Respectful Insolence

$37 million.

If you were a medical school dean or a hospital administrator and had $37 million for a project, how woud you use it? What would you build? What would you renovate? What research projects would you fund? What infrastructure improvements would you make? Yes, $37 million is a lot of green. Back at my old job, if memory serves me correctly, a whole new addition to the cancer center that nearly tripled its square footage cost somewhere in the range of $35-40 million. True, that was nearly ten years ago; so building the same building might now cost more than $37 million. My point remains, though. You can do a lot of good for a lot of people with $37 million. If you are part of the administration of a medical school or academic medical center, you could fund some major infrastructure improvements with $37 million.

Look at it this way. Imagine that you’re rich and have millions of dollars to throw around, $37 million, to be precise. You want to help a hospital and/or medical school. What would you do with the money? To which medical school or hospital would you give it? For what purpose? What would be your goals? For example, $37 million could fund close to 20 R01-level grants for R01-level research projects, for instance. Or, if you as a donor were so inclined, you could divvy up the money into finer chunks and let the medical school use it for startup packages, which typically range from $250,000 to $1,000,000 (but can be much more for “superstars”), to be used to recruit top research talent, who would bring exciting science (not to mention their grants) to the institution. If those research projects were good science, a lot of useful discoveries could be had for $37 million. Or you could use it to fund scholarships, so that students could attend medical school without going $200,000 into debt. You could mint a lot of new doctors that way.

Or, if you’re Bernard and Barbro Osher and the school is the University of California at San Francisco, you could use the $37 million to expand the “integrative” medical offerings there, and if you’re the administration of UCSF you could snap up the money and build a towering monument to quackademic medicine in the form of the UCSF Osher Center for Integrative Medicine:

UCSF’s center for integrative medicine has opened the doors of its new home at the UCSF Mount Zion campus. The UCSF Osher Center for Integrative Medicine offers the best of modern medicine with established healing practices from around the world, and is a major hub of research, education and patient care in integrative medicine.

The new Osher building underscores UCSF’s commitment to increasing access to integrative medicine and making it a larger part of the treatment relationship between medical caregivers and patients. It is the first center of its kind to offer fully developed programs in research, clinical care and education for health care professionals, practitioners and patients seeking an integrated, healing-oriented approach to health.

Oh, goody. More and spiffier space for “integrating” pseudoscience with science-based medicine. Just what we need. But let’s see what the Osher Center will be offering those in San Francisco who might be woo-inclined:

The center provides treatment, wellness and prevention programs for adults and children in areas including cancer, chronic pain and women’s health. Physicians and therapists are trained in general integrative medicine, integrative oncology, integrative psychiatry, Traditional Chinese Medicine, Ayurveda (a traditional healing science from India), mindfulness meditation, and manual therapies such as physical therapy and breath work.

The building includes spaces not usually found in conventional medical clinics or academic institutions, such as:

  • Group rooms for yoga and tai chi instruction;
  • Quiet areas for meditation and reflection;
  • The Takahashi Japanese Meditative Garden, accented with Japanese maples;
  • Treatment rooms for acupuncture, massage therapy, biofeedback and mind-body awareness;
  • Air conditioning that uses 100 percent outside air; and
  • Sustainable building materials like bamboo and recycled-content carpet.

The facility enables all of the center’s programs and its 80 scientists, faculty and staff to be housed under one roof, with room to grow over time.

Much is also made of how the interior features “natural light, fresh air, and simply organized spaces,” as well as how the building’s “size and exterior, veneered in brick and wood resin materials, were designed to be responsive to the surrounding neighborhood, and the construction involved sustainable building practices that received LEED Silver certification from the United States Green Building Council.” I love how not only have the architects designed this building for woo, but have made it environmentally friendly, something particularly amusing when one considers how many animals are endangered by the trade in alt-med remedies like rhino’s horn and bear bile. But that’s just the nasty cynic in me. Bad cynic! Nasty cynic! The good people of the Osher Center are so much better than you because not only are they in tune with their mind and body but they’re eco-friendly!

But let’s get back to the services. “Integrative oncology”? Quackademic medicine victorious! “Integrative medicine”? Integrating quackery with science-based medicine, something I whose advantage over–oh, you know–medicine I could never figure out. Not that the Osher Center doesn’t try to explain it. Check out this video that the Osher Center uses for fundraising (sorry, I couldn’t figure out how to embed it). It’s loaded with the usual claims that somehow “integrative” medicine is all about “prevention”; a truly nauseating bit about how “you” are so distinct and “you” know your body better than anyone else (the latter of which is true to a point, but that doesn’t mean you have a clue about how your body works or what represents a good treatment for it, although it does seem a custom-tailored appeal to placebo medicine); and a part about how at the Osher Center the “vested interest of the status quo is being challenged.” Of course, this video does confirm a sneaking suspicion I’ve always had, namely that much of alt-med is about self-absorption. In any case, here’s a hint: Challenging the status quo can be good, but not when the alternative offered is more faith-based than science-based.

If you want to see the sorts of nonsense the Osher Center is peddling, there’s no better place to see it than straight from the proverbial horse’s mouth. Here’s the UCSF Guide to Integrative Medicine, 2009 Edition, linked to from the Osher Center website. I think I’ll go through and make like an integrative medicine doctor and cherry pick a few choice quotes from this guide, the better to show how complete the infiltration of quackademic medicine has become at UCSF. I’ll start with what I always start with as a litmus test of just how deluded an alt-med advocate is, homeopathy. Any publication that says anything other than that homeopathy is pseudoscience, impossible, doesn’t work, etc., fails the test, and boy does the UCSF guide fail the test:

Dr. Hahnemann first formulated his principle of the Law of Similars after testing quinine, a cure for malaria. He found that it produced the symptoms of malaria in a healthy individual. However, when he discontinued the quinine, the symptoms disappeared. After several similar studies, Hahnemann found that very small doses of the substance are nontoxic and yet still work to produce the desired symptoms of the illness in healthy individuals. Homeopathic remedies are therefore diluted to different degrees so that only essences of the original substance are present. Often chemical testing will show no presence of the active ingredient. This, however, is consistent with the homeopathic philosophical belief that the ingredient leaves an imprint on the remedy and it is this “ghost” print that acts within the body, 4,6.

In other words, homeopathy is water, but it’s a ghost of a memory in the water of the original substance that gives homeopathy’s magic water its mojo. OK, OK, you say. But this is just a description of what homeopaths believe, right? Well, yes, but get a load of what the UCSF guide says about the clinical evidence for homeopathy:

The effectiveness of homeopathy has been disputed since its inception. While there are patients who swear that homeopathic medicine cured them, skeptics attribute successful outcomes to preconceptions and a placebo effect. Several clinical trials failed to find differences between remedies and placebos. For example, a study of the efficacy of homeopathic A. nitricum 12X (diluted in a one-to-ten ingredient- to- alcohol/water ratio twelve successive times) in test anxiety concluded that the substance had no effect.1 Another study found that although use of homeopathic remedies did not differ from placebo in treating anxiety disorder, both showed a substantial reduction in anxiety.2 Other trials have found homeopathic remedies to be effective, including one involving patients undergoing hemodialysis in which pruritis was found to be significantly reduced through homeopathic treatment. 3 Overall there is a need for more clinical research in this area.

No. There. Is. Not.

Homeopathy is water. There’s no active substance left in homeopathic dilutions greater than at most 12C. How many times does this have to be repeated? It is to UCSF’s eternal shame that it publishes such wishy-washing pablum that gives credence to the principles upon which homeopathy is based.

Let’s zip on down to another modality that I like to examine as another litmust test to see if a source is reliable. This time, let’s look at reflexology, which, as you recall, is the treatment system whereby it is claimed that every organ and body part maps to some part of the foot or hand and that massaging the foot or hand in the correct area can thus treat that organ. Feels nice? Probably. Treats any disease? Unless it’s something that can be treated by a glorified foot massage, not so much. I challenge you to go to p. 39 in the guide and read the two-page section on reflexology. Go on. I’ll wait. Then come back here. What do you think? Have you seen such a credulous load of nonsense in your life? No? Then read the section on reiki:

Ki refers to the life force or free energy that flows through all living organisms. Ki passes through chakras and meridians to nourish the body and support cells and organs in their fundamental functions. When this flow of life force is disrupted, it causes diminished function in one or more of the organs and tissues of the physical body. A restricted life force leads to compromised immunity and susceptibility to illness, as well as associated emotional distress. The body heals with ease when the life force is uninterrupted. Reiki heals by raising the vibratory level of the energy field in and around the physical body, causing negative thoughts and feelings to break apart and clearing the energy pathways, resulting in a healthy and natural flow of life force.

That’s right. An official publication of UCSF is speaking favorably of a modality that is nothing more than faith healing that substitutes Eastern mysticism for Christianity as the faith that underlies it. Instead of channeling the healing power of god, reiki practitioners claim to be channeling the healing power of the “universal source” through themselves and into patients. Personally, I fail to see much of a distinction between the two. To believers, both are some sort of universal spirit; the main difference is the name and how Christians attribute a much more personal nature to their god, as compared to the much more aloof energy-like nature of the reiki god.

But if there’s one section that disturbs the hell out of me, it’s the section on cancer therapies:

Many different types of complementary and alternative cancer therapies exist. These therapies are frequently incorporated into standard cancer treatment plans for patients in Europe and other parts of the world but are less commonly prescribed by medical professionals in the United States, possibly due to the relative lack of formal CAM training in U.S. medical schools. The most common complementary therapies include meditation and relaxation, acupuncture, massage, dietary treatment, herbal medicine, hypnotherapy, homeopathy, megadose vitamins, ozone therapy, therapeutic touch, bromelain, and spiritual healing. Currently used alternative therapies include antineoplastons, metabolic therapy, shark cartilage, botanical and herbal medicine, and immunoaugmentive regimens.

Alternative therapies may be dangerous because they are often unproven and administered in lieu of traditional treatment such as chemotherapy or radiation. Using alternative therapies instead of conventional treatment for highly curable, early-stage cancers is not recommended.

CAM therapies are also considered useful approaches to recurrence, metastatic cancers, and secondary cancers.

Uh, no. There’s no evidence I’m aware of that CAM therapies are considered useful approaches to recurrence, metastastic disease, or secondary cancers. Similarly, although it’s good that UCSF mentions that CAM treatments for cancer are dangerous when used instead of science-based treatments. It’s bad that UCSF lumps all this pseudoscience in with its list of CAM therapies. Even worse is this video, which advocates the use of traditional Chinese medicine for breast cancer:

It’s all right there, including tongue diagnosis, pulse diagnosis, and moxibustion. That’s right, here we have an acupuncturist working for UCSF Osher Center, peddling the pseudoscience that is TCM. If that ain’t quackademic medicine, I don’t know what is. As well it should be, given that UCSF has some heavy hitters in the world of quackademic woo, such as Dr. Donald Abrams, who is currently the president of the Society for Integrative Oncology.

Sadly, this is the way medicine is continuing to go. On Education page, the Osher Center provides a big “Did you know?” that asks:

Did you Know? Just ten years ago, integrative medicine content was not required at medical schools.

Today, UCSF is a leader in both required and elective curricula in integrative medicine for health professional students, as well as residents and fellows.

To me, that’s exactly the problem. We had it right ten years ago. We don’t now. Quackademic medicine is on the ascent. I worry about this, too, given that I’m not getting any younger these days. All I can say is that, when I’m 80, if I see a young punk doctor coming at me with herbs, reiki gestures, or acupuncture needles, I’ll show him what he can do with his needles. Either that, or I’ll make like Frank Zappa and:

I wrapped a newspaper ’round my head
So I’d look like I was Deep
I said some Mumbo Jumbos then
An’ told him he was goin’ to sleep
I robbed his rings
An’ pocket watch
An’ everything else I found
I had that sucker hypnotized
He couldn’t even make a sound
I proceeded to tell him his future then
As long as he was hanging around,
I said
“The price of meat has just gone up
An’ yer ol’ lady has just gone dow

And for good measure, here’s the real thing. Why? Because I’ll use any excuse to lay down a Frank Zappa video:

Sadly, the real cosmik debris is embedding itself in our medical schools and academic medical centers. I feel really sorry for medical students and residents who are science-minded. What do you do if you’re in medical school and some TCM practitioner is talking to you about moxibustion and tongue diagnosis as though they were scientifically established? Or if a naturopath starts spewing prescientific vitalistic pseudoscience? Or if a reiki practitioner starts talking about channeling “energy” from the “universal source”? Yet these very things are going on in schools like UCSF across the country and even around the world.

I fear for the future of medicine.

Comments

  1. #1 sharon
    February 17, 2011

    A glimpse into the near future?

  2. #2 sharon
    February 17, 2011

    Bugger link Fail.
    Try again.

    http://www.youtube.com/watch?v=HMGIbOGu8q0

  3. #3 prn
    February 17, 2011

    WSL: “because that’s where the money is.”
    Who said the academics were senseless?

    most common complementary therapies include…dietary treatment,… alternative therapies include… botanical and herbal medicine, and immunoaugmentive regimens …There’s no evidence I’m aware of that CAM therapies are considered useful approaches to recurrence, metastastic disease, or secondary cancers.
    The MD-PhDs from other countries, published data in hand, might beg to disagree somewhere in there. At least, on survival and quality of life using what is CAM in the US.

  4. #4 Lawrence
    February 17, 2011

    There may come a time, perhaps in the very near future, that common medical practice becomes so watered-down with this type of “woo” – (hey, they’re teaching it in medical schools now, right?) that standard care will no longer be able to compensate for people demanding “alternative” treatments inside regular medical facilities.

    What I mean, if someone pursues woo at the same time they undergo conventional therapy, there is a very good chance today that the conventional therapy will win out (but the individual will also credit the woo for saving them).

    When enough doctors have bought into the “alternative” practice, the scales will tip & there won’t be the emphasis on conventional – which will result in more deaths and disabilities.

    If this does happen & there is finally a large enough backlash against these so-called “alternative practices” i.e. lots of big malpractice lawsuits, it may take years to correct the problem (given the kind of retraining that would be necessary to cull out the woo-practices and get the doctors back to what they should be doing).

    In the end, I still think this is all about money. Doctors will be able to charge whatever they want for these “alternative practices” because they aren’t regulated or cost-shifted by the insurance companies. They get push-back on all conventional treatments & costs (just look at your benefits statements if you don’t believe me), while these other alternative treatments don’t fall under the current actuarial tables (aren’t covered) and patients pay cash.

    For a practice that may be losing significant profit margins to continual insurance cost restrictions, adding acupuncture, yoga, & homeopathy is a very low-cost, high margin way to make lots more money from very gullible patients.

    Unfortunately, at the end of the day, it can only result in much worse medical results for their patients.

    I hope this wasn’t too rambling – its early & this kind of woo-appreciation by any medical establishment ticks me off to no end.

  5. #5 Reading Frame
    February 17, 2011

    This. Is. Utterly. Disgusting.

    Even more so because it is in my backyard.

    Medical schools have pledged to up enrollment by 20% in the next five years. If this is how they are using their funds and how they are training their students, maybe they shouldn’t bother.

    How about using that bit of extra scratch to, say, train more primary care doctors and nurses to deal with the shortfall we anticipate in the next 10 years?

    In that vein I wrote an article on the triple whammy of tort, low salaries, and health care reform on primary care doctors. I’d love some feedback. http://reading-frame.blogspot.com/2011/02/primary-care-shortages-malpractice-and.html

    I wish there was some venue by which I could protest this.

  6. #6 Paul Browne
    February 17, 2011

    That is very disappointing, it’s hard to believe that this is the same UCSF where Shinya Yamanaka has been pushing the frontiers of regenerative medicine http://speakingofresearch.com/2009/10/06/nobel-prize-time-again-and-the-laskers-too/

    At some point in the not so very far future the scientific medical community is going to regret the tolerance it has shown to quackademic medicine.

  7. #7 David
    February 17, 2011

    $37M builds the building, but doesn’t necessarily staff it. Now UCSF will have to use general funds to pay the salaries to operate the building, and pay for the salaries of the quacks. That’s one of the problems with directed donations – they obligate the institution going forward to spend operating funds in a certain way.

    Oh, wait. I know how to pay the salaries of the quacks. Put $1 in a jar, and add some water. Transfer that water to 10 other jars, and start diluting…

  8. #8 LW
    February 17, 2011

    I was enthralled by the explanation of homeopathy:

    “He found that [quinine] produced the symptoms of malaria in a healthy individual. However, when he discontinued the quinine, the symptoms disappeared.” Deep, deep insight: quinine makes you sick, but when you stop taking it, it doesn’t make you sick anymore!

    “After several similar studies, Hahnemann found that very small doses of the substance are nontoxic and yet still work to produce the desired symptoms of the illness in healthy individuals.” “Desired symptoms” would mean “being sick”, right? Doses that make you sick are not nontoxic.

    Homeopathy is so incredibly stupid that I simply cannot grasp the fact that it is believed by anyone intelligent enough to take a bath without drowning.

  9. #9 timothy
    February 17, 2011

    author makes some valid points,but painting It All with one broad brush is no more fair than claiming that only Western civilized medicine is the best and only approach. Only alittle over a century or so ago had you told someone that a bacilli was causing an infection,i.e.,something not seen but believed to exist,you would be roundly pasted as a no-nothing…not so long ago,some people believed if you took a horsehair,put in in a bottle of alcohol,the next day a snake would have taken the hair’s place… and even in Western Medicine, the exhalted can be full of it,and the quack appears more often than thought. I say YES to expanding in new horizons…perhaps 100 yrs or so from now, people will look at not the alt medicine purveyors and laugh,but at the old school guard that refused to consider the potential and possibility that we dont know all we thought we knew,from a Western Civ approach.

  10. #10 Lawrence
    February 17, 2011

    Timothy – you paint the whole “Western Civ vs. Eastern Civ” falsehood again. Many of the “so-called” Eastern medical practices were actually first developed in places like Germany & acupuncture (as it exists today) was developed by Mao during the Cultural Revolution.

    There isn’t western medicine vs. eastern medicine – doctors around the world practice the same medicine. It really comes down to what works vs. what’s fiction.

  11. #11 Not House
    February 17, 2011

    @Timothy

    “Western Civilized Medicine” as you call it (or, medicine, as we like to think of it), is the best medicine, not because we say so, but because the evidence says so. That’s the key difference between what we use now, and what the convention was a century ago (where people just took in on a doctor’s authority how to treat someone).

    This isn’t expanding new horizons; all it is is stepping backwards.

  12. #12 Jean Hoagland
    February 17, 2011

    It is sad when these articles are written from someone’s opinion and they do not do their research first. Go to http://www.nationalcenterforhomeopathy.org for research information and then do some open minded thinking.

  13. #13 Poodle Stomper
    February 17, 2011

    Lady in the video says something along the lines of “Now you can have your oncologist and herbalist sit together and communicate…” F*ck the herbalist. If I have cancer I’m going to an oncologist that actually knows what the hell they’re doing. I couldn’t even watch the whole video for fear of vomiting. If lower income people turn to CAM-crap because they can’t afford real medicine then the solution would be to somehow lower the cost of medicine to them, not to bring woo into the hospital to suck more of their money out. GAH!

  14. #14 Mephistopheles O'Brien
    February 17, 2011

    Timothy,
    1. Orac uses “one broad brush” because the center he talks about appears to use one broad brush. It lumps a large number of proven, unproven, and disproven things into a single center without, at first glance, distinguishing between them.
    2. I, for one, am willing to believe any claim provided it is backed by evidence of sufficient quality.
    3. “Bacilli” is plural.

  15. #15 In Vitro Infidelium
    February 17, 2011

    “Sadly, the real cosmik debris is embedding itself in our medical schools and academic medical centers.”

    And not only in the guise of the complementary, but also in the cloak of the more pernicious ‘partial’, where invented quasi science is being located to take advantage of ‘locational legitimacy’ to more effectively bid for research funding:

    http://www.medicine.nevada.edu/cmm/
    the Center for Molecular Medicine will house portions of the microbiology, pharmacology, pathology and physiology and cell biology departments and serve as the headquarters for the Whittemore Peterson Institute for Neuro-Immune Disease.

    for more neuro-immune disease http://cfsmirror.blogspot.com/2011/02/creating-research-base-isnt-like-buying.html

    IVI

  16. #16 Todd W.
    February 17, 2011

    I have to agree that this sounds more like it is about the money than actually helping patients. In the world of philanthropy, big gifts are all-important. The publicity can draw in other gifts, generate news stories, etc. So, if a donor comes along saying, “Hey, I’ve got $37 mil. kickin’ around. I’ll give it to you if you do X,” the recipient organization would either be pretty dumb or incredibly ethical to turn it down. Keep the donors happy and they’re more likely to give you more money.

    And, in the interests of disclosure, my background is working in fundraising offices (not a fundraiser, though), and some of the kowtowing I have seen have just made me shake my head and wish I could actually do something about it without fear of losing my job.

  17. #17 Phil
    February 17, 2011

    Many people are desperate for anything to help with their disease, even to have some hope, so they waste a lot of time and money on treatments that are probably all or mostly all quackery. Therefore, I think that *if the money can be raised*, it’s worth doing controlled, randomized, blinded studies to put some of these things to sleep. On the other hand, if these alternatives have only a placebo effect, *do no harm*, and are inexpensive, why not let people continue to use them as long as they are aware that they will only help “feel” better and not cure their disease?

  18. #18 Composer99
    February 17, 2011

    Jean:

    If you don’t think Orac has done research on homeopathy, then you are negligent: use the search function on this site and enter the search term ‘homeopathy’ to see what else Orac has written.

    I also recommend that you also go to Science-Based Medicine and see other discussions on homeopathy by Orac’s friend and his friend’s associates.

    I would posit that Orac’s stance on homeopathy and other forms of quackery are informed by rather more than just his opinion.

    I wonder if anyone has gone to the time and trouble of systematically reviewing the Gish Gallop of references provided by the National Center for Homeopathy.

    (For a review of a number of papers purporting to support homeopathy, I would direct you to a co-citizen’s blog post.)

  19. #19 Todd W.
    February 17, 2011

    @Phil

    You touch on a paradox. Patients should be allowed to seek out whatever the heck they want to do to treat their condition. The problem is that health care providers have a responsibility to treat patients with honesty and with treatments that actually have evidence/science to back them up.

  20. #20 Composer99
    February 17, 2011

    I have a comment in moderation responding to Jean @ 11. Must be too many links.

  21. #21 reboho
    February 17, 2011

    Jean Hoagland; think that if you open your mind too much that your brain falls out; does that homeopathy thing work with alcohol? I could save a bundle on scotch if I could get water to remember scotch. Still haven’t figured out why water doesn’t remember all the bad things people put in it when I drink a glass of tap water…..

  22. #22 Todd W.
    February 17, 2011

    @Jean

    Simple question for you: how can you tell if you’re getting a real homeopathic treatment rather than a vial of water or alcohol or a handful of tic tacs (figuratively speaking)?

  23. #23 Militant Agnostic
    February 17, 2011

    I love how not only have the architects designed this building for woo, but have made it environmentally friendly, something particularly amusing when one considers how many animals are endangered by the trade in alt-med remedies like rhino’s horn and bear bile.

    Also shark cartilage which is contributing to the decimation of shark populations. This in in turn has lead to an explosion in the population of fish such as the cow nosed ray which are eating commercial fish stocks.

    I wonder what is going to happen if people become aware of the misogyny and homophobia that is embedded in many “Eastern” traditional beliefs.

  24. #24 SW
    February 17, 2011

    I have no problem with the idea of learning from alternative therapies, where a different perspective may have facilitated some observations that were otherwise easy to miss. I’m not even clear on why everything has to be translated into the western analytical vernacular, which has always had both its strengths and its weaknesses. But here whole theories are being imported, without critical engagement of any kind, besides appeal to inconclusive studies. I’m in the humanities, but is this how “studies” are supposed to be used?

    To me it seems as though western medicine’s focus on evidence is being used rhetorically against it – as if ALL we have are experiments, and the only way to determine whether or not “homeopathy” is a good approach to illness is to try out a homeopathic remedy, without any need to address the theoretical problems.

    As for the motivations behind all of this, I was reminded of the following satire aimed at the Cleveland Clinic’s prevention program ( http://thelastpsychiatrist.com/2009/07/time_magazine_asks_cleveland_c.html ). Maybe the cooking classes and casual yoga will help some people; I wouldn’t know. But it’s certainly a different approach to making ends meet!

  25. #25 Pablo
    February 17, 2011

    Somewhat related, I was listening to my favorite ER docs on satellite radio this morning, and they casually mentioned about how they often see acupuncture patients in the ER with a collapsed lung. I had never heard that before, but it happens enough, apparently, they they considered it a fairly common outcome.

  26. #26 Todd W.
    February 17, 2011

    @Pablo

    That’s something that was brought up in Trick or Treatment. I hadn’t really thought about it before, thinking that acupuncture only barely pricks the skin. I didn’t realize that some practitioners insert the needles far enough to actually puncture organs. Apparently, in some rare cases, even the heart has been pierced.

  27. #27 marcia
    February 17, 2011

    Virtually every sentence in this

    http://articles.burbankleader.com/2011-02-16/news/tn-blr-cancer-20110216_1_cancer-patients-offering-acupuncture-acupuncture-sessions

    makes me ill.

    Making the desperate pay AT ALL for nothing more than human contact is sickening.

  28. #28 SC (Salty Current)
    February 17, 2011

    Another study found that although use of homeopathic remedies did not differ from placebo in treating anxiety disorder, both showed a substantial reduction in anxiety.2

    I can’t help but laugh every time I look at this.

  29. #29 David Colquhoun
    February 17, 2011

    Can’t the president of UCSF be fired for bringing his university into disrepute?

  30. #30 Melissa G
    February 17, 2011

    I really, reeeeeeeeeally need to get that MedAlert bracelet now. You know, the one that says, “Allergic To Alternative Medicine.”

  31. #31 SB
    February 17, 2011

    As a California health researcher who is on the verge of losing a hell of a lot of funding with the new budget, this makes me want to cry, throw up, flail, and punch some UCSF people. Not the most mature response, but maybe I could find a way to market punching as a new-age therapy for all that ails you and get in on the apparently enormous amounts of money available for such scams. Oh wait, I’m not going to use my position of expertise, minimal as it is, as leverage to trick people into using ineffective therapies, because I try not to be an incredibly lame asshole most of the time.

  32. #32 Denice Walter
    February 17, 2011

    “much of alt-med is about self-absorption”- Definitely! From my perspective, most of what I survey absolutely reeks of it, whether it involves treatments or theory, be it about the body or the mind ( oh wait, they’re supposed to be the same) : the providers are drenched in self-laudatory solipcism and inspire the same attitude in their clientele. The whole notion, discussed yesterday, that the times are ripe for a revolution in medicine , implies that those fomenting the upheaval are somehow equipped to understand and criticize the entire body of medical lit and overrule the whole of what is currently accepted . Now, lookit at exactly *who* is saying this. I rest my case.

    The project is especially repellent in an era of fiscal austerity in a country where many people do not have basic medical care.

    BTW isn’t Ornish at UCSF?

  33. #33 Roadstergal
    February 17, 2011

    I love this whole ‘Eastern vs. Western’ crap. All of the various flavors of Easterners I do and have worked with would likely bristle at the implication that it is somehow un-Eastern to do good, quality science.

  34. #34 Sastra
    February 17, 2011

    “…an integrated, healing-oriented approach to health.”

    They’ve stolen the word “healing.” Apparently, scientific medicine is against healing. It’s also probably against “wellness” too. And, needless to say, scientific medicine is anti-integration. What sort of racist monster is against integration?

    Not those in “Integrative Medicine.”

    The term “holistic” ought to be problematic for them. Technically, I would have thought there’s nothing less consistent than seeing nothing wrong with medical science using forms of energy which physicists know nothing about. Shouldn’t the different parts of reality all work together, so that there is no division between “life energy” and energy? Not in a world view where “holism” isn’t about bringing all knowledge together as a whole, but about adding spirituality and its faith-based ways of knowing to science.

    Whenever I read panegyrics on Integrative Medicine and how wonderful it is to include all the different ways of doing medicine from over the world, I visualize an ecumenical Religious Tolerance panel, with the priests and rabbis and ministers and imams all patting each other on the back in mutual celebration of all “paths.”

  35. #35 Militant Agnostic
    February 17, 2011

    SB @31

    Oh wait, I’m not going to use my position of expertise, minimal as it is, as leverage to trick people into using ineffective therapies, because I try not to be an incredibly lame asshole most of the time.

    Why are you so sure that punching alties is not therapeutic?

  36. #36 daijiyobu
    February 17, 2011

    Per: “or if a naturopath starts spewing prescientific vitalistic pseudoscience?”

    Aligned with that is UCSF’s document “Profile of a Profession: Naturopathic Practice” from 2001

    (see http://futurehealth.ucsf.edu/Content/29/2001-09_Profile_of_a_Profession_Naturopathic_Practice.pdf )

    and such naturopathy-essential vitalism is on pages 91 and 93.

    Funded by “The Arkay Foundation”, but I’m not sure what their mission of promoting democracy and environmentalism has to do with naturopaTHICK absurdities.

    By the way, Orac, it may be your blog that has gotten the attention of the President of the ND / NMDs in the U.S.

    (see http://naturopathicphysicians.blogspot.com/2011/02/presidents-message-science-and.html ).

    You better stop your “biased misrepresentations”, and they’re going to have a “scientific summit” in August.

    I can’t wait, “in the warm sunshine make hay.”

    -r.c.

  37. #37 Chris
    February 17, 2011

    Roadstergal:

    I love this whole ‘Eastern vs. Western’ crap.

    Especially since is tainted with racism. But I do love the looks of confusion when I ask those promoting homeopathy, saying that it is better than “Western” medicine, when Germany stopped being part of the “The West” (was it 200 years ago when Hahnemann was a live, or more recent?). And even more confusion when I ask if the DTaP vaccine, varicella vaccine, statins and colonoscopies were okay as “Eastern” medicine because they were all developed in Japan.

  38. #38 Black-cat
    February 17, 2011

    I have been diagnosed with inflammatory breast cancer stage 3C. I recently have had chemo, a mastectomy with diep reconstruction and radiation. I received most of my treatment at California Pacific Medical Center in San Francisco, which I believe is UCSF’s biggest competitor, and also has an integrative health center.

    http://www.cpmc.org/services/ihh/

    I think there are more alties per square mile in northern California than any other area in the states but I am getting off subject.

    I did incorporate alternative complementary medicine in with my treatment because I was able to get it for free every Saturday in Santa Rosa where I live. Reiki masters, massage therapists, feldenkrais practionars, acupunturists, and other practionars volunteered thier time. This center was overseen by an MD and all practionars were under strict guidelines to not try to recruit patients in any way for profit. This was on a volunteer basis only and not for profit. The program was for women undergoing treatment for cancer and up to 2 months out of treatment.

    Massage was my first choice but more often then not was already taken. I did not believe in the hocus pocus of Rieki but I went anyway because I thought it was better than nothing. I felt scared and alone and it was very soothing to lie on a warm table and have a reiki master and 2 or 3 of her students fuss over me. Guided imagery helped me to relax. Accupunture really did not do anything for me other than relax me. When they would ask me which treatments that I liked best I would always say massage and to be polite I would say that I did not understand the rest. The women would give me pitying looks and say things like I just wasn’t an energy person. I even had a treatment where a women would hit a tuning fork and put it on my body. I had to keep myself from laughing but it helped me because it got my mind off of cancer and fear of my future. I always went to the center in fight or flight mode and left in rest and digest mode, no matter what treatment I had.

    When I told my chemo nurse at CPMC, that I was receiving these services in Santa Rosa, she told me that the hospital also has them and gave me a brochure with the treatments and corresponding price list. Each treatment that I received for free, was 125.00 and up. There are so many nice spas in San Francisco where I could have gotten a massage for fifty dollars cheaper!

    I would have enjoyed having massage, feldenkrais and guided imagery at CPMC if they were offered as a complimentary treatment. I am thousands of dollars behind on my insurance co payments so how the hell am I going to afford a 150 dollar plus 15% tip, one hour guided imagery session that insurance will not pay for. I have more important ways to spend my money like putting food on my table.

    I am not a slacker, nor am I into getting something for nothing but I don’t like reputable hospitals trying to con me into paying exorbent fees for a therapy that I could get cheaper at a nice day spa.

    I am thankful that my medical oncologist at CPMC has never referred me to thier integrative health clinic. If she did, I would be looking for another oncologist.

  39. #39 G.F.Jump
    February 17, 2011

    All `western` medicine is experimental. I hate the hocus pocus too. Riki/ reflexology,meditation, etc. are scams…. But `Western` medicine ain`t all it is cracked up to be either.

  40. #40 Jarred C.
    February 17, 2011

    @ daijiyobu #36

    I left a comment over on the naturopathic physicians blog, and it’s pending approval from the moderators.

    All I said was for them to drop homeopathy, acupuncture, detox schemes, the whole eastern vs western gambit, and any discipline which relies on faith (reiki, ayurvedic, etc…) – and the entire field of naturopathic medicine will improve more than it has in its entire existence.

    Do you think the moderators over there will let my comment through?

  41. #41 Sid Schwab
    February 17, 2011

    Really sad. UCSF is where I was trained to be a surgeon, a long time ago. Long enough that I could never have imagined that that place, then considered one of the best surgical training programs in the country, would end up heading in this direction. It’s shameful.

    Sadly, it’s entirely in keeping with the general trend of education and politics in the US: dispense with the tough stuff, turn to magical thinking, ignore (actively reject, actually) facts and input from experts.

  42. #42 T. Bruce McNeely
    February 17, 2011

    All `western` medicine is experimental.

    You say this like it’s a bad thing.

  43. #43 augustine
    February 17, 2011

    Chris

    And even more confusion when I ask if the DTaP vaccine, varicella vaccine, statins and colonoscopies were okay as “Eastern” medicine because they were all developed in Japan.

    You seem to be the one confused. Eastern medicine is not a geographical location. Neither is greek/western philosophy. Either you know this or your question is not in earnest.

    Not perfect but it might be in your language.

    http://www.ncbi.nlm.nih.gov/pmc/articles/instance/1238216/pdf/westjmed00262-0101.pdf

  44. #44 Sean
    February 17, 2011

    An entertaining piece but not sure that it qualifies as a scientific appraisal. It does very much come across as coming from an emotionally based, entrenched position. Im guesssing from the tone of the writing that you would be unprepared to change your position, even if presented with sufficient evidence.

    I’m guessing that this response will not be printed as it doesn’t agree with your position. However, and you come across as one that isn’t necessarily open to others opinion, but i would love to have a Skype chat with you to see if you were a considered in your approach as it seems.

  45. #45 nybgrus
    February 17, 2011

    I was quite sad when I didn’t get into UCSF med. Now I am not so sad. It is amazing how many conversations I have with my classmates and it takes some serious convincing (luckily I am now armed with the weaponry I need thanks to this site and SBM) to demonstrate to them how these modalities are crap, why we don’t need to research them more, and “what the harm” is. Ugh. I hear “But if it makes the patient feel better, then what’s the harm?” So many times it makes me sick. And we even have an “integrative medicine” lecturer here as well. Thankfully we don’t have a wing at our hospital for it, but still. So I cornered the guy after his lecture and started up a conversation. Things were going well until I started citing relevant articles disproving his stance and when he finally tried to claim that there must be “something” to reiki because more experienced practitioners get better responses than less experienced practitioners I just about up-chucked. He stated that just like a new doc just out of school versus a trained attending, experience counts. Thus it give credulity to reiki and acupuncture. I haven’t gone back to his lectures since.

  46. #46 synapse
    February 17, 2011

    OK, to put this is context: UCSF is in a huge building push. It has spent most of the past 10 years building another campus across town (Mission Bay), with several shiny new research buildings already in use and at least one more under construction (a second neuroscience facility). Eventually there’s going to be a new hospital there too, replacing the old Long-Moffitt which is apparently not “earthquake-safe” (even though it survived ’89 pretty much unscathed). At the Parnassus campus, people have just moved into the new stem cell research building, and there’s been this ongoing floor-by-floor renovation of the research areas as well. So, it’s not like the Osher Center is the only new construction that UCSF is doing.

    (Also, of course the new construction is going to get some sort of certificate for being environmentally-conscious. That’s the new fad in San Francisco now; every new construction project for a public-facing building emphasizes how awesome- er, environmentally-friendly- the building is.)

    That said, the Osher Center still a shame. That $37 million would go a long way in pushing the construction schedule forward on buildings where real science or medicine is being done. It would also, as you say, go a long way towards staffing all these new buildings, especially when the NIH seems likely to have its budget cut.

  47. #47 synapse
    February 17, 2011

    OK, to put this is context: UCSF is in a huge building push. It has spent most of the past 10 years building another campus across town (Mission Bay), with several shiny new research buildings already in use and at least one more under construction (a second neuroscience facility). Eventually there’s going to be a new hospital there too, replacing the old Long-Moffitt which is apparently not “earthquake-safe” (even though it survived ’89 pretty much unscathed). At the Parnassus campus, people have just moved into the new stem cell research building, and there’s been this ongoing floor-by-floor renovation of the research areas as well. So, it’s not like the Osher Center is the only new construction that UCSF is doing.

    (Also, of course the new construction is going to get some sort of certificate for being environmentally-conscious. That’s the new fad in San Francisco now; every new construction project for a public-facing building emphasizes how awesome- er, environmentally-friendly- the building is.)

    That said, the Osher Center still a shame. That $37 million would go a long way in pushing the construction schedule forward on buildings where real science or medicine is being done. It would also, as you say, go a long way towards staffing all these new buildings, especially when the NIH seems likely to have its budget cut.

  48. #48 Orac
    February 17, 2011

    @Sean

    Present your evidence. And, be careful. You have no idea how deeply I’ve looked into this.

  49. #49 Chris
    February 17, 2011

    Sean:

    I’m guessing that this response will not be printed as it doesn’t agree with your position.

    Are you confusing this blog with Age of Autism or the CureZone?

  50. #50 daijiyobu
    February 17, 2011

    @Jarred C.:

    The AANP site is a pretty commentless blog page. Which to me is odd since AANP has hundreds if not more members.

    I commented once and it wasn’t posted up.

    -r.c.

  51. #51 Jay
    February 17, 2011

    You have no idea how mad some of the students and faculty are about this new facility. But, the school’s line is they don’t want to lose donations. And the Osher’s have donated a lot more than what went into their building.

    From what I understand of the stipulations of the building, UCSF had to do this to get the money to continue with a lot of other projects they wanted or lose a lot of money tied to the Osher building.

  52. #52 basement cat
    February 17, 2011

    I read about a program in Baltimore in the NY Times a few weeks back and thought that it was something truly “integrative.” They have this program for young people who are doing rehabilitation after gunshot wounds, and as they do their rehab they have all sorts of support services (counseling, job training, legal aid, etc.) to help the patient leave the drug/gang lifestyle and escape the cycle of violence. Seemed like that was something that really deserved to call itself “integrative” and “patient-centered.”

    Of course, the program had run out of grant funding and was struggling to find enough support to continue… the cynic in me thought if only they could find some “ancient Chinese secret” they might be able to line more donors up. :(

    It’s sad to think how many programs like this could be funded with $37 million instead of magic water.

  53. #53 ESPness
    February 17, 2011

    As scary as this sounds, one of our hospitals is doing an RCT of ear acupuncture in the ER. I have yet to find any published results but the article is dated 2009.

    http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=10557683 and the trial has been registered: http://www.anzctr.org.au/trial_view.aspx?ACTRN=12610000104055
  54. #54 badedukation
    February 17, 2011

    Let me just say that at some point in the future I can comment rather intimately on this story.

  55. #55 Anonymous
    February 18, 2011

    I was a UC student when Roger Revelle was at UCSD. I was at UCSF with Bishop and Varmis.

    I am so very sad.

  56. #56 titmouse
    February 18, 2011

    Whenever I read panegyrics on Integrative Medicine and how wonderful it is to include all the different ways of doing medicine from over the world, I visualize an ecumenical Religious Tolerance panel, with the priests and rabbis and ministers and imams all patting each other on the back in mutual celebration of all “paths.”

    You remind me of a Prince who will soon be crowned “Defender of Faith.”

    Several old clans –George, Norton, and Anderson, at least– have rallied to his cause. Note the allusion in “Brave-well.” These tribes are quite serious in their intention to do battle against “THE MACHINE.”

    See “Beware the Believers,” and the animated movie “9.”

    See “Expelled!” and “Psychiatry: An Industry of Death.”

    There’s a second British prince among the postmodernist hoards. His father, recently deceased, was a naturopath with a large vitamin business. He also served as the director of an intelligence agency within a rogue paramilitary organization.

    The son keeps a low profile but seems quite ambitious. You may have read one of his books.

  57. #57 Fakrudeen
    February 18, 2011

    Shame on UCSF!

    If someone donates enough money they will open center for guillotine medicine for headache!

  58. #58 palindrom
    February 18, 2011

    I’m an astronomer, and I often teach elementary physics to premeds. Many are wonderful students (future Oracs!), but many others have the dimmest of understanding, and are just looking for a magic wand to wave over their MCATs. I’m not surprised that there are so many scientifically illiterate MDs. When you combine this with the patient demand for CAM, and the fact that there are diseases that even modern medicine can’t do much about, you have the makings for a place like this.

    But I still find it disheartening that UCSF would accept this gift. My wife is in a medical field, and UCSF’s reputation is very good — I thought they were better than this. I wonder if they considered how much harm it would do to their scientific reputation before they grabbed the loot?

    I’m using my huffpost anti-woo name, by the way. Just try to post something there saying that Robert Lanza is not the greatest genius ever! But I digress.

    “Is that a Mexican poncho, or is that a Sears poncho?”

  59. #59 Lawrence
    February 18, 2011

    Some good news for a change – look at one of the professions that made the top-ten list of jobs that may become extinct:

    Holistic Healers

    Alternative medicine specialists like acupuncturists, homeopathic doctors and hypnotherapists may be an endangered species. The field declined 44% between 2004 and 2009, losing about 26,000 jobs. Because health insurance companies typically do not cover these specialties, alternative medicine may be becoming a more niche, luxury service.

  60. #60 Jarred C
    February 18, 2011

    I’m not surprised that there are so many scientifically illiterate MDs.

    I used to work in the ER to help support my way through college (back when I thought I wanted to go to med school). At the time, I was dating a chemistry major; for one valentine’s day, I bought her a plush mole (which she loved). When I told the story to some of the ER docs, none of them got it – not one of them could remember the the connection between a mole and chemistry.

  61. #61 palindrom
    February 18, 2011

    @Jarred60 — What a cute story!

    Not knowing what a mole is makes it a lot easier to be bamboozled by homeopathy. I’ve crossed swords a little with some of the house homeopaths over on HuffPo – hopefully this is more constructive than pissing into the wind.

  62. #62 SFscruff
    February 19, 2011

    I’ve been a patient at UCSF for 15 years and a patient at the Mount Zion Comprehensive Cancer Center (right across Divis. Street from the new Osher Center) for 12 of those years. Many patients I’ve spoken with regarding the new improved Osher Center have experienced the same jaw-dropping incredulity as I have at the on-going osherization of UCSF. My cancer diagnosis twelve years ago was not met with a desperate grasp at anything out there, it was met with an intense effort to self-educate as quickly and thoroughly as possible (which was rather challenging given my science background consisted of one Biology 101 class in college 30 years ago).

    Most importantly, I quickly learned to recognize the difference between hedonistic feel-good placebos and effective and tested treatments, even if the evidence-based medicine wasn’t what I emotionally wanted to read or hear. Woo-woo is easy for an apparently large segment of the population to embrace because it’s so soft and fluffy and it’s easier to grasp parables, analogies, anecdotes, and similes than true science because it takes work to understand science and the scientific method. Sure, evidence-based medicine often raises as many questions as it answers, but that’s the nature of scientific inquiry. What that translates into in a patient’s real life is uncertainty about what to do in a medical situation, so the woo unfortunately gains currency.

    I crack up whenever I hear another patient berate evidence-based medicine because it doesn’t have all the answers and then hold their alternates to another standard of proof. I challenge them to go to an ‘alternative automotive mechanic practitioner’ the next time their car breaks down or to try healing touch on their computer the next time it crashes and see what happens and get back to me. I know, I just tossed out a couple of metaphors, but metaphor seems to be the only language in wooville that they comprehend.

    It takes well-informed, empowered, and courageous patients to stand up to the quackery that has been allowed to ooze into evidence-based medicine. If somebody wants to go the woo route, let them, but please, keep it away from a university hospital. I know of dozens of patients like myself who have stood up to woo in clinical encounters where we generally don’t like to have to take a contrary position.

    That said, I’ve also had to endure a most insensitive, uncaring, troll of a M.D. at UCSF. After a couple of appointments where I thought that maybe I wasn’t getting what I hoped was only an oddball M.D.’s quirky personality, I fired the guy and fled to a primary care physician who I’ve been seeing successfully for the past 8 years. The troll M.D. is still prowling the halls of UCSF and who knows how many patients he has sent crawling to the herb n’ spices scented halls of the Osher Center.

    The message is this, if patients get touchy-feely herbal-fresh lovin’ from quacks, they will go to quacks. If they get a wall of stone from a M.D. when they need some compassion and care, the woo might be the only thing that they can grasp.

  63. #63 Scottynuke
    February 20, 2011

    SFscruff, best wishes on continuing your successful fight, against both cancer and woo, well into the future. :-)

  64. #64 LG
    February 20, 2011

    Interestingly, Bernard Osher’s sister, Marion Sandler, also has a foundation. From what I can tell the Sandler Foundation funds actual medical research, no hocus pocus mumbo jumbo. Clearly Herb and Marion want their money to actually, you know, provide a real benefit.
    http://www.sandler.ucsf.edu/history.html

  65. #65 Babs Johnson
    February 20, 2011

    Watching CBS right now about Iscador. I wonder if this is one of the unproven products they plan on using??? Maybe this will be a source of very expensive antineoplastons? Oh, will they charge up-front before the treatments???

  66. #66 sortanonymous
    February 21, 2011

    These rich alt med proponents are closet Scientologists postulating a cleared planet.

    C’mon out of the closet, Bernard and Barbro.

  67. #67 Ashish
    February 26, 2011

    I feel sorry for the author’s bias and their limited knowledge of science. Western medicine is so far backward, the billions of dollars of research are such as waste, its a shame. Only a person who hasn’t studied Ayurveda, read supporting scientific studies and research or experienced its healing powers can write such a opinionated, unscientific article. Good luck with curing cancer, aids, and diabetes. What a joke !

  68. #68 tresmal
    February 26, 2011

    Only a person who hasn’t studied Ayurveda, read supporting scientific studies and research or experienced its healing powers can write such a opinionated, unscientific article.

    Well, the reading the “supporting scientific studies” part shouldn’t take long.

  69. #69 NJ
    February 26, 2011

    Ashish @ 67:

    Only a person who hasn’t studied Ayurveda, read supporting scientific studies and research or experienced its healing powers can write such a opinionated, unscientific article.

    Left off the leading “H” from your handle it appears.

  70. #70 SFscruff
    March 1, 2011

    Ashish, the cancer I had was cured by ‘western’ medicine. Had I chosen to go the Ayuveda route I’d be dead today. 10 years of semi annual check ups post-surgery/chemo and the cancer cells are no longer in my body. Of course, the cancer I had could have spontaneously remitted which can occur in a statistically small number of patients with the type and stage of cancer that I had, but it’s unlikely and I’ll never know, because I chose the ‘western’ route which cured and saved me. I didn’t arrive at my conclusion to be treated with ‘western’ medicine with a bias other than an ‘I want to beat this’ bias. You show your own bias and denial of science as there’s no scientific evidence that Ayuveda ‘works’ other than as a faith-based farce. Hopefully, you and your cronies will only harm yourselves and innocent victims of your foolishness will not be led astray.

  71. #71 Beamup
    March 1, 2011

    read supporting scientific studies and research

    Please provide said studies and research so that we may read them. PMIDs preferred.