Watch out, doctors, the quacks are after your patients!

The following is the text of an after-dinner speech I gave to a group of doctors and medical students on Wednesday, March 10, 2004. The doctors came from various hospitals and universities in Australia and neighbouring countries, and were in Sydney for a training course in hyperbaric medicine. I would like to thank the Hyperbaric Medicine Group within the Prince of Wales Clinical School at the University of New South Wales for giving me the opportunity to speak (and for the excellent dinner).

The speech as delivered might not have been exactly as published here, because I started off by consuming a handful of homeopathic sleeping tablets, washed down with an acceptable but not outstanding Riesling wine. I repeated the dose once or twice during the talk, so I was probably very asleep near the end, and maybe even needed emergency treatment after mixing these powerful drugs with alcohol. Actually, I didn't think there was much of a risk but in the 200C possibility that homeopathy might not be the logical and scientific absurdity it appears to be, at least I was in a room full of doctors and my wife was there to provide the necessary details if I needed hospitalisation. (I thought she was a bit eager in asking for the forms she would need to sign to release my body for organ harvesting. This caused some coolness in the conversation in the car on the way home.)

I'm going to talk briefly tonight about medical quackery and alternative medicine.

There's a tendency in Australia to think of alternative medicine as harmless buffoonery like aromatherapy or iridology or things which probably have some scientific basis but are on the fringes of real medicine, like homeopathy or chiropractic or acupuncture. Alternative practitioners are seen as people who have good intentions but are just following a different, more natural road than conventional doctors.

I'm here tonight to disabuse you of these ideas and to talk about the dishonesty and the dangers.

I would like to make it clear at the outset, however, that I am not criticising the users of quackery. Often these people don't know any better. What I am concerned about are the people who actively market products, services and ideologies which they must know to be fraudulent. Things which are scientifically impossible, not just implausible, but impossible. Machines which cannot possibly do what is claimed for them. Things which have never been tested and never will be tested (because they know what testing will show).

Part of the problem is that many of the promoters of alternative medicines have a different definition of facts and truth to the rest of us, and I will come back to this later.

To give you some idea of what quackery means, I have brought along a few examples.

Zapper – This device I have in my hand cures cancer. If the dial is set at another point, it cures AIDS. There are other settings for other diseases such as multiple sclerosis, diabetes and asthma. This particular device is better value that some others because not only does it beep when it's turned on, but it has a flashing red light to show you that healing is being carried out. It also has an attachment that lets you make your own colloidal silver solution to treat those rare complaints that cannot be cured by zapping alone. You may think that this is nonsense, but according to the people who promote this fraud, that would be because you are doctors who have been brainwashed by your medical training and you don't want your billion dollar cancer racket to be exposed and threatened. After all, didn't Hulda Clark prove in her book The Cure for All Cancers that zapping is the best way to kill the 7.5 centimetre Fasciolopsis buski parasite which is the cause of all cancer and is present in every single person with cancer? Yes, I did say 7.5 centimetres long. It is a disgrace that pathologists ignore these things when they do autopsies.

Homeopathic vaccines – This little bottle of water contains what the label describes as a homeopathic vaccine against meningococcal disease. As if that lie is not enough, the label also contains a claim which puts the product in breach of consumer protection and fair trading laws. It says that this preparation is "200C", but if that is the case then the manufacture of this single bottle would have involved 800 manufacturing steps (excluding packaging) and would have produced 495 litres of waste water. There is no possibility that this could have been manufactured according to what is on the label, so the people who made it must have deliberately lied. You don't even need science to reject this stuff, but it would help to know that according to the label the amount of active ingredient in this bottle is the same as finding a single molecule of the substance among all of the molecules in 10³²² universes the size of the one we live in.

Homeopathic sleeping tablets – I realise that it is usually recommended that you do not mix alcohol with sleeping tablets, but I don't think that I am at any risk by having a few of these with a glass of wine. Three things struck me as strange about these tablets. The first was that the actual amounts of individual ingredients are not listed on the package, but instead it says that each tablet contains equal amounts of some dilution of the ingredients. The second one was that the same ingredient appears at two different concentrations. The third was that the package does not bear the special number issued by the Therapeutic Goods Administration which is supposed to be on everything making some sort of medical claim. I wrote to the manufacturers about this, and I received the following reply:

1. Coffea exists in the product in 2 potencies. Like most homoeopathic remedies, it has slightly different actions at different potencies.

2. Brauer Sleep and Insomnia Relief, due to the strengths of the ingredients and the claims made on the product, is exempt from the TGA regulations and therefore requires no listing or registration. Feel free to contact the TGA to find out more about the requirements for listing.

Translated into sense, response 1 says that you can mix two different dilutions of a substance and those different dilutions remain discrete in the final mixture, a fact unknown to most chemists. Response 2 says that the pills don't do anything at all. I should point out that these tablets, which the manufacturer admits are useless, sell for $14.95 for a packet of 20. A packet of 24 brand-name ibuprofen tablets costs $3.89 at my local supermarket. I can see why there is no money for research in alternative medicine.

Informed Choice – This magazine is on sale at newsagents and purports to offer good advice about health. The title suggests that it is offering to provide the information which consumers need in order to make an informed choice, but it is in fact a publication of the Australian Vaccination Network, Australia's leading anti-vaccination liar outfit. The editor of this magazine has told me that measles is "benign" and less serious that a hangnail. In this particular issue there is a claim that the magazine tried to organise a pro and con debate about vaccination, with each side being offered a single page to present its case. As published it is one page of vilification of doctors who chose not to lower themselves into the cesspit and at least eight pages of the anti-vaccination side. There is a large feature promoting the fraud of removing amalgam dental fillings, and the previous issue contained an article advising women not to have mammograms to detect breast cancer. The Complementary Healthcare Council (the industry lobbying group) says that all advertisements for alternative medicines must, by law, be approved and carry a registration number. There is only one advertisement in this issue of Informed Choice which carries such a code. It is an advertisement for capsules guaranteed to supply at least a billion bacterial organisms to your nursing infant. I am a bit confused by this because previous issues of this magazine have extolled the miracles of breastfeeding and how it almost guarantees good health, and I have been wondering why breastfed babies need to be given germs to repopulate their intestinal flora.

Sydney's Child – This magazine actually represents more of a threat because it is not some whacko altmed publication, but is a serious paper providing good advice and information for parents. The problem is at the back of the paper in the classified advertisements, where under the heading "Professional Services" you can find listings for all sorts of quacks offering cures for bed wetting, asthma, autism, otitis media, allergies and many other childhood problems. These advertisements are mixed in with advertisements for real professionals offering assistance with learning and behavioural difficulties, and this mingling of nonsense with sense lends credibility to the quacks. I have written to the paper to point out this problem, but I have received no answer.

OK, there are some shonks in the alternative medicine industry, but surely, you ask, there must be some regulation of all this and there must be legitimate manufacturers and practitioners who want the industry to be honest and well run. You would be wrong.

216 years and a few weeks ago, about 1500 people arrived just around the corner from here after an eight-month trip from England. Only about 40 died on the trip, and the trip was only possible because in 1747 James Lind performed a the first ever clinical trial, which showed that fruit juice prevented scurvy. A leading spokesman for the industry said in 2003 that doing the type of testing that Lind did in 1747 would bankrupt the supplement industry.

When the disaster at Pan Pharmaceuticals became known, the reaction of the industry was not to celebrate the fact that the shoddy manufacturing practices were being cleaned up and that better quality products were on the way. It was to lie about what Pan made and accuse the government and the TGA of trying to shut down the alternative medicine industry. Oh, and to put disclaimers on their web sites saying that they didn't use the bad stuff from Pan.

When the NSW government set up a committee chaired by Professor John Dwyer to look at the more egregious forms of quackery, the reaction of the industry was not to be enthusiastic about weeding out the charlatans but to start an immediate ad hominem attack on Professor Dwyer and anyone else who might be involved. The closing of ranks was startling, with the anti-vaccination liars issuing press releases on behalf of the live blood analysts and the energy aligners calling in the loopy politicians. I even got mentioned in parliament!

When the federal government wanted to restrict claims on packaging and in advertising to that which was, and I quote, "balanced, truthful and not misleading", the reaction from the industry was to say that four years was not long enough for a phasing-in period because it would make people change things they had been doing for ten years or more.

I referred earlier to the idea that these people might have a different version of truth to the rest of us, so I will finish with an experience I have had over the last week which illustrates this.

I have a web site called RatbagsDotCom where I vent my opinions on certain matters. I ran a story last week about a doctor who promotes alternative medicine and makes different claims in different places. On her Australian web site she says that she has the degrees MB,BS from the University of Adelaide. No problem there. On her US web site she says that she graduated from the University of South Australia in 1975. That university did not exist in 1975 and has no medical school. Even better, on her US web site she puts the letters "MD" after her name.

I said that she was being dishonest. Apparently she tells a different story over there for marketing purposes. Americans know what "MD" means and have never heard of Adelaide. My point was that she was lying about her qualifications by claiming a degree she does not have.

During the last week I have been told the following things:

• The letters "MD" just identify someone as a medical doctor and therefore mean the same thing in Australia as they do in the USA
• Australian universities issue "MD" degrees, so what is the problem? I was given three examples, all of which were postgraduate research degrees which required at least two years practice after getting the MB,BS before even being considered for admission.
• She doesn't use her real name because it is illegal for doctors in Australia to publish books under their own names. I supplied the titles and authors of several books on my bookshelf but I was told that this meant nothing as I had no proof that Dwyer, Isaacs, Kalokerinos, Mears, or McBride were the doctors' real names.
• I can't find her real academic record because I don't know her real name, so I might be talking about someone else as she sometimes uses an alias. I asked why she was listed in the telephone book under the alias but got no answer.
• The NSW Medical Registration Board says that doctors can call themselves whatever they like, use any name they choose to practise under, and can call themselves "MD" if they want to because it is the same as MB,BS anyway.

And so on.

What nobody would say is that the woman does not tell the truth and is just one of the bad apples in the barrel. In altworld there are no bad apples. As I said, they use a different version of truth to the rest of us. Perhaps they live in one of those other universes that are necessary for homeopathy to work.

When you are out there talking to you patients and they start asking about alternative medicines, be patient and gentle with them. Remember that they are getting a lot of information from people who believe that black is white, that up is down, and that for some time today it was Tuesday instead of Wednesday.