One of the themes of this blog since the very beginning of this blog is the threat to scientific medicine represented by a phenomenon that I like to call quackademic medicine. Although I did not coin the term, I frequently use the term and have done my best to popularize it among skeptics to describe the infiltration of pseudoscience into academic medicine, be it in the form of fellowships, research and clinical trials studying prescientific magic like homeopathy or “energy medicine,” or even the offering of such services under the auspices of an academic medical center, thus putting the imprimatur of science on pseudoscience, prescientific vitalism, and outright quackery.
Here we go again.
It happened when I came across a press release. For some reason, academic medical centers are often proud enough of these programs integrating quackery into their cutting edge scientific medicine that they issue press releases about them. This time it’s the University of Florida in Gainesville, hot on the heels of approving a new chemistry building to do—oh, you know, actual science—doing the releasing in a press release entitled New UF Health program blends holistic therapies, modern medicine. As it typical of such propaganda, it’s chock full of the same deceptive language inherent in “integrative medicine,” whose proponents represent it as the “best of both worlds,” when in reality it represents the contamination of science-based medicine with pseudoscience. This is what I mean:
Acupuncture, meditation, massage — practices once considered “alternatives” to conventional medicine — are now becoming mainstream in hospitals and medical schools nationwide, and University of Florida Health’s Integrative Medicine Program is leading the way by expanding its services for patients.
As research continues to validate many of these ancient practices as effective treatments for chronic pain, nausea and stress, they’ve earned a new name that represents this unique partnership of conventional and holistic treatments: integrative medicine. This summer marks the one-year anniversary of the integrative medicine program at UF Health, led by the first fellowship-trained integrative medicine physician in Gainesville, Dr. Irene Estores. The program provides patients and staff with services such as guided imagery, medical acupuncture and yoga.
“Integrative medicine addresses the needs of the whole person — mind, body, spirit — in the context of community,” said Estores, the program’s medical director. “We’re coming back to our roots and honoring what was effective in other healing traditions and using that to be able to be more effective in caring for our patients.”
Ack! Not the “holistic” trope. Not the “taking care of the whole person” trope. Not the “integrative medicine is becoming mainstream” trope. As I’ve said many times before, being a good “holistic” physician and taking care of the “whole patient” do not require embracing pseudoscience or quackery. That is the false dilemma at the heart of integrative medicine and put on steroids by its practitioners like Dr. David Katz. Apparently the occasion for this press release was the one year anniversary of the founding of the integrative medicine program at UF. Sadly, the only thing that amazes me is that the program is that recent, that it’s only been in existence for a year. That puts UF behind the curve. Unfortunately, UF appears to be making up for lost time, as it’s offering integrative medicine services all over the UF hospital system.
The sad thing is, the integrative medicine program appears to have grown out of a potentially useful activity, Shands Arts in Medicine, an arts in health care program. Personally, I don’t mind art programs in medicine. Art beautifies the patients’ surroundings, and making art can be a fun activity for patients to help them take their minds off their illness. I do, however, have a bit of an objection to “art therapy.” Art’s a wonderful thing, but it’s not really a specific therapy for anything. I really hate to see art be the impetus for woo like this, but the UF integrative medicine program grew out of its art program. Where did the money come from? Wealthy donors, who made “several key donations,” of course.
If there’s another thing I’ve learned from this is that employee wellness programs can be an excellent Trojan horse to get integrative medicine into academic medical centers:
The Integrative Medicine Program is also unique in that it’s an outgrowth of UF Health Shands Arts in Medicine, one of the largest arts in health care programs in the nation, Mullen said. After years of providing services such as massage and yoga to staff but not having the resources or medical expertise to provide these services to patients, Arts in Medicine received several key donations that helped establish the program.
The medical director is Irene Estores, MD, and I find her biography quite telling. She was a trainee in Andrew Weil’s integrative medicine program at the University of Arizona. She’s also a Bravewell fellow as well as an acupuncturist. How an MD would ever want to learn the quackery that is acupuncture, I have yet to figure out, but acupuncture is what I like to call the “gateway woo,” which leads to additional interest in quackademic medicine. Even though it’s nothing more than a theatrical placebo, people tend to be more willing to believe acupuncture works because it involves an actual physical act of sticking needles into people. Never mind that the explanations for how acupuncture “works’ involve epic handwaving and special pleading, even as they try to brush aside the vitalistic origins of acupuncture, in which the thin needles stuck into non-existent meridians are somehow supposed to redirect the flow of “qi” (or life energy), to therapeutic effect.
So, yes, of course UF offers medical acupuncture. Pretty much every quackademic medical program offers acupuncture. It also offers meditation, massage, “wellness coaching” (whatever that is in practice), an a variety of other modalities that range from potentially evidence based to, well, integrative medicine consultations, with everything that goes with them:
Recommendations may include use of dietary supplements and botanicals, changes in eating and physical activity, mind-body procedures such as meditation, acupuncture and massage, and referrals to practitioners of other healing systems such as Traditional Chinese medicine, Ayurveda (a holistic medicine system from India), or homeopathy.
Homeopathy? Seriously? Homeopathy is The One Quackery To Rule Them All, and “integrative” doctors at UF are willing to refer patients to homeopaths. The same is true of practitioners of traditional Chinese medicine and Ayurveda, but to a slightly lesser extent. Even though both medical systems are based on prescientific vitalistic thinking, for sheer ridiculousness it’s hard to beat homeopathy and its law saying that diluting a remedy can make it stronger, particularly how so many homeopathic remedies are diluted away to nonexistence. In any case, homeopathy is something that no science-based medical school or academic medical center should have anywhere near it. While it’s true that there don’t appear to be any homeopaths actually working for UF (unlike a few places I’ve encountered), it’s also true that integrative practitioners at UF will use them, which is almost as bad. A science-based practice would never refer a patient to a homeopath to receive his magic water under pretty much any circumstances.
I suppose, then, it shouldn’t be too surprising that Dr. Estores characterizes her involvement in integrative medicine thusly:
Irene’s interest in integrative medicine grew out of self-exploration of other healing and belief systems, the deepening of her spiritual practice of prayer, self-reflection and meditation, and a mindful experience of both the good and bad things that have happened in her life as an individual and as a physician. She considers her practice of medicine as a vocation and a spiritual path.
Beware a physician who says medicine is a spiritual practice, who came to their beliefs through “explorations” and the “deepening of her spiritual practice.” While it’s true that religion coupled with a desire to help people often drive people to become physicians and that some physicians talk about a “spiritual” side to medicine, relatively few are the physicians who let it drive them into embracing practices that are not science-based to the extent that acupuncture, TCM, and homeopathy are not science-based. Dr. Estores’ story does, however, suggest the close connection between religion, faith, spirituality, or whatever you want to call it and the embrace of non-science-based treatments like acupuncture. Unfortunately, more and more, this sort of mystical pseudoscience is exactly sort of quackademic medicine that is infiltrating medical centers like UF.