When I think of Switzerland, I think of secret bank accounts, the Alps, chocolate, and high-end watches. Now I may have to add homeopathy to the list, since a recent survey found that a number of Swiss MDs have actually been prescribing these useless nostrums to their patients. What's going on?
An article in the Swiss Medical Weekly presents the results of a survey of Swiss physicians working in outpatient care in the canton of Zurich. They were queried about their prescribing of homeopathic "remedies", and the doctors' attitudes and beliefs about them. Thirty-eight percent of the approximately 4000 physicians approached by the investigators (Dr. Stefan Markun and colleagues from the University Hospital in Zurich, Switzerland) responded to the survey.
Of the respondents, 345 (nearly 23 percent) turned out to be ‘prescribers’ and 1160 were non-prescribers of homeopathic nostrums. Breaking these down by specialty, about 39 percent of pediatricians said they prescribed homeopathic remedies, and anesthesiologists and OB-GYN specialists were the second most frequent prescribers at a little over 32 percent each. And about 43 percent of MDs with no specific specialty were also prescribers. And the associations between likelihood of prescribing and specialty were significant for all the above except the anesthesiologists.
The investigators also found that slightly over half of the prescribing doctors actually intended their remedies to have specific effects. And about 21 percent intended “non-specific/placebo effects.” Further, over 80 percent of the prescribing MDs showed strong or moderate adherence to homeopathic doctrine. Some insight into these results come from the reporting that over 42 percent of these doctors either sold or manufactured homeopathic remedies as part of their practices.
Possibly the most disturbing result of the survey was that nearly 23 percent of the prescribers reported that they thought the evidence base of homeopathy proved its effectiveness. In contrast, 72 percent of non-prescribers believed that the effectiveness of homeopathy was based on the placebo effect (as did 35 percent of the prescribers).
Homeopathy, as we have explained previously, has no valid scientific basis. And there have been tragic results from the use of such remedies instead of standard medical care. The FDA has warned against their use for asthma, and recently homeopathic teething tablets have been found to be adulterated and have caused the deaths of about 10 babies. It’s legal to use homeopathic products in the U.S. — but just for self-limiting conditions, i.e.as placebos.
Besides the fact that these remedies are prescribed by Swiss doctors, it’s disturbing that so many of them seem to believe that they could be effective. However, if even those who don’t think that’s true prescribe them as placebos, the question arises as to whether it is ethical to deceive a patient by giving them a placebo when they think they’re getting a real drug? The results of that survey are indeed problematic. I would rather connect the Swiss with chocolate and watches than with the prescription of useless (or dangerous) homeopathic “remedies”.