Have you ever heard of a friend having a bad time with an alternative practitioner? Maybe their acupuncturist left them bruised and battered or their homeopath told them they could cure their incurable disease with an expensive potion, only it wasn’t to be? Maybe it’s happened to you? But what would you do if this did happen to you? Who could you turn to for help or to make a complaint?

For many years, unregistered practitioners such as naturopaths, acupuncturists, reiki practitioners, massage therapists, iridologists and the like, have been without any accountability for selling bogus or dangerous products or services.

In Australia, we have the federally controlled Therapeutic Goods Administration (TGA) which is responsible for “safeguarding public health and safety in Australia by regulating medicines, medical devices, blood and tissues”. But this does not include unregistered and alternative health practitioners. In NSW, a Code of Conduct for Unregistered Practitioners was released on August 1st, 2008. The code consists of 17 sections, covering such matters as;

practitioners are to provide services in a safe and ethical manner, are not to financially exploit clients and practitioners are required to have a clinical basis for their treatment”.

The code is designed to fill a loophole for the regulation of health providers who are not covered by a registration body, meaning that although the public could lodge a complaint about a practitioner, the regulatory bodies could do little more than slap them on the wrist. Whereas this new legislation means they can be banned from practicing either for a specific period or permanently. The code is administered by the Health Care Complaints Commission (HCCC) and if breached,

the Commission has the power to impose a prohibition order and/or issue a public warning about the practitioner and their services. A prohibition order bans a practitioner from providing health services, or places conditions on their provision of health services, for a specified period or permanently. It is a criminal offence to breach the order”.

But not every state in Australia has such a code for alternative health practitioners. (One wonders if Queensland is exempt since there seems to be so much woo in this state). For example South Australia (SA) does not, but a parliamentary inquiry is currently underway which plans to change this. Labour MP Trish White set-up a Social Development Committee inquiry in 2007. Its brief was to investigate “bogus, unregistered and deregistered health practitioners” and to develop a way to regulate the growing number of people making false claims about their ability to cure. White hopes the inquiry will expose the charlatans and work out ways to stop them popping up again under different names.

The current inquiry is spearheaded by the state head of the Australian Medical Association (AMA), Dr Peter Ford, the proposal is modelled on the NSW code. The impetus for the introduction of such a code came from Dr Ford as a mechanism for regulating quacks. Dr Ford told the inquiry that the unregulated practitioners are a “relative risk to patient health and have enjoyed immunity and lack of scrutiny from the legal and regulatory authorities which apply to the medical profession”.

In his submission about “bogus” doctors, he highlights colonic irrigation, thermography, subluxation and cancer cures as some of the more dangerous alternative medicine treatments. AS previously mentioned on Dr Rachie Reports, colonic irrigation can result in tearing of the colon and septicemia, or chronic depletion of electrolytes and death.

Thermography is a tool promoted as a way to detect breast cancer, but the AMA says it is unreliable, missing known cancers and diagnosing non-existent cancers – and further it is expensive. Chiropractic subluxations or spinal problems, can lead to other health complaints. The AMA is concerned about children being subjected to unnecessary X-rays for what is a controversial diagnosis and treatment (see here for more information). Regular listeners to Dr Rachie will remember that chiropractic manipulation has lead to death from tearing of arteries in the neck.

Dr Ford also cites fanciful claims of cancer cures as particularly insidious. And as is evidenced by some of the complaints currently being heard as part of the inquiry, it seems this is an urgent inclusion. He also cited other therapies, such as alternative massage therapies, Vega testing and coffee or chamomile enemas are “untested and potentially harmful”. Vega testing is as food allergy test, reminscent of alternative hair analysis, which claims to identify different food allergies and then prescribes you a special diet.

QuackWatch describes the Vega test as “…used to diagnose nonexistent health problems, select inappropriate treatment, and defraud insurance companies. The practitioners who use them are either delusional, dishonest, or both. These devices should be confiscated and the practitioners who use them should be prosecuted”.

Recently an article appeared in the local Adelaide press about a health practitioner treating cancer sufferers with massage, home-made remedies, and Kentucky Fried Chicken (KFC). The Favira Clinic, run by “miracle worker” Elvira Brunt uses a type of massage to change the way blood flows through the body, and this is supposed to cure terminal illnesses. Her supporters call her a gifted healer who can cure cancer. Her detractors have told a parliamentary committee that she takes money from vulnerable people, charging hundreds of dollars for a few precious minutes, paid in cash, with no receipt.

The AMA claims that she tried to convince the parents of a young leukemia victim to delay giving her treatment. The girls’ GP eventually told the committee the delays had a devastating effect;

….the interventions by the bogus practitioner served only to reduce the opportunity of giving the girl the best chance of a cure…..and when the cure could not be achieved she was deprived of optimal palliative care”.

Even more bizarre, Brunt apparently advised the girl’s father to give her the aforementioned KFC to get her kidneys functioning properly. The girl has since died. Her GP said; “People battling serious or terminal illnesses can be desperate and will sometimes hand over large amounts of money for quite useless treatments. We would like to think that the public is protected from such charlatans”.

Also reported to the inquiry is a man known as Lubo Bitelco who is alleged to have promised a woman a “50 percent” cure for cancer through a technique known as vaginal blowing, during which she had to move up and down on the bed saying “oh boy!”

In NSW, making claims of curing cancer or other terminal illnesses was outlawed in August 2008 with the introduction of the code. According to section 5, part 1 of the code; “A health practitioner must not hold himself or herself out as qualified, able or willing to cure cancer and other terminal illnesses”.

Also according to section 17 of the Code, Health Practitioners (with some exceptions such as the ambulance service and private hospitals) must display the Code and information about the way in which clients may make a complaint to the HCCC if necessary. These documents are available as easily downloadable pdfs from the Department of Health and the HCCC websites.

I am currently making enquiries as to whether it is an offence if the code is not displayed. If this is the case, it should make for an interesting visit to the Mind body Wallet festival at the end of this month, where all manner of fantastical woo is on display, with only the NSW department of health and the TGA are conspicuous by their absence.

I am personally very pleased to see the code introduced and hope that SA expect something similar. One expects Dr Peter Ford is not going to let these “wide-ranging ratbags” get off the hook that easily. He is a very active campaigner for science based medicine and features regularly on local ABC radio in SA.

What interested me most about the code is how it will be implemented. For example, can I dob in a website that claims to treat cancer with oxygen, water, sunlight and sleep? In accordance with Section 5,


health practitioners are not to make claims to cure serious illnesses”

including cancer, but do they actually have to state the word “cure” in their promotional material? What if they just infer they can cure an illness?

I was particularly interested in Section 12 which states that health practitioners are not to misinform their clients. Part 2 states that a health practitioner must provide truthful information to his or her qualifications, training or professional affiliations if asked. So, does this mean the end for people posing as doctors with bogus or on-line PhDs? One can only hope.

Section 3 is also interesting and has potentially far reaching consequences.

A health practitioner must not make claims about the efficacy of treatment or services if the claims cannot be substantiated”.

Sounds like curtains for KFC and “water can cure incurable diseases”. I will be very interested to see what impact the code has on alternative and unregistered practitioners in NSW.


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  • Stephen

    Hi all.

    I appreciate the feedback on my comments. I would like to clear some things up:

    1. Naturopaths do have to go through Government Accredited training (We come under the AQTF in the Health Training Package).
    2. I didn’t make the death rate up for medications (look up the Journal of the American Medical Association – JAMA I quoted.). It is funny how I am only one using medical references here.
    3. If a Doctor wrote the article initially, then they are not trained in Naturopathy, unless they do further Naturopathy training.
    4. We practice Evidence Based Medicine using peer reviewed Randomised Clinical Trials. Do a search on PubMed and look up a herb yourself. Here are a couple:

    Eur Neuropsychopharmacol. 2008 Nov;18(11):803-13. Epub 2008 Aug 9.Click here to read Links
    Continuation and long-term maintenance treatment with Hypericum extract WS 5570 after recovery from an acute episode of moderate depression–a double-blind, randomized, placebo controlled long-term trial.
    Kasper S, Volz HP, Möller HJ, Dienel A, Kieser M.

    Pharmacopsychiatry. 2006 Mar;39(2):66-75.Click here to read Links
    Comparative efficacy and safety of a once-daily dosage of hypericum extract STW3-VI and citalopram in patients with moderate depression: a double-blind, randomised, multicentre, placebo-controlled study.
    Gastpar M, Singer A, Zeller K.

    This one concluded: “These results revealed that hypericum extract STW3-VI is a good alternative to chemically defined antidepressants in the treatment of outpatients with moderate depression.”

    5. Is anyone making these comments even a Naturopath? Cause what some bloggers are saying about Naturopaths is really far from the truth. I have used peer reviewed medical journals to support my view. I hope people on this blog do the same.

    It is interesting to hear comments and I am actually glad that there are skeptics to ALL forms of medicine. It is actually healthy to ask for the science. Seriously, take the ’emotion’ out of the date and strip the discussion down to the ‘science’. Blood letting? That was done by Barbers, not Naturopaths. Medicinal leeches are still used by medics with good results I must add. Don’t just bag it for no reason.

    Have a good day all!

    Stephen.

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  • Elwood

    hey Dr Rachie,
    FYI this show will be starting next week… am interested to see how much science is involved. I too was unsure of the distinction between dieticians and nutritionists – and I wanted to get it right so I could get a friend of mine the badscience ‘nutritionist’ T shirt… 🙂

    http://www.sbs.com.au/food/article/3398/Food-Investigators

    PS looking forward to the Melbourne YAS event!

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  • David

    Yep – I love collecting letters – also an Accredited Exercise Physiologist (Australian Association for Exercise and Sports Science), Accredited Sports Dietitian an a few others!

  • @ David,

    Yes, you are correct. The Dieticians Association of Australia (DAA) does regulate nutritionists and dieticians.

    “Accredited practicing dieticians or APDs have sound university qualifications accredited by DAA, undertake ongoing training and education and comply with the Associations guidelines for best practice. They are committed to the DAA Code of Professional Conduct and Statement of Ethical Practice, and to providing quality service”.

    However, health services provided by dieticians (amongst others) are specifically listed in the code (under Schedule 3, part 1, definitions) since the profession is one where it is not a requirement to be registered.

    Hence,

    “Application of code of conduct:
    This code of conduct applies to the provision of health services by: (a) health practitioners who are not required to be registered under a health registration Act (including de-registered health practitioners)”.

    Health service includes the following services, whether provided as public or private services:
    (i) services provided by podiatrists, chiropractors, osteopaths, optometrists, physiotherapists, psychologists and optical
    dispensers,
    (j) services provided by dietitians, masseurs, naturopaths, acupuncturists, occupational therapists, speech therapists,
    audiologists, audiometrists and radiographers
    ,

    Point (i) includes health providers for which health registration acts are cited in the code (e.g;, Pharmacy Practice Act 2006 and Physiotherapists Act 2001 etc).

    The DAA Code of Professional Conduct and Statement of Ethical Practice is not mentioned, I guess since it is not an “act” per se.

    However, the DAA does warn about unregistered dieticians/nutritionists on their website.

    “There are no rules governing the use of the terms ‘Dietitian’ and ‘Nutritionist’ and they may be used by Dietitians, nutrition scientists and nutrition graduates, or people with very limited nutrition qualifications. To make sure you are receiving expert nutrition advice, always enquire about the qualifications of a dietitian or nutritionist and look for the APD credential”.

    To avoid confusion, (and so it doesn’t look like I am picking on certain professions) I have modified the post accordingly.

    You can read about APDs here

    Thanks for your comments.

    (Just out of interest, are you and APD?)

  • David

    Dietetians are registered health professionals (vs what was in the podcast) – you may mean nutritionists but even that term was registered last year or the year befroe, by Dietitians Association of Australia and i think Nutrition Society of Australia.

    Will post more info tonight when I get home

    Keep up the great work

    david the Dietitian

  • Stephen, please try to get the myth correct – is iatrogenic death the 4th, the 6th or the leading cause of death in the USA (as I was told today by some loon who rang and abused me)? Is the number really 100,000 or are you just quoting the number I made up some years ago?

    Why hasn’t the number changed in the last seven years? (Here’s a hint – because it is not true so it never needs to be changed.)

    See some more about this at http://www.ratbags.com/rsoles/comment/ksofdeaths.htm

  • Where does the “balance” lie, when a balanced view is expected? And for that matter, why should an article have to give a “balanced” view at all when people could be harmed by doing so? This is only Stephen making his own rules and imposing them on everybody else.

    If I were to discuss blood-letting as an alternative therapy, how much space should I devote to praising it? And a lot of today’s “alternative” medicine comes from that time.

  • “What he fails to realise is that Naturopaths must undergo Government Accredited training from the National Health Training Package.”

    No evidence for that claim.

    “…side effects of medications is the 4th to 6th leading cause of death in the U.S., killing a reported 100,000+ per year.”

    How many lives were saved by same medications?

    “Any article must give a balance view, which the author has failed to do… It is sad for a lay person to criticize a profession for which they know nothing about.”

    Yes, it is sad that you have clearly no knowledge and that you have no balance.

  • Oh, Stephen. What *you* fail to realise is that this “layperson” is Dr Rachie. Far from a layperson and even further from a “he”, incidently. Prepare for your misguided comment to be skinned and neatly eviscerated.

  • zombiwulF

    Natural Medicine; sounds warm & cuddly and well… natural. Much better than the scary muliti-national, corporationy, sciency, white coat guys!!

    So, every profession has its ‘quacks’. Those in medicine are held accountable for their malpractice, what about the ‘alternative’ quacks?

  • Whimsical

    Re Stephen’s “Government Accredited training”.

    THIS “layperson” visited the following AU Government website (Licensing and Accreditation of Health Professionals):

    http://www.healthinsite.gov.au/topics/Licensing_and_Accreditation_of_Health_Professionals

    Guess what? It does not list one body that pertains to naturopaths.

    As to the efficacy of alternative therapies. Prove it! Randomised, placebo- and/or comparator-controlled trials please. After all, that is what conventional medicine has to do.

    And the reason you have all those statistics on side-effect deaths? Because the conventional medicine industry is very heavily regulated and MUST maintain records of, and report to government agencies worldwide, all known adverse events (whether they are considered to be related or not). Alternative therapies are answerable only to themselves.

  • @stephen: Oh, sure. No-one disputes that things have risks, which is why there is such a lot of work to
    a) make sure that any drug or procedure has more benefits than risks for an individual (heart ops are very risky but also can have a huge benefit if indicated)
    b) monitor for side-effects, known (such as routine testing) and unknown (in the UK there’s the Yellow Card scheme, for instance)
    c) discuss with patients the benefits and risks so they can make an informed choice.

    Risk is not the problem – risk without benefits, and improper disclosure of risk is the problem.

    Things aren’t perfect at all – which is why there are systems to remove useless medics, withdraw ineffective or dangerous drugs, and so on.

  • Stephen

    This article quotes a lot of quotes and really nothing else. The author highlights some dodgy practitioners, which there are in every profession, including Natural Medicine. What he fails to realise is that Naturopaths must undergo Government Accredited training from the National Health Training Package.

    He also fails to mention that a report in the Journal of the American Medical Association stated that the side effects of medications is the 4th to 6th leading cause of death in the U.S., killing a reported 100,000+ per year. And these are the only ones that are reported (The JOURNAL of the AMERICAN MEDICAL ASSOCIATION (JAMA) Vol 284, No 4, July 26th 2000 article written by Dr Barbara Starfield, MD, MPH, of the Johns Hopkins School of Hygiene and Public Health).

    Any article must give a balance view, which the author has failed to do. With every medical/natural intervention, there are risks and every profession has ‘quacks’. It is sad for a lay person to criticize a profession for which they know nothing about.

  • zombiwulF

    KFC and magic water !!!!!!!!!!!! what a jaw-droppingly stupid thing to tell someone in genuine need!!

    Recently my wife & I had a short break at a nice resort in the Snowy Mountains where I spotted the book by the ‘Miracle of Water’ guy from Japan. Ughhh.

    All the usual suspects are in there, Sheldrake, intelligent bottles of water (maybe they’re flying the UFO’s Richard! 😉

    Keep up the good work ‘Zoners’