Last week, the University of California, Irvine (UCI) announced that Susan and Henry Samueli were donating $200 million for it to set up a massive new integrative medicine initiative. The plan would basically transform biomedical sciences and medical education at UCI—and not in a good way. Remember what “integrative medicine” is. What is being “integrated” into medicine is, of course, quackery. Oh, sure, integrative medicine also emphasizes lifestyle modification, such as diet and exercise, but that is part of “conventional medicine” already. There is no good scientific or medical rationale for a separate specialty devoted to just that. What integrative medicine does is that it rebrands perfectly science-based modalities, such as diet and exercise, as somehow “alternative” and then “integrates” quackery, like naturopathy, acupuncture, functional medicine, applied kinesiology, homeopathy, and basically any form of quackery you can think of. Without the quackery, there is no integrative medicine. Worse, the phenomenon has resulted in a most pernicious effect in medical academia, the infiltration of outright quackery into the research and education efforts there, a phenomenon I like to refer to as “quackademic medicine.”
Of course, The Very Serious Academics In Very Serious White Coats who have come to believe in integrative medicine to the point of devoting their careers to it would vehemently disagree with my characterization. I’m referring to the sort of doctors who present at conferences of learned academics and write what they claim to be evidence-based care guidelines for breast cancer patients. Perhaps the best thing to mention to rile up serious academic advocates of integrative medicine is homeopathy. Any mention of homeopathy is guaranteed provoke paroxysms of self-righteous denial. “Oh, no,” they’ll say, “homeopathy is pseudoscience! It’s quackery. Integrative medicine is evidence-based, and we would never do anything that isn’t evidence-based!” Sadly, as I’ve pointed out time and time again, you can’t have naturopathy without homeopathy, as homeopathy is an integral part of naturopathy. As long as you have naturopaths, you will have homeopathy. Oddly enough, many of these The Very Serious Academics In Very Serious White Coats are utterly oblivious to this simple fact, even ones who write Very Serious Clinical Guidelines with naturopaths and welcome naturopaths into their Very Serious Medical Society.
All of this brings me back to UCI, because yesterday there was a story by Michael Hiltzik for the LA Times about this very phenomenon. Well, not exactly. Rather, it’s about the relationship between UCI and homeopathy and how UCI seems rather—shall we say?—touchy about the subject:
As of late last week, visitors to the website of UC Irvine Health, that institution’s clinical arm, could learn that among its services to patients was “homeopathy.”
That was a problem, because homeopathy is a discredited and thoroughly debunked “alternative medicine.” Even Howard Federoff, UCI’s vice chancellor for health affairs, agreed that the scientific basis for homeopathy was “lacking.” The issue is important because the donors of a $200-million gift to UCI’s medical schools, the billionaire couple Susan and Henry Samueli, are sworn believers in homeopathy and supporters of a raft of other “integrative” health treatments. As I reported, some medical authorities have raised questions about whether the Samuelis’ beliefs and their rare generosity will undermine UCI’s explicit commitment to science-based medicine.
So it’s interesting that after I raised questions about the treatment’s listing on the website, it mysteriously disappeared. As of this writing, a UCI spokesman hasn’t gotten back to me with word on when it was removed, or whether its removal means that homeopathy no longer will be offered to patients, or merely that UCI is keeping it quiet. The listing was present as recently as last Wednesday, when I asked Federoff about it in connection with my column about the Samueli gift, which appeared online Friday; its presence can be seen on an archived version of the website dated Sept. 19.
Ah, yes. The light of national attention due to the Samuelis’ enormous donation to promote pseudoscience must have rattled UCI. After all, even the most avid proponents of integrative medicine are profoundly uncomfortable with homeopathy, even Dr. David Katz, whose “more fluid concept of evidence” led him to try homeopathy in a patient. That’s because homeopathy is quackery. Indeed, there’s a reason I routinely refer to homeopathy as The One Quackery To Rule Them All. To recap, homeopathy is based on two laws. One states that to treat a symptom you use something that causes that symptom. The other states that a homeopathic remedy becomes stronger with dilution. Neither are based in evidence. Indeed, many homeopathic remedies are 30C or greater in dilution, where C is a 100-fold dilution. Thus 30C means diluting the solution 100-fold thirty times, which results in a dilution of 10-60. Given that Avogadro’s number is on the order of 6 x 1023, a 30C dilution is more than 1036-fold greater, which means that it’s incredibly unlikely that a single molecule of original remedy remains. Most homeopathic remedies are just water or ethanol diluent. Even the most die-hard advocate of quackademic and integrative medicine has to admit that, which is why even they are so uncomfortable when homeopathy is brought up and so loudly and self-righteously deny that integrative medicine would ever have anything to do with homeopathy.
Amusingly, Hiltzik noted a web page that looked very, very familiar to me, that of Dayna Kowata, ND, LAc. Yes, she’s a naturopath and acupuncturist. She also expresses an interest in homeopathy. What’s so familiar about Not-a-Dr. Kowata? Well, I used her UCI webpage in talks about quackademic medicine several years ago, and I’ve even mentioned her on two different occasions on this very blog, albeit not by name. At the time, I didn’t know that Susan Samueli is strong believer in homeopathy, but I do now. I wonder what Ms. Samueli will think if Dr. Federoff actually does eliminate homeopathy from UCI. I rather suspect that she won’t be happy.
I particularly wonder this based on the original gift agreements between the Samuelis and UCI when the Samuelis first founded the Susan Samueli Center for Integrative Medicine (SSCIM) at UCI. The original gift was $20 million in 1999. Now here’s where it gets interesting. In 2003, the board of directors of the Samueli Center was formally founded in the UCI College of Medicine. You can read the whole thing if you like, but this is the key paragraph:
The proposed Center will build on the considerable knowledge and experience of its faculty to study the efficacy of various therapeutic modalities considered to be part of complementary and alternative medicine, including herbs and homeopathic medicine, as they relate to areas such as cardiovascular, autoimmune and neuromuscular diseases, cancer treatment and prevention; and menopaus and ageing. In addition, the proposed center will foster UCI’s emergence as a leader in the area of acupuncture by supporting basic and clinical research into the mechanism of action and the efficacy of acupunctxure as a modality. The proposed Center will encourage and foster multidisciplinary studies that involve appropriate faculty from across the campus as well as from other institutions.
That’s right. Homeopathy was baked into the Samueli Center from near the very beginning. I can’t help but wonder what would be found in the formal gift agreement for the Samuelis’ $200 million donation. Perhaps a Freedom of Information Act request would shed some illumination on this question. On the other hand, I note that homeopathy was only mentioned in one of the gift agreements. Perhaps then, as now, UCI and the Samuelis learned that homeopathy brought too much embarrassment to the university—and rightly so—and that’s why homeopathy hasn’t been mentioned in any of the Samuelis’ gift agreements since 2003. Alternatively, most of the gift agreements after that had to do with setting up fellowships and endowed chairs and gave UCI administration the latitude to use the gifts for whatever purposes it judged most consistent with the wishes of the donors.
Contrary to what Dr. Federoff claims, quackery is deeply embedded at UCI. It’s the raison d’être for the SSCIM. He might be in denial about it, but it’s true. That’s why I was amused to read Hiltzik’s observation:
The on-again-off-again appearance of homeopathy on UCI’s website and among its clinical offerings underscores the difficulties the university may face in navigating the inconsistencies between the world view of its biggest donors and its explicit commitment to rigorous scientific standards in its medical teaching, research, and clinical treatment. The Samuelis, after all, will have their names on UCI’s main on-campus medical building, and their gift will endow up to 15 faculty members, all of whom will have to demonstrate some “expertise in integrative health.”
We reported over the weekend that “integrative health” is interpreted by many in the medical profession as code for introducing unproven and debunked nostrums into a curriculum that should be based exclusively on scientific evidence. Although Federoff says science will govern at UCI, that hasn’t necessarily been the case at the Susan Samieli Center, which was established in 2001 with a $5.7-million donation from the couple and will be converted into the Susan Samueli Integrative Health Institute and absorbed into the university’s entire medical complex under the terms of the gift.
I can’t help but note that Dr. Federoff came to UCI from Georgetown University. Why is that significant? Georgetown was one of the “pioneers” (if you will) in quackademic medicine. Basically, Georgetown was the first to “integrate” quackery into all phases of medical education beginning in the first year of medical school, with acupuncturists giving lectures in gross anatomy class. I kid you not. By the time Dr. Federoff left Georgetown in 2015, quackademia reigned supreme at Georgetown, even to the point where Georgetown credulously teaches homeopathy to its medical students. Dr. Federoff was there when it began and took hold. You’ll pardon me if I call bullshit on his claims that the SSCIM will be rigorously based in science. It won’t. That’s not what the donors want, and that’s not what the culture at UCI will support. Thanks to the Samuelis and the credulous culture they have built at UCI and fueled by the enormous $200 million gift given by the Samuelis, quackademic medicine will reign more supreme than ever at UCI and serve as an example for the metastasis of the cancer that is integrative medicine.