Future doctors and nurses are learning acupuncture and herbal medicines as well as anatomy and physiology at a growing number of medical schools. This is another example of how alternative medicine has become mainstream. And this is often done with the help of Uncle Sam.
The government has spent more than $22 million to help medical and nursing schools begin teaching alternative medicines — lesson plans that some critics say are biased toward unproven remedies.
Additional taxes were spent to recruit and train young doctors to research this field, launching some of them into careers as providers of alternative medicine.
Doctors need to know folk remedies so they can discuss them without judgment and give competent advice, the government says, and many universities and medical groups agree.
“Patients use these things” whether doctors think they should or not, and safety is a big concern, said Dr. Victor Sierpina, an acupuncturist at the University of Texas Medical Branch at Galveston, who directs a group of academics in favor of such training. .
But for critics, it’s like teaching Harry Potter medicine. Students are asked to turn a blind eye to the scientific principles that guide the rest of their education in order to keep an open mind about pseudoscience, they say.
“I am concerned about teaching illogical thinking to medical students” and giving credence to biologically implausible theories like distance healing and energy fields, said Dr. Stephen Barrett, a physician retired who runs Quackwatch, a website about medical scams.
Teaching about alternative medicine involves accepting it and “potentially creates more credulity and less critical and objective thinking,” said Dr. Wallace Sampson, editor-in-chief of the journal Scientific Review of Alternative Medicine. “This will be felt in many indirect ways,” he said, including through errors of judgment, through misjudgments toward people with serious illnesses, and through lax standards and laws.
The real question is not whether alternative medicines should be taught, but how, said Dr. Joseph Jacobs, former head of the federal Office of Alternative Medicine.
“The parallel here is creationism and science,” Jacobs said. “If the subject is taught in an objective way, to help students communicate with patients, it’s a good idea. If it is taught in the context of advocacy, to be accepted by doctors, I think It’s a bit wrong.”
Sometimes the line is blurred.
Some schools have close ties with alternative medicine providers or advocates who shape information on schools’ websites or courses for students and the public. Two examples:
- The University of Arizona Center for Integrative Medicine offers medical residency programs at hospitals across the country, sponsored in part by renowned advocate Dr. Andrew Weil, founder of the center. A private group that promotes such care, the Bravewell Collaborative, is offering scholarships to dozens of students at the Arizona school so they can get hands-on training in integrative care clinics.
- The University of Minnesota is offering medical students an elective course on alternative healing methods at a Hawaiian medical center founded by a philanthropist advocate for such care, although students pay their own transportation and living expenses. In interviews with an Associated Press writer in 2007, several students raved about the things they had tried firsthand and said they came away more willing to recommend acupuncture, meditation, yoga, medicinal plants and other non-traditional treatments.
“Consumers are demanding it” and more research is needed to see what works, said Mary Jo Kreitzer, who directs the Minnesota school’s alternative medicine program. “Ultimately, we need to align policies” so that insurers pay for these therapies, she said. “You could say that in this regard we are defenders.”
The field boomed 10 years ago, with the creation of the National Center for Complementary and Alternative Medicine. He made the fusion of alternative and traditional medicine “a central and overarching goal” and gave $22.5 million to 12 medical schools, two nursing schools and the American Medical Student Association to develop curriculum plans.
Kreitzer and Sierpina universities have received grants and both are active in the Consortium of Academic Health Centers for Integrative Medicine – 42 centers involved in researching or promoting complementary and alternative medicine, or CAM.
However, a review of some of these teaching plans by Drs. Donald Marcus and Laurence McCullough of Baylor College of Medicine in Houston conclude that they are “heavily biased toward complementary and alternative medicine,” cite poor-quality research, and have not been updated after better studies revealed that therapy had not worked. The analysis appears in the September issue of Academic Medicine.
The section on medicinal plants in the Medical Student Association’s plan was written by the head of the American Botanical Council, an industry-backed research and education group, the article said.
Sierpina, the head of the medical school consortium, said the purpose of these lesson plans is not propaganda.
“We’re not trying to turn students into practitioners of traditional Chinese medicine,” but to train them to be “sensitive to people’s backgrounds, their traditional medicine, their home remedies,” he said.
Just as there are true believers who ignore the evidence that something doesn’t work, there are true skeptics who are guilty of “arrogantly thinking that we have it all figured out,” Sierpina said.
Dr. Mehmet Oz agreed. The Columbia University heart surgeon and frequent Oprah Winfrey guest, now with her own television show, has long demonstrated an open mind toward complementary and alternative medicine.
“Medicine is very provincial. We grow up thinking the way others have taught us to think. We are naturally biased. It is imperative that we look at what alternative cultures offer us, that we are at least fair in our skepticism about to their impact.” Otherwise, “we run the risk of excluding newcomers” with new ideas, he said.
“Another way of observing”
These would be people like Jimmy Wu, a newly graduated doctor from the University of Wisconsin-Madison. Raised in a family originally from Taiwan, Wu said traditional healing practices are “very ingrained” in his view of illness and health.
“It’s just a very different way of looking at” a patient to decide treatments, rather than relying so much on lab tests and other traditional medical tools, he said.
Madison’s medical school offered an elective course in alternative medicine. Seeking more than that, Wu spent a summer in Beijing with a university professor observing traditional Chinese medicine and acupuncture, and hopes to one day include them in a family medicine practice. With so many people using alternative care, “it’s important that this issue is treated as more than just an afterthought” by medical schools, Wu said.
Officials at several major schools say they teach respect for patients’ choices, but do not teach unproven cures or theories.
“All medical treatments should be held to the same standards,” whether it is a prescription drug, an herbal pill or a method of care, said Dr. Philip Gruppuso, dean associated with medical education at Brown University.
For example, acupuncture appears in several places in the school curriculum where there is evidence that it can relieve certain types of pain. However, students are not told which meridians in the body are said to channel energy, which acupuncturists claim to affect. Whether a school promotes magical thinking about a therapy depends “more on how it’s taught than what is taught,” Gruppuso said.
At Harvard University, students take a few elective courses on topics such as mind-body medicine, but a spokeswoman said the university does not advocate or teach alternative medicine.
Georgetown University, which launched the nation’s first graduate program in complementary and alternative medicine, strives to be objective, said program director Hakima Amri.
“We present the facts, we teach what we know today. We don’t promote anything,” she said.
That means speaking frankly about controversial areas like homeopathy, or the energy medicines qi gong and reiki, which claim to heal through the powers of a healer, even from a distance.
“The science isn’t there to support that,” Amri said.
Georgetown’s goal is “to train a new generation of open-minded but critical doctors or scientists,” she said. “We’ve seen students come in who are all excited about ACD because they’ve seen it work on their grandmother or someone like that. Then they go through the program and they see it differently. We want that they are truly critical, capable of separating good from evil.”
