“Integrative medicine” quackery infiltrates Kentucky

Yesterday, I expressed my dismay at learning that what used to be a bastion of science-based medicine, the Cleveland Clinic Foundation, is now peddling the quackery known as acupuncture to children, or, as I put it, “integrating” nonsense with science. Sadly, as I’ve written about all too often because I keep seeing it again and again, it’s an all too common trend. Hospitals are increasingly embracing pseudoscience and quackery, laboring under the misguided belief that by doing so they are somehow “cutting edge”; that the patients really, really want it; and as a marketing tool. Although I frequently refer to this trend to “integrate” quackery with real medicine “quackademic medicine” because it seems to be happening mostly in medical academia, sadly I’ve also documented it infiltrating community hospitals too. Worse, credulous reporters parrot the narrative of these places portraying themselves as “cutting edge” and the “wave of the future” in truly embarrassing ways that resemble advertising far more than journalism.

A perfect example popped up in the Louisville Courier-Journal just this weekend in the form of a title Louisville hospitals embracing alternative medicine. Before I get into the meat of the article, I must admit that I was surprised by the title. Clearly, either the reporter Laura Ungar or her editors didn’t get the message. Don’t they know? It’s not called “alternative’ medicine anymore, and it was a grave offense against the new nomenclature to refer to it as “alternative medicine” in the headlines. In fact, according to the evolution of quackery, the term “complementary and alternative medicine” (CAM) is falling out of favor among quackademics. The reason, of course, is that “alternative” implies “not real medicine” (which it’s not), while “CAM” still recognizes the primacy of science-based medicine such that the woo falling under the rubric of CAM is only “complementary” to real medicine. Actually, it’s not even complementary to medicine, itself being fake medicine, but selling it as being the “icing on the cake” to real medicine was at one time acceptable to CAM practitioners. No more. Now they want their woo “integrated” with real medicine. They frequently sell this as being the “best of both worlds,” the implication being that their pseudoscience is co-equal with science-based medicine. At least, that’s the message behind the move away from CAM and towards “integrative medicine” as the preferred term, and its practitioners aren’t shy about promoting the new party line. On the other hand, maybe it’s a subtle move by the editor signaling that he or she knows that this stuff is all fairy dust.

The title aside, even Ungar appears to have imbibed the message, because the term “integrative medicine” appears frequently in her article. She also promotes the desired message that this is the “wave of the future,” thus using the bandwagon argument to try to convince you that this stuff is great:

Coletta Campbell understood why she needed surgery, chemotherapy and radiation to treat her late-stage breast cancer — but when her doctors suggested she try massage, art therapy and Reiki, she was skeptical.

“I remember thinking: I’m not so sure about this,” said Campbell, a 62-year-old Louisvillian being treated at University Hospital’s James Graham Brown Cancer Center. “But I thought I’d give it a go.”

She did, and found herself more relaxed and able to cope — and now advises other patients: “Just try it.”

Hospitals across the region are increasingly weaving “complementary” services such as healing touch, yoga and art and music therapy into their care — reflecting a resurgence in these healing methods nationwide and an effort to combine them with traditional methods to form “integrative medicine.”

A passage like this more than deserves a heapin’ helpin’ of Insolence, in this case, the not-so-Respectful variety. First, from my perspective, any doctor who recommends reiki needs to be grabbed by the lapel, shaken, and have someone yell in his face, “Do you realize that what you’re recommending is nothing more than faith healing, magical thinking?” If he doesn’t, then he needs an education.

Nor is it an excuse that the quackery is being “seamlessly woven” into conventional care such that the patients don’t even get a bill at Norton Healthcare:

And patients often don’t get a bill for such therapies. Although insurers may or may not cover them outside the hospital, officials said integrative care generally doesn’t cost hospital patients extra because it’s woven into normal care.

In other words, the administration at Norton Healthcare is such a true believer in this that it’s willing to eat the cost of providing these “services.” One wonders if this is more of a cold, hard business decision. Most insurance companies won’t pay for most CAM therapies; so the hospital provides it as a “loss-leader” or marketing gimmick and eats the cost, hoping that they make up more than the cost by attracting a certain clientele. Of course, a lot of this is part of the old “bait and switch” or “rebranding” that I’ve written about before, in which “treatments” that aren’t really treatments at all but can be justified simply because they feel good (such as massage); interventions that are nothing more than “exotic” forms of more pedestrian recommendations that are science-based (yoga or tai chi as forms of exercise and mobility training), or recommendations that are nothing unusual and can, if properly done, be completely science-based (diet, exercise, relaxation) that have been “rebranded” as CAM.

Fear not, however. There is true woo here in abundance:

A steady stream of Norton employees laid down on padded tables or sat in a chair, getting massage; a light touch therapy called Jin Shin Jyutsu; and hands-on energy therapies called healing touch and Reiki.

As I’ve pointed out before more times than I can remember: Healing touch is nothing of the sort (the practitioner doesn’t even touch the patient, and it is claimed that the practitioner affects the patient’s “energy field” to healing intent), and reiki is simply a form of faith healing in which Eastern mysticism is substituted for Christianity as the religious belief at the core of the “healing.”

Meanwhile, over at the Brown Cancer Center, CAM rebranding is in full force. The real quackery doesn’t (yet) appear to be apparent, but the center is offering aromatherapy (if it smells good, it is good, I guess), massage therapy (which, as I’ve said before, feels good and doesn’t really need to be represented as “medicine” but often is), meditation (again, it probably doesn’t do any good but also probably doesn’t do any harm, depending on how it is recommended and performed), art therapy (why does this have to be called “therapy” when it’s simply something to do that might take one’s mind off of what’s happening?); and “nutrition.” Of these, the last is the most worrisome. It’s mentioned that there is an “oncology nutritionist” that the cancer center is bringing in. What does that mean? “Dietician” is a real specialty. Pretty much anyone can call himself a “nutritionist,” and the term tends to indicate a tendency towards woo in my experience. Dara O’Briain compares “nutritionist” to “dietician” as a “tootheologist” is to a dentist.

Later, Ungar cites more “evidence” of the bandwagon fallacy as justification for the infiltration of quackery into local hospitals, such as the recent Bravewell “jump on the bandwagon” report, Dean Ornish’s misunderstanding of cDNA microarray technology, and the like.

All of this concludes with testimonials of “skeptics” who became true believers:

“Stress is one of the major causes of illness,” said Reiki master Anna Menges, who recently worked with Norton’s Snack and Relax program. “This is a way of people taking time out of their day to be still and relax.”

Gerry Waddell, a surgical technician at Norton Suburban, said she’d never undergone touch therapy until she attended Snack and Relax. She said she arrived stressed, but left refreshed.

“I’m definitely relaxed, but energized as well,” she said shortly after getting Reiki and aromatherapy. “I’ve been a skeptic, but I definitely am going to seek out more.”

One suspects that Waddell was never much of a “skeptic” to begin with. Be that as it may, you don’t need to invoke magic like reiki (which, make no mistake about it, is definitely magical thinking) in order to relax. Yet, more and more, magical thinking is what is infiltrating medical centers. It’s not just academic centers anymore, either, but it’s clearly infiltrating the heartland. To look, for instance, at what Norton Healthcare posts on its website about “integrative” medicine is to be depressed about the state of medicine:

Integrative medicine looks at health in the context of nutrition, environment, and spiritual and emotional well-being. A growing body of scientific evidence documents the effectiveness and safety of integrative therapies, which have been used for centuries in non-Western cultures to optimize health and reduce suffering.

“An integrative approach may include things like nutrition, supplements, acupuncture, stress reduction or therapeutic touch,” said Rachel Busse, M.D., a family medicine physician with special training in integrative medicine. “We look at ways to support the body’s innate capacity to heal.”

The patented CAM-blather is there in abundance, concentrated into two brief paragraphs. There’s the false claim that CAM is “holistic” and treats the whole patient, with the implied false dichotomy that a good primary care doctor using science-based medicine is not. There’s the false claim that a “growing body of evidence™” is supporting quackery like reiki and therapeutic touch. There is the vacuous non-statement that somehow CAM “supports the body’s innate capacity to heal.” Here’s a hint: Every form of medicine relies on the body’s innate capacity to heal. When I take scalpel to skin and remove breast cancers, it wouldn’t work out so well if the tissue I cut and then sewed back together didn’t heal back together. Much of what we do in medicine is to try to prevent harm while the body heals itself, no matter what kind of medicine we practice. There’s nothing unique about CAM in this regard except that most of the time it doesn’t work and the body heals itself anyway.

In fact, the only thing true in the CAM blather is that CAM is trying to go back to “ancient therapies” from centuries ago. In other words, it’s trying to turn back the clock for medicine, and not in a good way. Just think of average life expectancy 500 years ago and compare it to average life expectancy to now.