Dr Phil Hammond, broadcaster and GP returner in Bristol

Which fat bigot of a GP said “Never underestimate the power of alternative medicine – it’s a marvellous dumping ground for your worst patients”? OK, you guessed. It was me, 15 years ago, trying to get a cheap laugh out of one of Britain’s fastest growing industries.

What I should have said is “never underestimate the power of the placebo effect”, since out of the 160 or so complementary practices currently on offer to the discerning British consumer, only a handful have been shown to be more than that – not that there is anything wrong with placebos.

It’s a bit like hairdressing. If you go to a good salon you get a cup of coffee, you get time to read the paper, you’re on first name terms with the stylist of your choice, you have a nice chat, you’re treated like a person, you have a scalp massage, you choose the bob you want, you get a soothing blow dry, you pay through the nose for it and you walk out feeling great.

It improves the quality of your life, but it isn’t medicine and no-one pretends that it should be.

At the hospice I taught at, by far the most popular day centre activity was a visit to Jayne in the salon. “Never mind the morphine, give me a purple rinse.” There’s no deception here. What she offers is what you get, and you should never underestimate the power of a good haircut.

Were Jayne to set up shop as a follicular toxicologist, removing poisons from your hair follicles along the 10 vital force lines as used by the Chinese for 5000 years, I might have second thoughts. Were she to claim to irradiate cancer and improve the life expectancy of her clients, I would definitely have second thoughts.

But she doesn’t, she just makes people feel better about themselves. It’s undoubtedly beneficial, but it isn’t therapy.

Many complementary offerings operate along similar lines, and reflexology is a good example. The philosophy is based on the hypothesis that connections exist between the foot and every part of the body via 10 energy channels.

(This is a bit of a blow to the iridologists, who make similar claims about the iris, but for every complementary theory there are several others that directly contradict it.)

These energy channels can become blocked. Any reflexologist worth his or her salt can break up the blockages by rubbing the relevant bit of the sole and allowing energy to flow freely again to the affected body part.

This may all sound very plausible, but the hypothesis has never been proved. If you observe that a baby’s colic improves when the mother rubs the bowel area of the baby’s foot, it could mean several things: the reflexology could have contributed to the improvement, any old foot massage could have done the trick or the baby recovered naturally, because of sterilised teats, or when the mother stopped eating peppers.

Unless you’ve proved a causal link in a controlled trial, the claims made for any treatment are pure conjecture. There is no alternative to scientific truth and the best complementary therapies have had their usefulness at least partially validated (e.g. acupuncture for travel sickness and osteopathy for back trouble).

Until reflexology can do the same, it remains an excellent catalyst for mother and baby to bond and a pleasant way to spend an afternoon. But it isn’t therapy and shouldn’t be sold as such.

“Come and have a friendly foot rub” may not have the placebo effect of “Your foot has a magical hotline to your spleen” – but it’s a lot more honest.

Guidelines in Practice, February 2006, Volume 9(2)
© 2006MGP Ltd
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