The National Center for Complementary and Alternative Medicine (NCCAM) was the US Federal Government’s lead agency, under the auspices of the US National Institutes of Health (NIH), for scientific research on complementary and alternative medicine (CAM). Originally set up in 1991 as the Office for Alternative Medicine (OAM), its first Director, Dr Joseph J. Jacobs had impeccable scientific credentials and intentions but resigned two years later, telling Science he “blasted politicians – especially Senator Tom Harkin…for pressuring his office, promoting certain therapies and attempting an end run around objective science”, and expressing his concern he was expected to “dance to the tune of the alternative medicine lobby.” OAM changed its name to NNCAM in 1998 continuing with a remit “To answer important scientific questions about natural products, mind and body practices and pain management.” It has failed. It has become directed by those who have no intention of enquiring into any scientifically derived evidence as to whether CAMs have a beneficial effect on any specific condition, and is now directed by doctors who believe that they do, and who want to have CAM (SCAM/camistry – by whatever name known), integrated with regular orthodox progressive medical practice. Apparently still dancing to lobbyists’ tunes.
NCCAM even rebranded itself a couple of years ago, dropping any suggestion it might critically consider ‘alternative’ medical approaches such as chiropractic, osteopathy, acupuncture or homeopathy (all of whose founders or original proponents stated that their modalities were ‘alternative’ to the regular medicine of their day) – and is now styled as the ‘National Center for Complementary and Integrated Health’ (NCCIH).
Ad hominem commentary is normally best avoided, but when the NCCIH’s current Director speaks, we should take note. The 2019 New Year’s Message from Dr Helene Langevin M.D. allows us critical insight into her state of mind, her facility with logical fallacies, and her lack of critical thinking. All of which is important considering that the Center has spent $2.5B over the past ten years on research, and found no benefit from the modalities studied beyond the placebo. The Center’s current budget is $142M p.a.
Here follows Dr Langevin’s ‘2019 New Year message’, and a slightly more critical review (in italics) than her own insights and editing offered:
”It has been my longstanding conviction that integrative health care is more than just the sum of conventional and complementary health approaches. When combined, these approaches provide a frontier of new insights into the physiology of health and the pathophysiology underlying diseases and disorders. Dr. Straus, Dr. Briggs, and Dr. Shurtleff have built a strong foundation for NCCIH’s strategic priorities and partnerships.”
Dr Langevin fails to mention her predecessor Dr Josephine Brigg’s opinion when, as Director of the US National Center for Complementary and Alternative Medicine she said: “Integrative medicine represents an invasive rebranding of modern equivalents of ‘snake oil’ by practitioners who raise unrealistic hopes and promote approaches that are not sensible, supported by evidence or proven safe.”
“I plan to help the Center continue to reach beyond its walls and across NIH, encouraging an emphasis on health promotion, whole person care, and nonpharmacologic treatments, especially for pain management.”
What she plans is the integration of implausible pseudo-scientific modalities with regular medical practices. She ignores the wise words of Dr Mark Crislip: “If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.”
“Our current approach to patient care, in general, is fundamentally limited. It often emphasizes the treatment of disease alone, while it many times neglects the promotion, support, and restoration of health.”
That may be a valid critique of ‘our current approach’, but that need not be the case. Orthodox treatment can adopt the other dimensions Dr Langevin identifies without having to ‘integrate’ with CAM modalities.
“Integrative health care can help correct this limitation by giving more consideration to the patient’s long-term recovery and overall health when treating an acute illness or injury.”
But can only do so within a framework of implausible pseudo-science.
“Another limitation of the conventional medical approach is its specialization, based on the basic organization of the body into physiological systems, which can lead not only to fragmented health care, but also fragmented research.”
That is because as ‘medicine’ has advanced since the 16th century Enlightenment, and specialisation has allowed the more focussed scientific consideration and attention to detail that is necessary to advance understanding. The CAM modalities have failed to ‘move on’ and are anachronistic. Any perceived fault of ‘the conventional medical approach’ leading to ‘fragmented health care’ can be remedied by greater co-operation and collaboration amongst conventional doctors. ‘Integration’ with camists (who practice CAMs) is simply not necessary, and proves a distraction.
“In contrast, many traditional healing systems, especially those based on Eastern philosophies, emphasize an understanding of the person as a whole.”
That may be their emphasis – given the lack of scientific endeavour in ‘traditional’ systems, they can hardly do otherwise – they have little else to offer. But conventional medicine is doing all it can to ‘understand the person as a whole’, without the encumbrance of outmoded approaches.
“Further, the widespread role of pharmaceuticals as the default means of medical treatment is an important issue, and nowhere is this more urgent than for pain management.”
So, don’t use them! Conventional medicine can change its ‘default mode’, and does so in the face of scientific evidence.
“NCCIH is playing an increasing role in finding solutions to the current opioid crisis with research on non-drug approaches for pain.”
We must all look forward to published evidence of the benefit arising from NCCIH’s approach to pain management.
Happy New Year, and may the Wu be with you all. (Wu: Chinese, nothingness – wherein CAM resides.)