Top US hospitals aggressively promoting alternative medicine offerings – Should prestigious hospitals promote unproven alternative medicine? – Stat News – Mar 2017
They’re among the nation’s premier medical centers, at the leading edge of scientific research. Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing.
- “energy healing” to help treat multiple sclerosis,
- acupuncture for infertility, and
- homeopathic bee venom for fibromyalgia.
- A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)
This embrace of alternative medicine has been building for years. But a STAT examination of 15 academic research centers across the US underscores just how deeply these therapies have become embedded in prestigious hospitals and medical schools.
And they’re promoting such treatments for a wide array of conditions, including depression, heart disease, cancer, and chronic pain.
Duke even markets a pediatric program that suggests on its website that alternative medicine, including “detoxification programs” and “botanical medicines,” can help children with conditions ranging from autism to asthma to ADHD.
“We’ve become witch doctors,”
said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine.
the University of Arizona, a pioneer in the field, received a $1 million gift to boost practitioner training in natural and spiritual healing techniques.
Even as they count on these programs to bring in patients and revenue, several hospitals were reluctant to talk to STAT about why they’re lending their distinguished names to unproven therapies.
Duke Health declined repeated requests for interviews about its rapidly growing integrative medicine center, which charges patients $1,800 a year just for a basic membership, with acupuncture and other treatments billed separately.
MedStar Georgetown quietly edited its website, citing changes to its clinical offerings, after a reporter asked why it listed the energy healing practice of reiki as a therapy for blood cancer.
Cleveland Clinic struggled to find anyone on its staff to defend the hospital’s energy medicine program, ultimately issuing a statement that it’s “responding to the needs of our patients and patient demand.”
And the director of an alternative medicine program at another prestigious hospital declined to speak on the record — out of fear, he said, that his remarks would be construed as “fake news” and stir a backlash.
By promoting such therapies, Novella said, physicians are forfeiting “any claim that we had to being a science-based profession.”
As for patients? They’re “being snookered,” he said.
The counterargument: Modern medicine clearly can’t cure everyone. It fails a great many patients.
So why not encourage them to try an ancient Indian remedy or a spiritual healing technique that’s unlikely to cause harm — and may provide some relief, if only from the placebo effect?
I believe patients should try any treatments that they think might be helpful because the wide variety of our genome means that some patients might be helped by some treatment at some time, which is not insignificant if you are the one patient helped by an unscientific treatment.
A gastroenterologist, Lee runs the Johns Hopkins Integrative Medicine and Digestive Center, which offers acupuncture, massage therapy, and reiki — a therapy that the center’s website describes as laying on hands “to transmit Universal Life Energy” to the patient.
Again, I have heard stories of such treatments helping some people for some conditions with some practitioners at some time in their lives.
But this is a far cry from allopathic medicine, which provides much more reliable and more proven treatments with better success.
Lee and others who promote alternative therapies are careful to say that they can supplement — but can’t replace — conventional treatments. And they make a point of coordinating care with other doctors so that, for instance, patients don’t get prescribed herbal supplements that might interact badly with their chemotherapy.
“Here at UF, we do not have alternative medicine. We do not have complementary medicine. We have integrative medicine,” said Dr. Irene Estores, medical director of the integrative medicine program at the University of Florida Shands Hospital in Gainesville, Fla.
Duke’s Integrative Medicine store, for instance, sells “Po Chai Pills” that are touted on the hospital’s website as a cure for everything from belching to hangovers to headaches.
The site explains that taking a pill “harmonizes the stomach, stems counterflow ascent of stomach qi, dispels damp, dispels pathogenic factors, subdues yang, relieves pain.” None of that makes sense in modern biomedical terms.
Novella gets alarmed when he sees top-tier hospitals backing therapies with scant evidence behind them.
“Patients only want [alternative medicine] because they’re being told they should want it. They see a prestigious hospital is offering it, so they think it’s legitimate,” said Novella.
“The perpetuation of these practices is a victory of marketing over truth,” said Steven Salzberg, a biomedical engineer at Johns Hopkins who lectures in the medical school. If a hospital is “offering treatment that’s based on fantasy, it undermines the credibility of the institution.”
A booming market for ‘natural’ therapies
There’s no question that patients want alternative medicine. It’s a $37 billion-a-year business.
A national consortium to promote integrative health now counts more than 70 academic centers and health systems as members, up from eight in 1999.
In most cases, insurers won’t cover alternative therapies — there’s simply not enough evidence that they actually work — so patients pay out of pocket: $85 for acupuncture, $100 for reiki, $38 for pills made from thyme and oregano oils that promise to “harmonize digestive and respiratory function.”
If they failed to offer “natural” therapies, some hospital executives fear they would lose a chance to attract patients who need more lucrative care, such as orthopedic surgeries or cancer treatments.
“The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. Customers have demands. Your job is to sell them what they want,” said Arthur Caplan, a bioethicist at New York University’s medical school.
The transformation of “patient care” into “customer care” is completely corrupting our medical system. Running healthcare like a business leads to following whatever trends consumers are willing to spend money on.
In too many cases, a doctor’s judgment and advice no longer have the authority to override a patient’s (or caregivers) desires. This has provided an excuse for politicians and law-enforcement to step in as arbiters of what’s right for every single patient.
If teachers, who are paid to criticize and tell students things they don’t want to hear, adopted such a “customer service” attitude, they would never deduct points, tell students they are wrong, or give anything but straight A’s.
Too often, he said, the attitude is, “We’re damn well going to do it if the guys down the street are doing it.”
Duke University’s integrative medicine clinic, a stunning space with arching wood ceilings and an indoor garden, has seen strong growth: Total visits jumped 50 percent in 2015, to more than 14,000, Dr. Adam Perlman, the executive director, told IntegrativePractitioner.com10. (He declined to talk to STAT.)
The center’s membership count also jumped, up 25 percent to 885, Perlman said. If all members paid the list price, that would bring in more than $1 million a year just for primary care.
It’s the alternative therapies promoted as a way to treat disease that raise eyebrows.
‘Energy healing’ takes root
Despite their deep wells of medical expertise, many top hospitals are offering to help treat serious medical problems with reiki — a practice based on the belief that lightly touching patients can unleash a cosmic energy flow that will heal them naturally.
So, where’s the evidence supporting it?
There is none, according to a division of the National Institutes of Health that funds research into alternative medicines.
It says the practice has not been shown to be useful for “any health-related purpose” — and adds that there is no scientific evidence that the “natural healing energy” it’s based on even exists.
Academic medical centers often boast that they’re more rigorous in evaluating alternative therapies — and weeding out scams — than a for-profit wellness center might be.
But that evidence isn’t always rigorous.
The University of Florida, for instance, is using Facebook to advertise a herbal medicine workshop for providers and the public that promises to answer questions including, “How can we stabilize or reverse Alzheimer’s disease?”
‘It’s not black and white’
Perhaps the most prevalent alternative treatment STAT found on offer is acupuncture. It’s promoted for more than a dozen conditions, including high blood pressure, sinus problems, infertility, migraines, and digestive irregularities.
A 3,000-year-old Chinese therapy, acupuncture is based on the belief that by stimulating certain points on the body, most often with needles, practitioners can unlock a natural healing energy that flows through the body’s “meridians.”
Research suggests it helps with certain pain conditions and might help prevent migraine headaches — but it also suggests that the placebo effect may play an important role.
But the Centers for Medicare and Medicaid Services won’t pay for acupuncture, dismissing the scientific evidence as insufficient.
He said, for example, that he used to avoid referring patients for acupuncture, until he saw the benefit it provided to some of them.
“I have seen it work in some chronic pain situations,” said Lang. “It can be very helpful. If it doesn’t work, I don’t know that you’ve lost anything. If it does, you do get to a better place.”
Yes, all these therapies are supported by anecdotes, and I believe they may be worth a try, but they should not be offered in a way that makes them seem on par with standard medical treatments.
And while the evidence of its efficacy is not ironclad, neither is the evidence for various pharmaceutical therapies that are routinely provided by hospitals and covered by insurance. Some of those solutions, such as opioids to treat pain, have resulted in addiction and harm to patients.
The above is an excellent point.
Plus research data is often manipulated to show what researchers want it to show (like the CDC guidelines), so even scientifically proven therapies aren’t always effective.
“We do use things that aren’t necessarily 100 percent evidence-based, but I would argue that’s also true within all of medicine,” said Dr. Jill Schneiderhan, co-director of the University of Michigan’s integrative family medicine program.
“I feel like it’s not black and white.”
This is always true in real life.
Too many doctors jump on “scientific evidence” as though it contained the great truths of life when it’s actually just our “best guess” at the moment.
When knowledge and science advance further, today’s scientific conclusions may later be disproven, just like we are disproving many beliefs that were thought “scientifically proven” in past ages.