MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Consensus recommendations to the ‘National Center for Complementary and Integrative Health from Research Faculty in a Transdisciplinary Academic Consortium for Complementary and Integrative Health and Medicine’ have just been published. It appeared in this most impartial of all CAM journals, the ‘Journal of Alternative and Complementary Mededicine’. Its authors are equally impartial: Menard MB 1, Weeks J 2, Anderson 3, Meeker 4, Calabrese C 5, O’Bryon D 6, Cramer GD 7

They come from these institutions:

  • 1 Crocker Institute , Kiawah Island, SC.
  • 2 Academic Consortium for Complementary and Alternative Health Care , Seattle, WA.
  • 3 Pacific College of Oriental Medicine , New York, NY.
  • 4 Palmer College of Chiropractic , San Jose, CA.
  • 5 Center for Natural Medicine , Portland, OR.
  • 6 Association of Chiropractic Colleges , Bethesda, MD.
  • 7 National University of Health Sciences , Lombard, IL

HERE IS THE ABSTRACT OF THE DOCUMENT IN ITS FULL AND UNABBREVIATED BEAUTY:

BACKGROUND:

This commentary presents the most impactful, shared priorities for research investment across the licensed complementary and integrative health (CIH) disciplines according to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). These are (1) research on whole disciplines; (2) costs; and (3) building capacity within the disciplines’ universities, colleges, and programs. The issue of research capacity is emphasized.

DISCUSSION:

ACCAHC urges expansion of investment in the development of researchers who are graduates of CIH programs, particularly those with a continued association with accredited CIH schools. To increase capacity of CIH discipline researchers, we recommend National Center for Complementary and Integrative Health (NCCIH) to (1) continue and expand R25 grants for education in evidence-based healthcare and evidence-informed practice at CIH schools; (2) work to limit researcher attrition from CIH institutions by supporting career development grants for clinicians from licensed CIH fields who are affiliated with and dedicated to continuing to work in accredited CIH schools; (3) fund additional stand-alone grants to CIH institutions that already have a strong research foundation, and collaborate with appropriate National Institutes of Health (NIH) institutes and centers to create infrastructure in these institutions; (4) stimulate higher percentages of grants to conventional centers to require or strongly encourage partnership with CIH institutions or CIH researchers based at CIH institutions, or give priority to those that do; (5) fund research conferences, workshops, and symposia developed through accredited CIH schools, including those that explore best methods for studying the impact of whole disciplines; and (6) following the present NIH policy of giving priority to new researchers, we urge NCCIH to give a marginal benefit to grant applications from CIH clinician-researchers at CIH academic/research institutions, to acknowledge that CIH concepts require specialized expertise to translate to conventional perspectives.

SUMMARY:

We commend NCCIH for its previous efforts to support high-quality research in the CIH disciplines. As NCCIH develops its 2016-2020 strategic plan, these recommendations to prioritize research based on whole disciplines, encourage collection of outcome data related to costs, and further support capacity-building within CIH institutions remain relevant and are a strategic use of funds that can benefit the nation’s health.

AND WHY DID THIS SURPRISE ME?

Well, I would have expected that such an impartial, intelligent bunch of people who are doubtlessly capable of critical analysis would have come up with a totally different set of recommendations. For instance:

  1. Integrative health makes no sense.
  2. Integrative medicine is a disservice to patients.
  3. Integrative health is a paradise for charlatans.
  4. No more research is required in this area.
  5. Research already under way should be stopped.
  6. Money ear-marked for integrative health should be diverted to other investigators researching areas that show at least a glimpse of promise.

Alright, you are correct – my suggestions are neither realistic nor constructive. One cannot expect that they will turn down all these lovely research funds and give it to real scientists. One has to offer them something constructive to do with the money. How about projects addressing the following research questions?

  1. How many integrative health clinics offer evidence-based treatments?
  2. Is the promotion of bogus treatments in line with the demands of medical ethics?
  3. If we need to render health care more holistic, humane, patient-centred, why not reform conventional medicine?
  4. Is the creation of integrative medicine a divisive development for health care?
  5. Is humane, holistic, patient-centred care really an invention of integrative medicine, and what is its history?
  6. Which of the alternative treatments used in integrative medicine can be shown to do more good than harm?
  7. What are the commercial drivers behind the integrative health movement?
  8. Is there a role for critical thinking within integrative health?
  9. Is integrative health creating double standards within medicine?
  10. What is better for public health, empty promises about ‘the best of both worlds’ or sound evidence?

2 Responses to Wow! A consensus document that took even me by surprise

  • The Quack division of the NIH is a politically protected sanctuary for the promotion of pseudoscience. Rational arguments really do not have much power against ideology. This is particularly true when proponents are scientifically illiterate and resentful of those “elitists” who have taken the time and effort to actually know what they are talking about. It is a mistake to hope for a scientific solution to what is ultimately a political problem where facts are not trusted.

  • What would be a truly integrative and “strategic use of funds that can benefit the nation’s health” is to re-allocate the money among the poor. It is well established that depression, poor nutrition, and lack of adequate health care are all caused by poverty. By treating the cause instead of the symptoms, the benefits would be significant and readily measurable.

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