MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Today, a 3-day conference is starting on ‘INTEGRATIVE MEDICINE’ (IM) in London. Dr. Michael Dixon, claims that it is going to be the biggest such conference ever and said that it ‘will make history’. Dixon is an advisor to Prince Charles, chair of the College of Medicine and Integrated Health (CoMIH, of which Charles is a patron), and joint-chair of the congress. The other co-chair is Elizabeth Thompson. Both have been the subject of several previous posts on this blog.

Dixon advertised the conference by commenting: “I am seeing amongst by younger colleagues, the newly trained GPs, that they have a new attitude towards healthcare. They are not interested in whether something is viewed as conventional, complementary, functional or lifestyle, they are just looking at what works for their patients.  Through this conference, we aim to capture that sense of hope, open-mindedness, and patient-centred care”. I believe that this ‘history-making’ event is a good occasion to yet again review the concept of IM.

The term IM sounds appealing, yet it is also confusing and misleading. The confusion starts with the fact that our American friends call it integrative medicine, while we in the UK normally call it integrated medicine, and it ends with different people understanding different things by IM. In conventional healthcare, for instance, people use the term to mean the integration of social and medical care. In the bizarre world of alternative medicine, IM is currently used to signify the parallel use of alternative and conventional therapies on an equal footing.

Today, there are many different definitions of the latter version of IM. Prince Charles, one of the world’s most ardent supporter of IM, used to simply call it ‘the best of both worlds’. A recent, more detailed definition is a ‘healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. It emphasizes the therapeutic relationship between practitioner and patient, is informed by evidence, and makes use of all appropriate therapies’. This seems to imply that conventional medicine is not healing-orientated, does not account for the whole person, excludes aspects of lifestyle, neglects the therapeutic relationship, is not informed by evidence, and does not employ all appropriate therapies. This, I would argue is a bonanza of strawman fallacies, i.e. the misrepresentation of an opponent’s qualities with a view of defeating him more easily and making one’s own position look superior. Perhaps this is unsurprising – after all, Dixon has been once named ‘a pyromaniac in a field of (integrative) strawmen’.

Perhaps definitions are too theoretical and it is more productive to look at what IM stands for in real life. If you surf the Internet, you can find thousands of clinics that carry the name IM. It will take you just minutes to discover that there is not a single alternative therapy, however ridiculous, that they don’t offer. What is more, there is evidence to show that doctors who are into IM are also often against public health measures such as vaccinations.

The UK ‘Integrated Medicine Alliance’, a grouping within the CoMIH, offers information sheets on all of the following treatments: Acupuncture, Alexander Technique, Aromatherapy, Herbal Medicine, Homeopathy, Hypnotherapy, Massage, ,Naturopathy, Reflexology, Reiki, Tai Chi, Yoga Therapy. The one on homeopathy, for example, tells us that “homeopathy … can be used for almost any condition either alone or in a complementary manner.” Compare this to what the NHS says about it: “homeopathic remedies perform no better than placebos (dummy treatments)”.

This evidently grates with the politically correct definition above: IM is not well-informed about the evidence, and it does use inappropriate treatments. In fact, it is little more than a clumsy attempt to smuggle unproven and disproven alternative therapies into the mainstream of healthcare. It does render medicine not better but will inevitably make it worse, and this is surely not in the best interest of vulnerable patients who, I would argue, have a right to be treated with the most effective therapies currently available.

The conference can perhaps be characterized best by having a look at its sponsors. ‘Gold sponsor’ is WELEDA, and amongst the many further funders of the meeting are several other manufacturers of mistletoe medications for cancer. I just hope that the speakers at this meeting – Dixon has managed to persuade several reputable UK contributors – do not feel too embarrassed when they pass their exhibitions.

 

7 Responses to Today, integrative medicine is about to make history, says Dr. Michael Dixon

  • Drat, for a moment there I misread the caption

    Today, integrative medicine is about to become history, says Dr. Michael Dixon

    And yes, IM would also make history by acknowledging the overwhelming amount of evidence that it does not do anything, and thus should be abandoned.

    It just goes to show how one’s (in casu my) observations can be misled by wishful thinking …

    • Yes, while it is impossible to proove a negative, isn’t it about time we looking at some of the reseach and concluded this modality has been evaluated long enough, time to move on….. Take the 4 humor concept of medicine….it was accepted, looked at and for the most part abandoned.

      • chris wrote “while it is impossible to proove a negative”

        Not having a go at you, chris, but I’m tired of reading this endlessly promulgated myth.

        QUOTE
        A principle of folk logic is that one can’t prove a negative. Dr. Nelson L. Price, a Georgia minister, writes on his website that ‘one of the laws of logic is that you can’t prove a negative’. Julian Noble, a physicist at the University of Virginia, agrees, writing in his ‘Electric Blanket of Doom’ talk that ‘we can’t prove a negative proposition’. University of California at Berkeley, Professor of Epidemiology Patricia Buffler asserts that ‘The reality is that we can never prove the negative, we can never prove the lack of effect, we can never prove that something is safe’. A quick search on Google or Lexis-Nexis will give a mountain of similar examples.

        But there is one big, fat problem with all this. Among professional logicians, guess how many think that you can’t prove a negative? That’s right: zero. Yes, Virginia, you can prove a negative, and it’s easy, too.

        In fact, ‘you can’t prove a negative’ is a negative [my emphasis] — so if you could prove it true, it wouldn’t be true! Uh-oh. Not only that, but any claim can be expressed as a negative, thanks to the rule of double negation. This rule states that any proposition P is logically equivalent to not‑not‑P.

        Hales, S. (2005). Thinking Tools: You can Prove a negative. Think, 4(10), 109-112.
        https://doi.org/10.1017/S1477175600001287
        END of QUOTE

        • Thank you for the comment, interesting. There are some pov’s when it comes to proving a negative:

          Carl Sagan said ” “Absence of evidence is not evidence of absence.”….which can go to the point of trying to prove a negative. An expectation of evidence makes its absence significant.

          Not being able to prove a negative is also related to the logical fallacy of the argument from ignorance.

          In terms of science, do you agree that ” Whether the scientific community will accept a null result as evidence of absence depends on many factors, including the detection power of the applied methods, the confidence of the inference, as well as confirmation bias within the community.”

          And I do stand corrected in that many feel you can prove a negative:
          “So why is it that people insist that you can’t prove a negative?
          I think it is the result of two things. (1) an acknowledgement
          that induction is not bulletproof, airtight, and infallible, and (2)
          a desperate desire to keep believing whatever one believes,
          even if all the evidence is against it. That’s why people keep

          believing in alien abductions, even when flying saucers always
          turn out to be weather balloons, stealth jets, comets, or too
          much alcohol. You can’t prove a negative! You can’t prove
          that there are no alien abductions! Meaning: your argument
          against aliens is inductive, therefore not incontrovertible, and
          since I want to believe in aliens, I’m going to dismiss the
          argument no matter how overwhelming the evidence against
          aliens, and no matter how vanishingly small the chance of
          extraterrestrial abduction.” from: http://departments.bloomu.edu/philosophy/pages/content/hales/articlepdf/proveanegative.pdf

          Thank you for the input peter and the information.

          • @ chris,

            Carl Sagan said ‘Absence of evidence is not evidence of absence.’

            That is a frequent misattribution. If Sagan said or wrote it then he was likely quoting cosmologist and astrophysicist Astronomer Royal Martin John Rees. Anyway, sans the context of the quote, bandying it around comes across as what Gordon Pennycook calls “pseudo‑profound bullshit”. (Again, this is not aimed at you, Chris.)
            https://en.m.wikiquote.org/wiki/Martin_Rees

            If a hypothesis or theory predicts a certain outcome and that outcome does not occur, despite actively looking for it, then it may be perfectly reasonable to state that:
            • absence of the (predicted) evidence is indeed evidence of absence
            • therefore the hypothesis/theory is incorrect.

            Not being able to prove a negative is also related to the logical fallacy of the argument from ignorance.

            In terms of science, do you agree that “Whether the scientific community will accept a null result as evidence of absence depends on many factors, including the detection power of the applied methods, the confidence of the inference, as well as confirmation bias within the community.”

            See Argument from ignorance, RationalWiki:
            “Not to be confused with negative evidence, which is where there is no evidence for something when there should be.”

            I’m not sure what your point is because if a hypothesis/theory is not falsifiable then it is very likely to be pseudoscientific at best, or anti‑scientific at worst. One frequent error committed by pseudoscientists is conducting an RCT to establish whether or not an effect exists, which needs to be established before conducting an RCT. If the effect does not exist then every RCT positive result is a false positive, irrespective of the p‑value.

            Examples of pseudoscience are plentiful in psi research.

            Examples of excellent science include the theoretical predictions, and subsequent discoveries, of: the Higgs boson; gravitational waves. Both have been confirmed to more than five sigma.
            QUOTE
            In experimental science, a theoretical model of reality is used. Particle physics conventionally uses a standard of “5 sigma” for the declaration of a discovery. A five‑sigma level translates to one chance in 3.5 million that a random fluctuation would yield the result. This level of certainty was required in order to assert that a particle consistent with the Higgs boson had been discovered in two independent experiments at CERN, also leading to the declaration of the first observation of gravitational waves, and confirmation of global warming.
            https://en.m.wikipedia.org/wiki/Standard_deviation#Experiment,_industrial_and_hypothesis_testing
            END of QUOTE

            Thanks for the enjoyable discussion, Chris.

  • An otherwise informative article in NYTimes on supplements (it even quotes Dr David Gorski!) relies heavily on quotes from “integrative” doctors other than the brief one from Dr Gorski. Even worse, these quotes are presented as absolutely valid with no discussion of what an “integrative” doctor even is. The only positive takeaway was that these doctors were pretty conservative in the claims made in their comments. Still, the whole thing led credence to this “speciality”.

    https://www.nytimes.com/interactive/2022/06/15/well/supplements-effectiveness-quiz.html

  • More important than making history?

    MAKING MONEY!

    Money-money-money medicine.

    Gizuz yer money!

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”

The most recent comments from all posts can be seen here.

Archives
Categories