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Issues about FSM


In this page we will deal with issues that are relevant to the activities of FSM.

Private Health Insurance (PHI)

Media following the Federal Budget 2012 announced that the Chief Medical Officer (CMO) has $1 million and 12 months to investigate the services offered by unregistered practitioners for modalities such as “homeopathy, Reiki, aromatherapy, iridology, ear candling, crystal therapy, flower essences, kinesiology and Rolfing." If they are found ineffective, these interventions will no longer attract the 30% subsidy currently paid to private health funds.

However, interventions offered by registered practitioners, including chiropractic and acupuncture, are outside of the scope of the investigation, despite ample evidence of their being ineffective for many of their claimed benefits. FSM has written to the Health Minister* suggesting that the project be widened to include these interventions.

Of the 36 PHIs, only one, the Doctors Health Fund does not support alternative medicine. On the June 8 2012, FSM sent an open letter* to the other 35 PHIs asking them to confirm that they will withdraw insurance support for all modalities which the CMO determines to lack an evidence-base.

 

Chiropractic treatments for babies and children

FSM has sent out a series of letters in relation to the inappropriate treatment of babies and children by chiropractors who claim they can use spinal manipulation for health conditions such as ADHD, Asthma, allergies, bedwetting, colic and ear infection and as a substitute for vaccination.

One letter(*) was sent to the chiropractic organisations including Chiropractic And Osteopathic College Of Australasia (COCA), Chiropractors' Association of Australia (CAA), Chiropractic Board of Australia (CBA), Australian Spinal Research Foundation (ASRF), Chiropractic Council of NSW and Council on Chiropractic Education Australasia (CCEA) and a second letter(*) was sent to the four Universities who teach chiropractic. Another question raised with these organisation was about 'subluxation' theory. FSM asked where they stand on these issues.

The third letter(*) was sent to healthcare organisations concerned about these chiropractic treatments encouraging them to write to the Government, in view of the Chief Medical Officer (CMO) current investigation that does not include chiropractic. It also requested that they issue their own warnings about the inappropriateness of applying chiropractic to paediatric problems.


Submission to ACCC on Medicines Australia Code of Conduct

A submission from FSM was sent to the Australian Competition Tribunal relating to the 17th Edition of Medicines Australia Code of Conduct. In the past the ACCC has imposed ‘conditions’ when authorising the Code that has strengthened its provisions so it was important to highlight our concerns.

Click here(*) to read FSM's submission.

A copy of the Tribunal's determination will be published on their website.


Therapeutic Goods Administration (TGA)

Following an invitation to comment on the new guidelines for listed medicines, the FSM sent in a response(*) to the TGA.

 

“Alternative” Health Courses in Australian Universities

In 2011, a table published by the Australian Skeptics* listed Australian tertiary institutions that were alleged to be offering non-evidence-based health courses under a scientific banner. FSM was interested in this account, and wrote to the Vice-Chancellors of all universities to enquire whether they were offering such courses and whether their university was committed to the principle of ensuring that all science offerings were, in fact, evidence-based.

To date (23/5/12) the responses have been mixed. Some universities have replied with ambiguous information while others deny offering such courses when their online advertisements for them are plain to see, readily accessed and even promote clinics run by the university in which these disputed treatments are offered. Furthermore, while some universities officially deny that they offer these courses, members of their staff and some students write privately to FSM to describe and complain about the details of the courses that the universities do, in fact, offer.

Some of the institutions wish to retain what they do on the basis that they believe "this is a responsible balance between meeting the demand for complementary health services and producing graduates trained in science and evidence-based health". This view raises questions about the motives behind such a decision, emphasising as it does the conflict between teaching to meet demand and teaching science courses that genuinely abide by the accepted methodologies and philosophy of science.

Some institutions which defend their dubious positions nonetheless agree that the non-scientific ‘disciplines’ listed by FSM "are not based on evidence and, if employed instead of genuine medical interventions for a serious disease, could lead to very serious outcomes for patients".

Believing that publicly funded universities have a responsibility to be clear about what they offer, FSM will continue to seek clarification from them about their courses, and we would welcome appropriate information from staff and students that can confirm or correct the information in the accompanying table.

While it would be inappropriate to publish the letters themselves, the various replies are summarised in the accompanying table in an attempt to clarify what is included in courses run by the universities (above the double lines) originally listed in the Skeptics table. Universities below the double lines are those which have replied to FSM, but which were not included in the original table. The dates after the summaries indicate when the response was received by FSM.

 

Institution

Skeptics description of courses offered (2011)

Summary of University Responses to FSM

(CAM = Complementary and Alternative Medicine)

Central Queensland University

Bachelor and Masters of Chiropractic Science


Charles Sturt University

Bachelor Health Science-Complementary Medicine

Agrees broadly with FSM call for evidence base. Says FSM has “moderated its views” to recognise research into Alternative medicine. Says FSM should recognise differences between courses in different universities. Says it has a responsible balance between demands for complementary health services and producing graduates trained in science and evidence-based health. 27/2/12

Curtin University

Evidence Based Complementary Medicine

Commends FSM stance that science is cornerstone of health education. Says that Complementary Med. units are evidence-based and “for sole purpose of provid(ing) pharmacy graduates with the knowledge, skills and ability to critically appraise the evidence around the use of a range of complementary and alternative medicines.” 15/3/12

Edith Cowan University

Complementary and Alternative Medicines

Email acknowledged receipt of FSM letter. 23/2/12

Macquarie University

Bachelor of Chiropractic Science, Master of Chiropractic, six MU chiropractic clinics


Monash University

Graduate Certificate in Medical Acupuncture

Endorses general proposition that teaching should be based on a solid scientific grounding. Argues that it is important to explore in a scientific manner areas not fully understood (possible efficacy of various natural products; social and economic effects of alternative health care approaches). 31/1/12

Murdoch University

Bachelor of Science in Chiropractic, Postgraduate Diploma in Sports Chiropractic, MU Chiropractic Clinic

Veterinarian Traditional Chinese Medicine & Acupuncture


RMIT

Bachelor and Masters of Health Science (Chiropractic) Chinese Medicine/Human Biology – Bachelor of Applied Science, Bachelor of Health Science (Acupuncture and Chinese Manual Therapy), Diploma and Masters in Acupuncture


Energy Medicine has not been taught since 2010. There are no plans to reintroduce it. 22/4/12

Southern Cross University

Bachelor of Clinical Science includes students pursuing a career in osteopathy and naturopathy. SCU Health Clinic will “Train students in applying naturopathic and osteopathic skills in assessment and treatment”


University of Ballarat

Course in Complementary Medicine


University of Newcastle

Complementary Therapies in Healthcare (including complementary therapies such as massage, aromatherapy, Reiki, meditation, and guided imagery).

Supports the need for health education to have a strong evidence-based approach underpinned by appropriate scientific research. Believes it is important that health practitioners are aware of a range of approaches they may encounter, so offers an elective in nursing about complementary health therapies and health care to help nursing students assist patients to make informed decisions in the use of these therapies. 5/3/12

University of New England

Bachelor and Masters programs open to alternative practitioners including naturopaths, herbalists, aromatherapists, reflexologists, and homeopaths


University of Queensland

(Centre for Integrative Clinical and Molecular Medicine)

This Centre undertakes “scientific research to evaluate the scientific foundation of complementary medicine and integrates evidence-based complementary therapies into clinical care”.

Sympathetic to FSM argument. Does not teach nor has ever taught any of the listed programs. Strong commitment to evidence-based practice. Conducts research into foundation science of CAM. 8/3/12

Centre for Integrative & Molecular Medicine was no longer functional and was disestablished.2/10/13

University of Technology, Sydney

Bachelor Health Science Traditional Chinese Medicine, UTS Traditional Chinese Medicine/acupuncture clinics.


University of Western Sydney

Bachelor of Applied Science (Naturopathic Studies), Graduate Diploma in Naturopathy, Master Health Science Acupuncture/Traditional Chinese Medicine, University Clinic offering naturopathy, podiatry, and traditional Chinese medicine and acupuncture.

Has conducted research and teaching in CAM, especially Chinese Medicine, for more than two decades. Uni has a direct impact on the formation of national (and other) policy, and provides evidence-based summary guidance. Allied health and medical programs, including those in Chinese Medicine, comprise a major focus on acquisition of scientific evidence and instruction in evidence-based clinical practice. Recognises the importance of adequate scientific evidence in all health care practices. Undergraduate program is approved by Chinese Medicine Board of Australia, “ensuring appropriate national standards.” Teaching programs will continue to be supported and strengthened by significant and focused research activities, and contribute to an evidence-based approach to clinical practice of CAM. 9.3.12

University of Sydney


Seeks to maintain the highest standards of epistemological rigour in all our courses.” Can’t speak for whether all courses in other universities necessarily do so. 17.2.12

Swinburne University of Technology


Shares FSM view that university health and allied health teaching programs should be based on sound scientific principles and clinical evidence. Programs in complementary medicine were discontinued in 2005. Graduate School of Integrative Medicine disestablished in 2006. No longer offers any complementary medicine programs. 2.3.12

University of Adelaide


Agrees that researchers need appropriate evidence to justify therapies and interventions. Once this is established it is important that medical and health graduates be informed of these. Believes “all our educational programs are underpinned by robust evidence and ... our graduates will contribute to improving the quality of our health system by being trained within this paradigm.” 20/2/12.

University of Melbourne


Does not offer any degrees in complementary or alternative medicine and has no plans to introduce any. 1/2/12

University of New South Wales


Does not teach any degree programs in area of concern. Does not believe that pseudosciences should be presented as though they have unwarranted credibility. Does expose medical students to complementary and alternative medicine to consider which of these is evidence-based. (Undated)

Griffith University


Does not have any specifically named programs in complementary and alternative medicine and has no plans to develop any (undated)

University of Tasmania


Regards the scientific validity of many CAM compounds as limited, but believes there is sufficient preliminary data to warrant further research to identify novel compounds, tested in formal randomised, controlled, clinical trials. Cautions against the potentially dangerous aspects of some CAM medicines and believes that it is important that health providers are informed about use and risks and have general knowledge of underlying philosophy in order to weigh evidence in regard to use of CAM. All courses are underpinned by evidence-based practice approach and developing skills to evaluate reliability and validity of public information. Currently engaged in research to establish efficacy of a range of CAM treatments to inform undergraduate and postgraduate curricula. 30.4.12

At some institutions the curriculum is not clear about whether alternative therapies are discussed, supported or actively taught to be practised. FSM has written to all universities and, on the basis of responses, has amended this table accordingly. Some universities have not replied or have responded with an ambiguous reply. Other institutions explicitly mention critical analysis of efficacy and safety as part of their courses.

(*) These are .pdf files, click on the name to download.

 


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