‘No Way To Treat a Friend’ - now in print

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Tue, 17 Oct 2017 18:26:55 GMT

[quote user="Arlo Guthrie"]it's an argument for looking more closely at the evidence for/against nutraceuticals ...[/quote]

That evidence should certainly be looked at but it is not something, IMHO, the RCVS should be ruling on. Highly implausible is one thing, virtually impossible and reckless to boot is quite another.

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Tue, 17 Oct 2017 18:23:56 GMT

[quote user="Malcolm Ness"]... many on this forum will use such products frequently and defend them just as robustly as the homeopath will defend their practice[/quote]

But they don't claim chondroitin can cure cancer or take the place of vaccinations. There is something peculiar to those who use ultra-dilute remedies which drives them to make grandiose claims and that is why they are a special case. You don't hear that sort of thing from acupuncturists or chiropractors, just the homeopaths, hence the concern.

Niall

RE: ‘No Way To Treat a Friend’ - now in print

Arlo Guthrie — Tue, 17 Oct 2017 17:37:45 GMT

[quote user="Malcolm Ness"]You might know something that I don't[/quote]

I doubt it

[quote user="Malcolm Ness"]Not disputing that, but the argument that homeopathic stupid is bigger than nutraceutical stupid appears thin.[/quote]

[quote user="Malcolm Ness"]I see very, very little difference between homeopathy and the pseudo-medical use of nutraceuticals, the proposed modes of action of which are often biologically implausible and which have been shown (by the accepted methods of clinical investigation) not to work.[/quote]

I know nothing about nutraceutical evidence or lack thereof, just argue from the point of view that however implausible they may be, at least the active ingredient is actually present, whereas the same cannot be said of homeopathy.

But if you're right, then it's not an argument for tolerating homeopathy, it's an argument for looking more closely at the evidence for/against nutraceuticals ...

RE: ‘No Way To Treat a Friend’ - now in print

Malcolm Ness — Tue, 17 Oct 2017 12:43:59 GMT

[quote user="Arlo Guthrie"]

[quote user="Malcolm Ness"]For example, should they also act against sellers of nutraceuticals for which the evidence base is as robust as that for homeopathy? [/quote]

Er no, that's not true.

[/quote]

You might know something that I don't but my understanding is that the negative evidence (that nutraceuticals don't help in osteoarthritis) is compelling and the supportive evidence is homoeopathically anecdotal.

[quote user="Arlo Guthrie"]Homeopathy is off the scale implausible.[/quote]

Not disputing that, but the argument that homeopathic stupid is bigger than nutraceutical stupid appears thin.

As you know, I am not a fan of homeopathy but I have significant sympathy with the regulator here. Some members are ardent homeopaths and the practice is currently legal and remarkably popular, especially among the chattering classes. I see very, very little difference between homeopathy and the pseudo-medical use of nutraceuticals, the proposed modes of action of which are often biologically implausible and which have been shown (by the accepted methods of clinical investigation) not to work. However, many on this forum will use such products frequently and defend them just as robustly as the homeopath will defend their practice.

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Tue, 17 Oct 2017 12:31:00 GMT

[quote user="Malcolm Ness"]I can understand your frustration, but if RCVS were able and willing to "take action" against homeopaths where should they stop? For example, should they also act against sellers of nutraceuticals for which the evidence base is as robust as that for homeopathy? Similarly, how robust an evidence base should exist for, lets say, a surgical procedure before vets are permitted to perform it without fear of the same kind of action being taken?[/quote]

I'm not convinced by the 'thin end of the wedge' argument, Malcolm. Homeopathy isn't just not evidence-based, it's tenets lie outside the real world, it is effectively impossible for homeopathy to work, there is literally no medicine in the medicine (or nano-particles, quantum bubbles or anything else of relevance for that matter).

This a priori consideration is critical and doesn't apply to other forms of treatment - herbal, nutriceuticals, certain surgical procedures - which at least have a chance of working, even if vanishingly small. This is not the same as someone giving B12 for diarrhoea on spec, before they've run the TLA, folate and cobalamine levels.

It would be very straightforward for RCVS to make the distinction between the use of content-free ultra-dilute remedies (i.e. homeopathy, isopathy, the use of sarcodes and Bach flower remedies) and other forms of treatment, and to put out a statement to the effect that they have been shown to be ineffective and RCVS won't condone their use by MsRCVS. I would also like to see them saying something along the lines of the human cancer act and that claiming to be able to cure cancer with these remedies (or any form of CAVM) is a disciplinary offence.

Niall

RE: ‘No Way To Treat a Friend’ - now in print

Arlo Guthrie — Tue, 17 Oct 2017 09:39:32 GMT

[quote user="Evelyn Barbour-Hill"]But what you are saying is that RCVS should say"you can't get this stuff from a veterinary surgeon (who is under our regulation, and to whom is confined by law the practice of veterinary surgery, including the making of a diagnosis), but don't worry, we are not reducing your choice, you can still get it from one of those groups of self-appointed practitioners who constantly bend and break the Veterinary Surgeons Act but of course we can't regulate and whose dubious or just plain illegal activities we seem to be unable to do anything to curtail."[/quote]

I think the clue is in the name; that the RCVS should not try to extend its reach to cover any Tom, Dick or Harry who wants to hold themselves up as offering some kind of quasi-healthcare.

Apart from the complexity in defining scope, do you really think the RCVS has the resources to police it?

And as Niall points out ...

[quote user="Malcolm Ness"][quote user="Niall Taylor"]But they are a toothless tiger, the RCVS have never taken action against any vet homeopath,[/quote]

I can understand your frustration, but if RCVS were able and willing to "take action" against homeopaths where should they stop?[/quote]

The RCVS has shown little sign of regulating quackery within its own ranks, so far justifying it as as 'meeting client demand'.

And yes, it could get very messy if the RCVS tried to regulate everyone. Far better, I would argue, to banish quackery to the sidelines and focus on veterinary healthcare. To stand up and say: "We are a proudly science-based profession, and our members make science-based treatment decisions."

The RCVS should champion science and the scientific method to consumers, and the benefits to consumers (that it improves veterinary care). To be fair, it does this already, it just makes some strange exceptions.

[quote user="Malcolm Ness"]For example, should they also act against sellers of nutraceuticals for which the evidence base is as robust as that for homeopathy? [/quote]

Er no, that's not true. Homeopathy is off the scale implausible. Up there alongside crystal therapy.

But the fear is that as you say, the evidence base for many things is weak, so where is the line drawn?

SIMPLE. This is not about things for which there is a weak evidence base. This is about the very small number of things which are, to all intents and purposes, scientifically impossible. It is a very well-defined line. It is also not cast in stone. If new scientific evidence emerges that crystal therapy or homeopathy or chiropractic has any medical benefit, it would be welcomed.

The profoundly important benefit to society, as we are seeing in the media coverage (another story today, this time in the Daily Mail: http://www.dailymail.co.uk/health/article-4984244/Homeopathy-QUACKERY-experts-warn.html) about the homeopathy paper by Danny Chambers, Martin Whitehead, Peter Lees et al, lies in educating owners.

It is difficult to understate the importance of this. We live in the post-truth era in which science is under threat; when everyone's opinion is held up as fact; when people have the opportunity like never before to preach their personal anecdotes to huge audiences.

Science and the scientific method, flawed as it is, needs more champions. The veterinary profession should be at the vanguard.

RE: ‘No Way To Treat a Friend’ - now in print

Malcolm Ness — Tue, 17 Oct 2017 08:04:12 GMT

[quote user="Niall Taylor"]But they are a toothless tiger, the RCVS have never taken action against any vet homeopath,[/quote]

I can understand your frustration, but if RCVS were able and willing to "take action" against homeopaths where should they stop? For example, should they also act against sellers of nutraceuticals for which the evidence base is as robust as that for homeopathy? Similarly, how robust an evidence base should exist for, lets say, a surgical procedure before vets are permitted to perform it without fear of the same kind of action being taken?

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Tue, 17 Oct 2017 07:21:43 GMT

[quote user="J G Wray"]I've always wondered what a homeopathic veterinary surgeon's CPD log looks like[/quote]

Very, very small and written in squid ink!

RE: ‘No Way To Treat a Friend’ - now in print

J G Wray — Tue, 17 Oct 2017 07:17:30 GMT

I've always wondered what a homeopathic veterinary surgeon's CPD log looks like

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Tue, 17 Oct 2017 07:02:52 GMT

But they are a toothless tiger, the RCVS have never taken action against any vet homeopath, mainly they take the line that any complaint must come from a client or owner, not from other vets, and that rarely if ever happens.

The one time they were persuaded to take action against someone who sold 'oxygenated water' as a health aid they backed out at the last minute with a behind closed doors settlement and the offending website and apart from a few minor tweaks literature remains essentially the same to this day; the RCVS seeming not to monitor the changes they insisted on. The RCVS hasn't acted to address claims from vet homs they can cure cancer with sugar tablets or when they tell conventional clients that their animals should stop taking real drugs or the homeopathy won't work or that you can make a diagnosis or decide on a treatment plan by means of dowsing or ESP.

Homeopathic remedies are available over the counter at Boots or direct from the pharmacies without a prescription. If an owner decides their animal has a fictional condition like 'vaccinosis' or 'electromagnetic stress' then there is no need to get a vet involved, these things are simply fantasy. If they prefer a real diagnosis then they should go to a vet who is grounded in real medicine, not one who will play on their fears.

Niall

RE: ‘No Way To Treat a Friend’ - now in print

Evelyn Barbour-Hill — Mon, 16 Oct 2017 21:40:39 GMT

[quote user="Arlo Guthrie"]

[quote user="Evelyn Barbour-Hill"][quote user="Arlo Guthrie"]

[quote user="Evelyn Barbour-Hill"]Do you want yet another group of persons joining the rodentologists and the acupuncturists and the back men and the chiropractors and the anaesthesia-free tooth scalers and all the rest of 'em who claim a right to escape the provisions of the Veterinary Surgeons Act?[/quote]

Yes.

That is precisely what should be done. [/quote]

Well, it may be because you're not a veterinary surgeon, Arlo, but I think you're mad to say that.[/quote]

What I was trying to say is that quackery should be relegated to the sidelines alongside these groups of people, not given the tacit endorsement of the regulator, or of being regulated.

[/quote]

But what you are saying is that RCVS should say"you can't get this stuff from a veterinary surgeon (who is under our regulation, and to whom is confined by law the practice of veterinary surgery, including the making of a diagnosis), but don't worry, we are not reducing your choice, you can still get it from one of those groups of self-appointed practitioners who constantly bend and break the Veterinary Surgeons Act but of course we can't regulate and whose dubious or just plain illegal activities we seem to be unable to do anything to curtail."

RE: ‘No Way To Treat a Friend’ - now in print

Arlo Guthrie — Mon, 16 Oct 2017 16:46:01 GMT

[quote user="Evelyn Barbour-Hill"][quote user="Arlo Guthrie"]

Yes.

That is precisely what should be done. [/quote]

Well, it may be because you're not a veterinary surgeon, Arlo, but I think you're mad to say that.[/quote]

What I was trying to say is that quackery should be relegated to the sidelines alongside these groups of people, not given the tacit endorsement of the regulator, or of being regulated.

[quote user="J G Wray"]This is a slightly specious reply to fella from Bangor, because the RCVS hasn't and wouldn't "endorse" these people. [/quote]

Really, well it didn't fall far short earlier in the statement from a past-pres: http://veterinaryrecord.bmj.com/content/179/3/79.1

[quote user="J G Wray"]The smart thing to do is not rely on the overwhelming argument in favour of science to cut any ice with the undecided, but to have an answer to the interference with choice/interference by the self-interested/homeopathy ban and, crucially, positive reasons for going with the science. [/quote]

This seems to suggest that you're saying the undecided have rejected science, and are fighting interference with choice by the self-interested.

I would argue that these constitute a relatively small (but vociferous) minority, and that the majority are just benignly ignorant of the facts.

I think back to when we were referred to an 'opathist' because my newly born child had a misshapen head (looked like a traffic cone). He advised us to put our child's head between two piles of encyclopaedias at night. I'm not joking.

We didn't realise he was a charlatan (in France, and we'd been referred by a GP). We weren't anti science. We were just ill-informed. And in fact, it wasn't until some years later that I discovered that osteopathy (and cranial osteopathy) is completely barking mad.

Wish there had been a regulator around to tell me that at the time.

RE: ‘No Way To Treat a Friend’ - now in print

J G Wray — Mon, 16 Oct 2017 15:34:00 GMT

[quote user="Niall Taylor"]No one's talking about removing animal owners' choice, they will still be able to access 'duff' stuff, just not from people practicing as MsRCVS. And that might go some way to folks asking why that endorsement no longer stands. Those who believe in an establishment conspiracy do so already, those who aren't already taken in by homeopathy but think there could be 'something in it' might be given pause for thought.[/quote]

I think, old fruit, you're being naive. The interference with choice and the interference by the self-interested look like two headline arguments along with "homeopathy ban". The smart thing to do is not rely on the overwhelming argument in favour of science to cut any ice with the undecided, but to have an answer to the interference with choice/interference by the self-interested/homeopathy ban and, crucially, positive reasons for going with the science.

This is so much more than finding weapons for a fight now. It's also about what comes after and moving animal welfare on, in a positive and active way

RE: ‘No Way To Treat a Friend’ - now in print

J G Wray — Mon, 16 Oct 2017 15:24:09 GMT

[quote user="Arlo Guthrie"]

Yes.

That is precisely what should be done.

Or would you rather the converse? That the RCVS endorses and embraces rodentologists, back men, chiropractors, anaesthesia-free tooth scalers et al, so that they can no longer claim exemption from the VSA?

[/quote]

This is a slightly specious reply to fella from Bangor, because the RCVS hasn't and wouldn't "endorse" these people. It is a Regulator that might wish to Regulate these people through a new VSA because that's what it does, up to a point - that point being similar to RCVS' current view of homeopathic veterinary surgeons.

You haven't presented two opposites.

RE: ‘No Way To Treat a Friend’ - now in print

Evelyn Barbour-Hill — Mon, 16 Oct 2017 15:04:37 GMT

[quote user="Bob Russell"]

I believe the RCVS should grow a pair of ++++ and make a clear statement that these therapies are not recommended because there is no evidence for efficacy.

Not sure I would ban them as such because as has been said, at least there is someone making a diagnosis.

Any vet found causing or failing to prevent undue suffering as a result of using these therapies should face disciplinary action.

[/quote]

Exactly so.

RE: ‘No Way To Treat a Friend’ - now in print

Evelyn Barbour-Hill — Mon, 16 Oct 2017 15:01:38 GMT

[quote user="Arlo Guthrie"]

Yes.

That is precisely what should be done.

[/quote]

Well, it may be because you're not a veterinary surgeon, Arlo, but I think you're mad to say that.

RE: ‘No Way To Treat a Friend’ - now in print

Bob Russell — Mon, 16 Oct 2017 14:27:41 GMT

At present there is nothing to stop a veterinary surgeon becoming a rodontologist should he or she be 'twisted' enough to join their ranks.

I don't believe the RCVS should provide any endorsement for the weird and wonderful so called therapies especially when it is individuals from within their ranks.

Magic sea water, therapeutic blankets and boxed bullsh+t are all going to receive a degree of credibility based on the 'prescriber' being a veterinary surgeon.

I believe the RCVS should grow a pair of ++++ and make a clear statement that these therapies are not recommended because there is no evidence for efficacy.

Not sure I would ban them as such because as has been said, at least there is someone making a diagnosis.

Any vet found causing or failing to prevent undue suffering as a result of using these therapies should face disciplinary action.

The RCVS should try to guide a gullible general public into making sensible, informed decisions. Obviously many or even most will ignore all of this.

Education is better than a ban. Someone will take over the mantle of homoeopathy in the face of a ban.

Keep your friends close and your enemies closer.

RE: ‘No Way To Treat a Friend’ - now in print

Arlo Guthrie — Mon, 16 Oct 2017 13:57:50 GMT

Yes.

That is precisely what should be done.

RE: ‘No Way To Treat a Friend’ - now in print

Evelyn Barbour-Hill — Mon, 16 Oct 2017 13:30:49 GMT

[quote user="Niall Taylor"]No one's talking about removing animal owners' choice, they will still be able to access 'duff' stuff, [/quote]

Not legally they won't.

Do you want yet another group of persons joining the rodentologists and the acupuncturists and the back men and the chiropractors and the anaesthesia-free tooth scalers and all the rest of 'em who claim a right to escape the provisions of the Veterinary Surgeons Act?

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Mon, 16 Oct 2017 11:41:26 GMT

[quote user="J G Wray"]Are your aims the same or satisfactorily similar?[/quote]

You've given two examples of what motivates us, our aims are the same.

[quote user="J G Wray"]And what would the reaction to that message be? Could it be anything other than the Establishment knows best?[/quote]

"The Establishment knows best" is already being used as an argument (conspiracy theory) by homeopathic proponents. I'm happier with that as a position to argue from than the contrary argument, "the establishment says homeopathy works.

[quote user="J G Wray"]are you forward thinking enough to see how you can make the other claim that a scientific approach has merit?[/quote]

A statement from RCVS to that effect would be a step in the right direction!

[quote user="J G Wray"]Owners want choice, even if it's duff choice... If you remove choice, then that which is left will not be the answer because it is happening in the context of restricted choice from some kind of Authority... I am asking whether you have planned for the day after and the year after homeopathic practice is proscribed[/quote]

No one's talking about removing animal owners' choice, they will still be able to access 'duff' stuff, just not from people practicing as MsRCVS. And that might go some way to folks asking why that endorsement no longer stands. Those who believe in an establishment conspiracy do so already, those who aren't already taken in by homeopathy but think there could be 'something in it' might be given pause for thought.

[quote user="J G Wray"]Nailing homeopathy does not look to me like a cure...[/quote]

Sorry, I have used a metaphor which has clouded the issue rather than simplifying it, please ignore!

RE: ‘No Way To Treat a Friend’ - now in print

Arlo Guthrie — Mon, 16 Oct 2017 09:59:08 GMT

[quote user="J G Wray"]

[quote user="Niall Taylor"]the idea behind 'No Way to Treat a Friend' and the Campaign for Rational Veterinary Medicine is to put a stop to the tacit endorsement of homeopathy by our governing body.[/quote]

[quote user="Arlo Guthrie"]

The idea here is to spread the word and educate people that homeopathy and most other forms of alternative medicine are discredited and ineffective, so they can be consigned to room 101. In other words, not to drive the practice underground, but to enlighten people so they don't want to use it any more.

That is the goal.

[/quote]

[quote user="Arlo Guthrie"]For me, this is about the bigger picture of human health. [/quote]

Are your aims the same or satisfactorily similar? For credibility and influence there should be no doubt.

[/quote]

Of course they are!

Part of educating people that some things have no basis in science is to put an end to the tacit endorsement by the governing body.

RE: ‘No Way To Treat a Friend’ - now in print

Martin Atkinson — Mon, 16 Oct 2017 09:14:36 GMT

[quote user="Jill Butterworth"]

[quote user="Martin Atkinson"]The problem with our local population is that they're mostly too thick to understand what the f*** its on about[/quote]Steady on Martin, you could do a Ratners...

[/quote]I did that a long time ago. I now have a nice quiet practice with mostly my bonded clients and a few thickos who are so thick they don't realise.

RE: ‘No Way To Treat a Friend’ - now in print

J G Wray — Mon, 16 Oct 2017 07:30:48 GMT

[quote user="Arlo Guthrie"]

That is the goal.

[/quote]

[quote user="Arlo Guthrie"]For me, this is about the bigger picture of human health. [/quote]

Are your aims the same or satisfactorily similar? For credibility and influence there should be no doubt.

[quote user="Niall Taylor"]If MsRCVS are prevented from using homeopathy, such a move from RCVS would send a strong message to the public about homeopathy and go a long way to quashing the idea that there must be something in it because qualified vets use it (which is heard ad nauseam on discussion forums).[/quote]

And what would the reaction to that message be? Could it be anything other than the Establishment knows best?

[quote user="Niall Taylor"]I am not convinced that an animal being attended by a homeopathic vet does have access to 'current scientifically based examination and treatment', the cases above and various statements from prominent vet homeopaths would suggest otherwise. The welfare implications are already entirely negative as things currently stand, veterinary homeopathic practitioners treat owners, not animals.[/quote]

Quite, but are you forward thinking enough to see how you can make the other claim that a scientific approach has merit? This may seem obvious to a logical premise where everything is binary, if not zero then one, but we know perfectly well this isn't the case here. Owners want choice, even if it's duff choice. Some people buy French cars for instance. If you remove choice, then that which is left will not be the answer because it is happening in the context of restricted choice from some kind of Authority.

if you are taking on a Crusade like this, with logic and certainty at it's heart, then you are also taking on a responsibility as well and I am asking whether you have planned for the day after and the year after homeopathic practice is proscribed. Will that be a place where animal welfare has been enhanced consequent upon your efforts and a convincing argument made to those who use homeopathy, or just the former.

[quote user="Niall Taylor"]As someone once said, 'if the cure is to nail a chicken to the stable door, what does it matter who does the nailing?'.[/quote]

This isn't about you, unless it is. I think your aims are in the wrong place. Nailing homeopathy does not look to me like a cure, if it does not go hand in hand with something convincingly and compellingly better and a logical approach to that ain't the answer.

RE: ‘No Way To Treat a Friend’ - now in print

Jill Butterworth — Sun, 15 Oct 2017 23:08:08 GMT

[quote user="Martin Atkinson"]The problem with our local population is that they're mostly too thick to understand what the f*** its on about[/quote]Steady on Martin, you could do a Ratners...

RE: ‘No Way To Treat a Friend’ - now in print

Niall Taylor — Sun, 15 Oct 2017 21:07:48 GMT

[quote user="J G Wray"]If this goes "underground" after RCVS caves to your pressure, then how will you be able to say that you have enhanced the quantum sum of animal welfare for those animals controlled by Believers?

Pressuring RCVS is one thing. Showing homeopathy to be bunkum is another, but what of the animals not accessing current scientifically based examination and treatment.

Isn't that the bigger game?[/quote]

There are plenty of examples of human patients being harmed or dying as a result of using homeopathy in lieu of proper treatment (for examples see here and here). There are fewer examples of cases in the veterinary world (here, here, here and here) but since animals don't benefit from the checks and balances, medical inquiries, coroners courts and pressure from grieving relatives that humans do we have no way of knowing whether these cases are only the tip of the iceberg.

If MsRCVS are prevented from using homeopathy, such a move from RCVS would send a strong message to the public about homeopathy and go a long way to quashing the idea that there must be something in it because qualified vets use it (which is heard ad nauseam on discussion forums). I am not convinced that an animal being attended by a homeopathic vet does have access to 'current scientifically based examination and treatment', the cases above and various statements from prominent vet homeopaths would suggest otherwise. The welfare implications are already entirely negative as things currently stand, veterinary homeopathic practitioners treat owners, not animals.

As someone once said, 'if the cure is to nail a chicken to the stable door, what does it matter who does the nailing?'.

That, for me, is the bigger game.

Niall