Quackademic medicine marches on, Stanford edition

One of the most pernicious changes in medicine that’s occurred over the last 25 years or so is the infiltration of what I like to refer to as “quackademic medicine.” It’s a term that was, as far as I know, coined by Dr. Robert W. Donnell in 2009 to describe the infiltration of pseudoscience and quackery into medical schools and academic medical centers under the mantle of “complementary and alternative medicine” (CAM), now more commonly referred to as “integrative medicine. However, over the years, I’ve embraced the term to describe the “integration” of quackery and pseudoscience into academic medicine, or, as Mark Crislip likes to put it, the “integration” of cow pie with apple pie. Unfortunately, over the last quarter century or so, quackademic medicine has invaded seemingly respectable bastions of academic medicine, such as traditional Chinese medicine, functional medicine quackery, and reiki at the Cleveland Clinic; a whole panoply of woo including naturopathy, functional medicine, and high dose vitamin C for cancer at the University of Kansas; “integrating” quackery to the point of teaching acupuncture points in gross anatomy class at Georgetown University; the embrace of naturopathy at more academic medical centers than I can count; and even homeopathy at Yale, courtesy of Dr. David Katz. It’s gotten so bad that there are even “integrative oncology” guidelines and “integrative oncology” has been featured at the yearly meeting of the American Society of Clinical Oncology (ASCO). Even institutions with champions of science-based medicine have fallen, such as when acupuncture was adopted by Children’s Hospital of Philadelphia, which is where Dr. Paul Offit is based.

Latest on the list (well not latest on the list but latest in the news) is Stanford University, which recently held a panel discussion on integrative medicine at its Medicine X Conference last weekend, a conference that Stanford describes as “our signature day of moonshot thinking and big idea inspiration.” As part of that conference, Stanford hosted a panel on integrative medicine, which was duly reported on its blog:

Ten years ago, Sangeeta Agarawal was a busy software engineer in Silicon Valley. Her lifestyle led to professional success, but eventually work-related stress began to take a toll on her health and she was diagnosed with a series of chronic health problems. She was able to maintain a facade of “being okay” on the outside, but Agarawal said she was “in pieces” on the inside. When her physician brought up the possibility of spinal surgery, she knew that something had to change — and a referral for physical therapy from her physician led her to yoga, ayurveda and eventually her life’s path. “Within a few years, I was a nurse. I was an ayurveda practitioner. I was a yoga teacher. I started to collect these credentials… and that was when I realized it was all about treating the whole person,” she said.

The founder of health startup Helpsy, Agawaral spoke as part of Sunday’s panel at Medicine X on integrative medicine’s role in treating chronic health conditions.

I took a look at the Helpsy website. The splash page portrays a woman, her hands raised, looking out over a beautiful hilly countryside. What is it about “integrative medicine” that it always—and I mean always—features images like this. Another favorite is someone, usually a woman, in a yoga pose in a beautiful natural setting, looking blissful. Be that as it may, here we note the usual tropes used to justify integrating quackery into medicine. As for Helpsy itself, it might have been a good idea if it didn’t integrate alternative medicine quackery, which basically fatally undermines the whole concept:

She [Sangeeta Agarawal] found her home in two key terms Quality of Life and Integrative Medicine. As she found ways to empower herself to be healthy and happy, she decided to devote her life to empowering everyone to living their best quality of life. She studied integrative medicine by studying, practicing and conducting research in both eastern and western medicine. She spent the next decade as a researcher, oncology nurse and integrative medicine practitioner at institutions including the Mayo Clinic, Stanford Cancer Center, and UCSF Cancer Center serving the community. She still found that most people continued to struggle with health and quality of life issues and access to such solutions was limited. Inspired to create a solution that can be accessible to all, Sangeeta created Helpsy, a platform that brings together health care experts from all evidence based health care modalities, researchers and health care centers to combine their efforts together to offer an all-in-one interdisciplinary health solution to treat all aspects of health. Our solution is ready to help everyone live their life to the fullest.

Prominently mentioned among the health care experts that Helpsy helps patients find are acupuncturists and chiropractors, for which it markets various services, including a Helpsy profile, management of online practice, and enhancement of online presence. Basically, Helpsy appears to be a marketing company for quacks.

Next up:

The 45-minute panel featured a lively and wide-ranging discussion, with all panelists acknowledging integrative medicine’s potential to help those struggling with chronic health conditions. But what exactly does integrative medicine mean? Victoria Maizes, MD, executive director of the Arizona Center for Integrative Medicine, clarified that it isn’t alternative medicine — but rather an approach that integrates complementary modalities with mainstream medicine. “We really respect Western conventional medicine,” she explained.

Maizes also stressed that integrative medicine is about more than just tapping into ancient traditions like acupuncture, ayurveda and yoga — that it’s also very much about moving into the future. “Which means we think a lot about genomics. We think a lot about the microbiome… It’s really integrating cutting edge science as well.”

Actually, it’s about tooth fairy science. Basically, tooth fairy science is the scientific investigation of an implausible phenomenon that has not yet been shown to be a real phenomenon, using the tooth fairy as the analogy. As Harriet Hall puts it:

You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.*

So much of what quackademic medical centers embrace and investigate is tooth fairy science: acupuncture, traditional Chinese medicine, naturopathy, functional medicine, homeopathy, reflexology, and so much more. When, for instance, scientists apply advanced genomics to these modalities, you get what I like to call “woo-omics,” something that the National Center for Complementary and Integrative Medicine (NCCIH) promoted and continues to promote. It’s basically a waste of sophisticated scientific tools to study phenomena that have not even been shown to exist. That’s why I actually laughed out loud when I saw this quote by Dr. Jeffrey White, an oncologist who used to be the Director of the Office of Cancer Complementary and Alternative Medicine (OCCAM) at the National Cancer Institute (NCI) for several years, who said, ““Ideally integrative medicine ought to be based on as high level of evidence as mainstream medicine.” Well, yes, as a concept that sounds all very well and good, but the statement is very, very problematic. The reason is that so much of “integrative medicine” is based on concepts that are either prescientific, pseudoscientific, or downright antiscientific. Modalities like acupuncture, homeopathy, reiki, and the like are so implausible on a basic science basis that clinical trials of them tend to be clinical trials of placebo versus placebo and “cutting edge science” to study their mechanisms are a form of scientific pareidolia, where scientists see what they want to see in random patterns seen in noise in their data.

Last up is Dr. David Spiegel, medical director of the Center for Integrative Medicine, who recaps the same sort of arguments he’s been using for a while now, portraying integrative medicine as being all about “empowering the patient.” My common response to this is simple. You don’t have to embrace pseudoscience and quackery in order to “empower” the patient and make him feel “more involved, more in control and responsible for their own health care.” It’s the false dichotomy at the heart of “integrative medicine.” That doesn’t stop Dr. Spiegel:

Stanford psychiatrist David Spiegel, MD, medical director of the Center for Integrative Medicine, brought up the fact that the desire for more integrative medicine is being driven by patients: “This isn’t a profession-driven movement. It’s a person-driven movement.” He told the audience that patients “don’t go to an acupuncturist for a heart attack. They go for chronic pain, stress and other things we have not dealt with well in mainstream medicine.” He also spoke about the importance of integrative medicine in treating the mental-health issues that often come along with chronic health conditions; it can provide “help with coping with the disease, not just help with the symptoms.” In fact, he explained, for this reason “integrative medicine becomes the default referral from oncology.”

Methinks Dr. Spiegel inadvertently admitted something. He’s absolutely correct about that one thing: Integrative medicine didn’t become popular because scientists and physicians cried out for it, because there was some sort of compelling science telling us that we in the medical profession really needed to start investigating this. As I’ve said many times, NCCIH was not formed because the physicians and scientists running the NIH demanded it. It was formed because Senator Tom Harkin, who believed that bee pollen cured his allergies and was interested in a lot of quackery, used his power to bring it into existence. Similarly, the adoption of integrative medicine by academic medical centers appears to be motivated far less by genuine scientific curiosity over a phenomenon compelling enough to draw scientists in to investigate than by marketing considerations.

Particularly chilling and irresponsible to me is Dr. Spiegel’s statement that “integrative medicine becomes the default referral for oncology. My reaction to that statement was: WTF? Is he serious? Sending patients to practitioners who “integrate” pseudoscience and quackery with real medicine becomes the “default” referral? Again, the false dichotomy at the heart of integrative medicine has eaten someone’s brain. It is not necessary to embrace quackery to provide “holistic” care to patients, and if medicine isn’t doing so well dealing with a condition or symptom, the answer is not to “integrate” magic like acupuncture into the patient’s treatment. It is to use science-based medicine to find ways to do better. It is to fix whatever systemic problems that lead to patients having trouble accessing care to find relief. Integrative medicine is a feel good delusion that lets eminent doctors like Dr. Spiegel feel good and believe they are doing something.

Let me remind you what Dr. Spiegel’s department offers at Stanford:

We provide an hour-long evaluation and counseling program to help patients match integrative medicine offerings with individual needs. This involves assessing medical problems, coping resources, family and social support, and evaluating patient goals, abilities, and opportunities.

We help patients evaluate available non-traditional treatment options. We help patients to combine "alternative" techniques, including acupuncture, hypnosis, mindfulness, and information regarding dietary supplements, with traditional medical care.

Our evaluation and counseling staff includes a physician-naturopath, an internal medicine/psychiatrist, and a psychiatrist.

Yes, everyone is evaluated by a naturopath at Stanford’s integrative medicine program. In fact, Stanford is a little bit sneaky about describing naturopath. I went perusing the list of its personnel for naturopaths by looking for an ND after names. I didn’t find any. But I did find Brian Karvelas, MD, who, it is noted, “did his internship at Santa Clara Valley Medical Center, and his residency in Physical Medicine and Rehabilitation at Stanford. He received a doctorate in Naturopathic Medicine from John Bastyr University, and graduated from the San Francisco College of Acupuncture and Oriental Medicine.” So why doesn’t he list himself as MD-ND? Does he feel ashamed of his ND? Maybe he is ashamed to use it at Stanford, because he uses it when providing a promotional blurb for a book. He should. No physician should ever become a naturopath, because naturopathy is a cornucopia of quackery that includes homeopathy as one of its core systems of medicine.

When I first saw the article describing the panel at Medicine X this weekend, I almost didn’t bother to blog about it. Universities and academic medical centers integrating quackery into medicine have become so numerous that such panels hardly register with me any more. However, Stanford is a big name in medicine, and to see it promoting integrative medicine at its own conference was noteworthy enough that I decided I couldn’t ignore it, no matter how much each new example of quackademic medicine depresses me.

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I think this widespread attraction that CAM has for many people is a reflection of their innate desire for mystical and eerie experiences. Since science/evidence-based medicine doesn’t admit magic or defer to wishful thinking, and much of it is understood mechanistically, it’s just plain boring. So it has to be sexed up with an assortment of zesty wow factors. For example, just look at how often CAM abducts the term “quantum” from physics and mangles it into some zany quasi-explanation. After all, “quantum” is ripe for such picking because even physicists themselves highlight the subject’s puzzling aspects and admit that nobody really understands it.

The difference is that those of a scientific bent view such mystery as a challenge, not as something to be emulated or, worse, to be opportunely invoked for the bedazzlement of spectators.

By Con-Tester (not verified) on 21 Sep 2016 #permalink

I’ve been reading you forever and am a devoted skeptic, BUT, as someone who has developed a number of minor, but chronic “issues” (mostly related to aging it seems) and getting nothing but shrugs or “see a psychiatrist”, I do think that the profession is not doing enough to offer something better. I can certainly see why the less-informed, more believer-oriented turn to these so-called alternatives. Sometimes I which I were not informed enough to know better, because I’m just left on my own to try to sort this out with an endless-seeming quest for a primary provider who can help me sythesize some sort of approach--I had one once, but then moved. BTW, I saw the shrink, who had no more to offer than the others.

By kissmetoad (not verified) on 21 Sep 2016 #permalink

wish, not which

By kissmetoad (not verified) on 21 Sep 2016 #permalink

Does the timeline for the Helpsy owner make sense to anyone? Supposedly, this woman, 10 years ago, was a "busy software engineer". So, within 10 years, she got an RN/BSN, worked at Mayo, Stanford and UCSF as a cancer nurse and started her own business? Something seems weird here.

@ MI Dawn--there's all sorts of nonsense out there. From an alumni mag of a place I went that should know better but does not (they glamorized their alumnus who started that rathole of naturopathy--Bastyr University--a few years back) comes this nugget of nonsense from a more recent edition (this year) of their alumni magazine article about someone I went to school with who ditched a lot of scientific training for a masters in psychology along with this rubbish:

"[The]NeuroAffective Relational Model (NARM), forms the basis of XXXX's private practice. NARM emphasizes self-regulation and working in the present moment, and XXXXX defines it as a “resource-oriented, non-regressive model [that] emphasizes helping clients establish connection to the parts of self that are organized, coherent and functional.”

“The most important piece here is that we’re all physiologically wired to move toward aliveness. So I really encourage everyone to keep listening to that inner voice and trust that you can overcome any limitation you encounter and to find people who can help, because we’re out there,”

“You don’t have to know what the outcome is going to look like or even the exact path. It’s just one foot in front of the other and trusting that basic aliveness.”

If you can make sense of any of that rubbish, please let me know. The pushers of woo and snake oil today have a bigger thesaurus and even less shame.

By Chris Hickie (not verified) on 21 Sep 2016 #permalink

Sorry, Dr Hickie! I have an infallable test for woo and nonsense: if my brain stops working and my eyes glaze over from teh stupidz, I know it's woo. I didn't even make it through your first italicized paragraph!

“You don’t have to know what the outcome is going to look like or even the exact path. It’s just one foot in front of the other and trusting that basic aliveness.”

...right off the edge of that cliff.

MI Dawn@5: My reaction to the mention of possible spinal surgery was that there is something in Ms. Agarawal's medical history that we're not being told. Recommendations for spinal surgery don't come out of the blue like that. Something was causing her back pain--whether it was an auto accident, a slip and fall, too much heavy lifting, or some ergonomic issue in the workplace, we aren't told. That's the thing which makes the timeline you point out implausible. A healthy, ambitious person might accomplish all of that in ten years, particularly the part about starting her own company (she would be using skills she acquired during her previous career as a software engineer). To do all of that while dealing with back pain severe enough to contemplate surgery is a lot harder.

By Eric Lund (not verified) on 21 Sep 2016 #permalink

NeuroAffective Relational Model (NARM)

Did you make that up, Dr. Hickie, or is that actually the acronym that your fellow university alumnus uses? Poe's Law is very much in force here, so I honestly can't tell.

I work in a field where people frequently get cute with acronyms. For instance, a now-defunct NASA online proposal system actually had the acronym SYS-EYFUS, where the last five letters were supposedly derived from NASA mail codes for the divisions involved. If you are familiar with the Greek mythological character Sisyphus, you will immediately recognize the similarity to the lifestyle of a soft money scientist.

By Eric Lund (not verified) on 21 Sep 2016 #permalink

"The splash page portrays a woman, her hands raised, looking out over a beautiful hilly countryside. What is it about “integrative medicine” that it always—and I mean always—features images like this"

It is the naturalistic fallacy at the core of many of these quackeries. That if only we got rid of man made things and instead were more of a part of nature, then all would be healed. From organic to homeopathy to naturopathy (it is in the name itself) the underlying belief is that man made things are bad and nature is good.

#6 Chris Hickie

Hey watch the psych cracks :) Dr Oz is not a psychologist.

NeuroAffective Relational Model

If you can make sense of any of that rubbish, please let me know.

Easy, it says, “ I may be an fraud and/or an idiot but give me money anyway”

By jrkrideau (not verified) on 21 Sep 2016 #permalink

@ Eric Lund #9 and MI Dawn #5
Yeah, there is something not being made clear. Before my wife was diagnosed with MS, her symptoms of leg pain, numbness and weird nerve sensations were blamed on possible disc problems and surgery was suggested as a fix. She passed on it as the cure seemed more extreme than the condition at the time.
In the early stages, as it comes and goes, it is easy to attribute success to random interventions, until eventually the downs outnumber the ups.
Who knows what Sanjeeta may have and how long it will respond to her wellness strategy.

@ jrkrideau
My favourite is Applied Psycho-Neurobiology.
"Trauma is an experience that cannot be digested. Epigenetics is the load of the system from the family tree and from your soul history, and from the early years, and the 9 months in the womb. It leaves an imprint that permanently changes our physiology and behavior and everything else."
We are taking orders for the new UV Mirror that detects "unwelcomed spirits", Turquoise Mercury Photon Pulser and Energetic Detox Kits"
The above is from the helpful website, unfortunately my SIL believes this guy is the real deal.

I saw this announcement posted at a university health clinic last week:

The University of New Mexico
Health Sciences Center
Brain-Centered Therapy versus Medication for Urgency Urinary Incontinence and RCT (Hypnotherapy or Pharmacotherapy-Hyp-hOP )
Yuko Komesu, MD

Do you suffer from Overactive Bladder….
UNM Urogynecology has a study opportunity for women with Urge Urinary Incontinence…
If you are over the age of 18, you may qualify for a research study to find out if Medication or hypnotherapy can help.
You may be eligible for free medication or hypnotherapy

Contact Urogyn Research for more details….

Stanford! Say it ain't so? I went down the rabbit hole of links provided by Orac and the cowpie could have choked me.
In northern California, it was just the corner quack-in-a-box but now the quacks are really making inroads into otherwise respectable institutions. Dr Speigle, Dr Maizes and Helpsy, Oh Jesus.
I am a pro patient seven years and counting. Post stem cell transplant patients like me have left cancer behind but with GVHD, we are the step children of the hem/onc clinic. I am at UCSF not far from Stanford, I would seem to be the perfect client for Helpsy. If they ever approach me they are sure to get a raft of negative about all of their positivity crap. What they really mean is, being negative means not being positive about their stupid integrative approach. It's like, if you don't believe, you'll get cancer ....and go to hell too.
I have a sharp eye for stuff like that at the UCSF clinic. So far there are only a few fliers and brochures offering mildly woo stuff but so far nothing as bad as acupuncture.
I looked at the Stanford primary care physicians and chose alternative in the drop down menu and came up with two PCPs who also offered acupuncture. I wonder what the insurance code number is for that?

By Mike Callahan (not verified) on 21 Sep 2016 #permalink

Oh No. I searched at UCSF just now and they also offer integrative medicine with seven PCPs available.

By Mike Callahan (not verified) on 21 Sep 2016 #permalink

If you can make sense of any of that rubbish, please let me know.

I was able to form a vague notion of where they're coming from, word salad aside. The introduction to Heller's book is available. The blab level isn't quite as bad. What's it's like in practice, I have no idea – Denice would be the authority here.

^ Skimming a bit further, though, it looks like Heller is trying to have it both ways with the relevance of childhood experience – we consider your childhood rather than where you are now only to the extent that it can be banged into this framework.

I looked at the Stanford primary care physicians and chose alternative in the drop down menu and came up with two PCPs who also offered acupuncture. I wonder what the insurance code number is for that?

Without anesthesia? The ICD-10-PCS one is 8E0H30. I'm only getting S8930, "electrical stimulation of auricular acupuncture points," from easy HCPCS searches; feel free to do it the hard way.

What I can only guess are current CPT codes are, e.g., here.

Face it. You've lost. The only thing to do now is invent your own Orac Protocol for detoxification, whole-body wellness, and casting out demons.

By Mark Thorson (not verified) on 21 Sep 2016 #permalink

I think this widespread attraction that CAM has for many people is a reflection of their innate desire for mystical and eerie experiences.

And at the same time, Americans are moving steadily away from churches. There's some kind of paradox
here.

By shay simmons (not verified) on 21 Sep 2016 #permalink

So much of what quackademic medical centers embrace and investigate is tooth fairy science:

Well, at least we aren't talking about the tobacco science of the vaccine industry. People don't get autism from accupuncture you know.

By Mark DePaun (not verified) on 21 Sep 2016 #permalink

Chris @6: Is that the same issues as the one with my friend the CRISPR guy? Or from before that?

When I told a fellow alum about the whole Bastyr thing I thought I would finally witness spontaneous human combustion, he was so pissed.

"Move toward aliveness" - uh, no, if you didn't sleep through all of freshman chem and physics you'd remember we're all moving towards death. Hello entropy!

(grumble grumble letting down the good name of my school that no one has ever heard of grumble grumble)

By JustaTech (not verified) on 21 Sep 2016 #permalink

Shay @22: Maybe it's like the "spiritualism" craze of the Victorian/Edwardian period, which also saw tremendous technological and scientific advances?

Except instead of sitting around a seance table waiting for dear dead Aunt Melba to play the tambourine we're hanging crystals in the window to cure our eczema.

By JustaTech (not verified) on 21 Sep 2016 #permalink

# 13 JDK
Amazing.
Applied Psycho-Neurobiology
http://www.holisticmd.org/treatments/applied-psycho-neurobiology/
It utilizes psychokinesiology (biofeedback-guided counseling and healing), understanding about color, eye movements (EMDR), energetic taping techniques (MFT), understanding about acupuncture, and unresolved emotions connected to acupuncture.

One does not see that level of inspired sciency baffle-gab very often. It must do more than just lighten wallets.

By jrkrideau (not verified) on 21 Sep 2016 #permalink

#6 Dr Hickie
I think it was the sentence about us being physiologically wired to move to aliveness (is that even a word?) that got me. After all we would have not moved very far along the evolutionary path if we were physiologically wired to move to deadness.

By Ailsa Graham (not verified) on 21 Sep 2016 #permalink

jrkrideau @25: understanding about color ? How does that even work? "You're an autumn who has issues with your mother, so I'll be stabbing you in this acupuncture point here."

By JustaTech (not verified) on 21 Sep 2016 #permalink

Oh boy. UCSF has the "Osher Center for Integrative Medicine". They have integrative oncologists too. I am attending a biannual reunion of UCSF Bone Marrow Transplant survivors coming up. We get to hang with our doctors and caretakers for an afternoon. I wonder if a rep from the Osher center will be there?
I wasn't there, but in 2012 at the reunion, Rob Schneider was there for some reason. WTF. He is invested somehow. I wonder if he'll be there this time?

By Mike Callahan (not verified) on 21 Sep 2016 #permalink

# 26 JustaTech

understanding about color ? How does that even work?

How would I know? I doubt the copywriter (err, doctor) knows.

I suspect it works very similarly to dealing withunresolved emotions connected to acupuncture. That is to say it does not. Well, unless you really, really BELIEVE.

Note the same site also offers homeopathic bee venom therapy. Steven Novella's review is not wildly favourable.

By jrkrideau (not verified) on 21 Sep 2016 #permalink

Mike Callahan, you wouldn't happen to be a time-traveling bar owner, would you?

CAM is everywhere in the Bay area. I was super confused to find several acupuncturists (some of whom were also MDs) in my public health program at UC (redacted). Like, why would people who are super into woo want a degree that's all math and policy and the greater good, rather than one-on-one patient interactions? I still have no idea.

By JustaTech (not verified) on 21 Sep 2016 #permalink

It seems to me "Helpsy" is a perfect name for this service.. It's like Stephen Colbert's "truthiness." It SOUNDS helpful, but really isn't.

By Emma Crew (not verified) on 21 Sep 2016 #permalink

energetic taping techniques

Applying tape here! And there! And I'll pull on it really hard! Wow, this is so exciting! Let's jump up and down a bit and then then we'll see what else we can tape!

I kid everybody not--the start of the article on this person who does this "NARM" is just as bad, and this alumni mag is from one of the highest rated undergraduate engineering/science colleges in the US . At the start of this article, this person rails on about having been a chemist but "got a look inside 'big pharma'" and changed her mind:

But XXXX quelled the thought, went on to earn her master’s degree in chemistry and landed a great job at a well-funded startup doing cutting-edge drug discovery research in a fast-paced, energetic environment. She went on to work in the biotech industry—doing research, overseeing operations and then consulting—for more than a decade. But when she got a look inside of “big pharma,” that unsettled feeling returned. She decided it was time to do something that could affect people’s lives in a more immediate way. Time for a career, she says, that “fit the deeper me.”

“I love science. I absolutely love research. So when I found Somatic Experiencing and the NeuroAffective Relational Model, I knew I had found something really important,” says XXXX. She returned to school and earned a master’s degree in psychology, became a Somatic Experiencing practitioner and trained in the NeuroAffective Relational Model.

Whatever she claims she's doing has no real research/backing to it. Lots of big words, though.

Also, not only is Stanford into quackademia in adult medicine, but here's a CME brochure I received about a meething they are hosting for quackademia in pediatrics: http://www.stanfordchildrens.org/content-public/pdf/cme-brochures/integ…

By Chris Hickie (not verified) on 21 Sep 2016 #permalink

@ MI Dawn #5: actually, the timeline does work. She could have gotten her ADN in two years, plus one year for an online BSN or just gotten a BSN from a four year school. Then six years practicing at the hospitals mentioned is very plausible before quitting to start her own business.

The BUSINESS is bullshit, but the educational path is not. You can learn a hell of a lot in six years of nursing practice.

@JustaTech #24: To hell with freshman chem and physics, what about freshman ENGLISH?

Aliveness is not a word you'd find in any reputable dictionary. Don't even get me started on the non-sequiturs.

@ JustaTech #24--yeah, it's the place you and I went to for undergrad. Pretty sad that they let crap like this run in their alum mag next to people doing real science. You can find the article online for this NARM alum and also the one for the Bastyr alum.

By Chris Hickie (not verified) on 21 Sep 2016 #permalink

I'm not surprised. For years Stanford has been offering dubious classes to the staff as part of the health improvement program.

See http://med.stanford.edu/content/dam/sm/hip/documents/HLAtAGlance.pdf

As usual they have their classes in Reiki healing.

A major problem is that given the known unscientific stuff, it is tricky to tell which classes have a scientific base. At least we don't have the Tibetan eye exercise classes anymore.

Anyone for Feldenkrais? Omada? Lantern?

After all we would have not moved very far along the evolutionary path if we were physiologically wired to move to deadness.

Some of us do seem to have that albatross around our necks; an evolutionary dead end, I suppose.

And at the same time, Americans are moving steadily away from churches. There’s some kind of paradox
here.

Well, churches are for boring, normal, ordinary people, like your mother and grandmother. Special-snowflake mystical woo experiences are for, well, special snowflakes. And they don't even have to make the effort to cook something for the church dinner. (Or the at-home potluck at a brother or sister's house if you're a Jehovah's Witness like my mom.)

I think it was the sentence about us being physiologically wired to move to aliveness (is that even a word?) that got me.

Meh. It's childish language, but it's not unimaginable that one would seek out a therapist for what are effectively feelings of death in life.

Like I said, I have no idea what it's like in practice. I didn't read the whole G—le books introduction, either.

^ Then again, that suggests a hydraulic model in which the "wiring" has lost conductivity,* or something. I think it's rather safe to assume that this is not snazzm-oriented, so, yah, if one can identify, say, maladaptive habits, the usual approach can be dragged out sessionwise with memory spelunking.

* Am I the only one who remembers the tabletop card game "Waterworks"?

energetic taping techniques
Ah, duct tape. Is there nothing it can't do?

By herr doktor bimler (not verified) on 21 Sep 2016 #permalink

Ah, duct tape. Is there nothing it can’t do?

I have found the quality of these tapes to vary widely, particularly in terms of withstanding repeated laundering.

@#1
I say that the widespread attraction to CAM stems from the miserable failure of modern medicine to cure anything significant besides a bacterial infection.

Synthetic chemicals do not have a good track record for healing disease.

shay simmons, #22:

“And at the same time, Americans are moving steadily away from churches. There’s some kind of paradox here.”

This isn’t necessarily a paradox because declining church attendance may be prompted by various other factors rather than waning desire for numinous experience. Nor is the desire for such experience necessarily the primary driver of church attendance. The burgeoning popularity of assorted irrationalities that characterise contemporary human history suggests that these are more attractive substitutes for formal religion. One important specific effect that Reiss neglects in his article is that of technological advances, in particular those related to the Internet, communication and the rise of social media, which combine to facilitate both awareness of alternatives as well as community from the comfort of an armchair at home.

By Con-Tester (not verified) on 21 Sep 2016 #permalink

Hi Orac

Is there evidence of academics and physicians having their careers damaged by resisting this tide of nonsense? Can physicians in the quackademically infected institutions freely refuse to co-operate and counsel patients against pursuing the quackery that the institution offers?

By Badly Shaved Monkey (not verified) on 21 Sep 2016 #permalink

"And at the same time, Americans are moving steadily away from churches. There’s some kind of paradox here.”

"When men choose not to believe in God, they do not thereafter believe in nothing, they then become capable of believing in anything."
G.K. Chesterton

By Badly Shaved Monkey (not verified) on 21 Sep 2016 #permalink

@ JP

Some of us do seem to have that albatross around our necks; an evolutionary dead end, I suppose.

The size of the bird could vary greatly, but many of us carry one.
Like many other commenters, the sentence "being physiologically wired to move to aliveness" made me cringe.
It's nothing more than an iteration of the "listen to your guts' instinct". There was a fad diet based on this. But for most of us simple clods, it's useless and guild-inducing garbage.

If I was "physiologically wired to move to aliveness", I wouldn't have eaten that second slice of pizza (or was it the third one?).

By Helianthus (not verified) on 21 Sep 2016 #permalink

I mean guilt, not guild.

Oh, well, alt-med aphorisms are indeed meant to induce you to join the guild, or cult, or whatever.

By Helianthus (not verified) on 21 Sep 2016 #permalink

@Panacea: The timeline - along with the fact that whatever was going on with her had suck severe back issues as noted above - still doesn't make a lot of sense. Nursing requires a lot of physical activity, especially as a student.

But let's work the timeline, pretending she didn't have back issues AND had all the courses needed within the required timelines for an accelerated RN program:

12-18 months to get her RN/BSN
1+years on a regular medical/surgical floor (most hospitals won't hire directly for specialty units like cancer treatment)
6 1/2 years as an oncology nurse, in 3 different hospitals. I can see the move from Mayo to Stanford (different states), but the move from Stanford to UCSF is interesting.

I just think her knowledge is very superficial, especially since she went full woo. Though as we all know to our sadness, WAY too many hospitals are offering woo along with standard care.

@Mark DePaun: you're as likely to get autism from acupuncture as from any other sham treatment or actual medical treatment. How many times must you be told that autism is a inborn DEVELOPMENTAL DELAY, not a disease you can "catch".

And at the same time, Americans are moving steadily away from churches. There’s some kind of paradox
here.

Nothing paradoxical about it. Most people who go to church (at least in the US) do so for the social community. Many people, particularly millennials but I am also among them, find that they would prefer not to be part of the community the church is offering. The subset of that group that still has unmet spiritual needs is likely to be woo-prone. And being a churchgoer does not make one immune; on the contrary, Orac has profiled many woo promoters who are also religious nuts.

By Eric Lund (not verified) on 22 Sep 2016 #permalink

Hi Dawn #50: I did overlook the back issues. Though even that wouldn't necessarily be much of a barrier, especially if she went to a community college. The open access nature of community colleges makes it very difficult for programs to eliminate students who have physical challenges. One of my former students actually had bilateral total knee replacements while a student (in fairness to her, she's a good nurse). Another student entered our program on a portable oxygen tank because her COPD was so bad (she passed away before she could finish the program).

But her knowledge isn't necessarily superficial because she went full woo. I know some very well educated nurses who understand the scientific method who are very into the woo. Nursing (my profession) seems to attract woo like moth to a flame; a lot of my colleagues buy into it. I suppose it's the touchy feeley aspects of nursing culture that make it attractive.

Like Orac, there were aspects of alt med that I thought might actually have some basis or merit to them, like acupuncture. I also thought there might be something to essential oils. So I gave it a chance to show me the evidence. Consistently, they fail. So I'm pretty much done with it. But many of my colleagues are not, and be it EBM on vaccinations, "Lyme Literate doctors", accupuncture, and so on, they just buy into stuff.

It's very frustrating.

Narad, I have indeed run into that nonsense previously

HOWEVER it was a long time ago and after a while, I have trouble recalling pertinent details because all of this crap sounds the same:
they find a well known theory ( Freud, Erikson, whomsoever) and blend it with nearly equal parts of Standard Woo ( frequent of the eastern variety- chi etc).

Usually some sort of hydraulic release to free up the frozen/ stuck parts is required.

And we all know what hydraulic release means
Use your imagination

At that, I must depart because my break is over.

By Denice Walter (not verified) on 22 Sep 2016 #permalink

Hello JP!
Glad to know you're around the ranch ( or whatever we're calling RI these days)

By Denice Walter (not verified) on 22 Sep 2016 #permalink

@Con-Tester

For example, just look at how often CAM abducts the term “quantum” from physics and mangles it into some zany quasi-explanation. After all, “quantum” is ripe for such picking because even physicists themselves highlight the subject’s puzzling aspects and admit that nobody really understands it.

As a physicist, I think that's an incredibly misleading statement. You have to remember that the way collaborative science is done, people have to talk to one another about pieces of information that don't quite fit in with the collective understanding. We pretty much always have to talk about what we don't understand, or else we would actually be talking about something that isn't scientifically interesting. This is the same as saying that because biologists are always talking about the puzzling aspects of evolution that the subject is ripe for abduction by cranks, or that because health science professionals are always talking about the puzzling aspects of vaccine science that antivaxxers are bound to catch on to their confusion.

I think that a big part of the reason that quantum gets abducted by cranks is because there are some very famous existential statements that have been made by equally famous scientists regarding quantum mechanics. It all boils down to an argument by authority. The problem is that the scale of these statements gets badly twisted when they are taken out of the context that generated them. And, naturally, nobody but physicists ever bother to spend time learning how those scaling arguments actually work. As such, every time popular culture naively generates an ansible or a teleportation device or something, people who don't know the machineries of quantum mechanics can coopt what that famous scientist said out of context as if that validates whatever crap they're talking about. A big part of the problem is therefore how people who don't actually understand the topic treat it when they're presenting what little they know to others. It's basically just a big game of 'telephone.' It pisses me off every time I read some Tech-press article about how 'quantum computing is about to change everything' because the zing words assure that the laymen are bound to misunderstand the science in favor of the fanciful image cast by the idiot journalist who was going for click-bait --nobody can possibly be surprised when people reading the article take that second hand piece of crap as gospel truth.

Yeah, physicists don't understand some parts of quantum mechanics, but that's overlooking exactly how much of it we do understand.

A quick post-script to comment #55 since I think it doesn't quite encapsulate my objection. The comment I was responding to is not a poor comment by any means.

I just don't think it's fair to single out quantum mechanics when cranks justify misrepresenting all sciences because no science is quite 'totally' understood. None of us can afford to -not- talk about what isn't understood in our respective fields and physicists aren't specially encouraging anybody by what we say. The cranks would seize on no matter what anybody does, and they seize on to everything!

After all, “quantum” is ripe for such picking because even physicists themselves highlight the subject’s puzzling aspects and admit that nobody really understands it.

I am also a physicist by training, and while I think viggen is going a bit hard here, this statement is indeed not fully accurate. It's not that quantum mechanics is puzzling and nobody really understands it. Lots of people do understand it and make a good living doing detailed calculations with it. The issue is more that quantum systems frequently work in ways that violate the intuition of people whose experience is entirely based on macroscopic systems. For instance, the concept that the act of measuring something can change the thing you are measuring. This concept derives from the Heisenberg Uncertainty Principle: there is a hard limit to how well you can simultaneously know the position and momentum of something, and any attempt to improve the precision of one of those variables beyond that point will reduce the precision of the other (e.g., to measure the position of an electron to picometer precision you have to whack it with a photon so energetic that it will knock your electron to kingdom come). That's why charlatans talk about quantum woo: lots of handwaving and "of course you don't understand this, because it doesn't work the way you expect it to."

The big difference between quantum physics (and chemistry and engineering) and quantum woo is that with a quantum physical system, you can make a detailed prediction of how your system will behave, and do detailed experiments that demonstrate that your system actually does behave that way (in some cases, to ten decimal places or more). Quantum woo can't do this, because if the experiment can be performed at all, it can only be performed once (on you, the subject).

By Eric Lund (not verified) on 22 Sep 2016 #permalink

Chris @37: To amuse myself I imagine these quacked-out alumns being dragged into a Star-Chamber-esque room before a hooded panel and being told, "Look at what we have given you, the education, the knowledge to do great things. And *this* is you repay us? You spit upon this illustrious institution! You are cast out!"
And then the alum is dragged off, stage left.

By JustaTech (not verified) on 22 Sep 2016 #permalink

This doesn't count as quackademic medicine (more like wooful community medicine), but a certain hospital system in my area is sponsoring a "wellness symposium" for physicians and staff. It will feature talks such as "Go With The Flow" and "Don't Try To Be Mindful" (along with an optional "Mindful Walk").*

The scheduled speakers include one RN and a bevy of people with odd-sounding degrees (I am afraid to find out what an E-RYT-500 is).

*"Hey! Mind you don't step in that pile of raccoon feces!"

By Dangerous Bacon (not verified) on 22 Sep 2016 #permalink

@ Eric Lund #57 --by chance did you major in physics at a college whose name rhymes with dud?

By Chris Hickie (not verified) on 22 Sep 2016 #permalink

I know Eric from meatspace. He did his undergrad at a school whose initials spell the German word for "with".

By palindrom (not verified) on 22 Sep 2016 #permalink

plaindrom: Ah, those folks. Far away enough to not be rivals but friends.

By JustaTech (not verified) on 22 Sep 2016 #permalink

Chris Hickie -- Are you thinking by any chance of a school whose first name is shared by an imaginary giant rabbit?

By palindrom (not verified) on 22 Sep 2016 #permalink

Tradition acupuncture was much different. Before the practice was modernized, needles of different metals were used. Each metal has its own reduction potential, and in this way, microcurrents could be induced.

By Zhang Wei (not verified) on 22 Sep 2016 #permalink

This concept derives from the Heisenberg Uncertainty Principle: there is a hard limit to how well you can simultaneously know the position and momentum of something, and any attempt to improve the precision of one of those variables beyond that point will reduce the precision of the other (e.g., to measure the position of an electron to picometer precision you have to whack it with a photon so energetic that it will knock your electron to kingdom come).

May I OCD use avoidance in the face of anxiety grumble at bit? That's just the Compton effect; although that example was presented early on, the uncertainty princple is epistemological: noncommuting observables just don't have simultaneous eigenstates.

The whole measuremment-as-disturbance thing seems to stick in people's heads, turning the quantum into the classical.

The big difference between quantum physics (and chemistry and engineering) and quantum woo is that with a quantum physical system, you can make a detailed prediction of how your system will behave, and do detailed experiments that demonstrate that your system actually does behave that way (in some cases, to ten decimal places or more). Quantum woo can’t do this, because if the experiment can be performed at all, it can only be performed once (on you, the subject).

I dunno; are identically prepared states really essential if one is positing one or more (not countably infinite, i.e., personal) additional fields?

Tradition acupuncture was much different. Before the practice was modernized, needles of different metals were used. Each metal has its own reduction potential

I take it that by "reduction," you are referring of circulating blood volume.

No, just kidding.

and in this way, microcurrents could be induced.

How did this work, e.g., with bone "needles"?

^ "referring of to"

This guy says: "How did this work, e.g., with bone “needles”?"

It doesn't.

Why would you say such a thing?

By Zhang Wei (not verified) on 22 Sep 2016 #permalink

This guy says: “How did this work, e.g., with bone “needles”?”

It doesn’t.

Why would you say such a thing?

Offhand, I'm guessing it's because I have more knowledge of the history of acupuncture than you do. Then again, the history is the only part of the farce that I find interesting.

#2 kissmetoad

Everything about your post is one of the primary reasons CAM exists. Why MUST there be something that can help you? Its an honest question and I want you to honestly consider your answer. Is it an impossibility that there just ISNT something that currently exists to help you with that particular issue you have?

This automatic assumption that things exist to help people (which actually might be true) AND that we know what they all are (this is definitively not true) leads to people being able to claim snake oil does X and Y without every having to prove it., because hey....something MUST work right, why not this?

I think if people actually accepted that there are many things that we simply do not have any remedies for, then we would see less of this snake oil.

@Palindrom--There was a same name person as E.L. that went to said school with imaginary rabbit first name and last name same as last name of Star Trek character who had lots of women (hence name of episode as "XXXX's Women"). Also if you don't say the name of this college with proper enunciation, some will think you went to Harvard Med.

By Chris Hickie (not verified) on 22 Sep 2016 #permalink

Why would you think that two bone needles, or two of any single material, could create and electric potential?

By Zhang Wei (not verified) on 22 Sep 2016 #permalink

@Adrian

Well, fair question I guess. Firstly, I absolutely accept that there isn’t always an answer to every problem, but I don’t say that to a friend who has terminal cancer because it seems uncaring and rather cruel. Maybe I’m naive, but I though doctors want to relieve suffering and when there is no pill or other treatment, something more than a shrug should be there to assist with acceptance if nothing else.

Furthermore, I didn’t say I agreed with those who turn to woo when faced with a diagnosis with no real solution, just that I could see why people who have real symptoms would go looking for someone who cares.

I think I mostly agree with you--that people should accept the limitations of medical knowledge, and I often feel that way when I hear that someone I know has cancer and is going to “fight it with everything possible and beat it”, even when told it is too late for anything but buying a bit of time. Again, while I might think that the person should accept his fate, I would not say that to the person unless we were very close and I knew such a conversation would be welcome. That isn’t to say I would recommend or quietly tolerate a woo-ish alternative, but after a gentle reprimand, I’d let it go. Someone in my family is in this situation and all the rest are praying mightily for him. I stay out of it.

My comment was directed at exploring why people look to CAM and how medical people can respond so that they don’t. Orac, et al, often say that some of CAM is just regular medical advice dressed up to sound alternative, and I agree. My point is that they need to get better at offering standard advice in a way that connects with people. For example, when I was much younger, I told a doc I wanted to lose some weight. He reached into a file drawer and handed me a page with a sample 2000 calorie diet and left the room. Gee, I wonder why I spend the next 20 years reading stupid fad diet books? Luckily, for a variety of serendipitous reasons, I became a skeptic along the way and actually did lose the weight under the supervision of an RD.

I hope this helps.

By kissmetoad (not verified) on 23 Sep 2016 #permalink

darwinslapdog: Please don't change 'noms without announcing who you are. I have a close to absolute ban on sock puppets. I let your comment through because of your long history commenting here, but please pick a 'nym and stick with it. Don't change them without making it clear who you are. Fair's fair. If I enforce this policy brutally on quacks and cranks, I can't let friends go without being accused of selective enforcement.

Kissmetoad

All fair points. I understand deeply the idea of telling cancer patients that there might not be much else to be done, but I am a firm believer in clinical trials and there is an abundance of those available that already have evidence of efficacy. How many patients are forgoing those because they have been told that eating 5000 carrots a day and hooping joints will cure them. There is a cost to that false hope. It can deny them actual benefit from treatments in trials (likely not cures though) and also can make them live their life in a way that it isnt coming to an end because they cant accept it, and may cause them huge regret when their chosen woo doesnt work and they could have at least bucket listed some things.

Cheers,

Adrian

Zhang Wei, please explain the electrical circuit.

Ah, duct tape. Is there nothing it can’t do?

It does a surprisingly poor job sealing ducts.

By Mephistopheles… (not verified) on 24 Sep 2016 #permalink

Why would you think that two bone needles, or two of any single material, could create and electric potential?

One wouldn't logically think that. Why, then, would people claim that acupuncture with bone needles would have a benefit if that benefit required electrical currents?

By Mephistopheles… (not verified) on 24 Sep 2016 #permalink

Why, then, would people claim that acupuncture with bone needles would have a benefit if that benefit required electrical currents?

Well, you have to wiggle them for triboelectric generation.

I think it is mostly about window dressing and cash flow.

If it attracts fickle patients seeking extra mental or physical comforts, so be it, is the message.

In my area of the cancer universe, normal US billings are $40,000 to $60,000 per month. CTCA can add several minor features or items and some minor supplements for over $100,000 per month. From a bonus based management pov, what's not to like?

Also, it probably helps diffuse blame and regrets when the treatments, conventional and not, fail. ( the patient progresses or dies)

Notes:
I have never been a patient of CTCA but knew someone.
The supplement schedules for CTCA that I've seen were not nearly as potent as I think is required to produced physiological responese.
Supplements can be cheap.

Does anyone know whether Dr. David Spiegel still believes in the reality of multiple personality disorder (Dissociative Identity Disorder)?

By William Stewart (not verified) on 25 Sep 2016 #permalink

Does anyone know whether Dr. David Spiegel still believes in the reality of multiple personality disorder (Dissociative Identity Disorder)?

He certainly appears to be actively promoting that field of fraudulent malpractice.

By herr doktor bimler (not verified) on 27 Sep 2016 #permalink