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Do GPs with training in complementary therapies get better outcomes?

Professor Edzard Ernst calls for caution when interpreting the results of a new study.

Dutch investigators recently published what must be the biggest sensation in CAM research in many years.

Patients whose GP has additional training in anthroposophic medicine, homeopathy, or acupuncture have substantially lower health care costs and lower mortality rates. The lower costs result from fewer hospital stays and fewer prescription drugs. Since the differences remain after controlling for neighbourhood specific fixed effects, the lower costs and longer lives are unlikely to be related to differences in socio-economic status.1

At the risk of being a true spoil sport, I'd like to offer a few interpretations of these results:

1) CAM use could prolong life and save costs (I think this is unlikely, not least because such a finding would have emerged from many other studies, if true)

2) GPs with any additional training might be more experienced, dedicated, competent etc. regardless of the nature of the training (the more meaningful comparison would therefore have been between patients with additional conventional and CAM training)

3) Patients who choose GPs with CAM knowledge are different from those who elect to consult non-CAM GPs. Here are a few factors that could

  • differ.
  • Type of disease
  • Severity of disease
  • Compliance with prescriptions
  • Poor lifestyle like smoking, stress, alcohol etc.

So, what's the bottom line? An interesting study, no doubt. But let's not jump at conclusions. As always, we should wait until we have independent replication of this finding.

Professor Edzard Ernst is professor of complementary medicine at the Peninsula Medical School, University of Exeter

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