Quackademic medicine now reigns supreme at the Cleveland Clinic


Quackery has been steadily infiltrating academic medicine for at least two decades now in the form of what was once called “complementary and alternative medicine” but is now more commonly referred to as “integrative medicine.” Of course, as I’ve written many times before, what “integrative medicine” really means is the “integration” of quackery with science- and evidence-based medicine, to the detriment of SBM. As my good bud Mark Crislip once put it, “integrating” cow pie with apple pie does not make the apple pie better. Yet that is what’s going on in medical academia these days—witha vengeance. It’s a phenomenon that I like to call quackademic medicine, something that’s fast turning medical academia into medical quackademia. It is not, as its proponents claim, the “best of both worlds.”

Quackademic medicine has been infiltrating many formerly science-based academic medical centers. Such centers have a seemingly amazing ability to compartmentalize, insisting on rigorous science for most treatments but possessing an amazing blind spot when it comes to anything having to do with “integrative medicine.” Unfortunately, in few places is this tendency as intense as it is at the Cleveland Clinic Foundation (CCF). It’s an institution with which I have some familiarity, given that I lived in Cleveland for eight years from the late 1980s to the mid 1990s because I did my general surgery residency at Case Western Reserve University and University Hospitals of Cleveland just down the street. At least, that’s what it was called at the time. I also worked as a flight physician for Metro LifeFlight, and a frequent destination for cardiac patients that we picked up from outlying hospitals was—you guessed it—the Cleveland Clinic. Twenty years ago, the CCF was Case’s chief rival in terms of medicine, science, and competition for patients. These days, their relationship is no longer as acrimonious as it was when I was at Case, but unfortunately the two institutions appear to have become rivals in quackademic medicine.

It’s a rivalry the CCF appears to be winning. Sure, Case has a big integrative medicine program and sponsored a meeting of the Society for Integrative Oncology and has been caught recommending reflexology, but that’s nothing compared to the CCF’s promotion of “energy healing’ (in particular reiki), acupuncture for children, and, most recently, the opening of a traditional Chinese medicine clinic run by a naturopath.

So what can CCF do to top that quackery? I wish I hadn’t asked. The reason is that I just learned over the weekend that the CCF has ratcheted up the quackery to 11 and beyond. How? Simple. See this article in the Cleveland Plain Dealer:

In its ongoing focus on wellness and disease prevention, the Cleveland Clinic is opening a new Center for Functional Medicine. In doing so, the Clinic is the first academic medical center in the United States to embrace functional medicine, the focus of which is more on identifying underlying causes of illness and less on symptom management.

The center will work together with Clinic specialists to study the impact functional medicine has on certain chronic diseases.

Within the next few weeks, screening will begin for the first of up to 300 patients for one of four clinical trials comparing the standard treatment for asthma, inflammatory bowel disease, type 2 diabetes and migraines with that of functional medicine approaches.

The new center at the Clinic’s main campus is a collaboration between the Clinic and The Institute for Functional Medicine. Dr. Mark Hyman, chairman of The Institute for Functional Medicine, whose offices are in Washington state and New Mexico, and founder of The UltraWellness Center in Massachusetts, will serve as director of the new Center for Functional Medicine.

That’s right. The CCF has embraced the quackery that is “functional medicine” and even hired the most famous practitioner of that quackery, Dr. Mark Hyman. We’ve met Dr. Hyman before many times on this blog. For instance, he has argued for turning back the clock and relying on anecdotal medicine instead of scientific medicine, mangled cancer research and systems biology to justify the quackery that is “functional medicine,” and twisted autism science even worse. Most recently, it’s been reported that Bill and Hillary Clinton have fallen under Dr. Hyman’s spell.

So what does this mean for CCF? Quackery. That’s what it means. Don’t believe me? Go back and read my description of functional medicine. Look at Wally Sampson’s multi-part analysis of what functional medicine is claimed to be here, here, here, here, and here. Basically, it’s a vaguely defined “discipline” in which it is claimed that measuring a whole bunch of metabolic factors and other lab values will lead to a “holistic” approach to disease. Never mind that just what “functional medicine” actually entails is kept quite vague. That vagueness is the very thing that allows Dr. Hyman to claim:

“Functional Medicine looks at the underlying causes of disease, while focusing on the whole person rather than an isolated set of symptoms,” Hyman said in the news release. “We look at a patient’s history and the personalized interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease.”

The new center is a collaboration with The Institute for Functional Medicine, an organization also led by Hyman.

Of course, “functional medicine” does nothing of the sort, at least not any better than conventional medicine. According to news reports, Hyman will only set foot in Cleveland three days a month, which makes me wonder how he can be the director of anything there, much less a center at a large institution like the CCF. Of course, there’s been a doctor hired to do the day-to-day grunt work of running this new center: Dr. Patrick Hanaway, was the chief medical officer of Genova Diagnostics from 2002-2012, a laboratory that offers all sorts of tests of dubious medical value, including a saliva adrenal stress profile, comprehensive diagnostic stool analysis, and toxic effects CORE, among others. Of course, Dr. Hanaway is an integrative “holistic” practitioner. After that, he apparently became the director of medical eduction for Dr. Hyman’s Institute for Functional Medicine. Frighteningly, the practice where Dr. Hanaway works offers “holistic newborn and pediatric care,” including what is characterized as “grounded discussions” on vaccines:

Each talk is facilitated by Dr. Susan Bradt or Dr. Lisa Lichtig, board certified family physicians who practice holistic medicine. We cover the hot topics of controversy including links made to autism and asthma, the ingredient thimerosal (mercury), individualizing schedules and current outbreaks of vaccine preventable disease in our community. We review each disease and its associated vaccine and discuss vaccine ingredients, school requirements and legal issues. An extensive handout is provided to supplement the class and serve as a future reference. This class is essential for all families so they can be more informed about vaccinations. It is especially helpful for parents feeling concerned or hesitant about vaccinating their children according to the standard schedule. It provides a grounded explanation of the issues and helps remove fear surrounding the topic thus helping parents navigate decision making from a more balanced and educated starting place. You will walk away with a great foundation on the topic of childhood vaccines and be able to confidently make choices that feel safe for your family.

I recognize the code words, as, I’m sure, do many of you who follow the vaccine manufactroversy from a science-based perspective. The big giveaway is that the clinic website doesn’t dismiss the “links made to autism and asthma” (hint: there are not, at least none that are evidence-based) and claims to discuss “ingredients,” a sure sign that the class involves the “toxin gambit,” a fallacious gambit designed to cause great. It’s of a piece with Dr. Hanaway’s boss Dr. Hyman’s recent foray into anti vaccine fear mongering with Robert F. Kennedy, Jr. One wonders why the CCF would hire someone who spreads such blatant antivaccine propaganda as Dr. Hyman does.

Then there’s this:

For uncomplicated pregnancies we encourage laboring at home as long as possible with the support of a birth partner and/or doula. Once at the hospital we help create an intimate and encouraging atmosphere utilizing low lighting, freedom of movement, homeopathy, vocalization, massage, water, birthing ball and stool to support women in labor as it intensifies. Medications and epidurals are available upon request. Woman birth in a variety of positions including in the water and squatting.

Yep, Dr. Hanaway’s partners practice “natural childbirth” woo.

So how on earth was someone like Dr. Hyman or Dr. Hanaway offered a job at an institution as prestigious as the CCF? Listen to the CEO of the CCF, Dr. Toby Cosgrove. He’ll tell you:

In the release, Clinic CEO Dr. Toby Cosgrove said the new center is “not a departure for Cleveland Clinic, but a continuation of the innovative, holistic approach that we have embraced.” Cosgrove cited the Clinic’s wellness institute, Center for Integrative Medicine, its Chinese herbal therapy clinic and the Center for Personalized Healthcare.

I can’t argue with this. The CCF has been traveling down the road of quackademic medicine for a long time. This new initiative is nothing more than a continuation of the “integration” of quackery into medical practice at the CCF. There’s nothing “innovative” about its practice; it’s just embracing ancient, pre-scientific medicine on the one hand (the traditional Chinese medicine clinic) and a modern version of the same sort of thing, in which the idea seems to be to check as many lab values as possible until something is found to be wrong (as it will be with virtually everyone if you check enough lab values) and then to “treat it,” labeling the “treatment” as somehow “holistic.”

Unfortunately, I can’t argue that CCF isn’t a trailblazer. Unfortunately, it’s a trailblazer in introducing quackery into conventional medicine. Cosgrove ought to rename the CCF to the Cleveland Quackademic Clinic, as sad as it is for me to contemplate the decline of a once-great institution.