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The most recent Skepdic newsletter contains mention of a report by the BBC on an intriguing scheme being undertaken by Northern Ireland's NHS involving referral of some patients to practitioners of complementary and alternative medicine with the NHS picking up the tab. While it may sound like a load of bollocks on the surface, the scheme promises to drastically reduce the amount of money spent needlessly on people who are not really all that sick, or who may benefit just as well from the placebo effect as from a costly drug.
Scott Sommers recently lamented on Kerim's blog that "no one who is truly ill uses [Taiwan's NHS]" and in another comment suggested that folk remedies available on the NHS represent additional costs. After reading about the scheme in Northern Ireland it struck me that the availability of traditional Chinese medicine on the NHS in Taiwan may actually be saving the government a bundle. Rather than over-prescribing prozac and other expensive pharmaceuticals of dubious efficacy, how's about a packet of dried fungus or a harmless session with an acupuncturist at a fraction of the cost? The patient feels better, the government saves money and the NHS remains in less debt than it would have been otherwise. Many Taiwanese use TCM almost exclusively for minor illnesses and non-illnesses. This is a good thing. The last thing we want is for them to be over at the real hospital being pointlessly prescribed pricey drugs. I never thought I'd hear myself say this but let's hear it for TCM on the National Health Service !
Update (2 March, 2009): This article describes some of the findings from the experiment in Northern Ireland. Eight-one percent of patients reported improvements in physical health after the treatments. So what if it's the good ol' placebo effect? It's saving money and people are happy! "The researchers concluded: 'Not only has this project documented significant health gains, but also the potential economic savings likely to accrue from a reduction in patient use of primary and other health care services, a reduction in prescribing levels and reduced absenteeism from work."
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7 comments:
Very interesting suggestion Peter. If I were open-minded and capable of listening to new ideas, this would prompt a re-think of my longstanding opposition to TCM in all forms.
I would add to the above that such a scheme would work best when the doctor is trained in both modern and folk medicines. That way the genuinely sick can get treatment and the rest can have sachets of tree bark or whatever. A number of educated Taiwanese have told me that if you want to see a TCM doctor it's best to go to a large hospital which has an integrated Chinese and Western medicine department such as China Medical University and Chung Shan Hospital in Taichung.
Actually, TCM is much more expensive than scientific medicine. I have tried it, and it is far more expensive than even paying the full cost for drugs from scientific medical doctors - which I have also done.
One of the major dangers of TCM is that patients expect an effect. As a result, manufacturers frequently add things that make you feel different. This can lead to an overdose or complications when combined with OTC drugs.
Scott Sommers.
www.scottsommers.blogs.com
"TCM is more expensive than scientific medicine." Is it Scott? TCM can be expensive but my understanding is that many Chinese medicines are dirt cheap compared with some of the most commonly prescribed "western" medications. Perhaps you were ripped off. I guess you would need to do a cost-effectivness study to compare Western medicine plus TCM and Western medicine alone for treatment of minor ailments. It will be interesting to see what impact the scheme in Northern Ireland has on overall costs. I wouldn't be at all surprised if costs go down substantially.
There have been reports about the dried fungus etc. being laced with Western meds. and even lead, for some strange reason. The reports are saying that the fungus is really quite harmful, and probably pretty addictive.
At least the dried fungus has nutritional value. Wasn't it Hypocrites who said 'let thy medicine be thy food and thy food by your medicine'? Or was it 'let your medicine and thy food'? Oh, I'm quite befuddled now.
Should I cut down on the whiskey or increase antacids?
You'll find that Placebo effect is usually at 30%. Your Ireland statistics are way off the scale for it to be just placebo.
Lead is in the herbs because mainland farmers have found that dosing their plants with it makes them heavier, thus increasing their payoff at market. Unfortunately, it has the longer-range effect of scaring off the market, as well as doing actual harm, but the farmer's either don't know, or don't care.
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