Respectful Insolence

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My Academic Woo Aggregator has become even more out of date. You remember my Academic Woo Aggregator, don’t you? It’s my list of medical schools and major academic medical centers in North America that have adopted what Dr. R.W. once so famously dubbed “quackademic medicine” in that they’ve created divsions, centers, or departments of “complementary and alternative medicine” (CAM) or “integrative medicine” (IM), in which pseudoscientific or mystical woo is “integrated” with scientific medicine in the mistaken belief that it will somehow improve patient care. Whether it’s for chasing money from the Bravewell Collaborative or the National Center for Complementary and Alternative Medicine (NCCAM) or whether it’s through a desire not to be “judgmental” taken to the level of an open-mindedness that leaves a real danger of brains falling out, these academic centers have decided that evil, reductionist, “cold,” “Western” medicine needs to be–shall we say?–supplemented with a heapin’ helpin’ of pseudoscientific woo. Worse, some really big names are there: Yale, Duke, Stanford, and Harvard. Clearly, going to an academic medical center is no longer an assurance that one will be treated with only the best science- and evidence-based medicine.

Add another one to the Woo Aggregator. Although this university is already in the Woo Aggregator, its entry needs a serious updating, because it looks as though it’s expanding its quackademic medicine offerings in a huge way. This time around, it looks as though the University of New Mexico is planning on going full throttle into the world of woo with its newly renamed Center for Life:

(AP) – Many academic health centers offer programs that include traditional Chinese treatments or Ayurvedic medicine from India. The University of New Mexico goes beyond that, says management of its new Center for Life.

“The uniqueness of our program is that we not only embrace Eastern and Western philosophies, but we try to integrate the traditions of New Mexico,” said Dr. Arti Prasad, the center’s director. Thus, Native American healers and Hispanic curanderas are invited to work with patients at the clinic.

Well, why not? If one’s going to embrace Eastern mysticism, why not bring in the Native American healers and Hispanic curanderas? I had never heard of a curandero (or curandera, if female) before; so I looked it up. It turns out that they are in essence shamans or traditional folk spiritual healers common in South and Central America. Their methods include a mish-mash of herbalism, ritualism, and various other “traditional” methods of healing. Wikipedia characterizes their methods thusly:

Curanderos treat ailments like espanto (Spanish for “shock”), empacho (Spanish for “surfeit”), susto (“fright”), mal aire (literally, “bad air”), and mal de ojo (“evil eye”) with religious rituals, ceremonial cleansing, and prayers.

Well, that certainly sounds scientific, doesn’t it?

Unfortunately, there is a dark side to curanderos, who have become mainstays in the care of illegal immigrants in the U.S., as alluded to in this article, :

While acknowledging some traditional treatments can complement modern medicine, they point out others do considerable harm. Powders used to quiet colicky babies, for instance, have been found to contain heavy doses of lead. Without legal status, the immigrants have little protection against dangerous or fraudulent practices.

And:

The healers, like their American counterparts, tend to specialize. There are hueseros, who set bones, and sobadors, who massage away pain. The curanderos use herbs and incantation to return the spirit to its equilibrium.

Farm workers, community leaders and health researchers said many immigrants devised their own antidotes. They brew recuperative teas from exotic herbs and roadside weeds. They enlist neighbors to inject them with vitamins and antibiotics from Mexico. Some of the medicines are sold under the counter at flea markets and botanicas, where amulets and incense share shelf space with Advil and Afrin.

Though the unlicensed sale of pharmaceuticals is not legal, and though some healers approach the edges of practicing medicine without a license, local police say enforcement of the laws is rare.

Yep, just the types of “healers” I want in my academic medical center! Is UNM going to check the background of the curanderos? What sort of standards are they going to insist upon? Most of all, I wonder if UNM will get a big grant from NCCAM to “study” whether their methods are effective. Overalll, this new initiative strikes me as little more than a cynical attempt to get more Hispanics coming to their clinic, given the high concentration of Hispanics in New Mexico. Truly, it’s woo taking advantage of local traditions!

Naturally, as they always do, the description of this new center of quackademic medicine is full of the stereotypical false dichotomies between “Eastern” and “Western” medicine:

Western medicine works to find disease early with such tests as mammograms, while Eastern medicine steps in earlier to try to prevent disease, she said. If there’s an imbalance in the body and a person becomes ill, Eastern medicine tries to get the body back in balance, she said.

This is, as I like to say, a load of fetid dingo’s kidneys. How, pray tell, does “Eastern medicine” step in to try to “prevent” disease? I’ve yet to see it. If I were a woman, when it comes to breast cancer, I’d take the mammogram over any “Eastern medicine” trying to prevent disease because by the time Eastern medicine realizes that a cancer is growing there it would be far larger and more difficult to treat than if found on a routine screening mammogram. As far as recommendations for diet and exercise, there’s nothing inherently “Eastern” about recommending healthy living practices.

Perusing the Center for Life website (which is fairly vague and minimal, by the way), I see that Dr. Prasad offers acupuncture, reiki, consultations with curanderos, cranio-sacral therapy (now that‘s some serious woo!), massage (if you want massage, go to a spa, I say), and traditional Chinese medicine. One bit truly caught my eye, though. It appears that the Center for Life offers something called “cosmetic acupuncture.” I hadn’t come across that modality before; so I did some Googling. Here’s what the American Cosmetic Acupuncture Association (yes, there really is such an organization) says about so-called acupuncture facial rejuvenation (AFR):

AFR can produce a surprising amount of improvement. Erasure of fine lines and mitigation of wrinkles can often be observed after the first several AFR sessions (normally, ten sessions are suggested, with monthly tune-ups). Puffiness and bags under the eyes can be lessened and jowls firmed. How is this achieved? There are various approaches. Some practitioners work primarily on the face, using acu-points that bring Qi and blood into the area. They will also stimulate acu-points on the body, points that activate specific internal organs. These organs, in turn, influence specific areas of the face and have the effect of lifting muscle, reducing edema, moisturizing skin and enhancing overall circulation.

Another AFR technique involves supplementing the above-mentioned acupuncture points with ones that stimulate facial muscle tonicity, thereby combining Eastern and Western therapeutic modalities. In both cases the AFR practitioner will probably insert super-thin needles into the wrinkled area and may even introduce an imperceptible electrical current. Facial massage and herbal cosmetic products are often included in AFR treatments, which last an hour or more.

While Acupuncture Facial Rejuvenation requires an extended commitment on the part of the patient, it promises a healthier body as well as a glowing face. Lungs, liver, spleen and kidneys are all fortified in an effort to invigorate the skin and its underlying structures. Consequently, patients often report feeling more energetic after their treatments. The process of AFR is one of inner transformation. During the course of treatments, patients will have learned about skin care, about their body’s nutritional requirements and, best of all, will have established a commitment to living more healthfully.

Other advocates of AFR go on and on about how Hollywood celebrities swear by it in their never-ending quest to remain youthful-appearing, as if the opinion of Hollywood celebrities has anything to do with science. (Remember, Jenny McCarthy is a Hollywood celebrity, and she’s into Indigo Child woo and serious antivaccine activism.) The glowing descriptions of cosmetic acupunture or AFR all contain testimonials of satisfied clients, but they do appear to lack one thing: Any scientific evidence at all that these modalities do one whit of good when it comes to one’s facial appearance. Indeed, this is the typical level of scientific discourse:

One of the modern pioneers of acupuncture facial rejuvenation is Mary Elizabeth Wakefield, L. Ac. Regarded widely as the dean of facial rejuvenation, she has trained over five hundred practitioners worldwide and maintains a busy practice in New York City. Her patented protocol, Constitutional Facial Renewalâ„¢, combines principles of Oriental Medicine with an advanced understanding of Western-based physiology. While some practitioners merely needle along wrinkles in an upward-and-outward fashion, Wakefield says, “That’s too simplistic. You must also work with underlying muscle structure.” The whole body, she notes, must be kept in the equation, since “anything you work with constitutionally shows on the face.” And so, when treating perimenopausal women, she says “we can work with hot flashes, we can work with imbalances in the system. During these sessions, they’re pleased to find they tend to lose weight.” It isn’t just women who flock to Wakefield’s door: men seek her help as well. “The job market is so competitive right now that they need to look younger. Those are the people who are getting the jobs.” Wakefield’s patients range from their late thirties well into their seventies. Often, she says, the older patients will look better surprisingly fast.

When I went to PubMed to look for any–oh–scientific articles to support these claims, oddly enough I couldn’t find any. Imagine that. Indeed, the entire rationale strikes me as dubious at best. Even if acupuncture actually tones facial muscles, that would actually have a tendency to make skin wrinkles look worse as the muscles tighten up and the skin sags further. As for claims that acupuncture produces collagen production, that’s probably true, given that needle holes are puncture wounds that need to heal, a process that involves collagen deposition, but that’s really nothing other than scarring, and the holes are so small it’s pretty darned unlikely that enough collagen would be produced to make a difference.

The bottom line is that UNM has gone headlong into quackademic medicine. Its Center for Life offers, as most such centers do, a mix of some sensible, science-based modalities (nutrition, for example), but it’s buried under a whole lot of unscientific mysticism (reiki and the curanderos, which come to think of it, would make a great name for a band), and rank pseudoscience (cosmetic acupuncture). It also reminds me once again: I really, really need to update my Academic Woo Aggregator, which hasn’t had a serious update since May.

Indeed, I have a request of my readers. Please peruse the Academic Woo Aggregator, and if there is an academic medical center with a center, division, or department of CAM or IM, please let me know. I’ll include them on the next update.

Comments

  1. #1 Scott
    August 20, 2008

    I’d wager that any studies of AFR would include the “herbal cosmetic products.” Then they’ll triumphantly attribute any improvement to the needling, and ignore the potential contribution from moisturizing, etc. due to the herbs.

    It would fit the typical pattern, anyway…

  2. #2 Gene
    August 20, 2008

    Orac,

    Is there a procedure for getting an institution off the woo aggregator? I was dismayed to find my alma mater (U. Penn) in the list, but the Office of Program Development (of which PENNCAM was a part) seems to have shut down, and the PENNCAM website has no current news or publications. How do we clear our name?

  3. #3 Orac
    August 20, 2008

    I’ll look into it. The University of Wisconsin’s Integrative Medicine site seems not to be functional at the moment, too.

  4. #4 D. C. Sessions
    August 20, 2008

    A useful reference to be sure, but it leaves us with a bit of a problem. Lacking any timeframe or severity indicators, we (the general public) are on our own to figure out whether someone proposing to fiddle with our very personal selves actually has been educated in medicine or has instead been required (e.g. per Georgetown) to master the wonders of homeopathy.

    Living in Arizona, I’ve had the “joy” of inquiring into whether a particular practitioner holds a recent degree from the home of Andrew Weil, and on one occasion let it be known that I’d prefer a real physician instead.

    Perhaps the practice will spread.

  5. #5 BB
    August 20, 2008

    The Olympics coverage included a story one evening on the wonders of accupuncture. Think that will lead to more quackupuncture at quackademic med centers? Sorry, I could not resist. But if you saw the story on NBC, you might have come away think that accupuncture is the cure for chronic pain and a safe alternative for anethesia.

  6. #6 Abel Pharmboy
    August 20, 2008

    Actually, the curandero culture is alive and well in the San Luis Valley of southcentral Colorado – see this and another 1988 paper by the same PI.

    But once again, quackademic programs are conflating woo with my scientifically legitimate area of natural products research. These herbs from Hispanic folk medicine are clearly worthy of pharmacological investigation.

  7. #7 Josh K
    August 20, 2008

    Lacking any timeframe or severity indicators, we (the general public) are on our own to figure out whether someone proposing to fiddle with our very personal selves actually has been educated in medicine or has instead been required (e.g. per Georgetown) to master the wonders of homeopathy.

    The problem isn’t that simple. For example, if you are trying to get help with addiction, as I am, you find that woo is horribly, horribly entrenched in the field. It is entrenched to such an extent that I hesitate to comment about it on a blog advocating science based medicine.

    Every school of thought I’ve encountered in the field of addiction states with a straight face some pretty outrageous recovery rates that, frankly, just don’t jive with either my direct observations or the statistics I’ve been able to review myself.

    Treatment seems to be either a cocktail of religion (I was in a 30 day program run by licensed physicians who stated that recovery from addiction was predicated by having a ‘religious experience'; the entire program was built around that concept), or a shotgun of varying, often contadictory concepts…and a heavy, heavy dose of woo.

    There are a few candles in the dark (Albert Ellis, Stanton Peele, et al) and they seem to be gaining some traction (REBT, CBT, etc) but the “addiction is a spiritual disease” meme is *huge* in the field. The prevailing school of thought still is, if treatment didn’t work, the answer is more of that same treatment…not a search for other treatment options.

    Sorry for the rant; it’s been very frustrating couple of decades. In particular, blaming the patient for treatment failure and an unwillingness to work with the patient to find a treatment option that will actually work have been, for me, incredibly frustrating.

    Personally, I find the most useful thing to be references such as Carroll’s Skeptic’s Dictionary and Barrett’s Quackwatch. Far from foolproof, but a good list of questionable procedures and medical theories.

  8. #8 marcia
    August 20, 2008

    They will flounder in a bad economy and the practitioners will spend all their free time drumming up business. They’ll hand out cards to clients to pass out to their friends. The clients will see this for what it is.

    Here’s a link that made me smile, (And, it wasn’t because someone needled my heart meridian.)

    http://www.mlive.com/grpress/business/index.ssf/2008/08/saint_marys_trims_alternative.html

  9. #9 Gun Nguyen
    August 20, 2008

    So, are there any medical schools left that explicitly do not subscribe to CAM woo? I mean, it’s one thing to bitch about it, but how about actively encouraging prospective medical students to embrace a science-based perspective by only looking at schools that reject this anti-scientific nonsense?

  10. #10 Nana FCD
    August 20, 2008

    Check out dcscience.net latest post about Yale lawyers pulling his youtube video and a positive response from Yale.

  11. #11 natural cynic
    August 20, 2008

    for a real ball of curandero or brujo woo, you should go to Carlos Castaneda and his works The teachings of Don Juan, A Yaqui way of Knowledge and following volumes. Probably the greatest [non-political] hoax of the 1970’s.

  12. #12 MH
    August 21, 2008

    Thought you might be interested in this story:

    Pastor Michael Guglielmucci spun gospel of lies.

  13. #13 Phoenix Woman
    August 21, 2008

    Somewhat O/T, but you or your readers who peruse publications owned by Village Voice Media will want to comment on this article about the alleged autism epidemic in Minnesota, which supposedly has the highest autism diagnosis rates in the country (one likely reason for which is, as the Minnesota Department of Health’s Judy Punyko points out, because state standards for autism diagnosis vary considerably).

    Yes, I know that Minnesota is the article’s focus, but VVM publications are spread all over the country.

  14. #14 Natalie
    August 21, 2008

    Phoenix Woman, I read that article in the City Pages (the Twin Cities free weekly that’s part of the VVM conglomerate) and it was incredibly frustrating. In an entire tabloid page they managed to say essentially nothing, while implying that the “vaccines cause autism” hypothesis is somehow plausible. At no point was it suggested that the reason autism diagnosis rates here are higher is because we are a relatively liberal state with a lot of state-provided social services, meaning more opportunities for autistic kids to be entered in the system.

  15. #15 Phoenix Woman
    August 21, 2008

    Natalie: Yup. Since the VV media empire is vast and since stuff printed in one VVM publication often gets recycled into other VVM pubs, I figured that it would rate bringing to Orac’s attention as it’s very likely going to go national.

  16. #16 Natalie
    August 21, 2008

    That’s frustrating. I often like the City Pages, but they really screwed up royal on this one.

  17. #17 Jacob Wintersmith
    August 21, 2008

    When I moved to Albuquerque, I was quite astonished at just how deeply this city has drank of the cool-aid. Grocery stores sell homeopathy products, psychics abound, and astrology maintains a hip image. Based on my own informal observations, I’d say that “alternative” medical practitioners outnumber the science-based ones. Really, I’m surprised UNM stayed off your list of infamy this long.

    I’m informed, however, that Santa Fe is the true center of woo, and makes Albuquerque look like a bunch of hard-nosed rationalists by comparison.

  18. #18 Dr. T
    August 21, 2008

    It might be less painful and more productive to list academic medicine institutions that have avoided or even disparaged woo. Readers could send them thank you messages for holding the line against quackery.

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