Friends of Science in Medicine
|CEO Loretta Marron|
The Friends of Science In Medicine (FSM) is an association which supports evidence-based medicine and strongly opposes the promotion and practice of unsubstantiated therapies that lack a scientifically plausible rationale. They accomplish this by publicly raising their concerns either through direct correspondence (E.g. the Australian government, universities, etc) or through media outlets. FSM was established in December 2011 by Loretta Marron, John Dwyer, Alastair MacLennan, Rob Morrison and Marcello Costa, a group of Australian biomedical scientists and clinical academics.
Scope and operations
Friends of Science in Medicine advocate the cessation of those university complementary medicine courses that are not based on scientific principles nor supported by scientific evidence, although they do support research into alternative and complementary approaches where there is evidence for potential benefit. By April 2012 they had widened their focus from university education to the clinical practice, use and legitimacy of complementary medicine within Australian society. Entirely volunteer run, FSM was initially supported by a A$3,000 grant from the Australian Skeptics Science and Education Foundation(ASSEF).
Throughout its history, FSM has been actively involved in a variety of medical policy issues surrounding evidence-based medicine and complementary and alternative medicine. They continue to appeal to the Australian Health Practitioner Regulation Agency, Medicare (Australia) and Australian tertiary education. to review current policies.
FSM entered into the Australian media and promoted their message through The Sydney Morning Herald, The Courier-Mail the Australian Broadcasting Corporation, The Conversation, The Medical Journal of Australia, the Australian Doctor magazine and regional radio stations. By May 2012 thirteen separate FSM discursive events created the unified message that all alternative and complementary medicines should be banned unless proven by rigorous scientific inquiry.
In September 2012 FSM was involved in lobbying the Australian Health Minister, Tanya Plibersek, to expand the chief medical officer's study into complementary medicine to include chiropractic and acupuncture. The group further demanded that all alternative medicines be taken off private health insurance which the Australian Government subsidizes. The Australian Government is currently examining the evidence of clinical efficacy, cost effectiveness, safety and quality of natural therapies. The result, expected in April 2015, will include a decision as to which natural therapies should continue to receive the rebate. The therapies under review are those not provided by an accredited health professional, which are covered by private health insurance but not Medicare. In addition to homeopathy, they include iridology, aromatherapy, various kinds of massage, Buteyko, yoga and pilates.
Several professional groups including the Australian Medical Association found that FSM had exceeded the boundaries of reasoned debate and risked compromising the values that the Friends of Science in Medicine claimed to support. The group underwent further criticism through editorials in The Medical Journal of Australia calling on the association to reverse its tactics.
Kerryn Phelps, former President of the Australian Medical Association, wrote the group had "cast its net too wide" in its condemnations, particularly in attacking courses in chiropractic, traditional Chinese medicine and Western herbalism. She further stated, "there is evidence supporting CAM approaches. You also have to remember that a sizable part of what is done in mainstream medicine lacks robust evidence."
Phelps, along with Stephen Myers, a Professor of Complementary Medicine and Director of the Natural Medicine Research Unit at Southern Cross University, in a 2012 editorial in The Medical Journal of Australia wrote, "there is great danger for the public if complementary medicine practice is allowed to develop outside mainstream education." They wrote it would undermine "safe practice and critical appraisal", and stated there is now an extensive evidence base for complementary therapies available.
In an open letter on their website which was triggered by FSM's position on the proposed partnership between nutraceutical company Swisse and La Trobe University, the Australasian Integrative Medicine Association (AIMA) criticizes the FSM for not reaching out to AIMA or other complementary medicine organizations which, the AIMA states, would at least establish "a more effective dialogue ...to improve the basis of health care and research for academics, medical professionals and the general population alike." They further state that "FSM appear to be purposefully limiting their use of scientific scrutiny." The Australasian Integrative Medicine Association is the Australian medical body representing the doctors and other health care professionals who practice integrative medicine.
Jeff Flatt published a critical discourse analysis of a selection of thirteen separate FSM media events as a single case. The findings are summarized as follows: "The Friends of Science in Medicine represent complementary medicine through a strategy of rhetoric and argumentation that contradicts the literature. Their discourse is symbolic and derives from a power-based ideological perspective that forms the basis for promoting exclusion of complementary medicine from university education and primary health care."
Activities and Impact
The following describes some of the initiatives and accomplishments of the Friends of Science in Medicine.
As a result of the efforts of John Dwyer and the Friends of Science in Medicine, in August 2013, the chairman of the Chiropractic Board of Australia said it had removed some courses from its approved training schedule and would be randomly auditing practitioners to ensure they were not making unsubstantiated claims about the benefits of chiropractic. It also announced all registered chiropractors would be required to remove anti-vaccination claims from their websites.
In April 2013, Macquarie University began discussions with higher education providers to transfer its chiropractic degrees by 2015. Executive Dean of Science, Professor Clive Baldock said the initiative was first and foremost an academic one, based on a need for the Faculty of Science to build upon the University’s recent major strategic investments in research-intensive disciplines such as biomedical science and engineering.
Earlier in 2013, FSM sent out a series of letters about inappropriate treatment of babies and children by chiropractors who claim that spinal manipulation helps health conditions such as Attention deficit hyperactivity disorder, Asthma, allergies, bedwetting, colic and ear infection and is a substitute for vaccination. This was prompted in part by the report that government funding of chiropractic care for children under 14 was reported to have risen by 185% in four years. FSM sent letters to the Chiropractic and Osteopathic College of Australasia (COCA), Chiropractors' Association of Australia (CAA), Chiropractic Board of Australia (CBA), the Australian Spinal Research Foundation (ASRF), Chiropractic Council of NSW and Council on Chiropractic Education Australasia (CCEA). A second letter sent to the four universities teaching chiropractic, asking them to justify the 'subluxation' theory. The response by the CEO of Chiropractors' Association of Australia, Andrew Macnamara claims that there is no evidence provided to back up these concerns,[clarification needed] however there is some evidence from a 2007 systematic review published in Pediatrics which would back up FSM concerns.[clarification needed]
In March 2014, surgeon John Cunningham and FSM's Joanne Benhamu published an article in The Medical Journal of Australia calling for a national system for chiropractors to report adverse events in the wake of allegations that a four-month-old baby had a neck fracture following treatment for torticollis. The Chiropractors' Association of Australia responded by saying that it was in favor of a mandatory adverse reporting system but that it should apply to all health professions and be run through Australian Health Practitioners Regulation Agency (AHPRA).
In systematic reviews of randomised controlled trials, Cochrane Researchers examine recent evidence for the safety and effectiveness of therapies. Edzard Ernst conducted a systematic review of reviews in the The Cochrane Database of Systematic Reviews (generally considered to be the most reliable source of evidence) in January 2010. Ernst's review, published in The Medical Journal of Australia, concluded, "The findings of currently available Cochrane reviews of studies of homeopathy do not show that homeopathic medicines have effects beyond placebo."
Commenting in an article in The Guardian on a National Health and Medical Research Council (NHMRC) study (draft) debunking homeopathy, FSM co-founder John Dwyer stressed an area that was not investigated; the use of homeopathy for protection. Dwyer told The Guardian, "the most serious issue was the spreading of the concept that homeopathic vaccinations were harmless and just as good as orthodox vaccinations. People who believe that are not protecting themselves and their children."
La Trobe University/Swisse Wellness Partnership Controversy
In January 2014, La Trobe University formed a A$15M partnership with vitamin manufacturer Swisse Wellness, causing a wave of controversy in the Australian medical community. One month later, Ken Harvey, Adjunct Associate Professor at the School of Public Health at La Trobe, resigned his position, stating "here were clear dangers in conducting research that was paid for by companies, and he could no longer be associated with the university given the 'fraught way' the research was being undertaken."
In light of this controversy, FSM wrote to the Australian Government's NHMRC, urging them to "generate formal guidelines for research funding that would reflect the 'world’s best practices,' as this is needed to protect the credibility and integrity of contracted research, particularly where the results could affect the pecuniary interests of the funder." As a result, the NHMRC is reviewing the evidence for the effectiveness of homeopathy and released a resource for clinicians entitled "Talking with your patients about Complementary Medicine – a Resource for Clinicians."
Loretta Marron, CEO of FSM, has been granted a 2014 Medal (OAM) in the General Division of the Order of Australia “for service to community health”. Marron has also received the Skeptic of the Year award three times from the Australian Skeptics who wrote she "has made great contributions to public health and the exposure of dangerous and discredited treatments that profit through offering spurious cures to the vulnerable and ill."
- "FSM Friends". www.scienceinmedicine.org.au. Friends of Science in Medicine. Archived from the original on 26 February 2014.
- Dell, Amanda (29 March 2012). "Complementary medicine - to teach or not to teach". Evenings with David Curnow. Australian Broadcasting Corporation. 612 ABC Brisbane. http://blogs.abc.net.au/queensland/2012/03/complementary-medicine-to-teach-or-not-to-teach.html. Retrieved 12 September 2014.
- Jooste, James (3 February 2012). "Alternative medicine debate". Razors Edge. 2SER. http://2ser.podomatic.com/entry/2012-02-03T20_59_34-08_00. Retrieved 12 September 2014.
- Marron, Loretta (7 September 2013). Friends of Science in Medicine - taking on pseudo-science (YouTube video). NZ Skeptics Society. 12 minutes in. Retrieved 12 September 2014.
- "Association and Executive". www.scienceinmedicine.org.au. Friends of Science in Medicine. Archived from the original on 28 February 2014.
- Costa, Marcello; Morrison, Rob; Dwyer, John; Marron, Loretta; MacLennan, Alastair (2011). "Join Us!" (Recruitment letter, vision statement). Morayfield: Friends of Science In Medicine. Archived from the original on 12 September 2014 – via i2p.com.au.
- Hughes, JD; Blott, LA (21 May 2012). "Tertiary education institutions should not offer pseudoscientific medical courses". The Medical Journal of Australia 196 (9): 566. doi:10.5694/mja12.10484. PMID 22621142.
- Ryan, Kath (16 July 2012). "Alternative medicine row erupts". MJA InSight (27) (MJA Group Australia). Retrieved 5 August 2014.
- Marron, Loretta. "What are 'Complementary and Alternative Medicines' (CAMs)?". www.scienceinmedicine.org.au. Friends of Science in Medicine. Retrieved 6 September 2012. More recent version (archived 12 September 2014)..
- "FSM Supported by Australian Skeptics". www.skeptics.com.au. Australian Skeptics. 22 April 2012. Archived from the original on 6 March 2014.
- Executive Committee, Friends of Science in Medicine (16 February 2012). "Thank you for your generosity and support" (Letter to Eran Sergev, President Australian Skeptics). Archived 11 May 2013 at the Wayback Machine.
- Levi, Scott (1 February 2012). "University "pseudoscience" criticised". Australian Broadcasting Corporation. 891 ABC Adelaide. http://www.abc.net.au/local/stories/2012/02/01/3420275.htm?site=adelaide.
- Thompson, Matthew (1 February 2012). "RMIT defends CAM courses". Australian Doctor. Archived from the original on 16 February 2013.
- Colvin, Mark (1 February 2012). "Doctors group fights to keep alternative medicine out of uni". PM. Radio National; ABC Local Radio: Australian Broadcasting Corporation. http://www.abc.net.au/pm/content/2012/s3420802.htm. Retrieved 12 September 2014.
- Corderoy, Amy (9 March 2013). "Treatment isn't always a cure". The Sydney Morning Herald. Retrieved 28 July 2014.
- Houghton, Des (26 May 2012). "Quacks galore in facade of quirky medicine". The Courier-Mail (Brisbane, AU). Retrieved 28 July 2014.
- Thompson, Matthew (28 January 2012). "Alternative medicine can be scientific, say besieged academics". The Conversation. Retrieved 28 July 2014.
- Kelly, Fran (30 January 2012). "New lobby opposes teaching alternative medicine". Radio National Breakfast. Radio National: Australian Broadcasting Corporation. http://www.abc.net.au/radionational/programs/breakfast/2012-01-30/3799620. Retrieved 12 September 2014.
- Kaye, Byron (18 September 2012). "Acupuncture, chiro should be investigated: Academics". Medical Observer. Retrieved 25 August 2013.
- "The Review of the Australian Government Rebate on Private Health Insurance for Natural Therapies". www.health.gov.au. Department of Health: Australia. Retrieved 6 August 2014.
- McCredie, Jane (6 May 2013). "Jane McCredie: A drop of credibility". MJA InSight. MJA Group Australia. Retrieved 12 August 2014.
- Newton, Kate (17 July 2012). "Anti-quackery group risks backlash: critics". Australian Doctor. Retrieved 17 July 2012.
- Komesaroff, PA; Moore, A; Kerridge, IH (16 July 2012). "Medicine and science must oppose intolerance and censorship". The Medical Journal of Australia 197 (2): 82–3. doi:10.5694/mja12.10500. PMID 22794044.
- Smith, Paul (7 February 2012). "Phelps defends CAM degrees". Australian Doctor. Retrieved 25 August 2013.
- Norrie, Justin (16 July 2012). "Attack on complementary medicine undermines safety". The Conversation. Retrieved 10 August 2014.
- Meyers, SP; Xue, CC; Cohen, MM; Phillips, KL et al. (16 July 2012). "The legitimacy of academic complementary medicine". The Medical Journal of Australia (editorial) 197 (2): 69–70. doi:10.5694/mja12.10491. PMID 22794038.
- "Open Letter to Friends of Science in Medicine". www.aima.net. Terrigal, AU: Australasian Integrative Medicine Association. Archived from the original on 26 August 2014.
- "About AIMA". www.aima.net.au. Australasian Integrative Medical Association. Archived from the original on 26 August 2014.
- Flatt, J (2013). "Critical discourse analysis of rhetoric against complementary medicine". Creative Approaches to Research 6 (2): 57–70. Archived from the original on 15 September 2014.
- Corderoy, Amy (9 August 2013). "Chiropractors pushing anti-vaccination line face crackdown, audits". The Sydney Morning Herald. Retrieved 28 July 2014.
- Baldock, Clive (24 April 2013). "Proposed changes to Chiropractic at Macquarie". mq.edu.au (notice to university staff). Macquarie University. Archived from the original on 26 August 2014.
- "Drs’ Tiresome Turf War Not About Patient Care" (Press release). Chiropractors' Association of Australia. 8 March 2013. Retrieved 10 August 2014.
- Vohra, S; Johnston, BC; Cramer, K; Humphreys, K (1 January 2007). "Adverse events associated with pediatric spinal manipulation: A systematic review". Pediatrics 119 (1): e275–83. doi:10.1542/peds.2006-1392. PMID 17178922.
- Cunningham, J; Benhamu, J; Hawkes, D (3 March 2014). "The need for a chiropractic adverse events reporting system in Australia". The Medical Journal of Australia 200: 204. doi:10.5694/mja13.11347. PMID 24580515.
- Ernst, E (19 April 2010). "Homeopathy: What does the "best" evidence tell us?". The Medical Journal of Australia 192 (8): 458–60. PMID 20402610.
- Davidson, Helen (8 April 2014). "Homeopathy is bunk, study says". The Guardian. Retrieved 15 September 2014.
- Luntz, Stephen (9 April 2014). "Meta Study Confirms Homeopathy Doesn't Work". www.iflscience.com. IFL Science!. Retrieved 23 August 2014.
- O'Connell, Brigid; Nash, Jonno (4 February 2014). "Dr Ken Harvey resigns from La Trobe University to protest against the $15m deal with Swisse". Herald Sun (Melbourne). Retrieved 10 August 2014.
- "Homeopathy Review: Assessment of the evidence - Effectiveness of Homeopathy for Clinical Conditions". www.nhmrc.gov.au. National Health and Medical Research Council. Retrieved 10 August 2014.
- "Talking with your patients about Complementary Medicine – a resource for Clinicians". www.nhmrc.gov.au. National Health and Medical Research Council. Retrieved 10 August 2014.
- "Governor presents Australian awards and honors Tuesday 9 September 2014" (Press release). Government House, Queensland: Government of Australia. Retrieved 15 September 2014.
- "Search Australian Honours: Simple Search: Marron, Loretta Josephine". It's An Honour. Government of Australia. 26 January 2014. Retrieved 28 July 2014.
- "Loretta Marron wins Order of Australia". www.skeptics.com.au. Australian Skeptics. 25 January 2014. Retrieved 15 September 2014.