Challenges for Our Practitioner Community

One of our stated aims is to raise the knowledge base of complementary medicine so that it can stand in equal partnership with mainstream medicine. Shared Care would like to host a comprehensive network of researchers in all complementary disciplines, and in the fullness of time to coordinate multidisciplinary research of the sort not seen in mainstream medicine due to its competitiveness.

We have certain advantages over orthodox medicine:-our practitioners tend to be more broadminded about other disciplines, often practising more than one; we tend to think in a holistic fashion and are therefore more attuned to our patients' real lives; and we are not funded by the pharmaceutical industry. That last point is of major importance in thinking about modern medical progress. The majority of funding for mainline research is provided by the drug industry. That industry exists primarily to generate profits for its shareholders from the sale of drugs. There is at the very least the potential for a conflict of interest between truth and profit that we leave you to ponder.

Mainline medical research is based on the randomised placebo controlled double blind trial. This works when a tablet with an active ingredient is compared with a sugar pill with the proviso that the research situation is truly artificial. For many years doctors have been persuaded by the drug industry that results obtained from these trials represented the true picture that they would obtain in the real world. A few doubts have crept in and an editorial in the British Medical Journal in 1999 discussed the two differing concepts "can it work" and "does it work". The former related to the rigorously controlled normal kind of research in which the patient is closely studied, pills are counted and questionnaires completed by a researcher on, say, a weekly basis. The latter referred to a study published that week that found disappointing (to say the least) results when a treatment regime to detect and treat depression in the elderly residents of old peoples' homes was trialed in a real world situation (Haynes.B., BMJ 319.Sept 11.1999. p652-653 "can it work, does it work, is it worth it?").

Even if the placebo controlled double blind trial is appropriate in grassroots mainstream practice it probably is not in most branches of complementary medicine. It is difficult to conceive of a placebo talking therapy that is not a valid intervention in its own right, nor a blind application of a massage therapy as this would require the patient to be unaware that they were having such a therapy.

Our task is to mount a multi disciplinary discussion using this page to determine the answers to the following questions.

• What protocols have we have successfully used in the past?
• What protocols from other disciplines can be applied?
• What protocols are the most credible both for us and the wider world?
• How we can set up networks of colleagues who will research using standard protocols?.

It is the hope of the editorial board that this page of Shared Care's site will become an authoritative, on-line only, journal announcing the best of complementary medicine research produced by grassroots practitioners and available in a completely open and non-exclusive way to everyone.