“My girlfriend gave me this, take a look – do you really think I need to continue with the strong medication?” – The patient proudly hands me a neatly cut out article from a magazine. “Healed through naturopathy” is emblazoned in large letters above the article. Below is a picture of Gabi B., who suffers from MS, posing proudly next to a wheelchair and smiling at the camera. Next to her is an elderly man who brews healing potions from plant seeds and claims this “miracle” for himself. Next to it, the advertisement for this “fantastic” product is inconspicuously placed.
Somewhat listlessly, I take the newspaper clipping from her and look at it. I have to be careful not to reply too harshly. It’s not the patient’s fault – anyone with a chronic disease keeps their eyes open and reacts interestedly and hopefully when therapeutic successes are reported somewhere. Nevertheless, such articles annoy me – I can’t deny it.
But I don’t want to brush off the patient, she deserves a reasonable answer.
As doctors, we are obliged to our patients, all our actions must be aimed at helping a sick person as best we can. That’s why I like to ask the patients with the newspaper articles why they think I have a reason to withhold such important information or such “effective” drugs from them. Why should the research institutions and MS specialists in Germany turn a blind eye to such an achievement?
“Maybe because it’s not so great after all” – patients usually come to this conclusion after careful consideration, and that’s exactly how it is!
Indeed, it is not the case that science ignores the concepts that come from homeopathy, naturopathy, and the entire field of alternative medicine. On the contrary, scientists are fundamentally curious and generally not averse to getting to the bottom of things. However, this is done according to certain rules, which are summarized under the term “empirical research”.
People in Germany usually place great value on empirical research. When they buy a car, they don’t want to believe that it will pass a crash test and the airbag will deploy, they want to know it. They read test reports, compare and value well-founded data. This is completely normal and accepted with technical products.
Strangely enough, when it comes to medical-therapeutic concepts, people in Germany are quite uncritical. Anyone can claim anything and often finds an audience, while empirical science is often dismissively referred to as “conventional medicine”.
Conventional medicine, however, adheres to certain rules – it is a kind of “consumer product testing organization”. Before a substance or drug can be said to work, for example in MS, it must go through a complicated testing process. Only when these tests have been passed may it be sold and prescribed.
The core of such a test is the controlled clinical trial with several (in the case of MS) thousand patients worldwide, in which the new active ingredient is tested against a placebo or a comparison preparation. In such studies, the medication is given blindly, i.e. neither doctor nor patient know whether they are receiving the active ingredient or a placebo preparation. This minimizes the influence of expectation, better known as the placebo effect.
At the end of the study program, the data are then evaluated by independent scientists, and statistical methods are used to check whether a significant difference emerges. The results are made available to scientists and doctors as early as possible and are therefore commented on and interpreted worldwide. This means that neurologists are aware of the most promising developments years before they become available.
But only if a study has had positive results, these results could be reproduced and the preparation did not show any severe side effects within the study program, is a preparation approved for the German market.
That means all the drugs that a neurologist offers you in practice or clinic to treat your MS have gone through this complicated process and have proven to be effective in clinical trials (although this does not necessarily mean that the effectiveness is sufficient in individual cases).
By the way, some alternative medical concepts have also been tested according to these standards. A prominent example is enzyme therapy, which is often taken by MS patients in addition. Enzyme therapy did not show superiority over taking placebo in such a controlled study.
But as long as these standards are not met, I cannot and will not advise my patients to use such alternative medical measures. Especially not if they cost money. And this attitude applies to almost all “miracle cures” advertised in any magazines.
But medicine is of course more complicated and often one does not reach the goal with rational science alone. The secret of complementary medical approaches might be that they pay more attention to the patient, that more time is available for the needs of the individual. In this respect, conventional medicine probably needs to take a leaf out of their book, so we don’t lose our patients to self-proclaimed “miracle healers”.
Best regards,
Mathias Mäurer
