Junk Medicine and Health Care Reform: Where Was the Scientific Community?

October 26, 2010

When Congress decided to tackle health care reform in 2009 and early 2010, many hoped that government would take the opportunity to ensure that the resources we devote to medicine are spent more intelligently - say, by promoting and funding only medical therapies that are shown to improve health, or at least those therapies we can reasonably expect to be effective.  Instead, the health care reform bill proved to be a bonanza for purveyors of junk treatments that have no grounding in evidence or basic scientific fact.

Congressional allies of the so-called "complementary and alternative medicine" industry successfully introduced language in health care reform legislation requiring insurers to cover any state-licensed health care providers – including, of course, complementary and alternative medicine practitioners.   Language prohibiting “discrimination” against any state-licensed practitioners survived in the Affordable Care Act President Obama signed into law on March 23, 2010. 

As a result, the hard-earned money you spend on health insurance will fund a variety of unproven -- and even disproven -- alleged treatments.  To take but one example, therapeutic touch (TT), during which practitioners purport to heal a patient by massaging his or her "biomagnetic field" using only their hands. TT, of course, is absolute nonsense.  The healing magnetic field TT practitioners purport to use is far too weak to affect the body's biochemical processes, and is more than 100 times weaker than the Earth's magnetic field.  TT is but one of a host of junk treatments that insurers will be forced to cover under the health care reform act.

Where was the scientific community when health care reform was hijacked by pseudoscience?  Sadly, the criticism offered by the nation's scientific academies and societies was muted, if any comments were offered at all. 

Scientists are often and understandably reluctant to speak out about policy issues when doing so requires them to enter the sullied, unforgiving, and frequently irrational realm of political debate.  When they choose to sit silently on the sidelines, however, society suffers.

Although many of their colleagues shied away from commenting on the alt med debate, a few courageous scientists bravely challenged government funding of alt med nonsense. Although I could name additional scientists, I will mention three here.

Dr. Wallace Sampson, a well-known critic of alternative medicine and fellow of the Committee for Skeptical Inquiry , commented during the health care reform debate that Therapeutic Touch "is a scientific absurdity. This is bold foolishness, elected representatives legislating into policy their own personal delusions."  

Dr. Steven Salzberg, director of the Center for Bioinformatics and Computational Biology, urged government to save over $240 million per year by eliminating funding for the two government centers that support alternative medicine research - the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Cancer Complementary and Alternative Medicine (OCCAM).  By Dr. Salzberg's count, "not a single 'alternative' therapy supported by NCCAM has proven beneficial to health."

And Dr. Eugenie V. Mielczarek, emeritus professor of physics at George Mason University, authored a Center for Inquiry report criticizing efforts to use health care reform legislation as a vehicle for guaranteeing taxpayer funding of alt med therapies.  Dr. Mielczarek urged that in "reining in the ballooning cost of medical care, every dollar of health care funding is needed to provide tested, proven medical treatment to those who require it. It is inexcusable to squander scarce resources by funding unsubstantiated, non-evidence-based medical techniques that have no basis in theory or experiment."  (Also see Dr. Mielczarek's posting on Science-Based Medicine on  physics and alt med therapies.)

Drs. Sampson, Salzberg and Mielczarek deserve praise for their courage and their candor.  Yet, to my knowledge their efforts received little, if any backing from the major scientific academies and professional organizations.  It is high time that scientific societies support the efforts of scientists like Wallace Sampson, Steven Salzberg and Eugenie Mielczarek.  They should serve not as lone voices of reason, but as models and spokespersons for the scientific community they represent.

Comments:

#1 Michael De Dora on Tuesday October 26, 2010 at 10:06pm

Great post, Derek. I completely agree.

#2 Lowell (Guest) on Saturday October 30, 2010 at 4:28pm

I really appreciate this information as I knew nothing about it. My understanding of state licensing boards is that their primary purpose—in regard to alternative treatments—is to protect consumers rather than to endorse therapies. However, I can’t imagine the harm that could come from a practice such as Therapeutic Touch.

#3 Greta (Guest) on Monday November 01, 2010 at 7:37am

This sort of knee-jerk reaction from science to alternative therapies only continues to do the community harm. Let’s face it, the bulk of alternative therapies cater to an area of medicine that is severely lacking competance and results in orthodox medicine: pain management. There is also a lack of honesty in the medical community about this. Most of the research into analgesia is still based on anecdotal response and much of the research has shown that the placebo effect has just as great an influence in orthodox medicine as it does in alternative medicine.

Do not begrudge the paltry amounts given to research into alternative medicine, I wish there was a great deal more (as I do with orthodox medicine) there should be more spending all around. I remember when acupuncture was regarded as voodoo, but now most of the scientific establishment is taking it seriously and finally serious research is being applied to it. I remember when vitamin supplements were poo-pooed, now MDs regularly prescribe them. Good. Science should be about open minds, and acknowledging ones own limitations.

The scientific community has to clean up it’s own house before casting stones. Let us also not forget the dubious relationships between commerce and medicine that has led to treatments like Vioxx being thrown onto the market only to be withdrawn a few years later for their lethal side-effects. For many people with chronic or terminal illness massage/ therapeutic touch has a wonderful benefit, and should not be so easily dismissed. It may be placebo, but we should remember that “pain is what the patient says it is” and if they respond positively to a treatment, that is only to be commended and further investigated. It’s clear we do not know enough about the placebo effect itself. We simply do not know enough about pain.

I am not a practioner and have no particular axe to grind, I’m just a registered nurse with 20+ years experience, who knows full well the draw backs of long term analgesia, that over time have diminishing returns and some devastating side-effects. I can therefore understand why people turn to alternatives, and am not so quick to dismiss them.

I myself, a life-long skeptic, decided to try chiropractic therapy, knowing that PT has very limited benefit for back pain, if any, and yet is regularly prescribed by MDs who know that full well. I have had very positive results with chiropractic treatment; it has not cured it and it’s not a panacea obviously. But it alleviates the need for medication and my liver and kidneys are grateful for that. I probably spend the same amount that I would have for medication so I certainly don’t feel exploited.

Personally, I think psychotherapy is a bunch of hokum, but decades have shown that people respond positively to it, so if some dildo with a pen & pad can stop a few people jumping off a bridge, who am I to bar spending on it?  It’s all about the returns.

There is a great deal of unnecessary wasteful spending in orthodox medicine, much of it for diagnostics of debatable value and efficacy, but are highly lucrative. There are also some very dubious ethical business relationships particularly in medical research which I think need to be addressed. So before bricks start being thrown at others, Doctor, heal thyself.

#4 Steve Engard (Guest) on Monday November 01, 2010 at 6:15pm

Practitioners of alternative ‘therapies’ should have these ‘therapies’ proven by the same standards the FDA requires for all other medications, therapies, and devices.  Otherwise, only the fools that want them should pay out-of-pocket for them.

#5 KJ (Guest) on Tuesday November 02, 2010 at 9:32am

Thank you Greta for your comment that speaks so well to what articles like this often over look.

Traditional medicine happens to be the mainstream right now. And as Greta said, mainstream medicine supports things that are known to often be unsuccessful like physical therapy in certain scenarios. But it makes hospitals a lot of money and it considered standard procedure, so they prescribe it. Some people will cost tax payers LESS if they are able to seek care they are comfortable with, like chiropractic or acupuncture treatments, than if they are required to have years and years of prescription pain meds as their only options.

And to Steve Engard’s comment above- plenty of treatments and medications that have been approved by the FDA have later been found to be unsafe, such as Vioxx, Yasmin, and Avandia. Don’t be so quick to call other people fools until you have been in their shoes. Alternative medicines aren’t going to be the culprits for burning through your tax dollars. That will be done by excessive prescribing of expensive medications and unnecessary xrays and tests. Yes, some tests save lives. Other tests are done because the doctor just has to sign a piece of paper to charge you and your insurance more money without it being necessary.

#6 G Money (Guest) on Tuesday November 02, 2010 at 1:14pm

@ Lowell, re: “I can’t imagine the harm that could come from a practice such as Therapeutic Touch.”

What is the value of a person’s last remaining hours on Earth? When every second and every dollar is precious, and could be spent on either proven treatments, or on family and friends and enjoying precious time left, what is the value of that?

In that perspective, it seems that anything that doesn’t help does harm.

#7 Stephen (Guest) on Wednesday November 03, 2010 at 12:32pm

The cost of healthcare needs to be controlled, not expanded. The beauty of evidence based medicine is that worthless treatments can be rejected and not reimbursed by insurance companies. Our goal should be to limit and reduce ineffective treatments, and I doubt this expansion to add alternative treatments is going to reduce expenditures. Better to have insurers required to cover nutritionists, excercise coaches, etc.

Believe it or not, standards of care actually evolve in evidence based medicine, which is why referring to it as “orthodox” is laughable, in comparison to traditional methods which cannot be changed by definition, unless they are concocted in modern times.

As to lack of harm, I have never met an alternative practitioner to did not expand their lack of scientific knowledge to include misconceptions that put individuals at risk. The anti-scientific bias is never (in my experience) limited.

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