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Why are unproven therapies so popular, asks physician Edzard Ernst, who has spent 18 years researching alternative medicines – and thinks homeopathy works

You have been described as a quack-buster for your work testing alternative medicine. Is that a fair description of what you do?
I don’t like the title quack-buster at all. I think it’s wrong. I see myself as a scientist. My remit was to conduct rigorous research into the effectiveness, safety and cost of complementary and alternative medicines (CAMs). That is not the role of a quack-buster. The results are often negative, but not always. We discovered 20 alternative treatments that work better than placebo. We also found that some CAMs do more harm than good.

Has the public’s attitude to CAMs changed in the 18 years that you have researched them?
In the UK, uptake of CAMs has remained largely flat, but in the US it has doubled in the last decade. In Germany, around 75 per cent of the population use a CAM at least once a year. I am often asked why Germans, who seem rational, are so taken by unproven therapies. I don’t have an answer.

What attracts people to alternative medicine?
I think for many people it is a fashion thing, a sign of affluence to have all these useless treatments. Like the L’Oréal slogan, people think: “I have reflexology or colonic irrigation because I’m worth it.” Then there is the image of CAM being “natural” and that everything that is natural is safe, with no side effects. At the extreme end of the spectrum, people who are dying may be desperately searching for a cure. You would be amazed at the lies these people are sold. I don’t hesitate to call it the criminal end of alternative medicine.

What new trends do you see?
Integrative medicine is a subject that annoys me intensely. People are being told it is the best of both worlds – conventional and alternative – but when you look behind that platitude, it’s a cover for quackery being smuggled into conventional use.

Do you think conventional medicine can learn anything from complementary practitioners?
Definitely. Understanding, time and empathy – what we used to call “the art of medicine” – are being neglected by conventional medicine. If we delegate these to complementary practitioners, then we undermine the core basis of medicine.

You have changed your mind about the efficacy of homeopathy. Why?
I honestly think that I am entirely evidence led. I worked in a homeopathic hospital and was open to the idea that there were laws of nature that we didn’t understand. I still think homeopathy works, the question is: why? After years of research, I think the answer now is conclusive. It works because of a very long empathetic consultation. It’s a powerful placebo effect.

Would anything change your mind again?
If homeopathy – by discovery of a new law of nature – one day becomes possible and the clinical evidence shows that my present conclusions are wrong then I will change my mind again. I think it is a sign of intelligence to change your mind when the evidence changes.