Thomas Jefferson University goes full quack with a department of “integrative medicine”

Ever since the beginning of this blog, I’ve been writing about a phenomenon that I like to call quackademic medicine. It’s a term describing the increasing infiltration of pseudoscience and quackery into academic medical centers and medical schools under the guise of what is called “complementary and alternative medicine” (CAM) or now more frequently “integrative medicine” or “integrative health.” Basically, from a science-based viewpoint, what “integrative medicine” really means is “integrating” pseudoscience and quackery like acupunture, reiki, naturopathy,and many other unscientific, pseudoscientific, or prescientific medical modalities, many based in ancient mysticism. Sadly, famous elite academic institutions as diverse as the Cleveland Clinic, Memorial Sloan-Kettering Cancer Center, M.D. Anderson Cancer Center, the University of Michigan, Georgetown University, and more. It’s so bad that the University of California now does research studies with Deepak Chopra, and the University of California, Irvine receives $200 million from homeopathy-loving billionaires to set up a center dedicated to quackademic medicine. Still, although there have been institutes, divisions, and centers for “integrative medicine” in academia, there has never, to my knowledgem, been a department of integrative medicine; that is until now, thanks to Thomas Jefferson University:

Thomas Jefferson University has landed a $20 million grant to launch what it says will be the country’s first academic department of integrative medicine.

Integrative medicine is an approach that combines elements of conventional and alternative medicine to address the whole person – mind, body and spirit.

“This is a historic first,” said Dr. Daniel Monti, a Jefferson senior vice-president and director of its Marcus Institute of Integrative Health. “Nowhere to date has a medical school embraces integrative medicine and put in on par with other departments like oncology and neurology and surgery.”

Jefferson’s Department of Integrative Medicine and Nutritional Sciences will be part of the Sidney Kimmel Medical College. Monti will serve as chairman.

Notice how Thomas Jefferson University is combining integrative medicine and nutritional sciences. This is another common ploy by integrative medicine advocates. They co-opt science-based modalities, such as nutrition, exercise, and other lifestyle issues as somehow being “integrative” rather than just medicine and then using them as cover for all the quackery that they are also “integrating.”

I must admit that I was a bit surprised that Thomas Jefferson University could be bought for so little. After all, UC-Irvine landed $200 million to sell out science. Thomas Jefferson University did it for a mere $20 million. But where did the $20 million come from? You guessed it! It came from another woo-loving billionaire. I guess he’s just not as generous a billionaire as Henry and Susan Samueli, the billionaire couple who donated so much to UC-Irvine. Who is that woo-loving billionaire? It’s Bernie Marcus:

The $20 million grant funding the launch of the academic department came from the Marcus Foundation that was established by Home Depot co-founder Bernie Marcus. It previously provided Jefferson with nearly $25 million for integrative medicine projects including the creation of the Marcus Institute of Integrative Health, which has offices in Center City and Villanova.

Jefferson has had an alternative therapy program, led by Monti, as part of its clinical care offerings for about two decades.

“We’ve been building this for a long time,” Monti said. “We continue to develop strategies for new and innovative approaches, particularly in area where we do not have optimal satisfaction both in terms of treatment outcome and patient quality of life, that are incorporated into the traditional allopathic model.”

Here we go again. Advocates of integrating quackery into medicine always use this rationale: If there is medicine that doesn’t work well, if there are patients who are unsatisified, the answer is to “integrate” pseudoscience and quackery into medicine. It is, of course, a false dichotomy that I reject and have been both railing against and deconstructing for nearly two decades now. As Ben Goldacre likes to say:

So what will this new department offer? Let’s take a look:

The department features a curriculum that focuses on the clinical applications of integrative medicine with an emphasis on functional biochemistry, nutrient-based therapies, mind-body neuroscience, novel mechanisms of healing and emerging therapies.

And:

Initially, the university is planning to offer several certificate programs in Integrative Nutrition and Mind-Body Medicine, in addition to offering a master’s degree as well.

Physicians who have completed an ACGME-approved residency program can also apply for a one-year fellowship in Integrative and Nutritional Medicine, hosted by the university.

So the department will start by indoctrinating medical students into quackademic medicine but will also offer a fellowship in combining woo with medicine.

Not surprisingly, integrative medicine advocates are pumped about this development. John Weeks (whom I’ve discussed many times before) has been singing the praises of the integration of quackery into medicine “pioneered” by Thomas Jefferson University for a long time now. For instance, in 2017, Weeks was overjoyed when the integrative edicine program was elevated in status to the Marcus Institute of Integrative Health:

For academic health centers, designation as an institute is huge. “Integrative medicine is not a department,” Monti said. “We started as a program, then we became a center. Now, after we established the Villanova Clinic, we are multiple centers and we’re beginning the planning process for new clinical care sites. I saw that the institute model elevated Neurosciences at Jefferson and thought that this would be a way to develop greater recognition for Integrative Medicine. The Institute creates a unified infrastructure for our work.”

The notice from Thomas Jefferson University and Jefferson Health underscored expectations that the change will “greatly expand the research, education and clinical care profile” of the integrative medicine program. The sponsoring academic health center went further, announcing pride in “Jefferson’s role as a national leader in the field and the organization’s strides in developing novel clinical therapies, wellness programs and cutting-edge, peer-reviewed research.”

At the time, the Marcus Center was co-opting what sounded like pretty conventional neuroscience research and portraying it as somehow “alternative” or “integrative”:

I asked Monti for an example. He highlighted work on Parkinson’s that ranges from basic sciences research, to laboratory exploration, to human clinical trials. The focus is n-acetyl cysteine. “It’s a great molecule that has anti-oxidative and probably anti-inflammatory value,” said Monti. ” Our protocol showed upregulation of the dopamine transporter, and some clinical positives—certainly an efficacy signal. We anticipate keeping adding to the literature until it becomes part of the treatment of Parkinson’s.”

As I said, there’s nothing whatsoever about this research that would distinguish it as being anything other than pretty conventional neuroscience research about Parkinson’s disease. What’s “alternative” or “integrative” about it? Absolutely nothing.

Interestingly, back then Weeks clearly admired Monti for promoting integrative medicine in what he considered a “conservative” environment:

Monti’s model has been site-specific. The integrative services mirror the conservative environment. Clinical services are provided through an MD-centric clinical model. No chiropractors, no naturopathic doctors – though there are licensed acupuncturists. The research impetus is not only significant, it speaks the basic science, high tech (PET-MRI) language of Jefferson’s conventional medical community. The planned expansion of clinics can support the basic business model of a volume-based context, drawing people into integrative primary care serves as a marketing strategy for the sponsoring organization’s high end procedures. The appearance of Bernie Marcus and his $14 million in 2015 certainly didn’t hurt.

When I Weeks discussion, I couldn’t help but think that this wasn’t the first time I had discussed quackademic medicine at Thomas Jefferson University. True, it was seven and a half years ago, but I have taken note of quackery at Thomas Jefferson University before. This realization made me wonder: What’s changed since 2011? So I took a look.

First, off, I can’t help but note that the Marcus Institute offers functional medicine. At this point, I shouldn’t have to explain why functional medicine is quackery, having written about it so many times, but I will give the CliffsNotes version. It’s a make-it-up-as-you-go-along “specialty” that relies on massive overtesting and overtreatment. It also touts “integrative micronutrient therapies.” I’m referring to intravenous infusions of vitamins, minerals, and other nutrients. This is, of course, also quackery. I mean, get a load of what Thomas Jefferson University is selling:

Discover how our targeted treatments can benefit your body if you have become nutrient-depleted from chronic illness, gastrointestinal problems, poor diet and a variety of other health issues.

  • Ascorbic Acid (Vitamin C): Infused at pharmacologic doses as an adjunctive agent for supportive cancer care. This protocol is given in collaboration with your primary oncological physician. Our team has published groundbreaking research on this therapy.
  • Restorative Micronutrient Mix: Includes a range of vital nutrients infused at physiological doses to replenish and restore; and can be helpful for patients who have become nutrient-depleted from chronic illness, gastrointestinal problems or poor diet. The precise blend is customized to the individual patient based on clinical presentation and laboratory values.
  • N-Acetyl Cysteine (NAC): When infused at moderately high doses, this is a powerful antioxidant with potential to treat a variety of health issues. We are currently studying the impact of administering this nutrient to patients with Parkinson’s Disease and neurocognitive/neurodegenerative problems, and our initial results are highly encouraging.
  • Migraine Mix: A magnesium-based infusion for patients with chronic or intense headaches.

We’ve observed patients with malabsorption issues benefit more from these therapies than traditional pill-formed supplements. As we continue our research, the potential power of nutrient infusions grows every day. Join us.

Let’s see. No science? Check. Anecdotal evidence only? Check. Bogus claims of “personalization”? Check. Taking advantage of cancer patients to sell them snake oil.

Check:

It’s downright unethical and dishonest to claim that the “micronutrient” and “integrative medicine” woo that this patient was given in addition to her conventional cancer therapy will prolong her life.

Then, of course, there are more anecdotes, this time with the oft-quacked recommendation to eliminate dairy and start taking probiotics:

None of this is cheap, either. For instance, initial evaluations cost $450 and followup appointments cost $250. Then, of course, there’s the “executive brain health program,” in which a bunch of screening tests not shown to do any good are offered, along with a PET-MRI scan, which also has no good evidence supporting it as a screening test for neurological disorders. The cost? The basic program is a mere $2,500, but if you want the full program with the PET-MRI scan, you’ll pay a lot more, namely $$6,500. None of it’s covered by insurance:

Executive Brain Health is a fee-for-service program not covered by insurance. However, laboratory blood tests will be billed to your insurance and are subject to the terms of your policy. The cost of these is not reflected in the program fee. No other elements of the program are billable to insurers.

Yep, cash on the barrelhead. That’s what Thomas Jefferson University wants. That’s one reason why “integrative medicine” is such a thing among academic medical centers. I wish that it were the only reason, as greed and money are far more easy to deal with than ideology. Unfortunately, ideology is what we’re dealing with when it comes to “integrative medicine.” Indeed, as I’ve pointed out before, a lot of these integrative medicine centers don’t even make much money for the hospital and are more the product of rich donors than a genuine interest on the part of faculty.

Sadly, though, Thomas Jefferson University has started the process of doing what advocates of quackademic medicine have long sought to do. It’s created a full-fledged department of integrative medicine, co-equal to departments of real medical specialties, like surgery, medicine, pediatrics, etc. I fear that it won’t be long before other medical schools and academic medical centers follow suit and elevate their divisions, centers, and institutes of integrative medicine to full departments. I’m only surprised that UC-Irvine didn’t do it first, although it did do more damage simply because the Samuelis donated ten times the amount of money.

Also, naturopaths are coming to Thomas Jefferson University. I predict that it’s only a matter of time. Once you let some quackery in, it becomes increasingly difficult to justify not letting it all in.