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07/06/2011 / Pedanto

Card Tricks will Save the NHS Trillions

Yes my title is a bit of a straw man, but I’d rather be throwing away a penny for the guy than being trained to practice a therapy I would be unlikely to ever want to use. Before I go on: the point of this blog entry is not to attempt to discredit hypnotherapy as a useful tool, in fact like much psychotherapy it holds a perfectly useful place in healthcare; I just want to point out yet another instant of the Daily Mail having a severe episode of bovine faecatemesis.

A knot of hypnotoads could be the most efficient way to work with this idea

The Daily Mail and the Daily Telegraph both reported this week that Hypnosis on the NHS could save millions of pounds . More specifically their major quote mine in this article Jacky Owens (the president of the RSM’s Hypnosis Section) is quoted as saying – “What we need are doctors, dentists, nurses, psychologists, physiotherapists, radiotherapists – the whole gamut of people who treat patients – trained in using hypnosis as another tool in their treatment programme” – I couldn’t really see how this would save too much money. A quick look at the UK college of Hypnosis revealed a vague idea of what this might cost. There are approximately 29,000 GPs employed by Primary Care Trusts throughout England alone, if only half of these were trained to treat IBS (the illness that hypnotherapy has the best evidence for with regards to positive outcomes with treatment but more on this later) with hypnotherapy at the cheapest tariff  shown on the UK College of Hypnosis website (£132) it would cost the NHS £1,914,000. This is of course assuming that the training required to treat IBS would be priced so competitively. I’m fairly certain that if all healthcare professionals were required to be able to provide some small level of hypnotherapy then the cost would likely be much higher and based upon the number of IBS patients in the UK (annual incidence 1-2%) this would in all likely not be cost effective. Throughout this article if not otherwise stated I will be using IBS as the illness of choice to be treated by hypnotherapy as it has been accepted by NICE as a useful therapy, thereby giving the other side of the debate the best chance it has by using their strongest piece of evidence.

I’m fairly certain that Ms Owens may well not have meant that ALL doctors and ALL dentist and ALL other healthcare workers need to be trained in the art/science/techniques of hynotherapy as such an exercise would prove both costly and in many cases fruitless. After all the NICE guidelines on IBS put hypnotherapy pretty much right at the end of the algorhythm of treatment. This perhaps indicates that the patients who are undergoing hypnotherapy for their IBS are being seen by a specialist gastroenterologist by this time who would refer them to a hypnotherapist, instead of putting aside a large amount of his outpatient clinic for treating this single patient. At this point I feel I’ve illustrated that training everyone would be a waste of time and money. What we see here is a quote which came from a credible source, which will have been edited perfectly into place so that the story seemed a lot more exciting than “PEOPLE AT MEETING DISCUSS THINGS AND COME TO SOME AGREEMENTS”.

I now look to Lee and Herring give us an incite into another practice of many journalists as a complete red herring (I almost want to pretend that was a pun – but if I did that I would have such a terribly poorly thought out pun attached to my writing and would have to commit harikari out of shame).

A closer look at the writing

Lets have a quick look at the major quote from Jacky Owens again: “What we need are doctors, dentists, nurses, psychologists, physiotherapists, radiotherapists the whole gamut of people who treat patients trained in using hypnosis as another tool in their treatment programme“. Notice anything? Well, you see those lovely little hyphens? That’s an editing technique I’m going to coin “sorting the emotive wheat from the factually accurate chaff”. If you go through any newspaper article (preferably in the Mail,  where articles are rife with what appears to be verbatim quotation) you might notice these all too easy to miss hyphens. They denote that something has been removed from this statement. If you want to point out that someone has either paused during their quotation, or moved onto a different clause we have the use of commas, semicolons, and even colons. In using hyphens to imitate a pause or change of clause journalists can utilized the quoted’s colon for a much more hedonistic pastime.

The all important evidence

A quick look at the evidence would also be nice. If you find yourself looking at the 2007 Cochrane review on the subject you might notice some very carfeul wording. Most particularly “The studies provide some evidence that suggests that hypnotherapy might be effective in treating IBS symptoms including abdominal pain. However the results of these studies should be interpreted with caution due to poor study quality and small size.”. Sounds like the writers were really committed to the idea that hypnotherapy was the be all and end all of IBS treatment.

The Daily Fail

The Daily Mail is often an advocate of CAM (complementary alternative medicine) – which in my mind is a disservice to much of CAM. I feel it is unfair for many people promoting treatments that they think might work to be championed by a paper which gives so much of its time to promoting racial intolerance, homophobia and fear. Of course at this point in when discussing ones opponent it is appropriate to invoke Ad Hitlerum, but fortunately the Daily Mail makes my job a whole lot easier on that front. I want to give CAM a chance, I really do. I want alternative medicine that stands up to the tests, because at that point it becomes something all the more magical, it ceases its alternative exile and becomes by definition medicine – which I will at some point soon I be allowed to use to help people – fantastic! Unfortunately once the Daily Mail throws its lot in with you it is almost inevitable that the skeptical scientific community will become even more wary of any claims you might make.

The rest of the article on the Daily Mail website (although a similar article printed in the Telegraph did not contain the following – having probably been edited down to keep only the most sensationalist angle) went on to talk about how important having good reliable hypnotherapists was as people paying to be treated for PTSD or suppressed memories could come off worse from hypnotherapy. Having read the article originally in the Telegraph and only examined the online version from The Mail it made me wonder if perhaps the Daily Mail had a more responsible web service than its paper equivalent, after all cyber space is cheaper than paper and doesn’t have to shift as many copies through sensationalist reporting.

A little friendly advice

In conclusion I would like to send a message to CAM promoters across the world – if you have some good evidence, if you’re making headway in getting your treatments accepted, and if you want to become integrated into normal healthcare – DON’T TALK TO THE DAILY MAIL. Don’t give them a quote they can throw in to an article. Don’t give them the fucking time of day! Just pass no comment to their lazy halfwitted reporters, go somewhere credible with your story and maybe then we’ll listen.

In fact I think the whole idea of making doctors aware of hypnotherapy and when to refer people for it is fantastic – more education and more emphasis on evidence based medicine can only be good; but unfortunately seeing the Daily Mail promoting an idea similar to something I might agree with I instinctively rebelled. They took a good idea and wrapped it up in emotive bullshit thereby nullifying the original good point that could have been made. And that dear CAM practicioners is where the Daily Mail bent you over and had its sordid way with you.

Don’t Deal With The Mail (or Telegraph for that matter).

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