UC-Irvine update: Quackademic medicine continues its takeover

I haven’t written about this particular atrocity against science and reason for over two years. Indeed, I had (mostly) forgotten about it. However, there was an update just this week that showed up in my Google Alerts for all things quackery. Also, Jan Bellamy took note as well, unfortunately before me. (I kid, I kid.) I’m referring to the University of California, Irvine (UC-Irvine). Regular readers might recall that, back in 2017, it was announced that Susan and Henry Samueli, a billionaire couple, were donating $200 million to UC-Irvine for the express purpose of…well, let me quote again UC-Irvine’s press release about the gift given that it’s been well over two years, the better to refresh your memory:

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.

It’s actually worse than it sounds, believe it or not. I’ll quote a little more to remind you of what I mean:

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.

As I said at the time, 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 like to lay down. As I’ve said so many times before and since then, 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.

Speaking of homeopathy, one of the worst things about the Samuelis is that they love homeopathy. Love it. No, seriously:

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.

The result of the Samuelis’ love of woo turned into a longstanding relationship between the Samuelis and UC-Irvine, in which they were frequent donors and demonstrated how agenda-driven billionaire owners can utterly corrupt the scientific mission of a medical school. What do I mean? Simple. In return for the Samuelis’ largesse, UC-Irvine embraced quackery wholeheartedly, up to and including The One Quackery To Rule Them All, homeopathy, although it did take some digging to find out just how far down the rabbit hole of homeopathy UC-Irvine has gone. In any case, it’s not for nothing that I described the situation as quackademic medicine reigning supreme at UC-Irvine. After all, a large part of the Samuelis’ gift will go towards “integrating” quackery into the curriculum of medical school there.

Now the gift is on the verge of coming to fruition, as this news story from Fierce Healthcare, University of California, Irvine to start construction on new 9-acre integrative medicine campus, last week shows:

The University of California, Irvine, will start construction this month on its new nine-acre campus that it says will be a national showcase for integrative medicine.

UCI will start construction on the $185 million Samueli College of Health Science complex, which will incorporate the university’s medical school.

Notice how this is phrased; The Samueli College of Health Science Complex will “incorporate the university’s medical school.” It’s as if the medical school is secondary to all the woo, an afterthought.

But let’s see what $180 million buys. According to the press release from the university:

The site – on the corner of Bison and California avenues adjacent to the UCI Research Park – will include a state-of-the-art, five-story-level, 108,200-square-foot building for the Susan and Henry Samueli College of Health Sciences and an adjoining four-story-level, 71,500-square-foot building for the Sue and Bill Gross School of Nursing.

The $185 million project also encompasses a 150-seat auditorium, a central courtyard that connects with the Gavin Herbert Eye Institute, landscape design elements that support activities such as yoga and tai chi, a Zen garden, and a 600-foot-long wellness walk that leads to the School of Medicine’s Biomedical Research Center. In addition, the health sciences building will house the Susan Samueli Integrative Health Institute, and the project includes a pad for a proposed School of Pharmacy & Pharmaceutical Sciences building.

“UCI is creating a national model for integrative health teaching, research and delivery,” said Chancellor Howard Gillman. “These two new buildings, part of our expanded health sciences campus, will ensure that our dedicated researchers and clinicians set a standard that, over time, other medical centers in the U.S. can follow.”

It certainly sounds swanky, but, damn, if that woo-speak from Chancellor Gillman isn’t irritating. In any event, I certainly hope that other medical centers don’t follow this standard. I’d be OK with swanky new buildings devoted to medical education and research, but leave out the pseudoscience and quackery.

Heck, even UC-Irvine seems a bit uneasy with the whole thing, if this aspect of the design is any indication:

The Susan Samueli Integrative Health Institute will have its own dedicated approach, entry and design, providing a distinctive experience and building a sense of community among patients and clinicians.

But wait! I thought that the whole idea was to seamlessly “integrate” the quackery with medicine. Here, by design, it appears that the SSIHI, although on the same campus, will be somewhat separate from the rest of the actual science-based institutions, such as the medical school, nursing school, and biomedical research center. Personally, if such a center had to be built, I’d have placed it somewhere far, far away from the main medical campus, where its pseudoscience couldn’t infect the rest of the biomedical research and education enterprise, but that’s just me. Still, one can’t help but wonder: Is this design element because the university, deep down on some level, knows that it’s erecting a monument to quackery and pseudoscience or rather because the “integrative” practitioners and advocates want their woo to stand out from the rest of the campus. Of course, another function of the separate entrance and design is so that the affluent worried well who make up so much of the customer base for “integrative” medicine will be able to avoid mixing with actual sick people as much as possible.

Design issues and questions aside, it’s worth noting how this whole thing came together. According to the press release, another billionaire couple Sue and Bill Gross (who apparently went through a bitter and bizarre divorce in 2017, spilling over well into 2018) donated $40 million in 2016 to establish a nursing school and assist in the construction of a new building to house it. (Bill Gross co-founded Pacific Investment Management Company, the largest global fixed income investment company, and Sue Gross has a successful real estate business). Together, they were known for their philanthropy (at least before their messy divorce). In 2017, Susan and Henry Samueli donated their $200 million, part of which was earmarked for construction of the integrative health center.

So what will be going on at this new “integrative health” campus? Certainly, the woo-speak is strong in the UC-Irvine press release, but it also invokes science, because of course it does:

The definition of integrative health and medicine is whole-person, patient-centered care that considers the factors that influence health, wellness and disease, including mind, body and spirit. It redefines the relationship between the practitioner and the 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.

“Optimal health and healing come from taking an integrative approach to healthcare that is patient-centered, science-based, transdisciplinary and team-delivered,” said Dr. Steve Goldstein, UCI vice chancellor for health affairs. “Moving from the status quo to improved care for our population requires an expanded focus to promote health and well-being and more effectively deliver healthcare using all evidence-based approaches across the lifespan. This health sciences complex will be at the epicenter of the transformation of the current healthcare system, as well as a site for research and the training of the next generation of healthcare professionals.”

Yeah, that’s kind of what I’m afraid of, that this new center will be at the epicenter for transforming medicine form science-based to a mixture of quackery- and science-based. I will repeat again, however, because it can’t be repeated enough times whenever verbiage like this is encountered from advocates of “integrative medicine”: It’s a false dilemma. The implication behind statements like the one above is that it’s an either/or issue. Either you embrace quackery or you can’t possibly take care of the “whole person” and focus on the “whole community.” Good science-based primary care physicians and practitioners do take care of the “whole person”! And they do it without embracing pseudoscience and quackery like homeopathy!

Make no mistake, too: UC-Irvine embraces quackery aplenty! Jann Bellamy catalogued the promises made at the time, in order to contrast them with what UC-Irvine actually does. I’ll borrow these quotes from Dr. Howard Federoff, the UC-Irvine’s vice chancellor for health affairs, for emphasis:

The teaching, research, and treatment funded via the Samueli endowment will be rigorously evidence-based.

We are not going to promulgate things that have been established to be ineffective.

There’s nothing I would ever allow in the context of clinical care if I believed the clinical evidence was lacking.

My promise [to the Samuelis] all along is that we will collect the best evidence.

Any non-proven or non-evidence based approach? We will not deploy it.

At the time, , UC-Irvine Medical School professor Dr. Jay Gargus was downright bristling with outrage that anyone (like myself) would have the temerity to say that UC-Irvine was embracing quackery and pushed back against the criticism, saying that the idea that the med school was going to become a home of “witchcraft” is “just not going to be the case . . . We’re only going to be doing evidenced-based medicine.”

Right. Let’s look at the SSIHI website. When I checked it out, the very first item in its news feed was a story about “electroacupuncture for hypertension,” with a link to acupuncture research. It’s a study by Dr. Shaista Malik, director of the Susan Samueli Center for Integrative Medicine looking at acupuncture to control blood pressure, and its description alone tells me it’s quackademic medicine writ large:

During needle stimulation, we have shown that sensory nerves located beneath acupoints send information to several regions in the brain that receive input from many other acupoints, as well as from visceral organs such as the stomach and gallbladder. For example, a balloon is distended in the stomach or an inflammatory chemical is applied to the gallbladder to simulate food ingestion or inflammation. During stimulation of these visceral organs, blood pressure is elevated. Nerves located under acupuncture points on the arm or leg that are stimulated by the acupuncture suppress the increased pressure, in part, because they cause the local release of endorphins and enkephalins, part of the brain’s opioid system.

These studies employ anatomical, pharmacological and physiological techniques to monitor activity in neurons in several areas of the brain and to dissect the neurotransmitter chemical signals, like opioids, that are responsible for the acupuncture-cardiovascular effect. We now know that these endorphins and enkephalins reduce the increased activity that is generated during stimulation of the visceral organ. Thus, these studies provide new information about how acupuncture works to lower blood pressure.

I can’t help but point out that Malik appears to be a true believer in acupuncture, having contributed some astoundingly stupid statements when the “new organ” that wasn’t was announced in the press, invoking the claimed organ known as the “interstitium” as a potential explanation for how acupuncture, Tai Chi, and yoga “work.”

Malik’s credulousness aside, the above study is an excellent example of the classic bait-and-switch of quackademic medicine research. First, “electroacupuncture” is not acupuncture. It’s the grafting of transcutaneous electrical nerve stimulation (TENS) with acupuncture. Acupuncture itself, as I and others have documented more times than I can remember, is nothing more than theatrical placebo, but TENS might have an effect. After all, it’s passing electricity through the body near nerves. Acupuncture enthusiasts combine the two and then graft acupuncture terminology onto the whole procedure, just as they did above. It’s all a big con to make people think that acupuncture is effective, when in reality if anything is found it’s the TENS that’s effective.

Let’s peruse some of the offerings of the SSIHI. Here’s a screenshot:

Wow!There’s some serious quackery there. Acupuncture is there, of course, complete with this description:

According to traditional Chinese medicine (TCM) theory, by stimulating acupuncture points, the flow of energy within the body is harmonized and health can be restored. The primary goal of acupuncture therapy is to restore the body’s balance. Conventional medicine refers to this balance as homeostasis.

Imbalances are common and can occur in one or more body systems. TCM associates these systems with organ names, such as liver, kidney, lung, and pericardium, whereas conventional medicine refers to these as the circulatory, nervous, musculoskeletal and endocrine systems. The mechanism underlying acupuncture’s effects are being explored and potentially include mediating autonomic nervous system signals.

Again, there’s nothing in human anatomy and physiology to link various organs to acupuncture points and meridians. The TCM view of the body is based on a prescientific understanding of how the body works. As for the whole “balance” thing, it never ceases to annoy me how quacks try to claim that what TCM means by “balance” is the same thing as homeostasis. No, what TCM means is more akin to imbalances between the four humors, except that it substitutes the five elements and adds imbalances between hot and cold, wet and dry, and the like.

Naturally (if you’ll excuse the term) there’s also naturopathy. I’ve explained more times than I can remember why naturopathy is quackery. Basically, naturopaths like to cosplay real doctors. Not surprisingly, where there’s naturopathy, there’s also functional medicine, and the functional medicine service includes a naturopath along with two real MDs. As I like to say, functional medicine combines the “worst of both worlds,” combining the tendency of conventional medicine to run too many tests of dubious value (while adding tests of zero value to the mix) and to overtreat the results of those tests with the rankest quackery of alternative medicine. As I like to say (with apologies to Mitchell and Webb), when when someone comes in with a vague sense of unease, or a touch of the nerves, or just more money than sense, functional medicine doctors are there for them with reams of useless and impossible-to-interpret lab results with a plan to correct each and every one of them in one hand, a huge invoice in the other. Functional medicine is quackery.

I could go on, but, damn, just look at UC-Irvine! It even offers IV vitamin therapies, including thiamine, riboflavin, niacinamide, dexpanthenol, pyridoxine, hydroxocobalmin, magnesium chloride, calcium gluconate, glutathione, and alpha-lipoic acid. Also, in case you’re wondering, UC-Irvine also offers—you guessed it!—high dose vitamin C—but only if “medically indicated,” we’re reassured. UC-Irvine claims these treatments are good for vitamin and mineral deficiencies (which is true, but rarely do such deficiencies require intravenous replenishment), fatigue (of course!), headaches, and immune disorders.

Sadly, this appears to be the way healthcare is going: “integrating” rank quackery with science-based medicine until patients (and even many doctors) won’t be able to tell the difference, and UC-Irvine is leading the way.