Is Integrative medicine credible or quackery?

Integrative medicineA term that you might have come across is “Integrative Medicine”, and if so then you might perhaps be wondering what this actually is. Google it and you find that the Wikipedia article sums it up quite distinctly like this …

Integrative medicine, which is also called integrated medicine and integrative health in the United Kingdom,[1] combines alternative medicine with evidence-based medicine. Practitioners claim that it treats the “whole person,” focuses on wellness and health rather than on treating disease, and emphasizes the patient-physician relationship.[1][2][3][4]

In other words, we have medicine, which consists of treatments that need to be rigorously tested to prove that they work, being combined with alternative medicine, the treatments that don’t actually work and have generally not provided any credible evidence that they are effective.

OK, I’m not being strictly fair there because we do actually have a very common term for the bits of alternative medicine that do actually work, we call that “medicine”.

The integrated medicine claim is that the focus is not on the treatment of symptoms, but rather that a more holistic approach is taken with the entire person. That of course sounds laudable, but if what you are deploying consists of fraudulent and completely unproven treatments, then you are not a medic but instead a quack.

As Dr Mark Crislip once put it …

“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.”

Edzard Ernst

Professor Eduard Ernst was recently writing about it and quite rightly labels it “one of the most colossal deceptions in healthcare today“. On his blog last Monday he explained …

I have repeatedly tried to explain why integrative (or integrated) medicine is such a deceptive nonsense; see for instance herehere and here. Today, I have reason to make another attempt: The International Congress on Integrative Medicine & Health.

In 2012, I published an analysis of the ‘3rd European Congress of Integrated Medicine’ which had taken place in December 2010 in Berlin (in Europe they call it ‘integrated’ and in the US ‘integrative’ medicine). For this purpose, I simply read all the 222 abstracts and labelled them according to their contents. The results showed that the vast majority were on unproven alternative therapies and none on conventional treatments.

The abstracts from the International Congress on Integrative Medicine & Health (ICIMH, Green Valley Ranch Resort, Las Vegas, Nevada, USA, May 17–20, 2016) which were just published provide me with the opportunity to check whether this situation has changed.

And the results? (Oh come now, if you are familiar with this bastion of quackery then you will already be able to guess) …

Here are the results: mind-body therapies were the top subject with 49 papers, followed by acupuncture (44), herbal medicine (37), integrative medicine (36), chiropractic and other manual therapies (26), TCM (19), methodological issues (16), animal and other pre-clinical investigations (15) and Tai Chi (5). The rest of the abstracts were on a diverse array of other subjects. There was not a single paper on a conventional therapy and only 4 focussed on risk assessments.

… and his key point then is this …

on the ‘scientific level’, integrative medicine is not about the ‘best of both worlds’ (i. e. the best alternative medicine has to offer integrated with the best conventional medicine offers) – the slogan by which advocates of integrative medicine usually try to ‘sell’ their dubious approach to us. It is almost exclusively about alternative therapies which advocates of integrative medicine aim to smuggle into mainstream healthcare.

Quackery by Stealth

Previously the most common term used would have been “Alternative Medicine”. However, the latest fad is to now re-badge and use the newer term “Integrative medicine” (or “Integrated Medicine”) so that what is basically quackery can be deployed by stealth via the crafting an illusion of credibility by trying to associate itself with the mainstream. If seriously considering these “alternatives” as viable, then you really do need to pause that thought and consider this …

“There are not two kinds of medicine, one conventional and the other unconventional, that can be practiced jointly in a new kind of ‘integrative medicine.’ Nor, as Andrew Weil and his friends also would have us believe, are there two kinds of thinking, or two ways to find out which treatments work and which do not. In the best kind of medical practice, all proposed treatments must be tested objectively. In the end, there will only be treatments that pass that test and those that do not, those that are proven worthwhile and those that are not”

– Arnold S. Relman, a former editor of The New England Journal of Medicine 

(For source of that quote, go here ..

… but let’s permit Professor Eduard Ernst to have the last word here …

you will find that, in the realm of integrative medicine, every quackery under the sun is being promoted at often exorbitant prices to the often gullible and always unsuspecting public. If you don’t believe me, search for ‘integrative medicine clinic’ on the Internet; I promise, you will be surprised!

Personally, I am sometimes amused by the sheer idiocy of all this, but more often I am enraged and ask myself:

  • Why are we allowing quackery to make such a spectacular come-back?
  • Why is hardly anyone voicing strong objections?
  • Is it not our ethical duty to do something about it and try to prevent the worse?

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