Has homeopathy had its day?

RE: Has homeopathy had its day?

David Mills — Tue, 21 Nov 2017 10:27:09 GMT

[quote user="Arlo Guthrie"]Nothing, surely?[/quote]

Don't let the high priests of EBVM hear you say that.

EBVM (or EBM) was touted as a revolution, a "paradigm shift" in the way we do medicine, back in the late 80s, early 90s. There is a system and a formula to its practice quite different to what people just "do".

The problem with EBVM is that it is very prescriptive when it comes to the external evidence bit. But very little work has gone into defining clinical expertise, or patient values. EBVM can't simply stick these on the end of its self-definition and then ignore them.

Of course, this is without even touching on what's the evidence for EBVM being better than, say, other ways of doing medicine? It is EBVM's central paradox that we are supposed to accept it is better because obviously it is...

RE: Has homeopathy had its day?

J G Wray — Tue, 21 Nov 2017 10:26:10 GMT

[quote user="Arlo Guthrie"]But one thing that always surprises me is how practitioners of alternative medicine have been able to claim 'holistic' as a badge of honour when in reality it is what you all do when you perform a basic health check![/quote]

It is surprising

But, in a strangely similar way

[quote user="Arlo Guthrie"]

[quote user="David Mills"]What marks out EBVM from, well, normal practice?[/quote]

Nothing, surely?

[/quote]

EBVM has a whiff of the Holy about it as well. It doesn't serve its purpose.

RE: Has homeopathy had its day?

Arlo Guthrie — Tue, 21 Nov 2017 10:09:12 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Arlo Guthrie"]There is a need for all vets and doctors to reclaim the so-called ‘holistic approach’ where longer consultations are structured in such a way that there is plenty of time to address the clients at their point of need, address their concerns, explain the treatment options better, truly empathise with the owners, show that we genuinely care about the animals, show that we don’t simply treat symptoms ignoring the rest of the animal and to empower the clients to feel they are in better control of the decisions and situation.[/quote]

Very true.

What do you feel the Royal College of Veterinary Surgeons should do about that?[/quote]

In fact, I would have thought a lot of this is not really the job of the RCVS, but something led by consumer demand.

But one thing that always surprises me is how practitioners of alternative medicine have been able to claim 'holistic' as a badge of honour when in reality it is what you all do when you perform a basic health check! I think if I was a VS, I might be slipping that word subtly into my website (for example): Our holistic health checks look at bloods, BP, temp etc. etc.

[quote user="David Mills"]What marks out EBVM from, well, normal practice?[/quote]

Nothing, surely?

I mean, to me as a layman, surely that is exactly what you all do every day. You all consider evidence. You all use your clinical expertise. You all consider the circumstances of the patient in front of you, and the values of the owner/carer.

It's only a question of how well you do it.

[quote user="David Mills"]Tell me what processes EBVM has in place to address the latter two limbs? Has it defined clinician expertise? Owner values? Whither patient values?[/quote]

Do you think it could or should have processes to address or define these things?

My perception, as an outsider, is that there are bigger priorities. Things like training medical professionals to better evaluate evidence and systems to make it less time-consuming. Things like demanding more transparency over the evidence (personally, I think all studies should be open source, and all studies should be published, not just the positive ones!)

RE: Has homeopathy had its day?

mariette asselbergs — Tue, 21 Nov 2017 01:21:26 GMT

I was at the RCVS Knowledge day where EBVM was high on the list and they proudly mentioned their recent statement on homeopathy in vet medicine.

But then I though it was extremely funny that they had bottled water on the table from the raw food company called "Nature's Way" or something like it, with the slogan: food (and bottled water) "as nature intended".

I seemed to be the only one finding this funny....

RE: Has homeopathy had its day?

Beats — Mon, 20 Nov 2017 19:59:59 GMT

[quote user="David Mills"]What marks out EBVM from, well, normal practice?[/quote]

Beats me!

The acid test: can you add the word "clinical" in front of it to improve it?

CEBVM (Clinical Evidence-based Veterinary Medicine)

Ah, that's much better now

RE: Has homeopathy had its day?

David Mills — Mon, 20 Nov 2017 19:47:48 GMT

For a longer argument on this, seek out my podcast on RCVS knowledge "putting the horse before the cart"

RE: Has homeopathy had its day?

David Mills — Mon, 20 Nov 2017 19:46:24 GMT

[quote user="Sarah Keir"]

Evidence-based veterinary medicine is the use of best relevant evidence in conjunction with clinical expertise to make the best possible decision about a veterinary patient.

The circumstances of each patient, and the circumstances and values of the owner/carer, must also be considered when making an evidence-based decision.

[/quote]

Tell me what processes EBVM has in place to address the latter two limbs? Has it defined clinician expertise? Owner values? Whither patient values?

What marks out EBVM from, well, normal practice?

RE: Has homeopathy had its day?

Sarah Keir — Mon, 20 Nov 2017 19:26:02 GMT

Evidence-based veterinary medicine is the use of best relevant evidence in conjunction with clinical expertise to make the best possible decision about a veterinary patient.

The circumstances of each patient, and the circumstances and values of the owner/carer, must also be considered when making an evidence-based decision.

RE: Has homeopathy had its day?

Sarah Keir — Mon, 20 Nov 2017 19:24:18 GMT

[quote user="David Mills"]

The holistic approach is an interesting one, because, philosophically, and practically, it stands quite at odds with EBVM and "rational veterinary medicine" as they are currently conceived...

[/quote]

Please explain why David.

RE: Has homeopathy had its day?

David Mills — Mon, 20 Nov 2017 19:22:32 GMT

The holistic approach is an interesting one, because, philosophically, and practically, it stands quite at odds with EBVM and "rational veterinary medicine" as they are currently conceived...

RE: Has homeopathy had its day?

David Mills — Mon, 20 Nov 2017 19:19:53 GMT

No surprise you missed the Daily Telegraphs piece

RE: Has homeopathy had its day?

Arlo Guthrie — Mon, 20 Nov 2017 19:17:26 GMT

[quote user="J G Wray"].....Alan Henness and Immy Grant for helping match up the names on the petition to the RCVS register.[/quote]

Haha - laughed out loud, Danny tells me he is rewording that when he gets to a desktop machine in order to make it clearer that I am not one of the group of vets!

RE: Has homeopathy had its day?

J G Wray — Mon, 20 Nov 2017 19:07:48 GMT

[quote user="Arlo Guthrie"]A group of vets called the Campaign for Rational Veterinary Medicine (Martin Whitehead, Alex Gough, Phil Hyde, Alexander 'Arlo' Guthrie, Niall Taylor, and Mike Jessop, Martin Atkinson)[/quote]

.....Alan Henness and Immy Grant for helping match up the names on the petition to the RCVS register.

RE: Has homeopathy had its day?

Arlo Guthrie — Mon, 20 Nov 2017 19:02:43 GMT

Evelyn Barbour-Hill - those weren't my words (sadly!), they were Danny Chambers' (I'll go and edit that post to make it clearer).

But it's a bloody good question all the same.

RE: Has homeopathy had its day?

Evelyn Barbour-Hill — Mon, 20 Nov 2017 18:54:51 GMT

Very true.

What do you feel the Royal College of Veterinary Surgeons should do about that?

RE: Has homeopathy had its day?

Arlo Guthrie — Mon, 20 Nov 2017 17:18:37 GMT

For interest, the College's new position statement was covered by The Times and the Daily Telegraph and the Daily Mail over the last couple of days:

https://www.thetimes.co.uk/article/animals-are-put-at-risk-by-alternative-medicine-say-vets-fdxmfq32d?shareToken=dd87de3097c1c50ccd3e95d977227dc3

http://www.telegraph.co.uk/news/2017/11/18/homeopathy-vets-must-stop-unnecessary-animal-suffering-royal/

http://www.dailymail.co.uk/sciencetech/article-5099855/Homeopathic-treatments-killing-animals-experts-warn.html

Danny Chambers posted the following on Facebook, which he has given me permission to share:

My final post on veterinary homeopathy... hopefully!
By Danny Chambers

Hopefully this will be my last post about homeopathy for a long while. As I have been filling up your social media timelines and pages of the veterinary press for several years now it seems to be appropriate to post a brief summary to wrap up what we’ve been working towards for so long, and why it is important.

For several years many of us have been concerned about the welfare implications of animals being prescribed homeopathy, and have been working and lobbying to get the Royal College of Veterinary Surgeons (RCVS) to update their position on this.

RCVS Council’s new position on homeopathy

At our last RCVS Council meeting we approved a position statement making it perfectly clear that because homeopathy is ineffective and not based on sound scientific principles we do not consider it to be acceptable for vets to use homeopathic remedies in place of appropriate treatment.

We also do not consider it acceptable for vets to supply homeopathic nosodes in place of vaccinations, or to make false claims of homeopathy being a cure for various forms of cancer.

Read the statement here: https://www.rcvs.org.uk/news-and-vi...

Why does this matter?

Animal welfare

Animals will be protected from unnecessary suffering because appropriate treatments, vaccinations or pain relief should not be substituted for homeopathy.

Adult humans can make a choice to ignore scientific evidence and opt for a disproven alternative medicine. However, the health of children and animals is in the hands of their carers so it is unethical to inflict disproven remedies on them - they have no choice in the matter.

Animal owners are protected

The public trust vets because they have an accredited degree from an accredited university. They do not expect to be offered treatments based on pseudoscientific principles which have been disproven but cost money and offer false hope.

Reputation of the veterinary profession

The reputation of the veterinary profession is important.

The overwhelming majority of our science-based profession do not want to be associated with a tiny minority of vets who reject rational thought, who mis-represent evidence based medicine and who make outlandish claims that cannot be substantiated.

Society is better informed

When vets or doctors prescribe homeopathy it lends it credibility it does not deserve, giving it the appearance of accepted legitimate medicine.

This RCVS statement highlights to society that homeopathy has no role in 21st century medicine and that it is clearly an alternative medicine.

This is important because many people assume it is part of mainstream medicine and do not even realise it is an alternative medicine.

A more thorough discussion on these subjects available here.

Was ‘Big Pharma’ involved?

Contrary to the many comments online regarding this statement, no pharmaceutical companies were involved in writing or influencing the RCVS Position Statement. Additionally, I have never have been paid by any sector of the pharmaceutical industry.

The need for a more holistic approach

I do not want this to sound like a triumphant post. I am well aware that many vets who use homeopathy and owners who believe it is appropriate are feeling upset and angry about this.

We all share the same goal of wanting to improve animal welfare and offer a great service to our clients. I am very sorry for any personal hurt caused by this.

However I believe that we do all have more in common than we have differences.

The mainstream medical professions (doctors and vets) have a lot to learn from the caring attitude and communication skills of those who practice homeopathy and have a loyal client following.

There is a need for all vets and doctors to reclaim the so-called ‘holistic approach’ where longer consultations are structured in such a way that there is plenty of time to address the clients at their point of need, address their concerns, explain the treatment options better, truly empathise with the owners, show that we genuinely care about the animals, show that we don’t simply treat symptoms ignoring the rest of the animal and to empower the clients to feel they are in better control of the decisions and situation.

What next?

If there’s something bothering you, something that you don’t feel is right, something that you think needs changing, I hope this will encourage you to get involved in veterinary politics whether it is contributing to the debates online, writing to the veterinary press, getting involved on BVA committees, voting for electoral candidates in RCVS and BVA Councils, or even standing for election yourself.

If you strongly feel that something needs changing, it is highly likely that others will feel the same way, so keep writing, keep posting, keep lobbying and you’ll find people do support you.

In order to wrap all this up, thank you to everyone who supported this new RCVS position on homeopathy.

I feel it is necessary to acknowledge the huge number of people who have contributed, campaigned, lobbied and shared posts which eventually led to the RCVS publishing this new position statement.

This is also to dispel the myth that is prevalent on the discussion forums among alternative medicine advocates that one or two zealous members of RCVS Council have pushed all this through against the wishes of the profession.

Firstly, thank you to everyone who has shared and responded to all the various articles and posts over the years, both online and in the veterinary and national press. This makes a huge difference.

When writing articles and setting up the change.org petition many people gave advice on the wording and helped share and promote it. There are too many to mention but in particular Alan Holford, Gwen Rees, Tom Bury, Ian Ashpole, Colin Whiting, Alex Young, Josie Parker and Chris Mimnagh. A particular mention to Robin Hargreaves who continually challenges my clarity of thought, and ensures that my approach and wording in all articles and posts (including non-homeopathy ones) are well thought out, measured and compassionate. When Robin eventually signed the petition a few months after it launched it was the first time I felt totally sure that this was a cause worth campaigning for.

One unexpected bonus of this campaign was meeting and making friends with so many lovely people along the way. My life is certainly a lot richer because of the following people.

Alice Porter was the first BBC journalist who picked up the story (her first story on joining the BBC), and as a direct result of this I ended up discussing the petition on Farming Today.

Michael Marshall, Laura Thomason and Simon Singh from The Good Thinking Society for all their support, advice, contacts and promotion of the Change.org petition. Check out their website, they do some very interesting and entertaining stuff.

A group of vets called the Campaign for Rational Veterinary Medicine (Martin Whitehead, Alex Gough, Phil Hyde, Alexander 'Arlo' Guthrie, Niall Taylor, and Mike Jessop, Martin Atkinson) who have been campaigning for the very same thing for much longer than I have. We originally found out about each other because co-incidentally they launched their own petition regarding homeopathy on the very same day that I launched the change.org one. Over the last couple of years we have collaborated in writing letters to the veterinary press which has helped to drive the discussion. Martin Whitehead in particular for his advice and meticulous research, and Arlo for very generously paying for the Vet Record homeopathy review papers written by Martin Whiting, Martin Whitehead and others to be open access.

Zoe Belshaw for general advice in a similar way to Robin, challenging the presentation and often the tone of any publications or posts. Emma Goodman Milne for contacting me even before the petition went live wanting details so she could sign and share it with her public profile.

Alison Price for contacting insurance companies regarding their approval of homeopathic nosodes in place of vaccination, and for also writing about this in the veterinary press, and having to put up with abuse as a result. It should be noted that since the RCVS Position Statement these insurance companies appear to have changed their stance on this.

Thank you to the more than 1100 vets who signed and shared the petition!

Alan Henness and Immy Grant for helping match up the names on the petition to the RCVS register.

Neil Smith for coming to Belgravia House the day I submitted the petition to discuss how to proceed, and for all his help since on pushing this forward. Also to Chris Tufnell for actively encouraging us to continue to lobby the RCVS during his Presidential term, allowing him to push for this positive change.

All the vets who elected myself and Sarah for RCVS Council when we stood on a joint ticket of improving veterinary mental health and promotion of evidence based medicine, allowing us to be involved in writing this position statement. I also very much appreciate insightful and experienced people like Neil, Amanda Boag and Stuart Reid staying up past midnight discussing and debating the best way to word and present this position statement.

Thank you to all my fellow council members for helping write this statement and then being bold enough to approve it, with no one objecting. And a special thanks to the staff at the RCVS who are on the receiving end of a barrage of angry communications over this.

It’s been 4 years since I first wrote a letter to the Veterinary Times asking why the RCVS permitted vets to use homeopathy, but between us all we’ve got there in the end.

Links and articles:

New Scientist- ‘Stop vets from offering homeopathy- placebo doesn’t work for pets’ https://www.newscientist.com/articl...

The Guardian- ‘Why we are calling for a ban on vets offering homeopathic remedies’ https://www.theguardian.com/science...

Discussion on BBC with a homeopathic vet who claims to be able to cure cancer http://www.bbc.co.uk/news/av/scienc...

Why 1100 vets believe homeopathy should not be used to treat animals: https://www.facebook.com/notes/dann...

The European Academies Science Advisory Council Statement on homeopathy August 2017 http://www.easac.eu/fileadmin/PDF_s...

RE: Has homeopathy had its day?

Michael Woodhouse — Thu, 09 Nov 2017 22:34:07 GMT

[quote user="R Falconer-Taylor"]

Extinction burst maybe?

https://www.thepetitionsite.com/219/768/240/we-need-to-stop-the-rcvs-from-banning-homeopathic-vets-from-treating-animals/

[/quote]

Over a million signed the one to bring back Jeremy Clarkson and that came to nothing.

I'm not worried!

RE: Has homeopathy had its day?

Niall Taylor — Thu, 09 Nov 2017 21:49:44 GMT

[quote user="Arlo Guthrie"]I find it rather frustrating that you can't comment on there without signing the petition ... I want to say: "Look, nobody has banned anything[/quote]

Homeopaths have never been ones to let facts get in the way of a good story.

Niall

RE: Has homeopathy had its day?

Robert FalconerTaylor — Thu, 09 Nov 2017 18:39:00 GMT

[quote user="Arlo Guthrie"]

I find it rather frustrating that you can't comment on there without signing the petition ... I want to say: "Look, nobody has banned anything. Anyway, don't worry, if you want veterinary medicine based on sound scientific principles and the best available evidence, talk to your vet. If you want homeopathy, ring https://www.thameswater.co.uk/

[/quote]

Indeed. But it doesn't matter. The RCVS has said it and petitions like this will cherry-pick and misuse the statement. 6,000 supporters? Their comments speak for themselves. The burden of proof is now on the vet-homeos as far as the VDS is concerned I think. It's not the owner's fault if they are mislead.

RE: Has homeopathy had its day?

Arlo Guthrie — Thu, 09 Nov 2017 18:26:22 GMT

[quote user="R Falconer-Taylor"]

Extinction burst maybe?

https://www.thepetitionsite.com/219/768/240/we-need-to-stop-the-rcvs-from-banning-homeopathic-vets-from-treating-animals/[/quote]

RE: Has homeopathy had its day?

Robert FalconerTaylor — Thu, 09 Nov 2017 18:03:32 GMT

Extinction burst maybe?

https://www.thepetitionsite.com/219/768/240/we-need-to-stop-the-rcvs-from-banning-homeopathic-vets-from-treating-animals/

RE: Has homeopathy had its day?

Francisco Gomez — Wed, 08 Nov 2017 06:55:40 GMT

[quote user="David Mills"]

Do the Spanish do sarcasm or just naivety?

[/quote]

Just naivety.

RE: Has homeopathy had its day?

David Mills — Wed, 08 Nov 2017 01:05:33 GMT

[quote user="Francisco Gomez"]

[quote user="Chris Barker"] Homeopathic remedies have a recognised legal status under the Veterinary Medicine Regulations, courtesy of an EU Directive. However much we may disagree with this nonsensical 'equivalence', it sits there enshrined in current Law. And thereby restricts the freedom of the RCVS, as regulator of our profession, to act; it cannot declare their use 'illegal'. There will be the opportunity post-Brexit for representation to be made to the Veterinary Medicine Directorate to require the remove of this anomaly.

[/quote]

I believe, and I don't have an iota of evidence, that most of the pro-homeopathic people are also pro-Brexit.

That's how well people were informed for the EU ref.

Please, do carry on.

[/quote]

Do the Spanish do sarcasm or just naivety?

RE: Has homeopathy had its day?

David Mills — Wed, 08 Nov 2017 01:04:29 GMT

If there's any justice in this world or the next one hopes there's a special corner of hell for homeopathic vets.

In more objective terms the RCVS has equated following EBVM with fitness to practise (2015). Bit of a pickle for homeopaths I would have thought.

Personal, again, I cannot comprehend how they sleep at night.

Hopefully a storm brews....

RE: Has homeopathy had its day?

Francisco Gomez — Tue, 07 Nov 2017 19:39:30 GMT

[/quote]

I believe, and I don't have an iota of evidence, that most of the pro-homeopathic people are also pro-Brexit.

That's how well people were informed for the EU ref.

Please, do carry on.