Alternatives winning mainstream friends

By MARTIN JOHNSTON health reporter

Nearly a quarter of GPs said in a survey that they had used some form of complementary or alternative therapy.

But the study, published in the New Zealand Family Physician journal, found that almost all the GPs who responded had concerns about the safety of complementary therapies, and 84 per cent wanted them subjected to better controls.

The study, conducted in Wanganui by GP Dr Marion Taylor, is small - 25 GPs and 104 patients responded.

But its main finding about GPs reflects those of earlier studies in Auckland and Wellington.

It also confirms New Zealanders' liking for alternative therapies: 67 per cent of the patients had used some form of them - from acupuncture to aromatherapy.

These findings are despite decrees from medical organisations that doctors must stick to medicines and therapies that have been proven by reliable research - what they call evidence-based practice.

"In spite of the culture of evidence-based practice ... it seems that GPs are prepared to tolerate high levels of uncertainty," Dr Taylor writes.

"Indeed, some studies show that scientific evidence does not appear to be the basis for physicians' endorsement of CAM [complementary and alternative medicine].

"Some CAM therapies are considered to have a strong placebo effect."

A ministerial advisory committee is calling for submissions on its review of complementary and alternative healthcare.

The review covers regulation, consumer information needs, research, and integration into mainstream medicine.

New Zealanders have a big appetite for alternative healthcare, spending about $145 million a year on nutritional supplements alone

Many in mainstream medicine believe this is largely wasted money.

But mainstream doctors and alternative practitioners say they are not surprised that two-thirds of patients have used alternative therapies.

"My gut reaction is that it would have been higher," said Medical Association chairwoman Dr Tricia Briscoe.

"Looking at all the over-the-counter dietary supplements and complementary therapies patients buy, it's big business."

As so many patients used these therapies, it was essential they were given good information about it, because of the risk of allergies or dangerous interactions with conventional medicines, she said.

"Acupuncture is a good example of an alternative therapy which has some evidence to back up its efficacy," Dr Briscoe said.

The association was comfortable with the use of complementary therapies - which could have a role within conventional treatment - as long as they were evidence-based.

Aromatherapy was one for which she did not know of any scientific evidence showing efficacy.

Dr Kenneth McIver, an acupuncturist and research director of the Charter of Health Practitioners, which represents natural-healthcare practitioners, said the study probably understated the national demand for natural therapies. "The two approaches can be used side by side. There are many instances where the more gentle approach of natural therapy should be investigated in the first instance."

* The ministerial committee will accept submissions until next Friday.

Alternative treatments

Doctors

* 24 per cent of the GPs had practised a complementary therapy.

* GPs rated acupuncture and chiropractic as helpful; hypnosis, homeopathy, aromatherapy as possibly helpful; iridology, colour therapy and reflexology as unhelpful.

Patients

* 67 per cent of the patients had used alternative therapy when ill.

* Chiropractic, Maori medicine, aromatherapy and acupuncture were their top preferences.

* 71 per cent of patients wanted regulation of complementary medicine to be on a par with orthodox medicine.