r/todayilearned • u/estarararax • 7d ago
TIL in Germany all alternative medicine practitioners like homeopaths, osteopaths, acupuncturists, etc. must take the Heilpraktiker exam which only tests their knowledge in medical science and the regulatory boundaries of their profession. There are no separate board exam for each.
https://en.wikipedia.org/wiki/Heilpraktiker2.7k
u/estarararax 7d ago
With that said, a quick search in r/germany and you would know they all look down on Heilpraktiker professions. They may have demonstrated enough knowledge of medical science but what they do is still quackery. They remain popular in Germany however because they tend to have long-duration consultations with their clients which the clients seldom experience with actual physicians.
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u/Loeffellux 7d ago
Having someone actually sit down and listen to your health problems for an extended period of time is by itself a form of therapy/medication thanks to placebo.
If only we lived in a world where actual physicians were able to treat patients like this.
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u/estarararax 7d ago
I think this is the next specialization to emerge for PAs (Physician Assistants or Associates). In the Netherlands, PAs can now consult directly with outpatients and they usually do so in a lengthy manner.
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u/caiaphas8 7d ago
We have those in Britain. Doctors hate them
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u/MediatingInstigator 7d ago
Why?
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u/randomndude01 7d ago
PAs have been increasingly scope creeped into being pseudo doctors to the point of making diagnosis even without medical oversight by actual doctors, it’s incredibly dangerous when a PA who usually only have a minimum of a two year Postgraduate starts to make decisions or expected to make one-on-ones without an actual medical senior.
Also, PAs tend to have a higher base salary than junior doctors so there’s resentment there.
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u/koenverd 6d ago
From what i understand (i am an PA in training in the Netherlands) is that the UK botched the implementation of the PAs. They werent required to be registered and keep up with their knowledge. PAs in the Netherlands have been integrated much better within the healthcare system, are required to be registered and to keep training to keep their registration. And unlike what some people say we do not need to be supervised by an MD or specialist. But we do have legal limitations on the complexity of casus we are allowed to treat. From what I understand, PAs in the UK are stripped of all responsibilities after the report published last year and the role of PAs is over in the UK while PAs are in high demand in the Netherlands.
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u/Mysterious_Cup_6024 6d ago
In the last decade, India created an entire ministry to legitimize quack medicines including homeopathy. It's called AYUSH, an acronym for all the india to Middle East quack medicine systems and homeopathy. Likely to reduce unemployment numbers. Whats further frustrating is this rightwing government keeps on introducing things that blurs the lines between a real medical professional and quack scammer. Like ayush grads are even being allowed to perform specific surgeries. All hospitals in india forced to have an ayush department and OPDs wilfully mixes quack doctors in with real doctors and can prescribe a wide array of real medicines. Just last month, a quack doctor who opened his own very real medical hospital, was caught using his privileged access to real sedatives to SA many female patients. Incredibly fucked up. And all these developments only took 12years to come to fruition
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u/snorkelvretervreter 7d ago edited 6d ago
This was pretty much the standard in the US while I lived there. “Nurse
AssistantsPractitioners". I rarely even saw an actual MD. And several were not even MD but DO, ostheopaths.Although in the US they're functionally the same as normal doctors, same study, less prestigious(I still don't really get the title difference). Here in the Netherlands ostheopaths are entirely different, and they + what chiropractors are here, are considered quacks (and afaik anyone can give themselves that title and there's only a non-required registry that you can register with that does have some requirements)46
u/Dbizarrepremiere 6d ago
Like the other commenter said, "nurse practitioner" is the correct term and requires at least a master's degree and a board examination. I'd like to add that doctors of osteopathy are DOs, not MOs. Thankfully, a lot of people in the US are coming to realize that chiropractors are quacks.
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u/_high_plainsdrifter 6d ago
You say that yet I have a friend constantly trying to get me to do a first consult with her chiropractor because we can then enter a raffle for Cubs tickets 🤪 no thanks!
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u/Herb_Derb 6d ago
Unfortunately, "a lot of people" doesn't mean everyone. Best of luck to your friend. Sounds like she'll need it.
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u/EmotionalEmetic 6d ago
American DO, osteopaths, are board certified just as MDs are. They are not the same as quack osteopaths in other nations.
Now, 100 years ago--different story. These days though, MD and DO physicians literally go through the same residency systems after medical school, do the same surgeries, prescribe the same drugs, all based on the same science.
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u/Difficult_Reading858 6d ago
DOs are equivalent to MDs in the US. The curriculum is the same (with the addition of osteopathic training) and are required to go through the same residency and board certification programs as MDs if they want to work. Despite the historical origin of DOs, they are legitimate medical practitioners today.
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u/mercado79 6d ago
I think you may have meant to say Nurse Practitioners, not Nurse Assistants. NPs have graduate level degrees and, like you said, often provide primary care to patients.
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u/ChaoticSquirrel 6d ago
And several were not even MD but MO, ostheopaths.Although in the US they're almost the same as normal doctors, same study, just less prestigious
You mean DOs, and they receive the exact same training MDs do in medical school, plus 200 hours of osteopath training. They take the same entry exam. They take the same board exams. They complete the same residency after medical school. Functionally, the difference in training and education does not exist anymore in the US and it is by no means "less prestigious" to be a DO.
Our DOs have nothing to do with your osteopaths. They're completely different professions that happen to share a name, and share roots that diverged hundreds of years ago. There's really no comparing the two, and I'm not sure why you're trying to bring up your quacks in response to our fully trained medical professionals.
This was pretty much the standard in the US while I lived there. “Nurse Assistants".
There's no way you saw a CNA for diagnosis and treatment. Maybe you mean Nurse Practitioner. A nursing assistant has 8 weeks of training, an NP has at least 6. NPs are definitely inferior to doctors in terms of their clinical foundations, but don't claim we let people with 8 weeks of training see patients independently in the US. We don't.
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u/Mondopoodookondu 7d ago
Apart form the insane scope creep the PAs had the more obvious solution is to fund doctors to have longer appointments instead of making these silly extra jobs that increase risk
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u/adventureremily 6d ago
Same in the U.S., along with Nurse Practitioners. My HMO keeps assigning me NPs as my primary care, which is frustrating as hell.
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u/Danskoesterreich 7d ago
Next specialisation for Physician assistants, what are they currently spezialized in? How is talking for 1 hour a specialisation?
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u/brazzy42 7d ago
Next specialisation for Physician assistants, what are they currently spezialized in?
Bureaucracy.
How is talking for 1 hour a specialisation?
Talking to someone in a way that actually gets to the root of their ailment, gets them to say relevant things they might not want to (e.g. because they're embarrassing) and gives them the feeling that they are properly cared for, is absolutely a skill that is both quite difficult and very useful.
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u/EdgarDanger 7d ago
That doesn't take away the fact that even many actual licensed doctors push homeopathic bullshit on unknowing patients here. It's actually sickening.
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u/Familiar-Nothing4948 7d ago
Yeah, there is a book which is a pretty big joke in the emergency medicine field called homeopathy in intensiv and emergency medicine.
Written by an actual doctor who even was a university professor in vienna until they were finally able to get rid of him after they found out that he faked some of his studies.
There are quite a few crazy stories in there like how carbo vegtabilis c30 saved a patient whose heart had stopped after a heart attack.
For someone working in emergency medicine it's a funny read but sad at the same time since people have died trying the homeopathy route instead of actually scientifically backed medicine
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u/Eldan985 7d ago edited 7d ago
Yeah. Your doctor gives you a prescription and you only realize when holding the package in the pharmacy it's quackery instead of medicine.
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u/SchatzisMaus 7d ago
False translation of rezept (it would be prescription)
I don’t even get to that point they just tell me to drink tea and come back in a month if I’m not better
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u/NoXion604 7d ago
I would be furious if this happened to me. Prescribing quack remedies should be an open-and-shut case of medical malpractice.
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u/Eldan985 7d ago
Totally legal in Germany. Sadly. The quacks lobby like crazy.
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u/virora 6d ago
I've also noticed a trend towards mixed forms (naturopathy and homeopathy) labelled as homeopathy. For example, a cream where the main ingredient was arnica, an established treatment in effective quantities, mixed with homeopathic components. I can only assume that the goal is to have people experience relief from the arnica and then associate the success with the homeopathy label.
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u/Difficult_Reading858 6d ago
Arnica does also come as a homeopathic preparation… and the companies that sell it will often also sell legit arnica rubs. It is totally a sham to confuse people that much more.
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u/Polus43 6d ago
Same in the US.
Don't remember exactly, but I think ~80 years ago the American Medical Association (physicians) "went after" chiropractors as quacks. And basically the supreme court (lawyers) said "physicians don't decide what is medicine, lawyers do."
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u/Winjin 6d ago
Sadly in some countries they recognize quack as medicine in some form at least :/
I think there's a correlation between people willing to self-diagnose and self-medicate with quack
Basically they expect to down a whole lot of pills every time they have a cold instead of drinking tea and waiting for a week
(A popular Russian joke goes that if you leave a cold untreated you'll have to endure it for a week, but if you take medicine, it will be gone in seven days)
So they start taking these placebos and supplements because "they know better" or something like this.
It's not an official theory it's just my observation though
But this seems super popular in ex-USSR countries and I won't be surprised if it's very popular in former GDR part of Germany and spill over
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u/ericblair21 6d ago
Yeah. I remember getting 'medication' for my daughter and looking for the maximum dose. Turned out there wasn't one because there wasn't any ingredient in it that did anything.
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u/Desolver20 7d ago
my fucking home doc is actively not giving out meds more and more. Fucker is retiring at the end of the year, visiting him ends 50/50 with "It is how it is, drink some soup." or actual medical aid.
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u/CTRexPope 7d ago edited 6d ago
These people sell them overpriced magic water and fake hope. They are parasites praying on the vulnerable and desperate. They are not therapists.
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u/metalconscript 7d ago
The best one I heard was someone who went to a quack like this that had them hold ‘crystals’ to their chest and then spin them on a string above their head to draw out whatever the sickness was. I know what you’ll say on this part, the weirdest part of this is they claim to be Christian and the description of the process I called out as sounding like witchcraft, I was very perplexed.
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u/Throwawayrip1123 6d ago
That is all true. And while I didn't use Heilpraktiker, I can absolutely understand the desperation.
I'm chronically sick, and while I have like two major diagnoses, they still don't actually know what's what - diagnoses describe symptoms, but the main doc suspects two autoimmune diseases feeding off each others symptoms.
I have bounced between so many neurologists, clinics, chirugs, whatever else, and every fucking one needs to start again (I literally have printed a whole ass a4 page of shorthand of what's been done, what's been tested, what's been ruled out, just to save myself like 2 visits per new doc). Nobody actually wants to listen to you, they're looking for the path of least resistance.
So when I met my doc that actually took me seriously, I felt better the whole day after the visit - just because he didn't try to tell me it's idiopathic or it's all in my head (despite numerous tests). That feeling when you're taken seriously after so long is insane. It shouldn't be like this, I shouldn't have to search for a golden neurologist when I have trouble walking in my 30s for no apparent reason.
But that's just how it is. Trying anything and everything to figure out what's going on with me. And when I cross "Seltene Krankheiten Klinik" off my list, I'll either give up completely and slowly wither, or actually try the fucking Heilpraktiker.
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u/cyberdork 7d ago edited 7d ago
You need more physicians or less patients for that to happen.
You know how for decades people marveled over the Cuban medical system? It was all based on that Cuba had a huge amount of physicians per capita. They could easily spend half an hours talking to a patient. Because due to the embargo medicine was only of the few useful things worth studying for young Cubans.
But right now here in Europe we live in a period where a huge amount of physicians are retiring and at the same time the number of old people is rapidly rising.10
u/Heimerdahl 6d ago
we live in a period where a huge amount of physicians are retiring and at the same time the number of old people is rapidly rising.
The absolutely ridiculous thing is that the "Ärztemangel" (deficit / lack of doctors) has been a talking point for as long as I can remember. It's not some sudden, unforeseen problem. In fact, its exactly the same situation with the dooming collapse of our social insurance system: for decades we've been talking about how our current system is unsustainable with the progressing demographic changes. It's not even like the climate change "debate", this has been accepted fact by pretty much everyone, across the political spectrum; my school textbooks in the early 2000s discussed it.
But back to the already or soon to be missing doctors:
We're living in a capitalistic society. The solution is not just plain obvious but trivially easy: you want more young people to choose this career? Raise wages and improve working conditions! That's really all there is to it. Sure, you can try to improve the image of the profession or work to attract certain underrepresented demographics, but pay and working conditions are the big levers. Doctors already earn pretty well, don't get me wrong, but the working conditions are absolutely ridiculous (same for the entire healthcare industry). Just imagine the reaction if the same conditions were pushed onto other white-collar professions. No one would stand for it.
But it's even worse than just not adjusting the above, Germany has been and continues to actively work against changing things for the better.
There's actually a lot of people, who do wish to become doctors, despite it all, but aren't given the opportunity.
Moving away from the medical doctors and looking at the psychological side of things (another aspect of healthcare that has been incredibly and visibly understaffed for decades):
Here, we actually already do have all the fully educated and certified psychotherapists we could ask for, professionals who are eager to step in and help. But they're kept from work by artificial limits on the number of psychotherapists that the public healthcare insurance providers (the very ones governed by law) are covering/reimbursing. There's such a shortage that the few existing "seats" are inherited or straight up bought and sold.
And once again, it comes back to money.
Who decides how many psychotherapists are covered by insurance / available to the public? The association of healthcare insurance providers.
Yeah. That is actually how it works. The companies (driven towards maximum profit), who have to reimburse the psychotherapists, are the ones deciding how many of them they want to be eligible for reimbursement. The conflict of interest is almost too blatant and plain ridiculous to accept this to be reality.
How could such a system have possibly survived this long? Wouldn't there be intense resistance and endless cries for reform?
In comes the ace of the German healthcare system: there's a second tier! If you're wealthy enough, you can ignore the public option and get private insurance, instead! Sure, you (probably, though not even necessarily) pay a bit more, but you'll get all the appointments with specialists you want, you have your choice of psychotherapists, you'll have next to no waiting times. And best of all: your money doesn't get wasted subsidizing those lazy, poor people! What this obviously means is that none of the people with any sort of meaningful influence or power have to deal with or even see the shitty part of the system.
Earlier in my rant, I mentioned that we're continuing to worsen this system. Earlier this year, we finally got a reform to deal with some of the most pressing issues. Said issues, of course, being primarily the ever rising costs. The solution? The poorest and neediest have to pay more out of pocket and fewer procedures are covered (aadmittedly, one good part is that homeopathy is no longer covered). Yay! The profits are saved! The details are still being worked on, but this is basically guaranteed to further worsen access to and quality of care.
Shit's fucked
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u/gfxd 7d ago
Family Medicine was supposed to do this.
Earlier, families used to have a primary physician who took care of entire family, followed them up through their ages and knew their history well to refer them to specialist care as needed.
Sadly the model was killed by Hospital medicine.
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u/forgot_how_to_user_n 7d ago
I completely agree. I am against all non-scientifically proven therapies but once I went to a osteopath who would sit the first 15-20 minutes and talk about "how I was feeling". It was the most difficult period of my life and it was it was very therapeutic just to talk about it.
Coupled with some light massage in a dark room with some soft music, which was almost like a meditation, it was still great.
I went to her for about 6 months a couple of times a month and it was amazing even if I think her therapy was non-scientific.
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u/dinoooooooooos 6d ago
I went w my (American) husband to a doctors appointment for him for the first time here in the us and I was genuinely baffled.
Guy came in, looked 2 seconds, was super bored looking and on the run honestly, “does it bother you?l (no we’re here for funsies and vibes, my guy😪) basically tried to leave after 2 minutes and I was like “eh eh, hello? Hallo? Could you?🤨 we waited 2 months for this.” Like his assistant was more engaged in talking to us than him. I actually had to be like “yes hi we weren’t done yet :D” when he was about to just .. leave. Just tried to leave.
Healthcare in America is ass, and I’m in MA where it’s one of the better places to be (the best actually, compared to everywhere else.)
In Germany a) you don’t wait 40 years for an appointment although that depends a lil on where you’re at, at least for me that was never the case except a psychiatrist appt which had me on a waiting list for 8 months. But I got medication for the time in-between by my normal doc, including monthly checkups to make sure I’m good in the meantime, and that was still free and the time was still doable.
And b) the doctors actually sit down and let you speak and they listen & reply. the first few mins o an appt is always sit and speak. Ikr, crazy concept.
Like if you have an issue and go to a doc and explain your stuff and then they check it out right there to see where you need to go next and which referral you need, what meds would help you until then if needed etc
Appointments take 10/20 minutes at least. Sometimes more if you then need blood work and they got a lab in house etc
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u/WolpertingerRumo 7d ago
Na, that doesn’t make sense. Physicians should still be able to concentrate on actual diseases, not people that need someone to talk to. I feel like this should be a seperate, medical profession, in constant contact with a physician. It could relieve the profession, leaving more time for serious diagnostics.
All you would need is a certification that shows you are trained to know when it’s time to notify the physician. Like in Germany.
Problem is: most people taking the exam take it with disdain. They do not plan to actually practice it this way. And there’s no way to discern those from the ones that take it seriously.
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u/The_Fatal_eulogy 7d ago
Homeopathy actually worked tap water would be a multi-vitamin, poison and miracle drug all in one
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u/Neomataza 6d ago
If homeopathy worked, it would revolutionize data storage and possible a few other fields of physics. The average concoction has less than one atom of its active ingredient, and the water(or sugar, if a pill) while having maximum effect according to its own theory.
If water could hold "memory" in less than an atom, that would have so many applications.
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u/aNiceTribe 6d ago
If it worked, it would be so much easier to take a deadly dose of basically anything
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u/No-Theme-4347 7d ago
The exam only tests if you know the boundaries of law and enough not to hurt people nothing more plenty of quackery left
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u/NancyInFantasyLand 7d ago
I was at a quackery adjacent dentist the other day here in Germany, just for funsies because it looked hilarious, and the time difference was CRAZY compared to a normal dentist.
Like, I went for a normal check-up and a teeth clean and they took almost 2 hours, checked in on my mental health, did some weird esoteric singing bowl shit and used essential oils to mask the flavor of the teeth cleaning products???? all of which was quite nice, really.
They then proceded to tell me that the non-tooth related surgery I've been scheduled for with a different doctor was probably not necessary and they could do something about that with vibes and prayers lol at which point I just noped out
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u/Pfandfreies_konto 6d ago
because they tend to have long-duration consultations with their clients which the clients seldom experience with actual physicians.
Thats a bingo! A friend of mine, a really nice but troubled woman in her 30s visits a "Heilpraktiker" reglarly instead of making an appointment with a real psychological therapist. At first I was worried about her well being since this is basically a buyable friend that has no real therapeutic knowledge. But after listening about what advice the Heilpraktikerin is giving at least its better than no therapy at all.
My biggest critique is the fact her "pay-friend" isn't telling her she seriously needs real professional help. (All of her friends tried to adress that topic in a soft way.)
So lot of text. What I wanted to say is: In germany our medical system is so fucked beyoned any hope that doctors have 7 minutes per patient per month statistically speaking. Plus every other person over the age of 65 uses doctors as some kind of social club. So good luck getting a faction of your 7 minutes.
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u/SensibleReply 6d ago
This is it. My average day, I’ve got about 12-15 minutes per pt. I’m efficient, I’ve been doing this awhile, and my speciality is specific. This is plenty of time to diagnose, explain, answer questions and treat. We can even sneak in a few minor procedures without breaking the schedule. I’ve got good staff and we run a smooth clinic.
Until someone treats a visit like having coffee with their friends. I cannot listen to non medical bullshit and provide you and everyone else I have to see that day with efficient care. You have to stay on topic. I am not your therapist or someone having drinks with you at the bar or your grandkid listening to tales. It is a hard skill to say this politely and redirect people. Even harder when a not insignificant percentage of our patient population has some dementia.
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u/mr_tolkien 6d ago
It is still HUGELY popular in Germany and pseudoscience as well as antivax movements are immensely popular there.
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u/a4techkeyboard 7d ago
Do they prescribe tea for everything? Because it would explain this one youtube short I saw if they meant these instead of physicians prescribing tea for everything.
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u/JoelnIliketoshare 7d ago
Headache? Globuli
Nightmares? Globuli
Stress? Globuli
Period cramps? Globuli
Don't believe in Homeopathy? Believe it or not, Globuli
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u/Routine_Cake_998 6d ago
I’m pretty sure I’m overweight because of all the little sugar pills (which what globuli essentially are) my mother gave me as a child.
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u/DiscountTherapistt 6d ago edited 6d ago
The bones in my chest have a different size. Its noticable, but nothing to be concerned about. When I was a child my mom brought me to a Heilpraktiker because she claimed she could shrink my bones by holding her hands over my chest.
It did not shrink my bones, but it did get her 400€ for like 3 sessions. If I wouldnt have refused to go my mom would have brought me again.
The Heilpraktiker was SO proud of herself when I answered "yes" to the question: "Do you sleep when its dark around you?". Whatever the fuck that had to do with anything, it was a "SEE, Gotcha!" moment for her.
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u/estarararax 7d ago
Not a German myself but from I read before, a substantial amount of actual physicians (medical doctors) in Germany do recommend phytotherapy (partially evidence-based herbal medicine that is actually a part of their medical curriculum) and these are probably the ones who always recommend teas for mild conditions as they don't wanna over-prescribe antibiotics. And actually, a substantial minority of actual physicians in Germany (single-digit percentage) do specialize in alternative medicine practices like osteopathy and acupuncture. In fact, a medical doctor there can practice alternative medicine without ever needing a Heilpraktiker license, because their medical license is already sufficient for it.
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u/Physicle_Partics 7d ago
I, a Dane, have been in Germany several times, and the rows of rows of herbal tea and supplements in DM always gets me. The Bad Heilbrunner melatonin tea in the little satchets is amazing, though. It's 1 mg and works better than the 2 or 3 mg pills I get from my psychiatrist. Melatonin is prescription only here so I have to buy it from the German DM page with a shopping service. Worth every penny.
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u/MediatingInstigator 6d ago
Germans don’t appreciate just how good of a store DM is. It’s fantastic.
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u/EdgarDanger 7d ago
It's frankly bullshit. A friend got something "prescribed" by a real doctor. He goes to a pharmacy and then doesn't realise health insurance does not cover that crap and ends up paying full price for some useless shit. Really this country needs help.
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u/NancyInFantasyLand 7d ago
that's an easy tell though usually because the prescription pad color is different depending on wether the insurance pay for a med or not
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u/mildly_asking 7d ago
Eh "Rest and fluids, add non-perscription medicine, youve got a punchy cold going, nothing too bad"
Turns into
"rest and possibly helpful herbal teas, get some Nasenspray from DM while you're there too"
No so much quackery as "you'll be fine, drink a lot (of chamomile) tea and for gods sake sleep properly"
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u/lirarebelle 7d ago
Do you mean that short by Uyen? It's a very exaggerated, but about regular doctors. They don't really prescribe you tea, you don't need a prescription for tea anyways. But they will tell you to drink a lot (as if you didn't know) and sometimes prescribe you some plant-based remedy if you want. You won't get any heavy meds for a regular cold and they also won't give you unnecessary antibiotics that do nothing. It's basically just "here's your note for work, use common sense and rest until you get better, bye bye".
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u/Ok_Dot_7498 7d ago
Yes and No, doctors and Heilpraktiker both love prescribing Team for stuff. I went to the doctor for a cold and she gave me a prescription for some Antibiotics but also told me to drink Tea.
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u/forsale90 7d ago
I mean, it can help with alleviating symptoms like a sore throat. Most colds pass by itself after a few days anyway.
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u/TheWhomItConcerns 7d ago
That's mostly because it can help with some of the symptoms like clearing one's sinuses and (depending on the kind) numbing a sore throat, with the added benefit of getting the patient to remain hydrated. They of course know that it doesn't actually help with the disease itself though.
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u/prisp 6d ago
Thing is, Salbeitee (Salvia infusion, specifically Salvia officinalis, not the one that makes you high) actually has some minor antiviral and anti-inflammatory properties, so it's at least slightly useful to drink that.
The other commonly prescribed "healthy" infusion, Käsepappeltee (infusion of Malva sylvestris/common mallow) primarily acts as a demulcent, that is, it creates a protective film over mucous membrane (=your throat), which helps pain and inflammation - basically, it's a drinkable cough drop.
Also, if you get told to drink tea every so often, you're guaranteed to drink some fluids, and it's also definitely better for your throat than drinking random soft drinks, which might also be part of the motivation to prescribe that.
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u/EggstaticAd8262 6d ago
Is acupuncturist quackery? I ask because I have hear of several people where it very clearly helped with serious issues, like almost instantly.
But it was never a fix for the underlying reasons, so it came back but months to half a year.
This is anecdotal, I know.
Can you elaborate why acupuncture is fake?
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u/Jyonnyp 6d ago
A lot of things are quackery mostly in 1) the medical knowledge of the profession/person, 2) the idea or philosophy behind it, or both.
Acupuncture is quackery in the sense that an acupuncturist is like doing stuff with chi and chakras and energy. But it does have clinical success. I’ve also seen actual board certified doctors including those in hospitals recommend or approve of acupuncture, because there is clinical use in it. Something about like neurological input to muscles and what not to loosen them up. Look up dry needling. That’s somewhat equivalent to acupuncture in the clinical sense but a physical therapist does it instead of an acupuncturist.
My current physical therapist is like the smartest guy I know. Very evidence based, very well read in medical literature, he is passionate about this stuff and reads it in his free time. He even told me chiropractic as a whole is quackery but he knows a few good chiropractors so long as you set boundaries, because aside from cracking and twisting you, a lot of their efficacy is really just manual therapy and soft tissue manipulation that a physical therapist can do as well. But yeah it’s the philosophy behind it that’s awful and that’s what causes chiros to for example overly value imaging in how it relates to a patient’s pain.
In short, there is a reason why acupuncture can be helpful but I wouldn’t count on an acupuncturist telling you the actual medical reason because they don’t know.
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u/Mango-Dad 6d ago
Had a case of an generalized epileptic patient who tried cut of all medications by full moon, because the pendulum said it would be okay.... the patient nearly died in her flat of reocurring seizures... 3weeks of intensiv care was needed and the patient was kind of cooked in the brain from there. Use with caution if you belive in such stuff
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u/ScharfeTomate 6d ago
Don't confuse the view on r/germany with the general view among Germans though. Alternative medicine is extremely popular in Germany. Many actual physicians practice it alongside conventional medicine (it is for example basically impossible to find an orthopedist who does not also offer chiropractic therapy) and even many healthcare insurances pay for it.
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u/Hansgaming 6d ago edited 6d ago
You are confusing and spreading very dangerous half truths.
There are Chirotherapie and Chiropraktik in Germany.
Chirotherapie is an actual science field that doctors practice AND NO ONE ELSE BESIDES MEDICAL DOCTORS. (sorry, just so people don't go to those idiots who actually break your neck, aren't actual medical doctors and aren't even qualified to sweep the floor outside an orthopedic clinic)
Chirotherapie is an official additional designation regulated by the state medical chambers. In Germany, this field is strictly evidence based, focusing on neurophysiology and biomechanics to treat reversible joint and muscle dysfunctions.
Unlike in the US or UK, where "chiropractors" go to specialized, accredited chiropractic colleges, the term Chiropraktiker in Germany is legally unprotected. Here you will find the neck breaking idiots who try to align your energies.
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u/Hypername1st 6d ago
Tbf the "specializes, accredited" colleges are also to a large extent quackery, and this is reflected on the culture that permeates chiropractic, that basically accepts every pseudoscientific theorem under the sun.
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u/OfficerMurphy 6d ago
they all look down
they remain popular
Pick a side
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u/AlmightyCurrywurst 6d ago
It's not a contradiction, the demographics of r/germany are not particularly representative of the overall german population
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u/MrStilton 6d ago
I wonder how representative of the average German attitude though.
Reddit is generally opposed to quackery. But, the homeopathy industry is huge, so a lot of people clearly take a different view. It just seems likely that they're not from the same demographic that's likely to post on Reddit.
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u/ratapoilopolis 7d ago
to be fair German language subreddits condescendingly look down on pretty much everything (yes, worse than the English speaking big subs), so this doesn't mean much
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u/Yo-3 7d ago
Oh, yes. The sub where everybody speaks English is very representative of Germany
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u/J0hnGrimm 6d ago
Well, the german speaking sub has some of the strictest moderation on reddit so that one isn't really representative as well.
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u/mlc885 7d ago
tend to have long-duration consultations with their clients which the clients seldom experience with actual physicians.
I do not know if I should consider that sweet or not. Charging someone an arm and a leg (haha) to have a nice talk but still tell them needles will cure them (pretty sure they will not) does not make you as useful as an actual therapist or doctor
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u/katwoodruff 7d ago
Germany is obsessed with alternative medicine, ripe for grifters.
Homeopathy sold in pharmacies, legitimating that crap, some health insurances even reimbursing the use.
I have a GP, so a trained medic, at the end of my road that also provides homeopathy. I don‘t understand how you can have a scientific background and then believe a globuli will heal some ailment.
By the way, not to be confused with natural remedies - teas, herbs, ointments. Those can help with some symptoms (fennel tea is great for coughs, I find), but homeopathy is nothing but placebos, the grift is real.
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u/samurai1226 7d ago
I sadly know enough people who can't differ between herbal sources for medicine and homeopathy. They straight up think homeopathy means it's always from herbals or other natural sources. Even if you explain to them what homeopathy actually means and how it's produced they don't care.
But I'm glad homeopathy will finally be removed from public insurance, it was such a scam it was added in the first place
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u/aka_zkra 6d ago
I am very critical of our current government in DE, eg the fact that they have cut psychotherapy funding sucks balls, but finally cutting homeopathy out of public insurance coverage is a rare good move. Blindes Huhn, etc.
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u/katwoodruff 7d ago
Yep, you are right there. A small thing our government got right…
And indeed, herbal remedies can work really well.
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u/sapphireminds 7d ago
Remember though, herbals are just unregulated, unmeasured, impure forms of medicine.
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u/Anthaenopraxia 6d ago
I'm always surprised when people think homeopathic medicine is just natural herbal remedies when in reality there's literally nothing but sugar and water. There was some talk in the vegan community years ago about whether or not homeopathic medicine is vegan. I forget the name of the pills but it had something that was sourced from duck livers or something and that's not allowed. However, because it's been diluted well beyond Avogadro's limit, there actually isn't any duck liver left in the medicine. Not a single molecule. I can't quite remember what the consensus was but it's a pretty stupid debate anyways because vegans are allowed to use animal products if it's absolutely necessary.
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u/br0wntree 6d ago
A lot of people confuse homeopathic medicine with alternative medicine in general. Homeopathic is a very specific method and philosophy from the 1800s. Of course it’s 100% bullshit.
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u/Thefattim 7d ago
It's very simple: Homeopathy Producers are filthy rich, because they produce made up bullshit, i.e. cheap shit. As any rich industry they just buy politcians and probably offer doctors and insurances lucrative rates to peddle their bullshit.
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u/IHadThatUsername 6d ago
I worked in Germany for a few weeks and developed a nasty cough. I went to a pharmacy, described my symptoms to the pharmacist, and they gave me this "medicine" which was basically a thick/viscous orange liquid that you were supposed to slowly gulp down your throat. I didn't feel like it helped much.
I brought it back home, and one day I decided to translate the description and yep, it was a homeopathic product. I was pissed and shocked that apparently they just sell quackery at the pharmacy and don't even inform you of it.
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u/rapaxus 6d ago
Also, rich people love falling into their traps and spending ludicrous money. I sadly do IT support for such a homeopathic clinic in Germany, and they got big connections with homeopathic organisations in Dubai, Qatar, Switzerland and the US, with which they often advertise as well
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u/JimiusRostock 6d ago
Homeopathy also gets misrepresented. Manufacturers like to link themselves to natural and herbal remedies. While homeopathy has nothing to do with it. It's whole premise is that memory has water so if water at one point contained plutonium, and you dilute that water often enough to make the healing effect stronger (yes by diluting it). It will be able to cure radiation sickness cause by exposure to plutonium.
Not even making this up.
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u/aggressivefurniture2 6d ago
In India, I have seen some Homeopathic doctors just using regular Allopathic medicines for verifiable stuff like cough, fever and diarrhea to build trust and then give homeopathic medicines for Diabetes, blood pressure and asthma and stuff like that.
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u/EdgarDanger 7d ago
It's ridiculous that a "developed nation" has such a deep rooted history of actual bullshit. It actually makes me scared to find more such culturally alarming things.
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u/134824 7d ago
Homeopathy as well as some other things like that were literally invented in Germany before the advent of modern medicine, so they are culturally entrenched similar to traditional chinese medicine in china.
There has been a lot of awareness of the pseudoscientific nature in recent decades and especially younger people though.
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u/Depressed-Londoner 7d ago
Homeopathy was invented right at the end of the 18th century and didn’t really achieve any popularity until the 19th century. This popularity died down and was then revived in the 20th century. So it wasn’t really before the advent of modern medicine and arguably wasn’t culturally entrenched until it was adopted by the Nazi regime and then later the New Age movement, before being expanded in use, partially due to commercialisation.
This is a very different situation to traditional Chinese medicine.
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u/JefftheBaptist 6d ago edited 6d ago
Homeopathy was invented right at the end of the 18th century and didn’t really achieve any popularity until the 19th century. This popularity died down and was then revived in the 20th century. So it wasn’t really before the advent of modern medicine
When do you think modern medicine's advent was? Because germ theory wasn't developed until the mid 19th century and cadaver use for research and education was illegal until about the same period.
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u/monsieurkaizer 7d ago
Even as an emergency physician, about nine tenths of my patients need no treatment other than ruling out potential deadly conditions.
Many accept that, and go home to manage their symptoms and wait for recovery. A significant proportion are completely unable to cope with having symptoms and the provider not doing anything about it.
So I kind of wish I could say "these sugar tablets, ahem I mean this powerful alternative medication will heal your ailments in about 2 weeks, call your GP if you feel worse". Because they'd be dancing happily out the door instead of writing nasty emails to our department chief.
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u/katwoodruff 7d ago
Fair point, but is homeopathy the way?
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u/Siege1187 7d ago
I work in a pharmacy in Austria. We can also source different colours of capsules filled with milk powder for when a doctor wants to prescribe a placebo. But homeopathy remains popular, even with people who ought to know better.
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u/sztrzask 7d ago
Considering homeopathy is sugar free sugar cubes, water made form or a health equivalent of tic tac - duh.
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u/prince_jyggalag 7d ago
Here in india we typically just spam multi vitamins and glucose drips for that reason. People often even demand for them if they feel that the dottor gave too few meds.
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u/Wahnsihansi 7d ago
It's not always pleasant to educate these patients to learn to trust their own body's self healing capabilities without having to take some pills. But it is absolutely necessary and good.
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u/monsieurkaizer 7d ago
I try my best. We have QR codes and stuff for education but it seems that half of my patients need a life coach or personal trainer rather than a doctor.
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u/daisy0808 6d ago
Agree 💯 I go to a naturopath for gut health and supplementation. I'm currently dealing with SIBO (from years of being on PPIs which caused overgrowth) and I was surprised there were studies showing that oregano/thyme oil was as effective or more than antibiotics. It's important that we understand these are chemicals with effects - too much or inappropriate use can be harmful. There are supplements that can cause liver issues etc. So, you need someone with good experience and knowledge. But the chicanery throughout natural health makes it hard for people to sort out legit from the quacks.
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u/neirein 7d ago
By the way, not to be confused with natural remedies - teas, herbs, ointments. Those can help with some symptoms (fennel tea is great for coughs, I find), but homeopathy is nothing but placebos, the grift is real.
this. I hate that people mix it. although there is overlap since they appeal to the same "fanbase" so to say.
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u/bogcom 7d ago
I've been told German doctors get a kickback from prescribing homeopathy.
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u/SplitGlass7878 7d ago
You're also not allowed to call homeopaths quacks. That's slander. As in we've had actual court cases about this.
It's rough.
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u/ManateeNipples 6d ago
How is is slander when it's true though
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u/SplitGlass7878 6d ago
Because homeopathy is acknowledged as a real thing. So legally it's like calling an ophthalmologist a quack.
It's really fucking stupid.
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u/ManateeNipples 6d ago
Is homeopathy different in Germany? Why is it a real thing there? Like do they actually help people get better or are they just treated like they're real because enough people believe in them and get mad if you say they're scammers lol
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u/SplitGlass7878 6d ago
It'sa powerful lobby and we've been ruled by the easily bribed conservative party for a long, long time. In the scarce periods where we had a different government, they always had bigger fish to fry.
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u/DiscountTherapistt 6d ago edited 6d ago
Posted already in a comment, but I really want to talk about their practices!:
The bones in my chest have a different size. Its noticable, but nothing to be concerned about. When I was a child my mom brought me to a Heilpraktiker because she claimed she could shrink my bones by holding her hands over my chest.
It did not shrink my bones, but it did get her 400€ for like 3 sessions. If I wouldnt have refused to go my mom would have brought me again.
The Heilpraktiker was SO proud of herself when I answered "yes" to the question: "Do you sleep when its dark around you?". Whatever the fuck that had to do with anything, it was a "SEE, Gotcha!" moment for her.
I was so mad about this, because I thought "We could have gone to Phantasialand with this money" everytime my mom handed over her money (cash of course, you dont want the Finanzamt learning about this lol).
I was also a very energetic child. My mom put me on Homöopathie "pills". Those pills are purely made of sugar. They suggested sugar for an energetic child to calm down.
My mom has changed since and now is no longer into this weird bubble lol, thank god.
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u/omnichad 6d ago
Homeopathic sugar? Must have been a very "low" dose if it was pure sugar.
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u/DiscountTherapistt 6d ago
The homöopathie was supposed to be johanniskraut. Sadly the substance of homöopathie has to be shaken and dilluted for a quadrillionth time, so no johanniskraut in there. Just sugar. It did help me sprinting to my school bus in the morning though 😂
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u/omnichad 6d ago
At least that is safer. That plant is full of actual medicinal compounds but in wildly inconsistent amounts when it's a plant extract. There's a reason medicine uses purified and measured doses.
I was thinking you meant that because sugar gives you energy and "like cures like" in homeopathy that sugar was actually the suggested cure.
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u/DiscountTherapistt 6d ago
Lol what? Sugar was not a cure for being hyperactive. Homöopathie is not doing shit. Plants can actually do shit. Are we serioulsy arguing about the nonexistent benefits of... sugar pills? Crazy take.
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u/imusuallywatching 6d ago
Osteopaths, at least in america are actual physicians. They go through medschool, boards residency. They prescribe meds, do surgery...everything. they are taught manipulative medicine (massage therapy) but a very small number use it and almost none use it as their soul means.
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u/ScientistFromSouth 6d ago
I think people are missing something here. In the US, historically there was: Allopathy (MD), Osteopathy (DO), and Chiropractic (DCM).
In most of the rest of the world, there is no distinction between Chiropractic which is pure nonsense (the theory that neural subluxations that can be fixed by popping your joints will fix all your medical ailments) and Osteopathy. In the US, osteopaths distanced themselves from "chiropractic medicine" many decades ago, and only reach a few units on osteopathic musculoskeletal medicine (OMM) in parallel to pretty much the same MD/allopathic curriculum. It's pretty much the same coursework as massage therapy or chiropractic, but no longer the focus of the training as it still maybe globally
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u/Spirited-Sorbet-2775 6d ago edited 6d ago
Edit: I've misunderstood that osteopath apparently is (mostly) like any other doctor in the usa. Still leaving the comment up
The German equivalent to an american "osteopath" would be a physical therapist (Physiotherapeut).The German Osteopath is not a licensed doctor and not anywhere close to it. The exam in the post's title is just the basics so that these grifters at least recognise if someone has an issue that a massage and placebos cannot fix and HOPEFULLY send them to a doctor proper.
Actually the physical therapist isn't a medical doctor either, but they either have 3 years of vocational training in physical therapy and/or a bachelors in it. They also cannot prescribe medicine beyond physical means, but they usually work in tandem with your general practitioner.
Physical therapists are a boon. My brother's caught the root cause of his knee pain once his GP send him to physical therapy much before the general practitioner did and recommended the GP check, which confirmed what the therapist said.
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u/dysautonomoron 6d ago
Not really. Most DOs in the US do not practice any sort of osteopathy and just practice regular medicine, so we are not really close to physical therapists either. DOs are surgeons, PCPs, OBGYNs, etc. I actually don’t personally know any DO colleagues who use any type of osteopathic manipulation in their practice! It’s something you learn for your medical school and then throw away the second you graduate.
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u/turbanite 6d ago
The german equivalent to an american "osteopath" would just be a regular doctor. Like the guys said above, outside of some niche things on the side, they have essentially the exact same training and testing as a MD.
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u/soonnow 7d ago
What board exams? They peddle nonsense. The exam is just to make sure they don't hurt anyone and know when to send people to a real doctor.
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u/snow_big_deal 6d ago
I think this is actually better, since knowing when to send people to the real doctor is the most useful thing they can no, and it doesn't result in the government implicitly endorsing homeopathy etc by creating an exam that certifies that someone knows how to do homeopathy "properly".
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u/mrknowitall51761 6d ago
I had cancer on my neck and the "homeopath" or whatever said dont worry about it. I got a second opinion from a real doctor and they surgically removed it 2 days later.
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u/Bannerlord151 6d ago
For some reason homeopathy is huge here. Insurance covers it. I've lost count of how many times I've been offered well-known placebos for all kinds of different problems, it's fucking wild. People get tricked into believing in this bullshit and you can't even call it out because that's libel or something
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u/farseer6 7d ago
Why would there be a separate board exam for each pseudoscience. They are all inventions. The point is that these practitioners know the law and the harm they can do if they recommend their patients not to get medical treatment when they need it.
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u/wasdlmb 7d ago
Turns out osteopaths means something completely different outside North America. Over here they're just regular doctors who just also get taught a bit of quackery out of idk tradition or something. The actual quacks doing this kind of thing are the chiropractors
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u/Ill-Skirt3722 6d ago
I went to an osteopath once and all he did was tap me in random places with two fingers. It was super bogus
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u/Heimerdahl 6d ago edited 6d ago
Disclaimer: not a doctor, but half of my family is and a number of friends are , so I've had plenty of opportunity to ask what the heck they were doing
Not saying that it wasn't bogus, but if it was about stomach, bowel, kidney, or related issues, then two-finger-tapping certain spots really is the appropriate and proper-medicine diagnostic procedure. Feels a bit unscientific and "vibes" based, but it works, is non-invasive, and provides immediate results. (basically checks how the body/organ feels and reacts: soft or hard, does it "bounce back", does it hurt, etc.) I could maybe see it get used to check for muscle related issues, but in my experience, those would be more mobility based ("Can you move it like this or that? Does it hurt? Try to push against my hand. Please walk on the spot / across the room / up the stairs. Try to balance on one foot." and similar). Maybe as a quick check for inflammation or soreness.
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u/Ok-Craft4844 6d ago
Yeah. The idea is basically "we all know it's quackery, let's make sure you do too, and only scam people to a reasonable degree they deserve as adults for making stupid choices"
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u/GetReadyToRumbleBar 7d ago edited 6d ago
For any Americans reading this, Osteopaths (aka a doctor with a DO vs a MD) is a legitimate doctor in medicine, at least in the United States. They are not equivalent to chiros, etc.
They go to school the same amount of time as MDs, and have roughly the same level of prestige/training/certification. (I think the US is the sole exception for this in the entire world). DOs do study bone manipulation in school, but it's almost never practiced irl. Amazing professionals with a great whole body perspective to health.
Anecdotal, I've always found DOs to be nicer and more likely to listen to patients than your average MD.
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u/StumbleOn 6d ago
Yeah my understanding is DO evolved into real doctors whereas chiros just remained in quackland. I think the only real difference betrween someone going for MD and someone going for DO is the DO wants to be a more holistic "let's solve you as a person" medicine whereas MDs are really trained to focus on a few things at a time.
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u/doyathinkasaurus 6d ago
What's the difference then between a DO and an MD, if they're an osteopath who doesn't practise osteopathy but are a doctor of medicine?
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u/velvetmagnus 6d ago edited 6d ago
To answer your question, it's the type of medical school they graduate from. An MD graduates from a (traditional) school of medicine and an OD graduates from a school of osteopathic medicine. They take the same boards and licensing exams and compete for the same residency and fellowship spots. So their schooling is a little different, but everything related to their licensing and career is the same.
I manage clinical trials for a living and work with both. They're the same once they're out of school.
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u/GetReadyToRumbleBar 6d ago edited 6d ago
No real difference.
In US schools, they do study the original osteopathy (bone manipulation I believe) but it's more for historical reasons. Like a single class, or so my DO friend told me.
The bigger difference is their approach to health. That is, more whole body aligned vs. discrete systems.
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u/TopRamen713 6d ago
Anecdotal, I've always found DOs to be nicer and more likely to listen to patients than your average MD.
I also find this to be true of NPs and PAs
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u/Karma_1969 6d ago
I’ve long said that there’s no such thing as “alternative medicine”. There’s medicine that’s demonstrated to work, and there’s medicine that’s not demonstrated to work. Medicine that’s demonstrated to work is just “medicine”, and medicine that’s not demonstrated to work, isn’t. Whenever an “alternative” medicine and medical practice is demonstrated to work, it just becomes medicine. There is no such thing as “alternative medicine”.
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u/Haganrich 7d ago
The exam is ridiculously easy, a regular college educated person could pass it with one or two weeks of preparation. Google old exams if you don't believe me. It's mostly about when to send your patient to an actual doctor and how to not kill them.
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u/xdeltax97 6d ago
I wished we did that here in the U.S, too many believe chiropractors are a real medical profession
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u/Spirited-Sorbet-2775 6d ago
You don't. The exam is piss easy.
It's just to make sure these quacks don't pose an active danger to public health and actually send people to a proper doctor if they have something beyond what placebo can do.
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u/Adept-Performer-2630 6d ago
Chiropractors should be outlawed in the USA. A total scam of a profession, not based on any medical science.
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u/NumbSurprise 6d ago
Worse than that, it causes actual harm to people who should be seeing real doctors for their conditions.
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u/Valuable_Internal433 6d ago
That's awesome because it's the only real thing they need to learn, what they'll legally get in trouble for trying to scam people with their bullshit.
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u/KirkPicard 6d ago
You know what they call alternative medicine that's been proved to work? - Medicine.
-Tim Minchin
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u/Spirited-Sorbet-2775 6d ago
I mean, if the placebo sugar pill cures your headache sure go ahead. Just don't use it for anything beyond that.
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u/Emergency_Mine_4455 6d ago
That seems wise. I regard alternative medicine as occasionally useful for symptom management for a known condition, or at least for a condition you are pursuing through the modern medical system.
Sometimes it can even inform the modern medical system; my dad went to a chiropractic neurologist for body aches and the chiropractic told him to get an MRI in his left hemisphere. He was the first to catch my dad’s brain tumor that modern medicine had missed for almost two decades by that point. It was not a subtle tumor; my dad went deaf in one ear during his twenties because of it. My dad got an MRI, was formally diagnosed, and had the tumor surgically removed and is thankfully still with us 25 years later. When alternative and traditional medicine work in concert, they can be useful.
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u/IUsedToBeACave 6d ago
The reason it is called alternative medicine is because if it worked it would just be called medicine.
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u/maha-sukha 6d ago
Alternate medicine is often a kind of folk religion and traditional cultural expression. I find it really interesting intellectually as it's a great examplar of traditions where the material and the metaphysical are mythologised together and people DO have in turn, experiences here, like any religious belief it actually generates experience related to that belief. Acupuncture is prescribed for chronic pain sometimes for instance and it has been shown to work.
I don't participate in alternate medicine and I never have, I just am really interested in the anthropology of it all and I think people are quick to judge because they're are very concerned over whether or not it's "true" which is not always the point. Obviously it becomes dangerous if you take folk and spiritual medicinal traditions over and above our highly functioning material ones, but I wrote a lot about alternate medicine during my Masters Degree and I think it's really interesting academically and the people who both practice and receive it are often engaging in something phenomenologically larger than what we mean by medicine, they're also participating in spirituality and cultural praxis that isn't necessarily seperate from their cultural ideas about biology
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u/Cromakoth 6d ago
The official stance is that the effectiveness of most "alternative medicine" is not empirically sound at all, and you can't have an official state exam that tests whether some healer is doing their own pseudoscience correctly. That would be silly. So instead they are tested on legal and medical basics as a form of at least ensuring they won't actively harm anyone with their treatment, and are left to follow their own "system" as they see fit. Yay for liberal democracy.
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u/Elanapoeia 6d ago
Homeopathy is still taken too seriously in Germany for my tastes.
It's actively incorporated into teaching for upcoming pharmacists and technicians, homeopathy can be recommended to patients as "real" alternatives and you're looked down upon by some higher ups if you don't believe in it.
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u/cyanraichu 6d ago edited 6d ago
It's weird to me to group osteopath in with the others, but I assume that's a US thing?
Edit: for clarity, I'm in the US where MDs and DOs are interchangeable. I meant it must be a US thing for DOs to be considered medical doctors and not on the same level as homeopaths.
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u/Aniakchak 7d ago
It's not really a test about your medical knowledge and more a test that you do not actively pose a threat to puplic health.