When good doctors go bad

Alternative medical practitioners often start out in the mainstream, but other currents may take them into new channels. This article is adapted from a presentation at the 2006 NZ Skeptics conference.

A recent survey of general practitioners found that about one third practised some form of complementary and alternative medicine (CAM). The term CAM refers to a range of medical treatments which are considered outside the realms of conventional medicine because they remain scientifically unproven. Why is it that so many GPs get involved with CAM? Should we accept the term CAM? There can surely be only proven and unproven medical treatments.

I entered medical school in 1971 when I was 19. For the next six years I studied and was taught that doctors were supposed to talk to people, examine them and make a diagnosis. This is quite a sound approach for hospital-based medicine but not very useful in general practice which is where I found myself.

Many general practice surveys have shown that a large proportion of patients do not have a clear diagnosis. These people are often referred to as the ‘worried well’. They have symptoms rather than diseases. There are GP abbreviations for common conditions such as TATT syndrome for ‘Tired all the time’. People who attend regularly with a litany of such complaints are often referred to as ‘heart sink’ patients.

In my own general practice I had the same sort of patients. I became dissatisfied with my inability to diagnose and treat problematic conditions and was in the right frame of mind to try something new, something alternative. Acupuncture seemed to offer all the answers.

I spent a week training in Auckland. The trainer had palatial rooms and drove a Mercedes. He was a charismatic figure. I was impressed! However, some things troubled me. I noticed that acupuncture points seemed to be very close together and it was time-consuming having to refer to charts to locate the correct points. Why use a particular set of points? The trainer said to me “Don’t worry John, acupuncture is very forgiving”.

My scientific curiosity was provoked and I immediately wondered whether it mattered at all where acupuncture needles were placed. I found that it didn’t and got the same results just sticking them in at random.

I soon lost interest in acupuncture.

The great thing about learning from your mistakes is that you recognise them when you make them again. My next experiment was with spinal manipulation. I attended a weekend workshop run by another GP who had written a book on the subject. The techniques were easily learned and I was soon able to produce pleasing noises from any part of the spine. The results could be spectacular and soon my appointment books were full and I was making a lot of money. I realised I had unwittingly stumbled across the secret of chiropractic and osteopathy. Create a need or a belief and then fill it.

I stopped doing spinal manipulation when I had a patient faint after I had manipulated her neck. I thought I had either damaged the spinal cord or damaged arteries in her neck.

There is a known association between manipulation of the neck and stroke. The shearing forces used in manipulation of the neck are capable of damaging the blood supply to the brain. It was always believed that this complication was rare but when a stroke unit started specifically enquiring about prior chiropractic or osteopathic manipulations they found that the incidence of stroke was ten times higher than previously suspected. A sore neck will get better on its own with no risk of such complications. I think I was wise to abandon spinal manipulation.

Case Studies

All of the information for the following case studies has come from the public domain. I have referred to some patients as index patients where for some reason they became important either through media interest or disciplinary proceedings.

Case One

Dr A became interested in Vega testing and homeopathy when he was about 35. The Vega test machine is a derivation of the Wheatstone bridge, an instrument used to measure resistance. Most alternative medical devices are derived from legitimate scientific instruments.

Testing of a small child involved the application of one electrode to the mother’s left middle toe while she held the other electrode in one hand. The child, who was not actually examined, sat in her lap until he became bored and ran around the surgery. Dr A directed questions telepathically to the mother with the responses being analysed by the Vega machine. This revealed allergies as well as evil miasmas which were treated by homeopathic solutions. Homeopathic solutions contain only water but they can also contain a lactose base. The child had lactose intolerance and suffered what was described as a violent gastrointestinal disturbance.

The next child was tested in the same manner and the diagnosis was further evil miasmas from a promiscuous grandmother but this time the mother was also diagnosed with latent diabetes and cancer of the cervix.

Another child with suspected allergies and asthma was diagnosed as having selenium deficiency, allergies to wheat, caffeine and dairy products, as well as more evil miasmas inherited from criminal ancestors. The Vega machine was obviously working to capacity on this day because Dr A was also able to predict for the child diabetes at age 40, and Alzheimer’s at 70, provided he did not succumb from the possibility of a fatal motor vehicle accident at 17. However, the machine failed to see the heavy hand of the Medical Practitioners’ Disciplinary Committee (MPDC) and Dr A was rebuked and heavily fined.

Case Two

Dr B was aged 32 years and a GP at the time of an emerging interest in CAM.

As a fourth year medical student, he was involved in the care of a patient who suffered a fatal drug reaction and died. At the time Dr B said “I was pretty horrified and from then on I questioned the whole philosophy of medicine.” Distraught, he dropped out for a while and then began using nutritional supplements in general practice. He consulted with a lawyer to avoid any breach of medical ethics and continued using nutritional supplements, hair analysis and chelation therapy.

The index patient was a 62 year old with terminal brain cancer who was not confident about proven medical treatments. He was diagnosed with heavy metal poisoning on the basis of hair analysis and treated with chelation therapy and nutritional products for which the GP was getting a 25 percent commission from Neo Life, a multi-level marketing organisation.

The patient’s son complained that his father was spending $800-1000 per month on these.

Dr B was investigated by the MPDC and Consumer but there was no adverse finding in law because Dr B had demonstrated the “honesty and good faith” required by the Medical Practitioners Act. Dr B said “there are some large powers that have financial interests in maintaining general practice as it is, with doctors writing a lot of prescriptions.” The irony of this appears to have been overlooked by Dr B whose own financial interests appeared to be flourishing.

Case Three

Dr C practises electroacupuncture using black box devices such as the Vega machine to diagnose mercury poisoning and other environmental illnesses.

Dr C is anti-immunisation, anti-fluoridation, anti-dental amalgam and claims that ascorbic acid (vitamin C) “is uniformly effective in treating all of the childhood illnesses including hepatitis and polio.”

In 1995 I complained to the MPDC about his anti-immunisation activities. Off the record, I was told that at least 30 other doctors had written similar complaints but the MPDC was powerless to act until a patient either made a complaint or was harmed.

Case Four

Dr D is also a GP who graduated in 1977. He became interested in an unconventional approach following a mysterious family illness which allegedly turned out to be arsenic poisoning, an unlikely diagnosis in my opinion.

Dr D took up using a combination of Bi-Digital O-Ring Test (BDORT) or peak muscle resistance testing as well as homeopathy and prayer.

Some patients complained they had been harmed by his treatments and duly complained to the MPDC. During this hearing one of the expert witnesses offered to devise a blind trial of BDORT and Dr D declined. Dr D was struck off the medical register and fined.

Some time later he was back for a second appearance. This time there was a complaint from a patient who had been suffering from abdominal pain, flatulence and was passing blood in his bowel motions. The patient was seen 19 times and diagnosed with: salmonella, campylobacter, helicobacter, bowel bug, blood fluke, Tordon poisoning, amoebic infection, colitis and irritable bowel syndrome.

He was seen by another doctor who organised a colonoscopy which revealed terminal bowel cancer.

So why do so many GPs get involved with CAM?

Doctor factors

There is still a great deal of uncertainty in medicine. Some doctors find it difficult to cope with uncertainty and are attracted to any pseudoscience that ends uncertainty and reduces complexity by relying on a simple diagnostic or treatment method.Some become disillusioned with medicine due to bad experiences in training or become unhinged by life events.

Psychologists refer to the “power of vivid instances” and this can apply equally to both good and bad experiences. Medical students are selected from the general population and bring with them their own belief systems.

Some doctors have a powerful personality and although they may be aware of and sensitive to the placebo effect this is no guarantee against becoming subject to a belief in their own placebo. Some doctors practising CAM have been challenged to put their methods to the test. They will generally refuse; since these doctors know that their methods work, they conclude there must be something wrong with the scientific method which must therefore be avoided. They will argue that their belief system works through some as yet unknown mechanism. This argument has been described as loopholeism or “the plea for special dispensation”. It is such a common argument that when it is invoked it is diagnostic of quackery.

There is no doubt that some doctors are motivated by money and this wealth becomes a de facto validation of their practices.

I could not find any comparable surveys of specialists who are actively involved with CAM but I suspect that few specialists would be, because the focused nature of specialist practice would tend to exclude unproven treatments.

Patient Factors

The essentially psychosomatic symptoms of the ‘worried well’ have changed very little from the 1920s, with pain and fatigue being dominant symptoms.

There is a huge market for all sorts of unscientific treatments and people are ready and willing to pay for these.

There has been a loss of the folk culture of knowledge which gave people commonsense understanding of their own bodily sensations. As a child I can hardly remember being taken to a doctor. My mother treated our colds, sprains and other injuries. Now people demand antibiotics, X-rays and physiotherapy.

The pharmaceutical industry has not been slow to exploit this by promoting drugs for symptoms rather than diseases. For example, indigestion is now called gastro-oesophageal reflux disease and widely treated with omeprazole or Losec.

Modern medicine can exclude organic illness with a high degree of certainty. Psychological illness is neither fashionable nor acceptable. Symptomatic individuals attribute their symptoms to some external cause such as poisons or toxins and there is a constant background of conditions such as total allergy syndrome and yeast infection, punctuated by epidemics such as Chronic Fatigue Syndrome and Occupational Overuse Syndrome. Because such conditions are largely rejected by conventional medicine they provide a fertile source of income for CAM treatments.

The treatment of cancer is often unpleasant and again it is hardly surprising that sufferers are attracted by the promise of painless treatments with good results. The Lyprinol scandal is a case in point. People are living longer and tend to accumulate a range of chronic disorders such as arthritis, insomnia, and diabetes. Chronic diseases typically undergo a cyclical course with peaks and troughs and the trick is to provide a CAM treatment during a trough so as to coincide with a naturally occurring improvement.

Lessons from Medical History

One hundred and fifty years ago you could easily argue that most doctors were quacks. Medicine had little scientific basis and treatments were often dangerous if not lethal. It was safer to have no treatment at all rather than subject yourself to bleeding or purging. Homeopathy was much safer and the doctors who chose such treatments would have had a following.

As medicine built on a secure knowledge base, the advent of the randomised placebo controlled trial (RPCT) meant the arrival of effective treatment.

Such trials are a threat to unscientific treatments and are able to refute them. A common argument is that RPCTs cannot be used to evaluate homeopathy, for example, because the homeopathic treatment is especially tailored for each patient. This has led to the testimonial becoming the form of evidence favoured by alternative medicine.

People are not comfortable with the idea that they have a psychosomatic condition. It’s easier to admit you have a broken arm than that you are depressed. In the 20th century the dominant theme is the loss of the nuclear family with associated isolation and a loss of intimacy leading to a great fear of the outside world, expressed as agoraphobia and multiple chemical sensitivity.

Perhaps the greatest lesson from medical history is the way various ideas are constantly recycled. The early 1900s was the era of autointoxication from the large bowel. People have always been obsessed by constipation and at one stage a fashionable surgeon, Sir Arbuthnot Lane, was performing total colectomies for this spurious condition. The operation soon fell into disrepute but the theory of autointoxication has undergone a revival with ‘colonic cleansing clinics’.

During the 19th century Parliament recognised the need for some kind of registration of doctors in order to give them some legal standing and acknowledgment of proper medical training. The first medical registration act passed in 1858 included a ‘homeopathy clause’ that has persisted to this day, which says in effect that no doctor can be found guilty of misconduct merely because of a particular practice or belief if he has acted honestly and in good faith.

In practice this means that registered medical practitioners can practise the most blatant quackery and get away with it provided that they don’t harm any patients. Some countries such as Canada have dropped the homeopathy clause and NZ should do the same.


Doctors used to be an authoritative source of health information. Now anyone can go online and access health information. Informed choice has become fashionable. An element of consumerism has crept into medi-cine and as well as being GPs, doctors have to run a successful business. CAM is a lucrative area and if people are prepared to pay it’s hardly surprising that many doctors cater for this demand. A recurring theme is natural versus unnatural. There is a nostalgia for the natural remedies used by Rousseau’s noble savage. Many herbal remedies vary widely in composition. Some brands of ginseng don’t contain any active ingredient at all. At least you get what’s on the label when you fill a prescription for digoxin.


There is something about general practice which attracts an interest in CAM. The case studies are extreme but there are plenty of GPs continuing to use such diagnostic methods and treatments. Is it acceptable for medical graduates with a science degree to be allowed to carry on in this manner? Should we amend the relevant legislation so they can’t? I welcome your thoughts and suggestions.

Hokum Locum

During my recent overseas trip I had two stopovers in Hong Kong. The South China Morning Post (3 October) reports that demand from patients has led to a policy where acupuncture treatment will be allowed for patients recovering from stroke and cancer. This is rather an unfortunate move because a very recent study found no difference between acupuncture and sham acupuncture in their ability to perform daily activities of living or in their healthrelated quality of life. The study involved 116 patients who received 12 treatment sessions during a two-week period. [Park J and others, 2005: Acupuncture for subacute stroke rehabilitation. Archives of Internal Medicine 165: 2026-2031, 2005].

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Body Enhancer’s benefits are Bogus

Fresh from a visit to Iraq, John Welch is ready to embark on a jihad against quackery…

The product Body Enhancer, marketed by the Zenith Corporation, costs $95 per bottle and is “claimed to assist fat burning, muscle growth and liver detoxification.” A judge, however, found that the product offered ‘bogus benefits’ although the couple behind the company remained defiant and claimed that they were “scapegoats for the natural remedy industry.”

Judge Lindsay Moore was reported as describing Lindsay Gallot as ‘calculatedly dishonest’ and accused his partner of making blatantly false claims. This is perfectly understandable criticism as Mr Gallot is described as an ex-geologist and his wife as an ex-physics teacher. One would be entitled to expect that two people with a scientific background would not get involved in such pseudo-scientific nonsense. In their defence the couple claim that the product was tested by a Maori health provider and their clinical advisor Dr Tane Taylor was quoted as saying “he understood the results were positive”. According to the NZ Medical Council website, Dr Taylor has a medical degree from Albania and I know from my time in Auckland that he was involved with a chelation clinic, and I think that ends any scientific credibility that he might lend to the subject. For a full report as published in the Sunday Star Times go to: www.stuff.co.nz/stuff/0,2106,3303250a10,00.html

The next website, www.zenith.co.nz/ComComm_Rebuttal07.html, describes some kind of pseudoscientific trial and then goes on to say that the results cannot be published on the web. Testimonials are called on in support, which is a hallmark of quackery. It is not a good business practice to test your own product and find that it is useless. Much better to rip off the punters who feel compelled after wasting $95 to give it an endorsement. However, one unusually sceptical ustomer described the product as “the most putrid stuff I’ve ever tried”. I bet that testimonial was never used!

Guns will make us powerful; butter will only make us fat

Herman Goering obviously didn’t follow his own advice and now it seems remarkable that his huge frame ever fitted the cockpit of a World War One fighter aircraft where he was an acknowledged fighter ace. Morphine addiction must have addled his brains.

No such excuse for John Keitz who weighs 283kg and has been bedridden since August, 1998. He even cooks from his bed and this recipe gives some clue to his problem: six chicken breasts, a pound of butter……need I go on? John is now in receipt of disability benefits and can be cared for in a home funded by Medicare benefits of US$313 per day. This sort of grotesque celebration of excess is made all the worse by the excuses made by those people who specialise in medicalising human behaviour and the denial of personal responsibility. As Ivan Illich pointed out, the medical profession among others has always looked to extend its sphere of influence by “expropriating the power of the individual to heal himself.” This means that people exhibiting sick behaviour need to be allowed to suffer the consequences of such behaviour in order to make changes. Here, a parody of the American dream of ‘success’ is looked after in such a way that he can afford to buy even more chicken breasts and even more butter. At least he had the good sense not to bother with any of the useless products from the Zenith Corporation.

Dominion Post 2 July 2005

Something is rotten in the state of Sweden (and Denmark?)

Dr Elinder was a paediatrician in New Zealand and after returning to his native Sweden he criticised the tendency of his colleagues to over-diagnose such conditions as ADHD, minimal brain dysfunction and autism spectrum disorder, as well as the excessive use of Ritalin in treating such conditions. He was supported by a colleague, Dr Karve, who found serious flaws in the work done by a group led by a Professor Gilberg. In 1998, Dr Elinder asked to see Prof Gilberg’s research data but this request was refused and subsequently the data was destroyed with the connivance of the University of Gothenburg. This sort of disgraceful behaviour is the antithesis of science, which depends on independent verification and reproducibility. One tends to view the Scandinavians as somewhat placid and serious people but all that changed with the extraordinary attack on Bjorn Lomborg (The Skeptical Environmentalist) by the Danish Committee on Scientific Dishonesty. Lomborg was cleared of any wrongdoing but I sincerely hope the DCSD is going to examine the behaviour of Prof Gilberg.
NZ Doctor 18 May 2005

Remunerative Post Traumatic Stress Disorder (RPTSD)

Is there anyone in New Zealand who has suffered some traumatic experience and not been diagnosed with PTSD? I can think of my late father who came back from the war, handed in his Thompson submachine gun, got on with his life and never spoke of the war again. Is there anybody else? I would like to hear from you.

A woman has been denied ACC compensation after having unprotected sex with a partner who concealed his HIV status from her. She has not contracted HIV but has been diagnosed with PTSD, or more properly called RPTSD because the motivation is to obtain money. I wonder whether the doctors or therapists who endorse this nonsense ever stop to think that they make themselves a laughing stock. I am reminded of the story told by Andrew Malleson (Need Your Doctor be so Useless) where a housing authority ignored people wanting better housing because all of them had the required letters of support from their doctors.

Another woman tried to get ACC cover because she was “retraumatised” while reliving a 20-year-old rape experience with a therapist. She alleged a ‘new injury’ on top of her existing PTSD. Why on earth somebody would either want or need therapy for something that happened 20 years ago is beyond me.

Perhaps I should ask Jeanette Wilson to contact my late father and see whether he wants to file a claim for PTSD from beyond the grave. I have never seen better examples of Welch’s Law, where claims expand to take up the amount of compensation available.

Pharmacists and alternative medicine

I went into my local pharmacy recently and was astonished to see that products that I would describe as ‘fringe’ medicines dominated the OTC medicine section. A full page infomercial in a local paper was clearly advertising one of these products but there is no acknowledgement that it is an advertisement. I wonder at the ethics of this. The same pharmacy had a similar article promoting ear candling and I hope the conference organisers are able to set up a demonstration of this bizarre practice.

One such pharmacy product is Esberritox. It contains various herbal products such as echinacea. A Google search produced 25,000 hits and echinacea is also well covered on www.quackwatch.com There is also a good article on that site by Dr Barrett about the unethical behaviour of pharmacists, which has them selling unproven remedies with a huge profit margin. It’s rather ironic that government policies to restrict pharmaceutical access to cheap and proven drugs has seen a parallel increase in the use of quack remedies as pharmacists stock them in order to maintain their incomes.

Acupuncture Flunks, not once but twice!

A German study found that sham acupuncture was just as effective as ‘real’ acupuncture for migraine headaches. The study was published in the Journal of the American Medical Association. I did the same experiments over 15 years ago and satisfied myself that the needles could be stuck anywhere and the same results were obtained. It follows that acupuncture theory and training is a delusion and as I demonstrated at one of our meetings, an intelligent group of skeptics can become ‘trained acupuncturists’ after a one-hour lecture. It is a disgrace and a fraud that ACC continues to fund acupuncture as well as many other unproven treatments such as chiropractic and osteopathy. GPs are able to claim credits for acupuncture training. This should be stopped. It would be interesting to do a study of treating migraine with sham acupuncture versus therapeutic touch. I predict that such a study would show little or no difference in outcome because both treatments are placebos.

Christchurch Press 5 May 2005

This graph shows once again how sham acupuncture and ‘real’ acupuncture achieve the same results. In contrast, oestrogen replacement is very effective in reducing hot flushes in postmenopausal women. I will leave the last word to the editor of Bandolier: “when will alternative therapies really prove that they work? While we wait, will they stop fleecing people of huge amounts of cash for doing nothing?”

Methyl bromide and hysteria

Workers at Port Nelson are complaining that the gas methyl bromide is responsible for ill health and has caused the deaths of former workers from motor neurone disease. A local woman who lives 300m from the fumigation facility has demanded that the port company notify her of fumigation work so she can evacuate herself and her children. An investigation found that the more likely cause of the workers’ complaints was not methyl bromide but chemicals used in the preservation of timber. The deaths from motor neurone disease were due to an epidemiological effect known as clustering. One worker is described as having symptoms of “chronic fatigue, a persistent dry cough and lack of concentration.” These are typical symptoms of the fixed illness belief of ‘chemical poisoning’. Note that the symptoms are all subjective and therefore difficult to disprove. Staudenmayer (Environmental Illness: Myth and Reality) has shown conclusively that these symptoms are caused by personal psychological factors.

Christchurch Press 26 July 2004, 1 January 2005

Hokum Locum

Now that Terri Schiavo has been allowed to die peacefully there is an opportunity to reflect on the matter free from the hysteria and religious arguments advanced as an excuse to maintain her in a vegetative state. When discussing the ethics of the situation with a local surgeon he commented that the main problem was that the feeding tube should never have been inserted in the first place. A feeding tube is surgically inserted into the stomach through a hole in the abdominal wall. Once such medical interventions have been made it is very hard to reverse them. In this case the debate appears to have been hijacked by Catholic pressure groups.

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If you don’t get the answers you want from a Government inquiry, press for another inquiry. Vietnam war veterans have continued such a campaign and have produced a map to confirm that they were present in areas that were sprayed with the defoliant under the US Army “Operation Ranch Hand”.

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Dioxin “Poisoning” or Hormesis in action?

It will be interesting to see how the government handles the latest health scare which is being helped along by the usual sensationalist media reporting. How about this example: “The men who made the poisons that blighted a New Plymouth community….” (Sunday Star Times, 12 September 2004).

There are many dioxins and the most toxic is considered to be TCDD, a contaminant found during the manufacture of the herbicide 2,4,5-T but also occurring naturally as a result of combustion, forest fires and smoking. Dioxin has been isolated from soot in prehistoric caves. Dioxin is found in body fat (lipid) and has a half life of around 7-10 years, meaning that a total body load diminishes by half during each such interval. The national average body level of TCDD is 3.5 picograms per gram of lipid. A picogram is one trillionth of a gram (ie. 1 x 10-12 grams, or if you like a lot of noughts: 0.000000000001 g). The mean TCDD level in residents of Paritutu was 10.8 picograms per gram of lipid with a range of 1.3-33.3. To date, there is no evidence of increased disease rates in the studied population. To put it bluntly, the Paritutu residents have 3-10 times the infinitesimal amount found in the general population, still well within international limits. I would like to see a similar study examining the levels of dioxin and mercury downwind from the local crematorium!

Hormesis is an effect where small doses of a toxic substance seem to promote health. A good example is alcohol, as was the Victorian habit of consuming small doses of arsenic and strychnine as a “tonic”. Rather than concentrating on looking at ill-health, researchers should be examining whether Paritutu residents are in fact healthier than most other New Zealanders.

Nevertheless, research will be ongoing and although not given to making predictions I offer the following observations:

  1. Residents will claim that every possible health problem they have ever had was caused by dioxin exposure.
  2. Residents will demand compensation in accordance with Welch’s Law (Claims expand to take up the amount of compensation available).
  3. Scientific evidence will be distorted and misinterpreted to justify any possible viewpoint.
  4. The “Greens” will claim that any amount of dioxin is “unsafe” and at some stage the phrase “cover up” will be used.

A former manager of the Paritutu chemical plant is quoted as saying that he worked there for 30 years and is still in perfect health at 85 years of age. Hormesis in action surely?

More Healthy Additives?

Britain is in the grip of such a serious depression that prescriptions for the anti-depressant “Prozac” (fluoxetine) have risen from nine million to 24 million per year. I read this as I sipped my ale in the Pint and Prozac, a quaint canal-side pub which I discovered while on my recent overseas trip to research taro cultivation by the gay and lesbian community (funded by a Community Education Grant – thanks Steve!).

Prozac is finding its way into ground water and hence into supplies of drinking water.

It is clear that I have been on the right track in calling for Ritalin (methyphenidate – a stimulant) to be added to the water supply as a Public Health measure. This combination of stimulant and antidepressant will surely lead to a euphoric and happy population. I am however concerned about problems of dosage as the Authorities have claimed that the Prozac is so “watered down” that it is unlikely to pose a health risk, except to those who believe in homeopathy.<br> Christchurch Press, 10 August

Touting for Business – “Chiropractic Kidz Week”

What better way to build up business than to convince parents and children of the need for regular assessment and treatment of “subluxations”, the core tenet of chiropractic pseudoscience. It is a matter of concern that “chiropractic kidz week” is a nationwide programme aimed at those “parents or caregivers or the child themselves (who) are not aware of a spinal problem.”

The reason such people are “unaware” is because they do not have any such “spinal problem”, which exists only in the self-deluded imagination of the chiropractor. Chiropractors interpret minor postural variations as signs of “disease” and requiring treatment. I wonder if any chiropractor has ever diagnosed a “perfect spine” unless it was achieved at the expense of 60 “treatments”. It is a national disgrace that this pseudo-science is funded by ACC and chiropractors should not be allowed to either take or bill the Health Service for x-rays.

Please keep an eye out for this scam next year and if possible get as many members as possible to take their children for a free assessment and report back to me what happens. Some tape recordings would be useful. A woman recently wrote to the paper and took Frank Haden to task for criticising alternative medicine. She went on to claim that chiropractic manipulations had cured her of migraine, cured her child’s squint and cured another child’s gait abnormality!

With such gullible beliefs out in the community it is no wonder that chiropractors continue to work their rich scams.
Blenheim Sun, 11 August
Letter to Editor, Sunday Star Times, 26 September

Anyone for Tennis?

A millionaire property owner has been getting $600 per week from ACC since 1974, despite earning $2400 per week from his investment portfolio. In a bizarre example of Welch’s Law, his claim was accepted under medical misadventure for psychological damage caused by prescription medicines, in this case benzodiazepines (Valium). His disability is “psychological” and prevents him from working at all but readers will be thrilled to know that the poor fellow is able to play tennis three days a week and in his own words “it’s better to have a peaceful life”. ACC have done a great service to tennis as the claimant is now in the top third of senior players in Auckland. Employers and taxpayers alike will be thrilled to know that their ACC levies are being put to such good use. Sunday Star Times, 26 September

In Brief

  • Despite local doctors showering sick notes like confetti, teachers at Hamilton’s Fraser High School failed in their bid for compensation from MAF for “illness” caused by the spray used to eradicate the Asian gypsy moth. Sorry people, no money for mass hysteria. Better to track down the millionaire’s doctor and go for PTSD caused by unruly pupils. (Dominion Post, 30 September)
  • In France the Académie de Médecine has upset homeopaths by issuing a damning report challenging the continued funding of homeopathy through the national health service. (Dominion Post, 9 June).
  • Acupuncture is ineffective for the treatment of tennis elbow. Hardly surprising given that “good evidence indicates that acupuncture does not work.” (Bandolier 126 Vol 11, Issue 8, www.bandolier.com).
  • Remember the Aoraki Polytechnic and their stupid proposal to run a degree course in naturopathy? They are at it again. They got $8165 community education funding for the New Zealand Council of Homeopaths’ Conference. (Sunday Star Times, 3 October).
  • For most of October I will be touring northern India by motorcycle and I intend filming and recording as much as possible. I have been asked by Paul Trotman to find him a “nose kettle”. If you want to know what that is you will just have to come to next year’s conference!

John Welch lives in Picton and is a retired RNZAF medical officer.

Hokum Locum

Vitamin B12-the new placebo?

A drug company has been perplexed at a shortage of Vitamin B12 created by a surge in use. A spokesman for the company said “doctors had so far failed to come up with a convincing explanation” and “Vitamin B12 was also used to treat chronic fatigue syndrome (CFS) and as a vitamin booster.”

It is clear from these comments that Vitamin B12 is being used as a placebo as there is no evidence at all that it is of any benefit in the treatment of CFS. In the course of my employment as a locum I have seen plenty of evidence that a lot of doctors are administering Vitamin B12 when there is no scientific indication. The deliberate use of placebos in this manner shows a complete lack of understanding of the consultation dynamic, a failure to understand the nature of the placebo effect, and a superficial grasp of basic science. If these doctors allowed patients sufficient time, listened and acknowledged their concerns in an empathetic manner, there would be no need for placebo injections.

Placebo vitamins can be dangerous. A three-year-old child choked to death after inhaling an animal-shaped vitamin C and echinacea tablet. A pathologist was of the opinion that “the tablet was too large for a child of three to be able to swallow”. Nowhere in the article was there any comment or criticism of the dietary supplement industry which promotes these totally unnecessary products.
Dominion Post June 25, 2004
Dominion Post May 26, 2003

Hey Noni Noni?

There is indeed “much ado about nothing” over Noni juice. It comes from a Polynesian plant and is widely touted as a cure-all for everything and anything, a sure sign of a quack remedy. A recent review (Bandolier 122) found no evidence that it is effective for any medical condition and commented: “Diluted noni juice does funny things to cells in test tubes, but then so might diluted orange juice.”

A Google search found over 600 websites complete with a medical PhD endorsement and the usual pseudoscientific language and testimonials.

Breast Implants — a silly con?

Welch’s law has struck again as claimants prepare to take their share of a US$2.35 billion fund set up by Dow Corning Corp in response to thousands of silicon breast implant liability lawsuits. This is despite the fact that a number of studies have conclusively proved that the claims of silicon-related illness were a delusion. These lawsuits caused a major upheaval in the American justice system and a review of the definition of an expert witness. Legal process was suborned by “expert” witnesses who managed to convince the courts that claimants should be rewarded and in today’s culture of complaint, it pays to attribute your “illness” to someone with deep pockets. The US insurance industry often influences the outcome of these cases as it is frequently cheaper to settle than to fight a long and expensive legal battle.

Abuse Claims

Medical practices are constantly changing but this has not stopped litigants from seeking to apply today’s standards in order to prove abuse and mistreatment in the past, in some cases going back several decades. An article in the Dominion Post (June 17, 2004) reports “invasive internal examinations” by a health camp doctor around 1983. An Act NZ MP has accused the doctor of committing and misdiagnosing sexual abuse.

At this time there were many erroneous beliefs about the examination of children and the signs that might be present indicating sexual abuse. It was believed, for example, that “reflex anal dilatation” was an indicator that abuse had taken place. Many children were taken from their families, and parents, normally the male, were accused of sexual abuse. It is now known that such simplistic forensic tests were flawed and we all know what happened when similar deluded ideas were applied to the behaviour of children at the Christchurch Civic Creche.

Hangover Cure

The product RU-21 contains dextrose and ascorbic acid and the makers claim that it prevents the build up of acetaldehyde which causes the hangover. Dr Mike MacAvoy of ALAC is quoted as describing the product as “ridiculous”. There is an associated claim that the pill was developed by the KGB so its spies would not suffer hangovers after drinking sessions. There is no scientific evidence that such a product will have any effect at all on the metabolism of alcohol.

This is the perfect product for silly binge-drinking yuppies (RU-stupid?), the same sort of people who buy energy drinks. These products are placebos and with proper marketing will prove hugely successful and make some people very rich.
Sunday Star Times June 13, 2004

Benefit Fraud

Many political commentators have noted the tendency of the latest budget to create a new class of beneficiaries. The Labour Government (aka the Nanny state) knows what’s best for us and will not be satisfied until we are all receiving some kind of targeted benefit. This mentality is behind the large increases in people on invalid (IB) and sickness benefits (SB). WINZ figures show that those receiving the IB rose from 45,519 to 71,394 over a seven-year period while the SB rose from 34,044 to 41,948. I have said before that the reason so many people receive these benefits is because they can!

A Christchurch GP has finally made a stand and refused to assess casual patients being referred from a neighbouring Work and Income Office. I support him as there are too many “rubber stamp GPs” signing these applications and there is no audit process at all. I have challenged various ministers about these abuses and they fall back on the same tired arguments that only doctors can assess work capacity. It is also remarkable how many career criminals appear in the courts described as either invalid or sickness beneficiaries.

The latest scam that I heard about is university students who want to have a holiday so they get their student health office to endorse them as being “stressed” or “depressed”. I recently did a locum on the West Coast and met plenty of people who met the criteria of “benefit bludgers”. One young man proudly told me that he had saved enough money from whitebaiting to pay for a new car. He was on a sickness benefit for “stress”.

In a truly amazing development, the same Christchurch GP is now the subject of a complaint by aggrieved beneficiaries!
Christchurch Press June 14, 2004

Taking the P*ss?

In a letter to the editor, a correspondent claimed that there were definite health benefits from drinking a daily glass of your own urine. I had a look on the internet and found a staggering 365,000 links to some truly disgusting websites. Deciding that New Zealanders couldn’t be that daft I narrowed the search to “NZ” and got 2000 hits and found none that directly referred to drinking urine. This could be a good test for the next conference — make a 30C dilution of urine and see if anyone is prepared to drink this homeopathic preparation.

John WelchJohn Welch

Hokum Locum

Selenium – Too Much of a Good Thing?

New Zealand soils are deficient in selenium and this can cause serious health problems for animals. A 500kg animal needs about 1mg selenium daily. There is no evidence that New Zealand adults need selenium supplements and this situation has been described as “a deficiency in search of a syndrome”.

A 52-year-old dairy farmer presented to her doctor with chronic aches and pains, lethargy, sore throat and painful swallowing. After some weeks of fruitless investigations she admitted to taking 0.5ml daily of a solution containing 5mg/ml of selenium, several times the recommended daily human dose. All of her symptoms disappeared once she stopped taking the supplement.

Despite the lack of proof for any deficiency syndrome in adults, local pharmacy leaflets stated “selenium is an essential trace element” and that “low levels of selenium are linked to a higher risk for cancer, cardiovascular disease, inflammatory diseases and other conditions associated with free radical damage, including premature ageing and cataract formation.”

It is quite clear that it would have been much safer for this woman to have taken a homeopathic selenium remedy and there would have been no risk at all of any toxicity from over dosage.
NZ Family Physician Vol 30 Number 6, Dec 2003

Animal Homeopathy

I know that homeopathy has been done to death but it crops up everywhere, even in the treatment of animals. People defend this delusion by claiming that the placebo effect does not work in animals, therefore any observed effect must be real. Any observed effect is clearly due to expectation on the part of the person administering the water, sorry, I mean the homeopathic remedy. An article in the Christchurch Press (March 12, 2004) described how Taranaki’s first qualified animal homeopath has gained an “advanced diploma of homeopathy”. She also has a BSc and it beggars belief that someone with that background can take up a pseudoscience such as homeopathy. This is what HL Mencken was referring to when he said: “How is it possible for a human brain to be divided into two insulated halves, one functioning normally, naturally, and even brilliantly, and the other capable of ghastly balderdash?”

I find it amusing reading such accounts because the clue to the belief system is usually contained in the article but is unrecognised. In this case the animals are described as “glowing with health in a way that suggests good feeding and love but their appearance is so striking it indicates there is another ingredient as well”. You guessed it — the other ingredient is homeopathy! It’s obvious that the animals’ condition is due to the “good feeding and love” and to claim otherwise is a delusion.

It would not in the least surprise me if the diploma of advanced homeopathy is NZQA approved.

Snake Oil Flunks for Snake Bite

Boonreung Bauchan was known in Thailand as the “Snake Man” and held a Guinness world record for spending seven days in a snake enclosure. The Mamba family of snakes are extremely venomous and when one of them bit him on the elbow he relied on a traditional herbal remedy and a shot of whisky. As we all know, herbal remedies are mostly placebos and should not be used for serious or life-threatening conditions and Boonreung is sadly no longer with us. Had he taken a proper antidote, his chances of survival would have been excellent.
Christchurch Press March 23, 2004


If you get up in the morning and find your letterbox has been vandalised, don’t worry, counselling is available to help with your distress and grief. (Dominion Post March 6, 2004).

Following September 11, an estimated 9000 grief counsellors turned up in New York and one hotel was booked out by a single group of 350 counsellors. This absurd behaviour is of course defended by the counselling “industry” despite the existence of research that shows that many of such interventions are actually harmful. Counsellors defend their behaviour by claiming that it cannot be scientifically tested. For example: “People working from the scientific model want to measure outcomes. A lot of people would say, ‘I feel better’, but that doesn’t fit a scientific model.”

Such claims should be treated with complete contempt. This sort of reasoning could be used to justify the implementation of all sorts of quackery because it makes people “feel better”.

To put it bluntly, counselling is a placebo therapy. Third-party funding ensures that an industry has been able to develop. This has disempowered people from learning to deal with personal trauma by simply talking to a friend or other family members.

Hair Analysis

Last year I spent some time working in Westport and noticed an advertisement for hair analysis. Hair analysis does have a scientific basis but it has been taken over by quacks who offer all sorts of ridiculous assessments. When I got home I wrote to the address and sent hair from my wife Claire and my oldest daughter Eve, under their own names, and some hair from “Russell”. “Russell” was actually my daughter’s dog, a wheaten terrier.

For $40 I received a detailed four-page handwritten report and after reading it I felt quite mean because the writer’s sincerity was obvious. I have sent a copy of the letter to the Editor but will summarise the main findings. I see no value in exposing the writer because the letter was written in good faith but note that sincerity and good faith can go hand in hand with gullibility and foolishness. His findings were as follows:

Claire needs natural estrogen — “raspberry leaf” two tabs daily. Wormwood — 5 drops in water daily. Bach flower remedies — “Mimulus, Rock Rose”. Conscious deep breathing — practise six times daily. There was also a recommendation to have “faith” and consider the Bahai religion for that reason.

Eve had a systemic yeast infection. Recommended treatment: nystatin, aloe vera juice, Blackmores chewable tablets, wheatgerm capsules, super strength kelp, rescue remedy (Homeopathic), extra progesterone in the form of “wild yam cream”.

Russell also had a systemic yeast infection, and iodine deficiency. Recommended treatment: nystatin (oral antifungal agent), self heal tincture — 50 drops twice daily, herbal B vitamins — six tabs daily, super strength kelp — three tabs daily. Repeat hair analysis in three months.

It is easy to see that such a “scatter gun” approach to treatment would be bound to work in a well-motivated believer. I did not inquire as to the method of hair analysis but this is unimportant because any diagnostic method will work provided it is plausible and the treatment offered is congruent with the particular belief system. The homeopathic vet would no doubt approve of Russell’s diagnosis and treatment.

Shockwaves for chronic heel pain

High energy sound waves are now being used to treat various conditions such as tennis elbow and other painful areas such as the heel, knee and shoulder. It is claimed that 60-70 per cent of patients will gain relief from the treatment.

The same technology (extra-corporeal shockwave therapy or ESWT) is used to disintegrate kidney stones.

In the case of kidney stones there is no need for a randomised controlled trial (RCT) because it is obvious when a large stone has been broken down into smaller pieces.

When treating various painful conditions with no such “marker”, one has to be much more cautious and this therapy is crying out for a randomised controlled trial with a placebo group who would receive treatment administered when neither the patient nor the technician were aware that the machine was actually switched off. I predict that when such trials are carried out, there will be no advantage over placebo.
NZ GP November 12, 2003

Hokum Locum

Cellulite – Just a Euphemism for Fat

Cellulite is the term used by women’s magazines to describe dimpled fat. It has no scientific or anatomical validity and it is simply ordinary fatty tissue that assumes a waffled appearance because fibrous tissue prevents the skin from fully expanding in areas where fatty tissue accumulates. This has been confirmed by a study where biopsies of fat and cellulite were microscopically indistinguishable by pathologists who were blinded as to the samples’ origin. Calling fat “cellulite” is part of the modern trend to seeking alternatives to the (unpalatable) truth, in this case an adipose euphemism.

The latest treatment for Cellulite involves a machine called Cellu-M6. It is described as having “even been approved by the strict Amer-ican Food and Drugs Administration”. I checked the FDA website and although I could not find the machine specifically mentioned it did refer to a “Dermosonic Non-Invasive Subdermal Therapy System”, presumably using ultra-sonic stimulation of the skin. The FDA “approval” is nothing of the sort, merely an acknowledgement that the machine is similar to others already on the market. There is nothing in the FDA response indicating any approval or endorsement of the device beyond noting that it “temporarily reduces the appearance of cellulite”.

Given that about half of the New Zealand population are obese, and roughly half of these are women, this makes for a huge and lucrative market. The Cellu-M6 machine is described as “breaking down the cellulite, toxins and abnormal water build-up are expelled and the increased blood flow stimulates enzymes which encourage fat cells to break down.” Journalists sometimes inadvertently get close to the truth and the article states in part “While it seems almost too good to be true…” Well, yes, it is.

With all worthless treatments it is essential to get the punters to do something for themselves, which in itself is actually effective, for example: “You’ll still need to do some work. Walking, exercise and watching what you eat.” The most well-motivated customers will be the ones who actually do exercise and lose weight. They will be thrilled with the results, happy with the cost and completely oblivious as to the real reason for their loss of cellulite (weight).
New Idea 4/1/03


For various legislative and historical reasons, cannabis use is illegal in New Zealand. My feeling is, why legalise cannabis when we already have so much suffering from the abuse of tobacco and alcohol? Nevertheless, on the medical evidence available, moderate indulgence in cannabis has little ill effect on health. Cannabis has been studied for possible use in various medical conditions but there are problems with drug delivery as most researchers feel that it is unacceptable to administer it through smoking and oral bioavailability is variable.

A recent Lancet study of patients with multiple sclerosis found that cannabis had no measurable effect on muscle stiffness or jerkiness. The patients, however, stated, “it had reduced their symptoms and improved their mobility.” I went to the Lancet website and there are problems with this study. Fifty percent of the placebo wing of the trial claimed benefit and because of the psychoactive effect of the cannabis, subjects knew whether they were taking cannabis or placebo. I have written before on the problems of clinical trials becoming “unblinded” through this effect. The researchers should have used an ‘active’ placebo, something that mimicked the effects of cannabis. It appears that researchers still lack an understanding of this process. Perhaps they should call in James Randi to help them?

Despite the lack of evidence for the medical use of cannabis, “a wealthy Christchurch businessman caught growing cannabis has escaped without a conviction after convincing a High Court judge that he used it medically.”

I can just see future headlines at the next sitting of the Dargaville Court: “Unemployed Maori youth of no fixed abode acquitted of growing cannabis after convincing the Judge he used it for a medical condition”. Yeah, right.

But wait! The businessman, we are told, suffered from a painful bowel condition diagnosed as “pyloric sphincter”. That explains everything. We all have a pyloric sphincter. It is a thickened muscular valve at the outlet of the stomach.

All of us can now smoke cannabis with a clear conscience (write or email me for a medical certificate, but only if you are rich, say $5000 per certificate will be fine).
Dominion Post, 8/11/03, 14/12/03

Veterinary Homeopathy

I don’t normally concern myself in this area although I did recently correspond with the Veterinary Council and their policy over alternative medicine is very similar to that of the Medical Council with Doctors.

The Press (18/11/03) carried an article, which I thought was unintentionally very funny. A trainer was fined for injecting a horse with a homeopathic remedy. It was further reported, “another horse injected with it had won, been swabbed and tested negative in the past.”

Of course it tested negative! Homeopathic solutions are water and this simple fact seems to have completely escaped notice by the Judicial Control Authority. I thought I would have a bit of fun by writing to them and pointing this out so will keep you posted.

The homeopathic remedy was “Vetradyne” and was easily found by Google. A 50ml bottle costs $215 but I was unable to find its composition, or any given therapeutic indication, apart from the cryptic comment “no claims made.” It was also detailed as being for “oral” use only so it does seem strange that it was given by injection. An inquiry of the website was no more forthcoming over composition or dilution factor.


Every time something unpleasant happens we hear the dreaded phrase “counselling has been arranged.” Can we do anything to stop this clichéd response?

Following the illegal viewing of pornography at a school, pupils have been offered counselling. What’s wrong with today’s teachers? Can’t they handle a situation like this in a reasonable and intelligent manner? It seems that our population are willing to hand over all responsibility whenever they can. Is it because they lack confidence or is this a deliberate social policy on the part of the government? It’s certainly consistent with Government policies that encourage dependency and allow hundreds of thousands of people to indefinitely remain on welfare payments.
Dominion Post 27/8/03

Badly Behaved Children

Readers will know my attitude towards the socially engineered fad diagnosis of attention deficit hyperactivity disorder (ADHD). ADHD is treated with methylphenidate (Ritalin) and there was a 17% increase in prescriptions over the past year. The drug is being sold by parents on the black market. This does not surprise me but readers may be surprised to know that most street drugs are sourced from legal prescriptions. There are doctors in every part of New Zealand who over-prescribe a wide range of psychoactive drugs, which are then sold.

To paraphrase a well-known psychiatrist: “any behaviour of a child can be consistent with ADHD.” We must act now and add Ritalin to the drinking water. This will have the dual benefit of removing the need for parents to discipline their children and of destroying the illicit drug trade. The whole population will be happy, well behaved and in no need of counselling.
Marlborough Express 1/12/03

Multiple Chemical Sensitivity

This is a pseudoscientific diagnosis where people develop a fixed illness belief about chemical exposures. It is increasingly becoming an employment issue and is a classic example of psychosomatic illness. In a typical case, a radiographer is reported as needing a face mask before leaving home because “when I have a new dose of chemicals I become unreasonably upset about anything and everything, and become ill and extremely tired, plus a host of other physical effects.” Such patients have been studied by Staudenmayer (Environmental Illness: Myth and Reality). He tested 20 patients complaining of universal sensitivity to multiple chemicals and found that “the patients’ appraisals were no different from chance performance” (ibid. p. 99). In other words, the patients’ beliefs were disproved. There is an urgent need for such testing to be available in Australasia, otherwise there will be an increasing number of these spurious claims, misattributed to employment conditions.
Marlborough Express 10/10/2003

Interview with the Giraffe

Hokum Locum talks with one of the unsung victims of the Christchurch Civic Crèche

The New Zealand Judiciary has consistently refused to face up to that gross miscarriage of justice, the Christchurch Civic Crèche case. There has been a call for “new” evidence. In a sensational development I recently tracked down “Julian” (not his real name) at a secret Christchurch address. Here is his story.

HL: Thank you for talking to us Julian. How have you been over the last few years?

J: I’ve certainly missed Peter. It must have been hell for him in prison and I’m really sorry for his co-workers. You know, he was a really gifted childcare worker. The kids loved him.

HL: I know. So you were living in Peter’s house. Where? In a tunnel?

J: Can you see me in a tunnel? No, I was in the laundry chute. With a neck like mine it was the only option.

HL: But how come nobody found you? The police searched the house on numerous occasions.

J: I was always covered in dirty laundry, something the police are used to, so they always overlooked me. I think they were looking for paedophiles, or werewolves.

HL: Weren’t you lonely?

J: Oh no. Peter and I used to have some wonderful talks, and there were other pets for company — a cat and a frog.

HL: Ah, that must be some of the children, you know, that Peter changed into small animals.

J: You must be joking — nobody would believe that would they? Would they?

HL: I’m afraid so. I think that particular allegation ended up as a charge of unlawful transmogrification on an unknown child in an unknown location.

J: Bloody hell! Did they list me as an accomplice?

HL: No, you’re lucky. The interviewers, police and jury obviously found that a giraffe could not have been involved. No need at all for you to have been in hiding all of these years. How’s your health?

J: Not good. I’ve been having nightmares, wetting the bed, talking in my sleep and I’ve developed an allergy to hay.

HL: I’m sorry to hear that. I hope you’ve been to a vet.

J: Yes. She told me that all of my symptoms were consistent with sexual abuse in my early life. In fact, she said that any behaviour of a giraffe could be consistent with sexual abuse.

HL: Still, you could have put in a claim for ACC compensation. Lots of parents took the money even when they knew perfectly well that their children hadn’t been abused.

J: I have scruples.

HL: I’m sorry to hear that — I hope the vet has something for it…

J: No, you idiot! I mean I have a conscience.

HL: Just kidding. I heard a rumour that you were writing a book about your involvement in the Civic Creche Case.

J: Yes, I was disappointed I only rated a brief mention in Hood’s book. Even so, I think I was being confused with my cousin Gerald who works for the Life Education trust.

HL: How’s the book coming along?

J: Good thanks. I’ve always been a fan of the Jungle Books so I called it the Bandarlog. I’m going to blow this case wide open; that is, if I can persuade Val Sim and Mr Goff to read it.

HL: Make it a comic book then. We all look forward to reading it. Thanks again for talking to us.

J: Thank you.