I’m quite ashamed to admit that I’ve been duped by complimentary and alternative medicine (CAM). A long while ago I mentioned to my general practitioner (GP) that I suffered from breast tenderness, or mild mastalgia, just prior and during my period (i.e. cyclical mastalgia). She suggested I try Evening Primrose Oil as that should help.
I thought fair enough and sauntered off to Boots to buy a jar. As it turns out, I’ve never actually got round to trying it. Then recently, with all of the hullabaloo around homeopathy, I decided to look up Evening Primrose Oil (EPO) on PubMed to find this:
“EPO did not offer any advantage over placebo in pain relief”
Now this pissed me off lots and lots. I had believed that my medically trained GP would suggest something that was evidence-based and had not done so because either a) she was unaware of the current evidence and/or was one of these CAM-peddling NHS doctors or b) she was trying to placebo my ass. Both of which are troubling.
Firstly, if it was because she was unaware/a CAM peddler then this undermines my trust in the medical opinion of NHS doctors (and none of this “but she was only a GP”). Not everyone is going to check their medical advice online or if they do they are more likely to come across pseudoscience and quackery than know where to look for a systematic review. We can’t check everything all the time and so generally we rely on the expertise of those we assume will have more knowledge than us.
Obviously this was a very minor aliment for me and so I didn’t check. Most people on finding out that they have a serious illness do and should investigate it as much as possible.
But secondly, if she was trying to palm me off with a placebo then I’m fucking livid. There is over-prescribing in certain areas of general practice because people go expecting an intervention for their health problem. I, however, didn’t want an intervention and mentioned the jublies pain as an aside.
If she knew that EPO only acted as a placebo not telling me has left me feeling stupid and lied to. If I had had all the information at the time I would have made a different decision on the basis that the tit ache isn’t that bad, just a mild annoyance, and chocolate is my preferred placebo.
This of course links nicely to homeopathy; if it is simply a placebo then doesn’t the positive outcome justify the means? The placebo effect is real and therefore if homeopathy works solely as a placebo can’t it still ‘help’?
The significance is displayed in my outrage at finding out that EPO has no evidence-base for treating bap pain. I felt stupid and disempowered. I had been made an unwilling victim of marketing over substance. And this is what is wrong about homeopathy; its marketing and spin masquerading as authoritative medical knowledge. It dupes individuals into thinking they are taking control of their own health when in fact they are not being given access to the full facts.
If you want to know what my GP should have done, here’s a handy guideline flow-chart from NHS Lothian (*cough* her Health Board).