Last week, the University of California, Irvine (UCI) announced that Susan and Henry Samueli were donating $200 million for it to set up a massive new integrative medicine initiative. The plan would basically transform biomedical sciences and medical education at UCI—and not in a good way.
Remember what "integrative medicine" is. What is being "integrated" into medicine is, of course, quackery. Oh, sure, integrative medicine also emphasizes lifestyle modification, such as diet and exercise, but that is part of "conventional medicine" already.
There is no good scientific or medical rationale for a separate specialty devoted to just that. What integrative medicine does is that it rebrands perfectly science-based modalities, such as diet and exercise, as somehow "alternative" and then "integrates" quackery, like naturopathy, acupuncture, functional medicine, applied kinesiology, homeopathy, and basically any form of quackery you can think of. Without the quackery, there is no integrative medicine.
Worse, the phenomenon has resulted in a most pernicious effect in medical academia, the infiltration of outright quackery into the research and education efforts there, a phenomenon I like to refer to as "quackademic medicine."
Of course, The Very Serious Academics In Very Serious White Coats who have come to believe in integrative medicine to the point of devoting their careers to it would vehemently disagree with my characterization. I'm referring to the sort of doctors who present at conferences of learned academics and write what they claim to be evidence-based care guidelines for breast cancer patients. Perhaps the best thing to mention to rile up serious academic advocates of integrative medicine is homeopathy. Any mention of homeopathy is guaranteed provoke paroxysms of self-righteous denial.
"Oh, no," they'll say, "homeopathy is pseudoscience! It's quackery. Integrative medicine is evidence-based, and we would never do anything that isn't evidence-based!" Sadly, as I've pointed out time and time again, you can't have naturopathy without homeopathy, as homeopathy is an integral part of naturopathy. As long as you have naturopaths, you will have homeopathy. Oddly enough, many of these The Very Serious Academics In Very Serious White Coats are utterly oblivious to this simple fact, even ones who write Very Serious Clinical Guidelines with naturopaths and welcome naturopaths into their Very Serious Medical Society.
ll of this brings me back to UCI, because yesterday there was a story by Michael Hiltzik for the LA Times about this very phenomenon. Well, not exactly. Rather, it's about the relationship between UCI and homeopathy and how UCI seems rather—shall we say?—touchy about the subject:
As of late last week, visitors to the website of UC Irvine Health, that institution’s clinical arm, could learn that among its services to patients was “homeopathy.” That was a problem, because homeopathy is a discredited and thoroughly debunked “alternative medicine.” Even Howard Federoff, UCI’s vice chancellor for health affairs, agreed that the scientific basis for homeopathy was “lacking.” The issue is important because the donors of a $200-million gift to UCI’s medical schools, the billionaire couple Susan and Henry Samueli, are sworn believers in homeopathy and supporters of a raft of other “integrative” health treatments. As I reported, some medical authorities have raised questions about whether the Samuelis’ beliefs and their rare generosity will undermine UCI’s explicit commitment to science-based medicine. So it’s interesting that after I raised questions about the treatment’s listing on the website, it mysteriously disappeared. As of this writing, a UCI spokesman hasn’t gotten back to me with word on when it was removed, or whether its removal means that homeopathy no longer will be offered to patients, or merely that UCI is keeping it quiet. The listing was present as recently as last Wednesday, when I asked Federoff about it in connection with my column about the Samueli gift, which appeared online Friday; its presence can be seen on an archived version of the website dated Sept. 19.
Ah, yes. The light of national attention due to the Samuelis' enormous donation to promote pseudoscience must have rattled UCI. After all, even the most avid proponents of integrative medicine are profoundly uncomfortable with homeopathy, even Dr. David Katz, whose "more fluid concept of evidence" led him to try homeopathy in a patient.
That's because homeopathy is quackery.
Indeed, there's a reason I routinely refer to homeopathy as The One Quackery To Rule Them All. To recap, homeopathy is based on two laws. One states that to treat a symptom you use something that causes that symptom. The other states that a homeopathic remedy becomes stronger with dilution. Neither are based in evidence. Indeed, many homeopathic remedies are 30C or greater in dilution, where C is a 100-fold dilution. Thus 30C means diluting the solution 100-fold thirty times, which results in a dilution of 10-60.
Given that Avogadro's number is on the order of 6 x 1023, a 30C dilution is more than 1036-fold greater, which means that it's incredibly unlikely that a single molecule of original remedy remains. Most homeopathic remedies are just water or ethanol diluent. Even the most die-hard advocate of quackademic and integrative medicine has to admit that, which is why even they are so uncomfortable when homeopathy is brought up and so loudly and self-righteously deny that integrative medicine would ever have anything to do with homeopathy.
Amusingly, Hiltzik noted a web page that looked very, very familiar to me, that of Dayna Kowata, ND, LAc. Yes, she's a naturopath and acupuncturist. She also expresses an interest in homeopathy. What's so familiar about Not-a-Dr. Kowata? Well, I used her UCI webpage in talks about quackademic medicine several years ago, and I've even mentioned her on two different occasions on this very blog, albeit not by name. At the time, I didn't know that Susan Samueli is strong believer in homeopathy, but I do now.
I wonder what Ms. Samueli will think if Dr. Federoff actually does eliminate homeopathy from UCI. I rather suspect that she won't be happy. I particularly wonder this based on the original gift agreements between the Samuelis and UCI when the Samuelis first founded the Susan Samueli Center for Integrative Medicine (SSCIM) at UCI. The original gift was $20 million in 1999. Now here's where it gets interesting. In 2003, the board of directors of the Samueli Center was formally founded in the UCI College of Medicine.
You can read the whole thing if you like, but this is the key paragraph:
The proposed Center will build on the considerable knowledge and experience of its faculty to study the efficacy of various therapeutic modalities considered to be part of complementary and alternative medicine, including herbs and homeopathic medicine, as they relate to areas such as cardiovascular, autoimmune and neuromuscular diseases, cancer treatment and prevention; and menopaus and ageing. In addition, the proposed center will foster UCI's emergence as a leader in the area of acupuncture by supporting basic and clinical research into the mechanism of action and the efficacy of acupunctxure as a modality. The proposed Center will encourage and foster multidisciplinary studies that involve appropriate faculty from across the campus as well as from other institutions.
That's right. Homeopathy was baked into the Samueli Center from near the very beginning. I can't help but wonder what would be found in the formal gift agreement for the Samuelis' $200 million donation. Perhaps a Freedom of Information Act request would shed some illumination on this question. On the other hand, I note that homeopathy was only mentioned in one of the gift agreements.
Perhaps then, as now, UCI and the Samuelis learned that homeopathy brought too much embarrassment to the university—and rightly so—and that's why homeopathy hasn't been mentioned in any of the Samuelis' gift agreements since 2003. Alternatively, most of the gift agreements after that had to do with setting up fellowships and endowed chairs and gave UCI administration the latitude to use the gifts for whatever purposes it judged most consistent with the wishes of the donors.
Contrary to what Dr. Federoff claims, quackery is deeply embedded at UCI. It's the raison d'être for the SSCIM. He might be in denial about it, but it's true. That's why I was amused to read Hiltzik's observation:
The on-again-off-again appearance of homeopathy on UCI’s website and among its clinical offerings underscores the difficulties the university may face in navigating the inconsistencies between the world view of its biggest donors and its explicit commitment to rigorous scientific standards in its medical teaching, research, and clinical treatment. The Samuelis, after all, will have their names on UCI’s main on-campus medical building, and their gift will endow up to 15 faculty members, all of whom will have to demonstrate some “expertise in integrative health.” We reported over the weekend that “integrative health” is interpreted by many in the medical profession as code for introducing unproven and debunked nostrums into a curriculum that should be based exclusively on scientific evidence. Although Federoff says science will govern at UCI, that hasn’t necessarily been the case at the Susan Samieli Center, which was established in 2001 with a $5.7-million donation from the couple and will be converted into the Susan Samueli Integrative Health Institute and absorbed into the university’s entire medical complex under the terms of the gift.
I can't help but note that Dr. Federoff came to UCI from Georgetown University. Why is that significant? Georgetown was one of the "pioneers" (if you will) in quackademic medicine. Basically, Georgetown was the first to "integrate" quackery into all phases of medical education beginning in the first year of medical school, with acupuncturists giving lectures in gross anatomy class. I kid you not.
By the time Dr. Federoff left Georgetown in 2015, quackademia reigned supreme at Georgetown, even to the point where Georgetown credulously teaches homeopathy to its medical students. Dr. Federoff was there when it began and took hold. You'll pardon me if I call bullshit on his claims that the SSCIM will be rigorously based in science. It won't. That's not what the donors want, and that's not what the culture at UCI will support.
Thanks to the Samuelis and the credulous culture they have built at UCI and fueled by the enormous $200 million gift given by the Samuelis, quackademic medicine will reign more supreme than ever at UCI and serve as an example for the metastasis of the cancer that is integrative medicine.
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I wonder what she will think if Dr. Federoff actually does eliminate homeopathy from UCI.
He's just diluting the curriculum to make it more effective.
I always find it stunning that someone can have a very scientific mind and have invented/patented multiple devices of incredible complexity and then turn around and buy into something as ridiculously stupid as homeopathy. But smart in one area never means smart in all areas.
"smart in one area never means smart in all areas."
Just can't leave Ben Carson alone, huh?
Wait, they're going to use homeopathy to treat heart disease, cancer and autoimmune diseases? That's what they're saying?
Chris Hickie (#2) writes
But smart in one area never means smart in all areas.
But, being creative (i.e., invented/patented) in one area often means creative in other areas.
It appears Henry Samueli is simply being creative with his $ based on the love and affection he has for his wife.
Remember the Taj Mahal?
It was commissioned in 1632 by the Mughal emperor, Shah Jahan (reigned 1628–1658), to house the tomb of his favourite wife, Mumtaz Mahal.
The Taj Mahal didn't change world architecture and, in parallel, UCI's $200 million from Mr. Samueli will not change science-based medicine.
Stop whining and let it play out.
MJD: The Taj Mahal didn’t change world architecture.
Oh man, every time I think you can't be more wrong, you prove me wrong. Obviously, you've never been to Southeast Asia. Or seen a Russian orthodox church. Or Aladdin.
"UCI’s $200 million from Mr. Samueli will not change science-based medicine."
That's about as ridiculous as saying that Russia has no influence in the US. Do you know where doctors come from? Medical schools. If one medical school is teaching inaccurate and just plain bad medicine, the practice will spread to other medical schools and hospitals. California already has a huge problem with quacks and people who abandoned their medical degrees (see "Dr" Gordon and "Dr" Sears.) So no, Orac can't just let this one 'play out.'
So no, Orac can’t just let this one ‘play out.’
If Orac wants to confront Dr. Gordon and Dr. Sears that's fair.
But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI.
If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?
In the spirit of freedom-of-choice, homeopathic medicine may have a theatrical placebo effect that may improve the quality-of-life for some individuals dealing with science-based medicine.
I wonder if UCI will apply homeopathy methods for teaching their med students. Think how fast you can turn out docs if you dilute each course by 30c. I think they may need to start with a blood sample from a real doctor before they begin their dilutions.
I can just see the RonCo knock-off: Become a MD for only 49.95 but wait if you order right now get the second one for only process and handling.
Wandering in from my respite...
PGP: " Every time I think that you can't be more wrong, you prove me wrong"
Srsly, MJD telling Orac to "stop whining" truly illustrates self unawareness at its most ironic
It's like Mike Adams bemoaning the current state of education
or AoA's Managing Editor discussing poor writing or Jake Crosby investigating anything
MJD: But, the billionaire couple Susan and Henry Samueli are NOT medical professionals and can most definitely be appreciated for their charitable contributions to UCI. "
Nope. Still wrong. If they'd donated a no-strings attached gift to UC Irvine, that'd have been fine and no one would find fault with them. Unfortunately their "gift" came with more strings attached than you'd find on the entire Muppet cast of Sesame Street.
What a ridiculous article. Everything is prejudged and makes mockery of basic human knowledge. Pharna lobby seeing a danger to its business is out in the open.
Oh, to be blissfuly clothed in the raiments of ignorance.
"If UCI made a disclaimer that homeopathy is intended to be researched as a supplementary-treatment would you back off?"
I hope not - nobody should, since the fact that homeopathy is discredited means there is no evidence that it benefits anyone except the quacks who practice it and pocket the checks. People who understand science and reality understand that. Given your history of comments it's no surprise that you don't understand it.
Ash: "Everything is prejudged and makes mockery of basic human knowledge."
What basic human knowledge? A couple of big pharmaceutical companies are Boiron and Hylands. You may have actually bought some of their special little pills in the tiny bottles. So to save from the tyranny of supporting Big Homeopath Pharm, I present you this way to make your own:
Recipe for Nat Mur or Natrum Mur or Natrium Mur or Natrum muriaticum:
1) Take ½ teaspoon of sea salt and dissolve into 1 cup of distilled water in a bottle.
2) Shake well.
3) This is a 1C solution (ratio 1/100).
4) Take ½ teaspoon of the 1C solution and put it a bottle with 1 cup of distilled water, throw out the 1C solution.
5) Shake well.
6) This is a 2C solution (ratio 1/10000).
7) Take ½ teaspoon of the 2C solution and put it a bottle with 1 cup of distilled water, throw out the 2C solution.
8) Shake well.
9) This is a 3C solution (ratio 1/1000000).
10) Take ½ teaspoon of the 3C solution and put it a bottle with 1 cup of distilled water, throw out the 3C solution.
11) Shake well.
12) This is a 4C solution (ratio 1/100000000).
13) Take ½ teaspoon of the 4C solution and put it a bottle with 1 cup of distilled water, throw out the 4C solution.
14) Shake well.
15) This is a 5C solution (ratio 1/10000000000).
16) Take ½ teaspoon of the 5C solution and put it a bottle with 1 cup of distilled water, throw out the 5C solution.
17) Shake well.
18) This is a 6C solution (ratio 1/1000000000000).
19) Take ½ teaspoon of the 6C solution and put it a bottle with 1 cup of distilled water, throw out the 6C solution.
20) Shake well.
21) This is a 7C solution (ratio 1/100000000000000).
22) Take ½ teaspoon of the 7C solution and put it a bottle with 1 cup of distilled water, throw out the 7C solution.
23) Shake well.
24) This is an 8C solution (ratio 1/10000000000000000).
25) Take ½ teaspoon of the 8C solution and put it a bottle with 1 cup of distilled water, throw out the 8C solution.
26) Shake well.
27) This is a 9C solution (ratio 1/1000000000000000000).
28) Take ½ teaspoon of the 9C solution and put it a bottle with 1 cup of distilled water, throw out the 9C solution.
29) Shake well.
30) This is a 10C solution (ratio 1/100000000000000000000).
31) Take ½ teaspoon of the 10C solution and put it a bottle with 1 cup of distilled water, throw out the 10C solution.
32) Shake well.
33) This is a 11C solution (ratio 1/10000000000000000000000).
34) Take ½ teaspoon of the 11C solution and put it a bottle with 1 cup of distilled water, throw out the 11C solution.
35) Shake well.
36) This is a 12C solution (ratio 1/1000000000000000000000000).
37) Take ½ teaspoon of the 12C solution and put it a bottle with 1 cup of distilled water, throw out the 12C solution.
38) Shake well.
39) This is a 13C solution (ratio 1/100000000000000000000000000).
40) Take ½ teaspoon of the 13C solution and put it a bottle with 1 cup of distilled water, throw out the 13C solution.
41) Shake well.
42) This is a 14C solution (ratio 1/10000000000000000000000000000).
43) Take ½ teaspoon of the 14C solution and put it a bottle with 1 cup of distilled water, throw out the 14C solution.
44) Shake well.
45) This is a 15C solution (ratio 1/1000000000000000000000000000000).
46) Take ½ teaspoon of the 15C solution and put it a bottle with 1 cup of distilled water, throw out the 15C solution.
47) Shake well.
48) This is a 16C solution (ratio 1/100000000000000000000000000000000).
49) Take ½ teaspoon of the 16C solution and put it a bottle with 1 cup of distilled water, throw out the 16C solution.
50) Shake well.
51) This is a 17C solution (ratio 1/10000000000000000000000000000000000).
52) Take ½ teaspoon of the 17C solution and put it a bottle with 1 cup of distilled water, throw out the 17C solution.
53) Shake well.
54) This is an 18C solution (ratio 1/1000000000000000000000000000000000000).
55) Take ½ teaspoon of the 18C solution and put it a bottle with 1 cup of distilled water, throw out the 18C solution.
56) Shake well.
57) This is a 19C solution (ratio 1/100000000000000000000000000000000000000).
58) Take ½ teaspoon of the 19C solution and put it a bottle with 1 cup of distilled water, throw out the 19C solution.
59) Shake well.
60) This is a 20C solution (ratio 1/10000000000000000000000000000000000000000).
61) Take ½ teaspoon of the 20C solution and put it a bottle with 1 cup of distilled water, throw out the 20C solution.
62) Shake well.
63) This is a 21C solution (ratio 1 in 10^42 or 1/1000000000000000000000000000000000000000000).
64) Take ½ teaspoon of the 21C solution and put it a bottle with 1 cup of distilled water, throw out the 21C solution.
65) Shake well.
66) This is a 22C solution (ratio 1 in 10^44 or 1/100000000000000000000000000000000000000000000).
67) Take ½ teaspoon of the 22C solution and put it a bottle with 1 cup of distilled water, throw out the 22C solution.
68) Shake well.
69) This is a 23C solution (ratio 1 in 10^46 or 1/10000000000000000000000000000000000000000000000).
70) Take ½ teaspoon of the 23C solution and put it a bottle with 1 cup of distilled water, throw out the 23C solution.
71) Shake well.
72) This is a 24C solution (ratio 1 in 10^48 or 1/1000000000000000000000000000000000000000000000000).
73) Take ½ teaspoon of the 24C solution and put it a bottle with 1 cup of distilled water, throw out the 24C solution.
74) Shake well.
75) This is a 25C solution (ratio 1 in 10^50 or 1/100000000000000000000000000000000000000000000000000).
76) Take ½ teaspoon of the 25C solution and put it a bottle with 1 cup of distilled water, throw out the 25C solution.
77) Shake well.
78) This is a 26C solution (ratio 1 in 10^52 or 1/10000000000000000000000000000000000000000000000000000).
79) Take ½ teaspoon of the 26C solution and put it a bottle with 1 cup of distilled water, throw out the 26C solution.
80) Shake well.
81) This is a 27C solution (ratio 1 in 10^54 or 1/1000000000000000000000000000000000000000000000000000000).
(the zeros are running off of the page!)
82) Take ½ teaspoon of the 27C solution and put it a bottle with 1 cup of distilled water, throw out the 27C solution.
83) Shake well.
84) This is a 28C solution (ratio 1 in 10^56 or 1/100000000000000000000000000000000000000000000000000000000).
85) Take ½ teaspoon of the 28C solution and put it a bottle with 1 cup of distilled water, throw out the 28C solution.
86) Shake well.
87) This is a 29C solution (ratio 1 in 10^58 or 1/10000000000000000000000000000000000000000000000000000000000).
88) Take ½ teaspoon of the 29C solution and put it a bottle with 1 cup of distilled water, throw out the 29C solution.
89) Shake well.
90) This is a 30C solution (ratio 1 in 10^60 or 1/1000000000000000000000000000000000000000000000000000000000000).
And then you are done! To make the pills, go to baking center of your grocery store and get some plain cake decorating sprinkles. You can try dropping some of the solution on the sprinkles, or just set the bottle next to the solution for it to absorb the energy (which is the typical method used for over the counter homeopathic remedies).
dean (#13) writes,
Given your history of comments it’s no surprise that you don’t understand it.
It is written, "Homeopathy is based on the idea that "like cures like." That is, if a substance causes a symptom in a healthy person, giving the person a very small amount of the same substance may cure the illness. In theory, a homeopathic dose enhances the body's normal healing and self-regulatory processes.
Q. Doesn't allergy shot immunotherapy, which is science-based, falls within the parameters of homeotherapy.
Example, low dose of a natural allergen with repeated exposure to decrease sensitivity to that allergen.
In this instance, conventional medicine and integrative medicine overlap.
I don't know how much experience anyone here has with college/university development offices, but those folks are usually glad-handing snakes. Their job is to get as much money from donors first, and then see that the fewest strings are attached to it so the school administrators can use it any damn way they please. In this, they are expert are snowing both the faculty and the donors. They have lots of tricks for this – making it look to the donor like the money will go to one thing when it actually goes to something else, and then forcing the faculty into continuing the ruse through the years...
Which is not to say that $200 million doesn't buy a lot of influence. Just that how much influence and where it lands is a complex negotiation, and PR releases can't be trusted to give a proper indication of how it all will play out. My guess would be that most of the The Susan and Henry Samueli College of Health Sciences will be giving only lip service to IM, and continuing the re-branding of useful stuff they were already doing as "integrative". That is, very little of the $200 million will be going to 'quackery'. But, on the other hand, the old Susan Samueli Center for Integrative Medicine is being upgraded and more firmly anchored institutionally within UCI along with the renaming to the Susan Samueli Integrative Health Institute.
Another way to put it: $200 million buys getting your name on a school, but it's probably not enough to dictate everything that goes on inside, (or even all that much of it...). Academic institutions much smaller than the UCI med school are as easy to turn around as the Titanic, and declarations of 'new cutting edge program!!' are more often than not puffed up with hype while most day-to-day business stays pretty much the same.
That's my experience anyway in my corner of academia, which I admit is far away from health sciences, but it seems pretty common, fwiw. Of course, things could be different at Irvine ("Zot! Zot!"), but of all the news I'll read this week, this is likely to worry me the least.
Spectator @12: Oh, that is brilliant. May I borrow it when the need arises?
#15 Michael J. Dochniak, September 26, 2017
The difference is that the low dose is a low but non-zero dose; where the homœopathetic dose is diluent only, a dose of zero.
The other fallacy of your simile is that the extremely low dose of active ingredient in the anti-allergy treatment is designed to produce a subtle effect, teaching the patient's immune system that the allergen really ain't anything to be askeered of. That's why the dose is small rather than non-zero.
OTOH, the homœopathetic "dose", with no remaining active ingredient, is claimed to produce a profound effect, curing whatever the symptom might be.
The similarity you imagine vanishes upon examination.
What is this zot thing everyone keeps going on about?
PGP, you should look up UC-Irvine's mascot for the answer.
Sadmar: I think you're underestimating the influence donors can have on a school.
Why go to the Susan and Henry Samueli College of Health Sciences when you can be taken for a more enjoyable ride at nearby Disneyland?
Despite the classic Hahnman infinite dilutions theme, historical connection or popular association with herbal, natural or nutritional treatments exists with (some?) homeopathic doctors.
So I'm unclear what percentage of lay persons saying that they want homeopathic treatment are really buying into the infinitely dilute treatments superstition.
Go Eaters! Zot!