Professor David Peters

Complementary medicine is a misleading umbrella term for this cluster of unconnected theories and methods.  Osteopathy, chiropractic, acupuncture, herbal medicine, nutritional therapy, hypnotherapy?  Their most obvious shared feature is their being absent from the medical curriculum. 

Yet for the last twenty years or so years doctors – especially GPs – have had a growing interest in them.  A decade or two ago as many as 60% of GPs surveyed responded positively when asked about complementary medicine, and quite a few GPs practice medical acupuncture themselves (or horrors! even homeopathy).

About 25% of the public have paid for a complementary therapy at some time, usually because of the kind of stress-related or painful condition that conventional medicine isn’t terribly good with, and usually after having tried first line medical treatment, which presumably hadn’t met their need.

Back in the noughties these methods were on the rise in the NHS, but over the last ten years cash-strapped PCTs, influenced no doubt by high profile attacks on complementary medicine have reined back.  This is frustrating not just for for patients but also for the substantial numbers of GPs who find these approaches may fill  some of their ‘effectiveness gaps’.   If complementary therapies are both clinically useful and popular with patients then ought their future integration into the avowedly patient-centred primary care-led NHS to be a no-brainer? But where’s the evidence-base you cry! It’s because the practitioner’s ‘human effect’ can play as big a part as an individual practitioner’s skill, that these subtle approaches are so difficult to submit to standard randomised controlled trials.  Nonetheless, clinical commissioning, wellbeing services and orthopaedic service redesign are all great opportunities for pilot studies of a public sector role.

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