Dr Kimball Atwood IV at Science-Based Medicine and my long-time blogging colleague Orac have spilled oceans of e-ink on the institutionalization of alternative or integrative medicine in North America’s top academic medical centers. Complementary and alternative medicine (CAM) is now often called “integrative medicine” to intellectually justify the incorporation of evidence-free, anecdotal practices into the business of academic medicine. Of course, integrative medicine does co-opt a few areas of conventional medicine, like nutritional and psychological counseling, supported by an evidence base just to add a veneer of legitimacy under which highly-questionable practices can proliferate and metastasize.
In these discussions by other bloggers, one question continually arises: Why do revered medical centers at places like Harvard, Cornell, UCSF, Mayo Clinic, risk their academic reputations by pandering to public demand for practices based in magical thinking?
Why else? Cash. Cold, hard cash.
Submitted for your approval: Leadership and Business Strategies for Integrative Health Care
The 6th Annual Conference on Integrative Medicine for Health Care Organizations is the only conference that focuses on business strategies for the implementation of complementary and alternative medicine (CAM) programs in hospital settings. Attendees will leave with practical, take-away tools and ideas while enjoying invaluable networking with peers and leaders in the field.
Yes, you can even begin your Saturday morning at the conference with a 45 min session of “Laughter Therapy” to ease one into the comfort of laughing one’s way to the bank.
Now, remember, I am an herbal medicine researcher who has spent at least a decade examining natural products for their potential therapeutic benefit. But again, this is another research area that has ever-so-slowly been claimed by integrative medicine as their own – all despite the fact that this research area has been called “pharmacognosy” for well over 50 years and has been a cornerstone of pharmacy and chemistry since the Hanover pharmacist Friedrich Wilhelm Sertürner first isolated and standardized opioid alkaloids from the poppy, Papaver somniferum, in 1805.
In this capacity, and as a young faculty member, I witnessed the emergence of complementary and alternative medicine on academic medical center campuses in the early and mid-1990s. In general, these centers were initially funded by interested philanthropists but I had difficulty in understanding how these centers would be sustainable financially. Even research grants from NIH’s National Center for Complementary and Alternative Medicine has never exceeded a national budget of $125 million or so and I anticipated that CAM, or integrative, centers would be jettisoned by academic hospital administrators and medical school deans as quickly as they sprung up.
But, alas, I do not have an MBA and probably don’t really understand the economics of integrative medicine. Thankfully, I can fly to Phoenix this May and learn where I have gone wrong:
Workshop #2: Philanthropy as a Key Component in Building an Integrative Medicine Program
Sid Mallory, executive vice president for philanthropy, Allina Hospitals and Clinics, Minneapolis, MN, and Mary Love (Bitsy) Henderson, president, Henderson Mallory Partners, Minneapolis, MN
The question of funding is upper most on the minds of hospital CEOs and other health care executives as they consider integrative medicine as a key strategy to improving the health of the population they serve. Many are wondering if philanthropy can provide a significant source of funding in building and sustaining a program. This workshop will focus on the philanthropic environment that must be in place to allow prospective donors to partner with a health care institution to build and support a campus-based integrative medicine program. Participants will examine a proven philanthropic case and learn about the key elements of the philanthropic plan and structure that must be in place to achieve a high level of community support.
Conversely, one can also learn how to get an integrative medicine program off the ground without philanthropy:
When There’s No Free Lunch: How One Integrative Clinic Started and Thrives Without Philanthropic Support
Lynn Durand, MD, medical director, Center for Integrative Medicine, Concord Hospital, NH
Most integrative medicine clinics get started with significant philanthropic gifts. Despite this, many clinics that are launched with financial backing or receive continuing philanthropy do not survive financially. This session describes how one hospital-based integrative medicine clinic started and continues to operate without external financial assistance. Participants will gain expert advice on how to articulate a compelling rationale for an integrative clinic, and learn effective strategies for structuring the clinic to ensure that it is supported by the medical staff and the public. Dr. Durand will share the steps that the Center for Integrative Medicine followed to successfully facilitate this endeavor.
There are too many other gems to list here, so I refer the reader to the session and event descriptions.
You might not be surprised to learn that no sessions are scheduled that discuss the ethics of plying evidence-free practices on patients in the name of “improved quality of care and a better patient experience.” Perhaps a session on how to live with one’s self while knowingly offering fraudulent services in the context of trusted professions and professional institutions might be in order.
I really don’t mean to be facetious here – a legitimate concern exists when health systems, academic or private, offer the trade of charlatans in the name of medicine.
But as with managed care organizations, pharmacy benefits management companies, and, dare I say, academic medical center administrations, all bets on medical ethics are off once business infiltrates the system.
The resulting situation is one where economics trumps science and medicine and the reputation of medical and allied health professionals become secondary concerns.