followed by either the Chinese Medicine Board of Australia (CMBA) nor the Osteopathy Board of Australia (OBA) in challenging the false and misleading advertising for these belief-based interventions.
'The Review of the Australian Government Rebate on Private Health Insurance for Natural Therapies', published in 2015, found no evidence of clinical efficacy to support any of the interventions investigated.
In this most scientific of all ages, clinical effectiveness, determined by quality research, should be the appropriate standard for healthcare. This approach is vital for ensuring cost-effectiveness. Our main concerns are not only the inefficacy of pseudosciences and the waste of money involved but also the potential harms from delay or prevention of evidence-based diagnosis and therapies.
We ask you at this time to review the evidence yourself and if not satisfied withdraw insurance support for these and all other interventions that lack a strong evidence base. We are willing to help you with such an exercise.
Professor John Dwyer AO, President of FSM On behalf of FSM
WELCOME FROM THE PRESIDENT OF FRIENDS OF SCIENCE IN MEDICINE
Welcome to our website. We hope you visit often. Our Association, Friends of Science in Medicine (FSM) was formed at the end of 2011 to emphasise the importance of having health care in Australia based upon evidence, scientifically sound research and established scientific knowledge.
The founders of FSM were and are concerned about the increasing number of health courses and interventions on offer to Australians that fall far short of this standard, as well as the inadequacy of the measures that are supposed to protect students and consumers from such practices.
This is no alarmist statement. Many supposed health treatments have no scientific evidence of their effectiveness, some have been shown to cause harm, while many could not possibly work as they are incompatible with well-established principles of physics, chemistry, physiology and pharmacology. Many are pseudoscientific; assuming the trappings of scientifically sound practices in order to gain the credibility of these without subjecting themselves to the well understood tests of scientific examination that have proved so effective in giving us medical procedures and medicines that really work.
We were particularly concerned that some of our universities were allowing pseudoscientific approaches to health education to be presented in health science courses without critical analysis of the principles behind them or of the claims of efficacy made for these procedures and treatments, including such practices as Homeopathy, Energy Medicine, Kinesiology, Chiropractic “subluxation” theory, Cranial Sacral therapy and more. All of these approaches lack scientific credibility, but apparent endorsement of them by our universities can confer undeserved credibility on useless and sometimes dangerous approaches to healthcare.
While suspect university courses provided the impetus for the creation of FSM, all aspects of the penetration of pseudoscience into our healthcare system concerns us. Many, such as Iridology, Reflexology, Rolfing, Homeopathy, much of traditional Chinese and Indian medicines, etc, are an affront to our knowledge of physiology and pathology and, relying as so many of them do on mysterious, undefinable, undetectable “energy”, could never be validated by scientific investigations as, virtually by definition, they have made themselves impossible to test.
We would emphasise, however, that FSM strongly supports the need to conduct independent and disinterested scientific evaluations of those “Alternative and/or Complementary” therapies where the anecdotal evidence for benefit is strong and the underlying explanations are not incompatible with modern biological and physical sciences. Much that is of current therapeutic benefit was developed by such an approach.
As Friends of Science in Medicine, we are also aware of and concerned by the discovery of cases where poor scientific methodology and the fraudulent manipulation of data have occurred within the medical/scientific establishment. Some individual researchers and some of the major pharmaceutical companies have been involved in these unacceptable practices. While FSM deplores such activities, it recognizes that there are already many and increasing checks and balances within Medicine that aim to minimise such incidents.The same cannot be said for Alternative and/or Complementary medicine, which is why FSM is concentrating its efforts in this area.
Valid scientific and medical research must adhere to well-established and widely recognized “best practice” protocols. FSM wants the evaluation of all potential health treatments to be subjected to similar standards for validation.
When we informed the scientific and clinical communities of the establishment of FSM and sought support, we were overwhelmed with encouragement from home and abroad. As of January 2014 we have over 1000 leading scientists, clinicians, lawyers and consumer advocates, (listed herein), as supporters.
FSM has no formal links to any industry or organisation and its executive members serve in a voluntary capacity.
Speaking with a strong voice provided by our constituency we will make every effort to ensure that Australians have access to interventions and medicines backed by science-based tertiary education and scientific evidence of their clinical effectiveness. FSM will work towards ensuring that precious public health dollars are not wasted funding spurious treatments, many of which have actually been proven to be ineffective and thus dangerous, despite their small direct risk.
With the efforts of hundreds of like-minded and knowledgeable Friends, we will strive to help the public understand the importance of a good evidence base for any treatment they are offered. We will advocate for regulatory changes that better protect the public from misleading, even fraudulent, health-related claims.
You will find much more about us, and the outcomes we seek, in the pages that follow. We issue a regular online newsletter to our Friends to keep them informed of our activities. We will keep the content fresh and would welcome your feedback about our work as well as about the effectiveness of this site.
Professor John Dwyer AO
Founding President FSM