Presentation by Prof. Betz

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Doctor and professor at the VUB, Head of Department General Practitioners education.

Besides educating general practitioners, the professor also engages himself with a critical view in alternative therapies. The group of people that deals with this also has a website www.skepp.be where they register and explain all their findings. SKEPP is also an independent advisory body.

Often a general practitioner has to advise a patient when he/she has a question about one or other cure that could bring salvation. The general practitioner has to be able to verify whether these are quacks and/or charlatans. It has to be verified what they sell, if there is scientific evidence… Also the price ticket is important, it must be certain that no financial gain is involved. When you have to pay impressive sums for a treatment, you may demand to have a look at the published results.

Before resorting to alternative therapies we must ask ourselves what the probability of improvement is, mortality, which effects there are, the risks attached to it…. To all these questions, concrete answers should be given so you can draw up clear objectives.

Often one also relies on testimonials.  Some sound very enthusiastic, but sometimes the enthusiasm diminishes. There must be a clear belief that improvement was noted and you should be able to make connections with your own situation.

Example:

- A therapy with a Mongol child was applied based on living cells. The general practitioner didn’t notice any visible changes, but the mother was convinced that her child did much better.

- Sometimes someone is difficult to leg and therefore uses a wheelchair. When this person is prodded, he can suddenly walk again.

We must therefore be aware of the placebo effect. This sometimes plays a major role in the assessment of alternative medicines.  The idea that you get something that will help, even though it is a Chinese herb mixture, pep pills…. will sometimes actually give you the feeling that it worked.

A general practitioner may only go along with these stories to a certain level. He/she should keep in mind the reality and patients not deprive their luck. He/she must therefore be able to make up the balance between telling the truth and not taking away the hope. He/she must ensure that his/her patient can accept bad news, but he/she may not take away his/her illusions.