s The Universities (and others) Respond to FSM | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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The Universities (and others) Respond to FSM

Mark Coleman

articles by this author...

Mark is a semi-retired pharmacist.

"First do no harm" is the first law of orthodox medicine.
CAM practitioners embrace this law and are proud of the fact that their version of medicine causes minimal damage when compared to some of the practices of orthodox medicine.
Drug damage compared with alternate medicine damage is like comparing "chalk with cheese".
So what's all the fuss about?
The Friends of Science in Medicine (FSM) have certainly attracted a lot of media attention with their campaign to eliminate university training (and degrees) to a wide segment of complementary and alternate medicine (CAM) sciences.
CEO of FSM, Loretta Marron, said in a recent posting to the i2P site:

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“Government funded 'Faith healing' has no place in medical or health related degrees.
The real questions that no-one who supports quackery is prepared to answer are:

"Should tertiary institutions be teaching homeopathy, iridology, tactile healing, reiki, reflexology, kinesiology, 'fundamentalist' chiropractic and 'energy medicine' as belief systems?"

"Should they be indoctrinating 17 year olds (as first year students) that "innate intelligence", qi, meridians and chakras as a fact?"& "Should we be paying for these services in our health funds?"

If it is 'allied health' (such as hypnotherapy and massage) call it that, instead of CAM, which is an umbrella that covers all sorts of nonsense.

Of course test herbal remedies in universities but why not put "Trick or Treatment" (Ernst & Singh) as a text for all health students (some universities are already doing so) - so that students can learn about CAM from Prof Edzard Ernst the first Chair of CAM in the world, instead of from texts full of mumbo-jumbo."

The above questions are valid and do need to be answered. Certainly the various terminologies and descriptions need to be agreed and sorted.
But the debate triggered by FSM is too narrow in its focus and should embrace all players in the health industry – including those areas that are well-financed and politically well-connected.

That begs the next question – which person or body of persons could adjudicate on the various issues (which range from “snake oil” and faith healing, to downright medical fraud - and who would be at sufficient arms-length to avoid contamination from any powerful lobby group under instruction from Big Pharma, or their first cousins, orthodox medicine.

In essence, FSM has shot itself in the foot because its membership is overwhelmingly from orthodox medicine, including academics that have a close relationship with Big Pharma.
Unless it broadens its membership base to include a more representative membership (including science representatives from the CAM disciplines and consumer groups) it will be seen as elitist and dictatorial.
Another person lodging comment on the i2P site, Dr J Cowley, said:

"I do find the recent attempt by these medical academics to influence Universities re alternative medicine degrees quite astounding. It confronts the very basics of freedom of knowledge. And it makes these signatories look like a totalitarian outfit that wants to stop certain knowledge and disciplines of knowledge. They claim they are protecting consumers, because consumers want the right to choose. I have spent 30 years listening to consumers and seeing the changes-and the big reason they go to alternative medicine is they don't trust the medical theorists."

I could not help but think of that other famous totalitarian group that started off under different circumstances, and surprisingly included health in its basic philosophy i.e. Hitler's Nazi Party.
It also developed as elitist and dictatorial.

The following is from a reference site I found on the Internet:

“Hitler's Nazi theory also claimed that the Aryan race is a master race, superior to all other races, that a nation is the highest creation of a race, and great nations (literally large nations) were the creation of great races. These nations developed cultures that naturally grew from races with "natural good health, and aggressive, intelligent, courageous traits." The weakest nations, Hitler said were those of impure or mongrel races, because they have divided, quarrelling, and therefore weak cultures.”

Follow the link below for more background and make your own comparisons and assumptions as to which areas of health wear the "mongrel race" tag.

http://www.nazism.net/about/ideological_theory/

There are many CAM practitioners who regard themselves as friends of science in medicine and stand ready to defend that concept. Many have felt the contempt from orthodox practitioners who look down on them from a superior height and dump on them at every opportunity.
And legitimate allied health practitioners have also experienced this venom.
Few would feel encouraged to join the FSM organisation unless there was a major shift in policy and approach.

But what of the universities themselves?

Why would they accredit subjects that were not science-based?

A response to FSM was published recently in the New York Times (I couldn't find an Australian reference) which stated:

http://www.nytimes.com/2012/02/06/world/asia/australian-universities-defend-alternative-medicine-teaching.html

“Such universities have asserted that their courses are legitimate.

Macquarie University, which is in Sydney and offers bachelor’s and master’s degrees in chiropractic science, said it offered rigorous, high-quality courses.

“Our chiropractic science students are well trained in the fundamental relevant sciences (physiology, anatomy, biochemistry, biophysics, radiology, etc.) together with units in chiropractic methods and clinical practice,” the university said in a statement. “Our students are taught to understand that science proceeds only on the basis of evidence. We are confident that our graduates have been taught those techniques that are known through science to be beneficial.”

Nick Klomp, dean of the science faculty at Charles Sturt University, in Wagga Wagga, New South Wales, said while Friends in Science in Medicine made some valid points, the degree offered at his university, a bachelor of health science (complementary medicine), was based on science.

He said the course was designed to impart evidence-based science to people who already had a qualification, like a diploma, in alternative health care. The course includes such subjects as biology and physiology.

“They’re all subjects that are already mainstream, hard health science subjects,” Mr. Klomp said.

He said that thousands of practitioners were already providing alternative medicine and that there was much demand for their services.

“I could ignore them or I could train them better,” Mr. Klomp said, adding that a majority of the university’s students were already practicing. “We actually create graduates who are much better health care providers. It’s all about evidence based, science based.”

Murdoch University, in Perth, said it was committed to the promotion of research-led teaching and evidence-based practice across all disciplines, and that its School of Chiropractic and Sports Science was “established to be consistent with that approach.”

“Students are taught the science-practitioner model and our aim is to produce graduates who are critical thinkers,” the university said in a statement. “This enables them to distinguish between fad and genuine innovation in the discipline as practitioners, intelligent consumers of research and promoters of the scientific method. A clear distinction is made in all of our courses between areas for which the evidence is clear and those in which the science has not caught up with accepted practice and where sufficient evidence has yet to be accumulated.”

Universities Australia, which represents the country’s universities, said in a statement that the schools were “self-accrediting institutions with the autonomy and capacity to ensure the quality and relevance of the courses they offer.”

So it looks like the debate is going to be long and arduous and the real underlying agendas have yet to be fully understood.

The Bachelor of Health Science Degree offered by the universities is a stepping-stone to all the major health disciplines- pharmacy, medicine and nursing – so you have to scratch your head to understand what FSM is about.

Certainly qualifications obtained outside of a university might be questioned, but if they become university accredited at a later date then at least they have the basic building blocks to provide a professional service .

The broad-stroke approach by FSM needs to be tailored to a more rational policy.

The “big fish” that need to be fried will be found in a totally different direction, and if FSM decides to head that way, they are likely to get my full support.

Until then, I will assume that FSM has been constructed to protect a closed medical monopoly to create an expensive health monoculture. Orthodox medicine has already lost its way by selling its soul to Big Pharma. CAM practitioners do provide a genuine alternative and patients are marching with their feet because they get good and compassionate service.

Orthodox medicine needs to realise that it needs to be competitive in all of its service provision – otherwise patients will continue to march with their feet.

This is the real issue!

Return to home

Submitted by Peter Kennedy on Fri, 17/02/2012 - 09:43.

There is no "Dr J Cowley" listed on the AHPRA site as a medical practitioner nor a registered member of any other health profession.

Submitted by Mark Coleman on Mon, 20/02/2012 - 14:23.

Dr Cowley makes no reference to belonging to any of the health professions.
He could be one of those real doctors - you know, the PhD's.
Or he may be using his second name as many people commonly do (and there is a medical practitioner listed in that instance).
Or he may be from overseas- we do have a global coverage.
I think you must be getting a bit desperate in this instance and I would place on the record that nobody associated with i2P would attempt to fabricate comments in that regard which you may be trying to imply.

Submitted by Peter Kennedy on Fri, 17/02/2012 - 09:35.

Godwin's Law: The man who makes an absurd analogy equating his opponents with Hitler/Nazis, thereby automatically loses the argument.

Almost equally offensive and absurd is your continual reference to rational scientific-based medicine as "orthodox" in order to appeal to the prevailing Australian culture's residual sympathy with traditional protestant sectarian bigotry against Catholics and Eastern Orthodox who profess to maintain orthodoxy ("correct belief").

Submitted by Mark Coleman on Mon, 20/02/2012 - 14:13.

Your religious bigotry has no place in the pages of i2P and how you can argue that the word "orthodox" leads you to this view is beyond me.
After discussion with the editor I am advising that I will have no further part in this particular conversation, nor in any future comment along those lines.

Submitted by Dr Ken Harvey on Fri, 17/02/2012 - 05:51.

It’s a pity that an important debate on the role of universities in teaching complementary / alternative medicine gets side-tracked into putting up straw men and then knocking them down.

In their media release dated Jan 24, 2012 the Friends of Science in Medicine (FSM) merely argued against the uncritical acceptance of pseudoscience in Australian universities and for their removal from Australian health benefits schedules. Homeopathy, Iridology, Reflexology, Kinesiology and Energy Medicine were cited as examples.

To equate this call with the totalitarianism of Hitler’s Nazi Party and suggest that the group has been formed to protect a closed medical monopoly is both unfair and unhelpful. Stating that orthodox medicine has lost its way by selling its soul to Big Pharma is just as absurd as denying that a number of complementary medicine modalities are evidence-based and clinically useful. Equally, there are problems with some orthodox medical practitioners just as there are with some complementary medicine practitioners.

I support the call by FSM for critical analysis of the claims made by health modalities and I’ve complained equally about the unethical promotion of Big Pharma [1] as well as the sponsors of complementary medicine [2].

Let’s focus on the evidence to support claims made rather than attribute motives that may apply to a few to all.

1.http://medicinesaustralia.com.au/files/2010/01/20120214-rep-gen-pub-activities-Jan-Feb2012.pdf

2.http://www.tgacrp.com.au/index.cfm?pageID=13&special=complaint_single&complaintID=1834

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