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Dr B. C. Dixon-Warren, chair; Drs B. Fleming, A. K. Garg, L. Oppel, T. Wong, F. Yakura. College of Physicians and
Surgeons of BC: Drs T. E. Handley, P. Rebbeck.
The committee's activity during this past year again reflects the continuing high interest of the public, the media, and
the profession in unconventional medical and health practices. Five regular meetings were held. Presentations were
received from interested parties. Members of the committee responded to requests from the news media for comment.
On behalf of the committee, the chair gave presentations to several groups.
Highlights
Dr Barry Beyerstein, PhD, is a well-known brain-behavior scientist with a special interest in critical assessment of the
claims of "alternative medicine". He also chairs the BC Skeptics. He attended one of our meetings by invitation and
provided a penetrating review of the medical and psychological pseudoscience that is being uncritically promoted and
currently receiving some acceptance.
Dr Lloyd Oppel responded on behalf of the committee to a request from ICBC for assistance. He has organized a
freestanding Expert Advisory Committee that will be available to advise ICBC on the available evidence to support
requests for the funding of unconventional therapies. This is a very important initiative.
The committee was pleased to note the appointment of Dr Allan Best, PhD Psych, as Research Director and CEO of the
Tzu Chi Institute for Complementary and Alternative Medicine in Vancouver. Dr Best gave a presentation to the
committee with his vision of the future, and described the protocol for the Mind-Body Research program, which has
received ethical approval. There are some concerns about methodology and the generalizability of the results, but we
will await the outcome of this study with keen interest.
The committee is gratified that our 1997 resolutions have been fully endorsed by the board of the BCMA.
On behalf of the committee, the chair has attended meetings of the steering committee for the proposed joint
conference of the BC College of Family Physicians and the Tzu Chi Institute to provide suggestions about programming.
Principally, we have stressed the importance of a valid research underpinning being in place before there is any
advocacy or promotion of unconventional treatment modalities. The chair has also attended, by invitation, meetings of
other committees with common interests. Finally, there have been a number of opportunities to explain the
committee's viewpoints via both electronic and print media.
Future directions
There is clearly a need to keep emphasizing the importance of Western mainstream evidence-based practice in medical
care and health care, both to the public at large and to workers in the health-care field, including physicians. News
media seem to exercise little restraint in publishing newsworthy medical stories, even when their reliability is
questionable. The committee is developing a quick-response strategy, so that some of the misinformation can be
promptly countered with reliable, authoritative medical opinion. The resolutions attached to this report deal with
related issues.
Equally clearly, some members of the public feel that physicians frequently do not meet their health-care needs. After
studying this perception, the chair now believes that the deficiency is not usually in the core content of the
treatment offered, but rather in the context. Technical competence may be present, but patients often complain that
"the doctor's always in a hurry" or "he didn't seem to care". Outcome in the illness experience, from the patient's point
of view, is often a product of the context of care more than anything else. Attending to the context of care means,
among other things, giving the patient adequate time to tell his or her story, and listening actively to the story to
establish a common ground of understanding. It seems likely that unconventional healers, being relieved of the
requirement to practise medicine to current mainstream standards, intuitively put extra effort into achieving rapport
with the patient. In many cases the specific modality, such as therapeutic touch, or homeopathy, may simply be a
magical metaphor for caring and healing. A physician, by having more responsibilities, has more challenges; but medical
training and experience still equips the physician, better than anyone else, to give needed medical care. The
patient-centred approach pioneered by lan McWhinney, among others, is a way of integrating content and context and
meeting these challenges.
I would like to acknowledge the support of all the COHP staff during a year of change; especially that of our assistant,
Diane Quesnel, who has set a standard for efficiency that has been hard for the chair to match!
Resolutions
1.Pharmacies and pharmacists are seen by the public as sources of reliable health information. An increasing
and significant number are selling and prominently displaying unproven so-called alternative medicines such
as herbal supplements and homeopathic preparations. This activity can spread misinformation about
appropriate health care, and may result in a financial burden to the public. Moreover reliance on information
contained in the advertising of certain of these products may lead to delays in obtaining appropriate medical
care for significant health problems.
BE IT RESOLVED:
That the BC Medical Association call upon the BC College of Pharmacists to implement
measures requiring members of that College to recommend only products shown to be
effective in well-designed scientific trials.
BE IT FURTHER RESOLVED:
That the BC Medical Association call upon the BC College of Pharmacists not to advertise or
present unproven therapies to the public as bona fide treatments.
2. Legal recognition, with licensing powers, has been granted by government to a number of
self-styled health practitioners who offer care lacking a scientific basis. Growth in the
number of unregulated practitioners and "alternative" health-care practices is occurring in
BC, pointing to a need for a university-based
scientific body to assist the provincial and federal governments in discerning valid from
invalid treatments.
Therefore,
BE IT RESOLVED:
That the BC Medical Association recommend to federal and provincial governments that
standing scientific councils be established to evaluate and report on unconventional practices
and practitioners to ensure public funds are allocated to health care appropriately.
-Brian C. Dixon-Warren, MB, BS
Chair
