Posted by: Edzard Ernst25 August 2012
After serving in my post as ‘Professor of Complementary Medicine’ for 19 years, I am retiring to become Emeritus Professor, on 12 June.
This is a big step for me and a good occasion to briefly look back. Dr Kaplan asked me in a comment on one of my blogs to assess how well (or poorly) I did in my job regarding specific items from the original job advertisement. There is no shortage of people who claim that I abused my position to do things I was not hired to do. Here is the advertisement for my job which appeared in 1992 in the New Scientist.
Some people say that I had an insufficient research background in complementary and alternative medicine (CAM). Obviously the appointment committee did not think so. At the time, I had around 50 peer-reviewed articles on CAM and about 100 in other areas of research. The appointment committee apparently found that the quantity of quality of these publications was more than my co-applicants had to offer.
Some people say that I have no clinical training in CAM. This is not true: I had received hands on training in homeopathy, acupuncture, massage, autogenic training. Homeopaths, in particular, are irritated that I have no formal qualifications in homeopathy. Alas, I never said I had, and neither in Germany (where I trained) not in the UK, do doctors need them to practice homeopathy.
Some critics even claim that they doubt my medical qualifications and imply my (now quite long) publication list (currently well over 1,000 articles) is fraudulent. What can I say? They are wrong! And I often wonder why people promote such notions. Ad hominem attacks seem to be a quick and easy way to tarnish the reputation of someone who disagrees, particularly, if no credible arguments are available.
Dr Kaplan wants to know specifically how I 'encouraged the assimilation of appropriate complementary techniques into orthodox medicine'. His concern is shared by many who are convinced that I have been far too critical in my research.
'Appropriate' in relation to medical interventions can mean only one thing: demonstrably generating more good than harm. In turn, this means my remit was to foremost investigate the risks and the effectiveness of CAM. This I have done by publishing ~35 clinical trials and ~300 systematic reviews. Their results were frequently disappointing to CAM proponents. What did they expect me to do? Encouraging the assimilation of inappropriate CAM techniques would be wrong.
Yet not all our research was negative. I even have summarized our positive evidence in an article1, which draws on one2of our books3;4specifically written for busy healthcare professionals. Can anyone show me a CAM researcher who has demonstrated the effectiveness of more CAM than I have?
Dr Kaplan and others also doubt that I engaged in medical teaching. This is as absurd as the other allegations from CAM proponents. Throughout the 19 years in Exeter, I taught students. Before we became an undergraduate medical school, I taught postgraduate course for doctors and undergraduate courses for occupational medicine and other students. More recently, I taught medical students by giving plenary lectures and offering three different special study units in CAM work in the framework of our medical school. In addition, I gave about 600 invited lectures in the UK and abroad. For 14 years, we also ran an annual conference, and our journal FACT is in many respects also a teaching tool.
I had many occasions to ponder why, despite all these activities, so many CAM enthusiasts insist on doubting my achievements. The reason is not difficult to see, I think: they would have liked a promoter of CAM in my position. This, however, was never an option for me. As an academic and a medical scientist, the only things I should promote is good science, the truth and progress in healthcare. This I did, and the evidence is there to see for everyone who wants to look at it. My H-Index currently stands at 73 which is more than twice that of anyone else working in my field. At least two independent evaluations of CAM research centres have identified my team to be the world-leader in CAM.
And finally, there is the allegations that I conducted my job with a closed mind towards CAM. Specifically homeopaths seem to believe that notion, not least because I recently co-authored an article explaining why my mind has now closed on this particular subject.5 But when I began my research, my mind was entirely open to homeopathy. Those who do not believe me might study the chronological quotes I extracted from my 46 peer-reviewed articles on homeopathy for a recent review of this specific question.6
I believe they demonstrate the gradual change that occurred as a result of the evidence becoming more and more clearly negative. If tomorrow the evidence regarding the plausibility and effectiveness of homeopathy should change, I am prepared to re-open my mind.
When I retire the many CAM enthusiasts might breathe a sigh of relief believing that an influential critic of CAM has finally fallen silent. But they would be wrong again. I will continue to write and lecture; if anything, I will become more outspoken regarding the truth about certain issues. During the last two decades, I have learnt many facts about CAM but one stands out as being particularly crucial: patients, consumers GPs and everyone else are being bombarded with misinformation about CAM.
Some of this misinformation is laughable, silly and utterly unimportant, but lots of it is dangerously misleading, often to the point of putting lives at risk. I, for one, intend to continue to do my very best to prevent harm.
1. Ernst E. Complementary and alternative medicine: what the NHS should be funding? Br J Gen Pract 2008; 58(548):208-209.
2. Ernst E, Pittler MH, Wider B, Boddy K. The Desktop Guide to Complementary and Alternative Medicine. 2nd edition. Edinburgh: Elsevier Mosby. 2006.
3. Ernst E, Pittler MH, Wider B, Boddy K. Complementary therapies for pain management. An evidence-based approach. Elsevier, London. 2007.
4. Ernst E, Pittler M, Wider B, Boddy K. Oxford Handbook of Complementary Medicine. Oxford: Oxford University Press; 2008.
5. Baum M, Ernst E. Should we maintain an open mind about homeopathy? Am J Med 2009; 122(11):973-974.
6. Ernst E. Homoeopathy and I. Int J Clin Pract 2009; 63(11):1558-1561.