"I could perhaps draw some wild conclusions about you personally and how you treat people you see based on something you've posted here and what I percieve to be your political affiliations. Anyway, I digress."
No - go on. Do say what you think about my 'political affiliations'.
"Just because it's a popular therapy and many people spend lots of money on it, doesn't make it effective."
No. True. I don't tell people it's effective. I tell them what the research evidence say and I tell them what people who've opted to try CO tell me about about their experience with it. Are you saying it's wrong for me to pass on what parents tell me?
"How many people would get back to you and say CO was bollocks w/o hurting your feelings because you obviously believe in it"
I make a point of asking them. I say - what did you think of the treatment? Do you think it made any difference? I have no vested interest in them going and I always point out that there's no scientific evidence in support of its efficacy. I have a good enough relationship with these people for them to tell me if they thought something was useless. They're certainly quick enough to tell me if information I've given them on other aspects of postnatal life has been unhelpful or irrelevant!
"How many times do you tell your hairdresser that you don't actually like the haircut they've just given you all that much?"
But I'm not an alternative therapist. Why would they not tell me if the treatment didn't work for them? I don't recommend this therapy - I just tell parents what the research evidence is and what I am told about people's experience with it.
"If you "treat" a child over a number of sessions I think all children will improve to some degree. It's called growing up. Colic doesn't last forever, feeding improves with maturity as well. You can believe it was the nothingness that did it and give it a name, let's say "homeopathy" or you could go w/o all that and accept it's part of life."
Yes - except that's not the feedback I get. Most people I know take their babies for cranial osteopathy between week 1 and week 3 after the birth. Most have told me that they've seen an immediate improvement - usually within the first week, and often after the first session. The research shows that colic related crying peaks at around six weeks and begins to level off at around 8 weeks. So - that doesn't fit with your theory. I often suggest that parents think about keeping a diary of their baby's sleeping/feeding/crying patterns in the first few weeks and months as it's a nice thing to have years down the line as a reminder of the early days and that it can help if they need to see a GP or the HV about their baby further down the line. Point being - many of these parents are very conscious of changes in their baby's behaviour and the timescale over which it happens.
"I do believe all those educated people you're in touch with are imagining improvements. I don't think it matters if it's imagined or not as long as theer's honesty about it and not this hocus-pocus energetic medicine and such-like."
So as long as people are willing to admit that these therapies are basically ineffective in every way, and that any improvements in symptoms are completely imaginary, you are happy to say it's ok?
In fact you feel they don't even have a placebo effect - because the placebo effect often causes an ACTUAL reduction in symptoms, and not just impacts on the patient's PERCEPTION of pain/discomfort?
"Also, Sabire, maybe if you were in touch with people for whom £40 matters, perhaps you wouldn't be so eager to point them to expensive sugar pills."
I live in one of the poorest parts of South London and my daughter goes to the local school where over 80% of the children are from ethnic minority backgrounds (as are my own children) and large numbers of children qualify for free school dinners. It's not gentrified in any way - you can still buy a four bedroom house here for around £300K, despite the fact we're only 20 minutes from Victoria by train. It's the sort of area you'd probably drive through with your windows wound up and your doors locked.
The people I work with are often fairly privileged, (though not all). However, most of my friends are ordinary mums living in social housing whose children go to this school, and they can ill afford to spend money on ineffective treatments. Many of these people use homeopathic and herbal remedies because they are cheaper than prescription charges (unless you're on benefits) and because they find them effective. Many also use acupuncture and rate it very highly. In our poor little high street we have two Chinese herbalists and two alternative therapy clinics (and no - we don't have a large Chinese community - the schools aren't good enough!)and they are well used.
So, out of interest, how many socially disadvantaged people who suffer from long term minor health issues do you mix with socially? Do any of your friends live in social housing and claim benefits or work in Sainsbury's? I suspect you have no idea about the sort of feelings ordinary people have about how they can manage their symptoms, or how people feel about their experience of medical care within the NHS because the only contact you have with these people is when you're patronising them in a professional capacity. Have you ever experienced ill health that's been on-going? Have you ever had to cope with the reality of regularly seeking treatment for minor but distressing conditions through the NHS? - the hours spent in dirty waiting rooms with small children for GP appointments, only to be dismissed in five minutes by your GP who can barely remember who you are? Have you been repeatedly prescribed conventional treatments which haven't worked and that have given you additional problems and made you ill? I have. I know plenty of other people who have. If alternative therapies aren't illegal and if they help people why do you object so strongly to their existence?
Honestly Christina - 'evidence' comes in all forms. Experiential evidence is important too. Listening to what people tell you about how they feel won't make you a bad scientist and it will definitely make you a better doctor.