An alternative option?
If a patient asks for your advice on using an alternative therapy, what will you tell them? Let’s flick through their evidence bases: homeopathy—shown not be better than a placebo; healing—no evidence of efficacy; chiropractic—may be effective for back pain but has harmful side effects. And so on. Edzard Ernst summarises the evidence bases (doi:10.1136/sbmj.f1604).
So, that solves the problem of what to tell your patient. Or does it? When a chronically ill patient wants to try homeopathy as a last resort, what will you say? After all, as Margaret McCartney points out in her editorial (doi:10.1136/sbmj.f1794), it can be hard to stick up for mainstream medicine, with its unpleasant side effects and large, grim hospitals, in the face of gentler alternatives. “In hospital, despite the efforts of committed doctors and nurses, people sometimes died. In alternative medicine, that didn’t happen—at least, not visibly. There was time, space, and a