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

The ‘Münster Circle‘ is an informal association of multi-disciplinary experts who critically examine issues in and around so-called alternative medicine (SCAM). We exist since June 2016 and are the result of an initiative by Dr Bettina Schöne-Seifert, Professor and Chair of Professor and Chair of Medical Ethics at the University of Münster.

In the past, we have published several documents which have stimulated discussions on SCAM-related subjects. Yesterday, we have published our ‘MEMORANDUM INTEGRATIVE MEDICINE‘. It is a critical analysis of this subject and will hopefully make some waves in Germany and beyond.

Here is its English summary:

The merging of alternative medicine and conventional medicine has been increasingly referred to as Integrative (or Integrated) Medicine (IM) since the 1990s and has largely replaced other terms in this field. Today, IM is represented at all levels.

IM is often characterised with the thesis of the ‘best of both worlds’. However, there is no generally accepted definition of IM. Common descriptions of IM emphasise:

– the combination of conventional and complementary methods,

– the holistic understanding of medicine,

– the great importance of the doctor-patient relationship,

– the hope for optimal therapeutic success,

– the focus on the patient,

– the high value of experiential knowledge.

On closer inspection, the descriptions of IM show numerous inconsistencies. For example, medicine in the hands of doctors is stressed, but it is also emphasised that all relevant professions would be involved. Scientific evidence is emphasised, but at the same time, it is stressed that IM itself includes homeopathy as well as other unsubstantiated treatments and is only ‘guided’ by evidence, i.e. not really evidence-based. It is claimed that IM is to be understood as ‘complementary to science-based medicine’; however, this implies that IM itself is not science-based.

The ‘best of both worlds’ thesis impresses many. However, if one investigates what is meant by ‘best’, one finds that this term is not interpreted in nearly the same way as in conventional medicine. Many claims of IM are elementary components of all good medicine and thus cannot be counted among the characterising features of IM. Finally, it is hard to ignore the fact that the supporters of IM use it as a pretext to introduce unproven or disproven modalities into conventional medicine. Contrary to promises, IM has no discernible potential to improve medicine; rather, it creates confusion and entails considerable dangers. This cannot be in the interest of patients.

Against this background, it must be demanded that IM is critically scrutinised at all levels.

________________________

 

6 Responses to Memorandum ‘INTEGRATIVE MEDICINE’

  • Perfect.

  • A very good, concise piece.

    About Integrative Medicine combining ‘the best of both worlds’: I think this is a good concept. I therefore propose IF, or ‘Integrative Flying’, whereby we make the daily practice of aviation even safer and more effective by having special ‘flying priests’ blessing every single flight before take-off into (yes, indeed) heaven.
    We can then expand upon this principle by chartering 10% of all de-icing tanker trucks and loading them up with holy water, with which each plane is hosed down before departure. Now of course we will have to make allowances for passengers of other religions, but that is a mere practical problem – in fact, it is not a problem so much as an opportunity, to further expand and diversify the exciting new field of Integrative Flying! As an added bonus, IF is much cheaper than other security measures in aviation, so the extra cost to passengers will be modest.

  • Dear Prof. Ernst,
    great text, but I have one question. Would you recommend patients to forward your critical analysis to their general practitioner? I am tempted to do just that, since the last time I saw mine, I asked him what he thought of TCM, and he was very positive about it as an “additional” option (at least he mentioned that it should not interfere with other evidence-based treatments).
    I hesitate to send him your text because in my experience, doctors do not at all appreciate getting advice from their patients, which I can to some degreed understand. Therefore, I am worried that forwarding your document would rather cause a backfire effect and undermine the doctor-patient-relationship.

    • I would send it without hesitation
      but if you are worried, make an appointment, discuss the issue and then send it

      • Thanks. Guess I will soon find out if he is willing to challange his apparently rather uncritical attitude towards TCM. Since he is a rather young fellow and still “Arzt in Weiterbildung”, I have some hope.

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