opinion: rules for alternative med need enforcement

the  current version  of the cpso’s cam policy was written in 1997, at a time when health misinformation had a much different (and less powerful) role in our society. since then, social media has taken on a new role. we are saturated with information, both accurate and inaccurate, making people more vulnerable to anti-vaccine rhetoric and conspiracy theories at a time when we desperately need public support for science.

physicians are not immune to health misinformation, nor to the financial temptations of offering phony “alternative” treatments for a fee. over the past two decades, alternative health companies have created more and more products and thus more opportunities for physicians to earn money by promoting them. this can lead to conflicts of interest in which doctors prescribe products that are not needed because it  creates revenue  for them. doctors can also profit from the referral fees for sending patients to alternative health clinics. these practices compromise public confidence in our health institutions.

i’ve seen a draft of the new policy. it’s stronger than the 1997 version (and its 2000/2011 updates). the revised policy now clearly emphasizes physicians’ responsibility to avoid conflicts of interest and scams. the overall wording of the document is more forceful as well. as the cpso notes in its survey, it has evolved from using “ informed  by evidence” as a standard of care to “ supported  by evidence and scientific reasoning.” it has also replaced the concept of “ advised ” conduct with the phrase “ physicians must , ”  which appears in bold letters throughout the new document. for example:

• “physicians must not provide complementary or alternative treatments that have been proven ineffective.”
• “physicians (prescribing cam) must specifically document the risk-benefit analysis undertaken to determine its appropriateness.”

the new version makes it easier to gather evidence in complaints about a physician because it mandates better record-keeping by physicians prescribing cam. its conflicts of interest section is also stronger, outlining consequences for physicians who make money selling phony products or who profit from bogus referrals to alternative care clinics. it includes the directive that physicians “ must not  associate themselves with any advertising for a commercial product or service other than their own medical services … and  must  ensure any published materials relating to a professional affiliation are accurate, factual, and based on evidence and scientific reasoning.”

the opim doesn’t acknowledge that some forms of cam exploit patients, nor that some products put patient safety at risk. instead, it has framed the issue as “cam under attack.” but in this era of health misinformation, it’s almost comical to conceive of cam being under attack because cam is everywhere– from the pharmacy aisles and convenience stores to palliative care clinics and our social media feeds. meanwhile, anti-mask rallies and the  plandemic  movement compromise our ability to manage covid-19 and bring the pandemic to an end. these projects paint a grim picture of the broader cam community as an enabler of dangerous health misinformation.

in fact, that is how the old policy sometimes played out. in 2018, i  wrote a complaint  to the college about an md who was promoting anti-vaccine ideology while treating autistic children with an expensive, off-label drug (chelation) that has no evidence of benefit and clear evidence of harm, including deaths. the procedure violates both u.s. and u.k. law as well as the college’s own cam policy. yet the cpso claimed that it was not required to pursue the complaint and  dismissed it  without even reviewing the evidence i’d submitted. three years later i am still asking myself: why?