Quackademic medicine now reigns supreme at UC-Irvine

It’s not infrequently that, whenever I complain about the increasing infiltration of quackery and pseudoscience into medicine, I sometimes lament that skeptics and supporters of science-based medicine are massively outgunned, because we are. Thus, we have the continued growth of what I like to refer to as “quackademic medicine,” the infiltration of pseudoscience into medical academia in the form of whole divisions, departments, and institutes dedicated to studying fairy dust like acupuncture, naturopathy, and other “unconventional” treatments that are then “integrated” into medicine. It’s not for nothing that I refer to “integrative medicine” as integrating quackery with medicine.

Unfortunately, I was reminded yesterday of what an uphill battle it is to counter the increasing pseudoscience in medicine when I learned that wealthy donors Susan and Henry Samueli just donated a whole bunch of money to the University of California, Irvine (UCI) to establish an institute dedicated to pseudoscience:

The University of California, Irvine today announced the largest gift in its history: $200 million from Susan and Henry Samueli, longtime campus supporters, to name a first-of-its-kind College of Health Sciences focused on interdisciplinary integrative health. The far-reaching donation – the seventh-largest to a single public university – positions UCI as a bold, new leader in population health, patient care, education and research.

“This gift catalyzes UCI’s belief that human health and well-being requires a science-based approach that engages all disciplines in caring for the whole person and total community,” said Chancellor Howard Gillman. “Susan and Henry Samueli’s dedication, their vision for what is possible and their deep generosity will help UCI set a standard that, over time, other medical centers in the U.S. can follow.”

Thanks to the Samuelis, unfortunately UCI has long been a prominent force in the brave new world of integrative medicine. Now, it appears to be taking this “integration” a step further, by “integrating” the pseudoscience across not just the new institute. Behold:

The Susan and Henry Samueli College of Health Sciences will be the first university-based health sciences enterprise to incorporate integrative health research, teaching and patient care across its schools and programs.

Integrative health redefines the relationship between the practitioner and patient by focusing on the whole person and the whole community. It is informed by scientific evidence and makes use of all appropriate preventatives, therapeutic and lifestyle approaches, and healthcare professionals and disciplines to promote optimal health and wellness.

The existing Susan Samueli Center for Integrative Medicine will become the Susan Samueli Integrative Health Institute and will focus on improving medical care by supporting multidisciplinary research, education, clinical service and community programs. Faculty and students in computer science, engineering, social sciences, business and other areas will collaborate within the institute to study the future of human health.

Of course, the whole paragraph about integrative health “redefining” the relationship between the practitioner and patient by focusing on the “whole person” is the usual blather that quacks everywhere. As I’ve said so many times before, it is not necessary to “integrate” pseudoscience into medicine in order to take care of the “whole patient.” A good science-based primary care doctor takes care of the “whole patient,” with no need to resort to appealing to magic like acupuncture, reiki, reflexology, homeopathy, and the like. And if you don’t think this is about all of the forms of quackery I just mentioned, take a look at how the Samuelis became interested in “integrative” medicine:

Susan Samueli caught a cold while visiting France more than three decades ago. Instead of the usual medicines, a friend suggested aconite, a homeopathic remedy derived from a plant in the buttercup family.

She was cured — and became a lifelong advocate of homeopathy and other alternative healing methods to complement conventional medicine. Her husband, Henry — the billionaire co-founder of Broadcom, the Irvine semiconductor maker — says he was initially skeptical but found the integrative health approach helped him easily shake off colds and flus and kept their children healthy without antibiotics.

Now the couple’s passion for integrative health has led to the largest donation ever made to UC Irvine.

As an origin myth, This is just downright silly. Colds are self-limited, and the homeopathic remedy Mrs. Samueli took almost certainly had no effect on the course of her cold. She just got better, as the vast majority of otherwise healthy adults with colds do. As for Mr. Samueli’s apparent belief that homeopathy and other “integrative” approaches helped him shake off colds and flus, the same thing is going on. Colds are self-limited. So is the flu for most people, although what most people call the “flu” isn’t really the flu but much milder “flu-like illnesses” caused by other viruses. (The real flu can easily knock you on your posterior for a week or even more.) Basically, this story is a load of confirmation bias and good old-fashioned regression to the mean being confused with therapeutic effect. Yet, that’s all it takes for otherwise intelligent people to become believers. Humans are pattern-forming animals. If we take something and then get better we’ll say that what we took caused us to get better, whether it really did or not.

Of course, supporters of “integrative medicine” will no doubt become indignant at my description of their favored new medical specialty. They will point to how diet and exercise are an important part of integrative medicine, how integrative practitioners emphasize prevention and healthy lifestyle. The problem, of course, is that diet, exercise, healthy lifestyles, and prevention are all part of conventional medicine. There is no need for a separate specialty for them, any more than there is a need for a separate specialty in order to take care of the “whole patient.” The reason “integrative medicine” exists is not to promote science-based prevention, lifestyle, and exercise interventions, but rather to provide a vessel into which quackery can be poured and mixed with the science-based care until it becomes difficult to tell which is which. That’s the idea, whether physicians who have become integrative medicine practitioners will admit it to themselves (or others) or not.

So here’s how this next stage of “integration” will go. The Susan and Henry Samueli College of Health Science will eventually include the existing Samueli Center plus the following schools at UCI:

• School of Medicine
• Sue & Bill Gross School of Nursing
• School of Pharmacy (currently the Department of Pharmaceutical Sciences)
• School of Population Health (currently the Program in Public Health)

And here’s where the money will go:

The Samuelis’ gift will provide $50 million toward construction of a facility to house the college and $5 million for state-of-the-art technology and labs – forming the foundation of a national showcase for integrative health. It also earmarks $145 million to create an endowment for:

• Up to 15 faculty chairs across the medicine, nursing, pharmacy and population health disciplines for senior, midcareer and junior faculty with expertise in integrative health
• Integrative health training and mentoring for interested medical school students
• Scholarships and fellowships for undergraduate and graduate students planning careers in related fields
• Innovative curricular development and campuswide interdisciplinary research projects
• Ongoing clinical services, research and education in the Susan Samueli Integrative Health Institute, including investigations of nonconventional interventions as part of medical treatment and educating medical and lay communities about benefits and risks associated with new healthcare approaches

That last bullet point is critical. The whole point of “integrative medicine” is to integrate “nonconventional interventions as part of medical treatment.” That means quackery. There is no other reason for integrative medicine. Just think about the evolution of the naming of integrative medicine. First, it was known as alternative medicine. But “alternative” implied that the “nonconventional interventions” weren’t medicine (or weren’t good medicine, which they weren’t). So the name evolved to “complementary and alternative medicine,” or CAM. However, that wasn’t good enough either, because the name mean that the quackery was “complementary” to real medicine. It wasn’t real medicine itself (or at least it wasn’t as effective or important as real medicine). It was just “icing on the cake.” So a new name was coined, “integrative medicine,” in which all the quackery was (and still is) portrayed as co-equal with conventional medicine and “integrative medicine” as “the best of both worlds.”

And here we are. A wealthy couple has donated $200 million to a public university to promote their vision of pseudoscience, and the university has eagerly accepted, even though it will utterly reshape its medical school and all its biomedical sciences for decades to come.

I find it helpful to look at what UCI’s Samueli Center already offers. I first took note of the school just shy of 10 years ago, when I added the Susan Samueli Center for Integrative Medicine as part of an early version of my Academic Woo Aggregator.Really long time readers of this blog know that for a time I maintained a list of medical schools that had embraced quackademic medicine. I only maintained the list for a relatively brief period of time, not because I didn’t think it was a worthwhile endeavor, but rather because there were just too many schools for me to keep track of alone. Quackademic medicine has become the norm, not an outlier. It’s schools like mine, where I’m faculty, that have little or no quackademic medicine that are the outliers.

So what does Samueli Center offer? It’s basically the same slate of “integrative medicine” that most quackademic “integrative medicine” centers offer:

• Acupuncture & traditional Chinese medicine
• Ayurvedic therapies
• Functional medicine
• Massage therapy
• Meditation
• Mindfulness
• Nutritional counseling
• Physical medicine & rehabilitation
• Preventive cardiology
• Sports medicine & osteopathic manipulation
• Tai chi
• Vitamin infusion therapy
• Women’s health
• Yoga

Of course, traditional Chinese medicine and Ayurvedic medicine are prescientific systems of medicine based on mysticism and vitalism. Functional medicine is a bit of “make it up as you go along” quackery that combines the worst of conventional medicine on steroids (e.g., massive overtesting) with quackery. Vitamin infusion therapy, of course, is also not scientifically supported. As for the rest, Tai Chi and yoga are nothing more than exercise. Massage therapy makes people feel better, but specific therapeutic claims are to be treated with skepticism.

If you want to get an idea of the level of pseudoscience going on here, it’s useful to look at what UCI says about various modalities. For instance, “functional medicine” turns out to be all about naturopathy as well:

Functional medicine, which is based on naturopathic principles, takes a more comprehensive approach. At the Susan Samueli Center for Integrative Medicine, our highly trained naturopaths:

• Identify and treat the root causes of illness
• Harness the healing power of nature
• Treat the whole person
• Emphasize disease prevention
• Encourage self-responsibility for health
• Explore alternatives to drugs and surgery

And, based on functional medicine, UCI might offer:

Based on your individual needs, we develop a treatment plan which may include:

• Detoxification
• Dietary and lifestyle changes
• Exercise therapy
• Herbs and dietary supplements
• Homeopathy
• Manipulative therapies
• Psychotherapy and counseling
• Stress reduction

There you go. “Detoxification” is virtually always the purest of quackery. Then, of course, there’s homeopathy, or, as I like to call it, The One Quackery To Rule Them All. If you don’t know why that’s the case, I refer you to any of a number of my previous posts, like this one.

Of course, one aspect of “integrative medicine” is bias. Basically, its adherents don’t ask whether it will help patients and result in better outcomes. Rather, they confidently predict that they will be vindicated in their beliefs:

“As a preventive cardiologist and researcher, I cannot stress enough the critical need for society to adopt a truly integrative approach to health, whether we are talking about community health, nutrition, prevention or appropriate medications. It must start with those who provide care and guidance,” said Dr. Shaista Malik, director of the Susan Samueli Center for Integrative Medicine and the endowed chair of integrative medicine. “Through this exciting new college, we will demonstrate to everyone involved in the health system – from patients to providers to policymakers – the value of an integrative approach.”

And:

Fundamental change in thinking about healthcare and how it’s delivered will take time, a steady stream of new evidence and strong academic leadership. The Samuelis’ transformational gift is the first step toward creating an expanded health sciences campus, integrating the affiliated schools and programs of the college as well as new teaching, research and clinical spaces.

“Susan and I have supported healthcare research for nearly 20 years, and over that time, we have seen a significant expansion of the scientific evidence demonstrating the value and efficacy of integrative health. This evidence base is critical as UCI – a young, innovative institution – takes this big and influential step,” said Henry Samueli, Ph.D., an engineer and co-founder of Broadcom Corporation. “We are very excited for the UCI College of Health Sciences to become a national model for integrative health. We believe this model will eventually become the standard approach for promoting health and well-being in our society.”

That’s right. Adherents of “integrative” medicine “believe” that it will eventually become standard of care. What evidence do they base this belief on? Certainly not on evidence. I do note that advocates of integrative medicine are quite honest about their goals, as you can see from this article in the the LA Times:

The Samuelis said they hope their financial support for research will help build evidence for alternative therapies that would convince insurers to pay for them, thus letting more people benefit. Acupuncture, for instance, has been widely documented to ease migraines, according to Howard Federoff, a specialist in neurodegenerative disorders and UC Irvine’s vice chancellor for health affairs. But not all health plans cover the treatment.

No, acupuncture is nothing more than a theatrical placebo.

When I say that skeptics and supporters of science-based medicine are at a profound disadvantage, this development at UCI is exactly what I’m talking about. What we have is a ragtag band of physicians and skeptics alarmed at the infiltration of pseudoscience into medicine versus very wealthy believers like the Samuelis willing to donate far more money than we can imagine. Sure, we have science on our side, but will it matter?

We have to make it matter.