Sweden Gets a Homeopathic ER

Millions of people have seen the “That Mitchell and Webb Look” video where comedians enact the absurdities of what it would be like at a homeopathic ER. A man with suspected internal injuries is rolled into accidents and emergency department and given extremely diluted substance. However, did you know that Sweden got its first homeopathic ER just a couple of months ago?

It is part of the Salve Health Center situated at the Maria Square in central Stockholm and it opened its doors in early January of this year. Behind the initiative stands three women: Carita Bramstedt, Päivi Barsk and Viveca Wilhelmsson. All of them either run their own homeopathic practices or “education” programs in homeopathy. In this post, we will look at who these people are and their goals, science-based objections to both their individuals claims and the homeopathic ER, their responses to criticisms and recent events.

Who are the people behind the homeopathic ER?

According to her website, Bramstedt considers herself a “classical homeopath” and is the chairperson of the Swedish Academy for Classical Homeopathy (SAKH). She has a three-year degree in civil economics from The Stockholm School of Economics, but became a homeopath after taking a three-year program in classical homeopathy. She has also attended various seminars on homeopathy throughout the years. Beyond that, she has no medical degree or formal training in medicine.

Things looks slightly better for Barsk. She claims to have worked “a couple of years” in the health care system in the 1980s and taken 65 points (65 weeks in the old Swedish system) in basic medicine from Umeå in the late 1990s. Barsk is a classical homeopath and has taken a four-year program. In addition, she has taken courses in various other quack treatments such as Reiki, supplements and reflexology. Like Bramstedt, Barks has no medical degree and no formal training beyond the couple of years she worked in the health care system (presumably as a care assistant?) and ~1.5 years of introductory medicine.

Wilhelmsson has a degree in psychology from the 1970s, yet no medical degree or formal training in medicine either. Looking at her background page, she has spent at least 11 years taking courses and programs in various complementary and alternative practices, including homeopathy. Like Bramstedt, Wilhelmsson can be found higher up in the homeopathic food chain as she is the person behind the program in classical homeopathy at the International Academy.

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What do they believe?

Browsing through their various websites sends chills down the spine. These people really do subscribe to ignorant beliefs and they expose sick patients to worthless treatments. They do not have any credible science to back it up. Instead, they used a variety of historical revisions and after-the-fact rationalizations. Here are a couple of the most stunning examples.

Bramstedt claims that homeopaths were carrying out proper clinical trials very early. As evidence for this, she cites the alleged fact that Hahnemann recruited friends and family as subjects for his extreme dilutions. Apparently, Bramstedt has never heard of key clinical trial principles such as randomization and control group. In comparison, one of the early pioneers of clinical trials called James Lind used both randomization and control groups around the same century as Hahnemann.

She claims that most diseases can be treated by homeopathic ultra-dilutions, both “acute and chronic” (including physical injury!). This kind of portrayal of a non-scientific treatment as a cure-all qualifies as a major red flag. The diseases she lists as most susceptible to “homeopathic treatment” are e. g. ear infections and urinary tract infections. These are conditions that usually resolve without medical treatments. What is worse is that Bramstedt claims that homeopathy can successfully treat sever psychiatric conditions such as depression. Individuals with depression deserve the best available medical treatment, not homeopathic quackery. She does point out that it is illegal for homeopaths in Sweden to treat e. g. very young children, cancer, STIs etc. Has she ever wondered, without instantly resorting to conspiracy theories, why those rules are in place?

Bramstedt even has a list of common objections and her failed attempts at a response. The objections she decides to respond to are just two, and they are varieties of the same objection (namely, that homeopathy is not more effective than placebo). Her response is two-fold. First, she appeals to “clinical practice” claiming that hundreds of thousands of people have been helped by homeopathy. In reality, anecdotes by themselves are not scientific data and such sweeping claims have to be backed up by evidence. Her second response is that children and animals appear to respond to homeopathic treatments and she does not think it makes sense that they can get placebo effects. However, regression to the mean is still in effect (i.e. parents and owners are more likely to try it when their children or animals are sicker than average) in children and the evaluators of child or animal health is always going to be a human, who can be blinded by his or her own biases. I doubt that most of these evaluations are blinded.

It is clear that Barsk shares similar beliefs when she, on her website, claim that “most diseases – acute, chronic, physical and psychological can be treated with homeopathy”. However, Barsk offers a wider range of alleged treatments, including reflexology, ear acupuncture and pelvic corrections (presumably some form of chiropractic “treatment”). It also seems that she has the exact same introduction text to homeopathy on her website, so either one of them plagiarized the other, or they both plagiarized a common source. So much for scientific integrity.

The same text also comes up on the website of Wilhelmsson. This indicates that they share the bulk of their beliefs about homeopathy.

What do they charge their customers?

Since homeopathy does not treat any medical condition, their services are nothing but placebo. So what do they charge for their placebo treatment? Bramstedt charges around 140 USD (+ 25% in taxes), so she brings in about 175 USD per first-time visit. Assuming she sees two people per day and works Monday-Friday, she would bring in about 7000 USD per month without giving her customers any real treatment. Barsk does not list prices, but she has a web shop for vitamins.

Wilhelmsson charges people a lot of money for their “homeopathic degree”. The first two years costs 1000 Euro plus 25 000 Swedish crowns without taxes (~6625 USD with taxes) and the third year “just” 25 000 Swedish crowns without taxes (~4900 with taxes). So for a three-year “degree” in homeopathy, her organization charges 11500 USD (rounded). That is a lot of money for teaching quackery.

News coverage

From the above information, it is clear that these people subscribe to a large collection of pseudoscientific (and arguably anti-scientific) beliefs and they charge a lot of money to teach it or “treat” people with it. With that in mind, let us look at the news coverage of the homeopathic ER. It has been very sparse, presumably because most news organizations do not find it interesting or worthy of PR.

Swedish Radio (SR) published a credulous interview steeped in false balance with some of the partners involved in the homeopathic ER. Wilhelmsson claims that they will focus on acute conditions, such as “throat infections, eye infections, sinus infections, cough and pneumonia”. She claims that they will not treat life-threatening conditions. That is a small comfort. However, she apparently does not realize that pneumonia can be a very serious condition and if those severe cases do not receive adequate medical treatment, it can be very harmful. When confronted by the fact that homeopathy has a very weak presence in Sweden and rules preventing them from treating young children, she deploys the rationalization that a lot of Swedes trust the government. In reality, homeopathy has a weak standing in Sweden because it is quackery and we want to protect our children from it. SR does interview a lawyer working at the National Board of Health and Welfare.

Recent events at the homeopathic ER

In the middle of February, a new post about the homeopathic ER was published on the Dagens Homeopati website. Although considerably sparse on details, it seems that they had a visit from someone who they think were posing under a false name. Why do they believe this? Here is what they say (my translation):

How do we know that a person has stated a false name? Because the symptom description is not coherent. When a person gets sick, the symptoms create a holistic picture, from which we can pick the substance that the patient needs.

In essence, the homeopaths thought the symptoms were vague and incoherent. The visitor allegedly responded differently to the same general question asked in different ways. Apparently, they also performed some kind of web search to reach the conclusion that the person must had given them a false name. They now believe that the person had abused their trust and taken advantage of them for his or her own allegedly nefarious goals.

In the comment section, readers ask the blogger how they can be sure what they motive was. The website owner (Marina Szöges) wrote the following (my translation):

I can attest that, since I know who this false “patient” is, I also know the motive. But because we will not reveal who the person is, provided the person does not do it on their own, the identity of the person behind this skeptical attack will not come to public attention.

Was this person an undercover reporter or skeptic trying to expose them? Or is it just their own paranoia shining through? I do not know, but it will be interesting to see what, if anything, comes from this.