Scientists and Physicians Gather in Philadelphia for "Science Meets Alternative Medicine"

The American Medical Association defines alternative medicine as a diagnostic method, treatment or therapy that appears not to conform to standard medical practice, or is not generally taught at accredited medical schools. Some alternative therapies are centuries old with origins in non-western cultures such as Chinese acupuncture or Native American herbal remedies. Other practices like homeopathy, chiropractic, faith healing, and naturopathy emerged in the nineteenth century as competitors with scientific medicine. Recently developed alternative therapies include therapeutic touch and scores of "engineered" dietary supplements.

Alternative medicine's popularity appears to be increasing. According to a study last year in the Journal of the American Medical Association (JAMA), American's spent $27 billion on alternative medicine, a 50 percent increase from 1990. A survey also published in JAMA showed that people using one of sixteen queried therapies increased from 33.8 percent in 1990 to 42.1 percent in 1997. Responding to consumer demand, health care companies have added coverage to a number of alternative practices including chiropractic and acupuncture. States have begun licensing alternative medicine practitioners, with naturopaths regulated in eleven states. Seventy-five of the 125 U.S. medical schools, or 64 percent, teach alternative therapies as part of course work. Last year New York Times health columnist Jane Brody wrote that "alternative medicine is clearly the largest growth industry in health care today."

While some physicians deem the figures measuring demand and popular use of alternative medicine as inflated and often exaggerated in the media, it is clear that the scientific and medical communities can no longer afford to ignore a host of unsupported claims. In a September editorial in the New England Journal of Medicine (NEJM), editors Dr. Marcia Angell and Dr. Jerome Kassirer wrote that "It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine- conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work."

A History of Skepticism of Alternative Medicine

Responding to the need for a scientific summit on alternative medicine, in late February, over two-hundred physicians, scientists, health care professionals, and students from across the country gathered in Philadelphia for the Skeptical Inquirer-sponsored conference "Science Meets Alternative Medicine." The two-day event featured keynote addresses by Marcia Angell of the NEJM and George Lundberg, former editor of JAMA, and included presentations and plenary discussions ranging from scientific critiques of chiropractic, homeopathy, and other alternative therapies to medical ethics and consumer/physician education.

The conference was also the first major public unveiling of the year-old Scientific Review of Alternative Medicine (SRAM), a peer-reviewed science journal focused exclusively on alternative medicine. At a news conference held on Saturday, journal publisher Paul Kurtz of Prometheus Books remarked, "Today is historic. It stimulates a new direction of concentrated, scientific evaluation of unproven therapies."

Journal editor Dr. Wallace Sampson, a retired professor of medicine at Stanford, described the origins of SRAM. "When we began the journal, we did so simply because no one else was doing it. By definition, we have to start with the premise that alternative medicine claims are all unproven or false." Dating back nearly three decades, Sampson is one of the first members of the medical and science communities to raise alarm at the lack of scientific support for many alternative medicine claims. Sampson along with psychiatrist Dr. Stephen Barrett, biochemist Saul Green, physician Dr. John Renner, public health educator William Jarvis, and others have actively worked to improve the quality of consumer, physician, and media information on alternative medicine.

Sampson and his colleagues realized the need for a journal after years of reviewing the published literature on alternative medicine and finding many inadequacies in testing and verification. "That shocked me and was very disturbing," said Sampson. Though science and medicine attempt to constantly evaluate both new and established theories and data, the verification process can sometimes fail. "There has to be another side to peer-review." He described SRAM as offering reviews and commentary on previously published studies and controversies in alternative medicine.

Not only are studies and verification of alternative medicine claims often inadequate, but there exists what SRAM editors described as a "massive science gap" in alternative medicine. "The science is missing. It's the science that matters and we're trying to get into the debate on alternative medicine," said Lewis Vaughn, executive editor of SRAM. "If we approach alternative medicine as a political debate, focusing on whose on each side, then we don't get at what consumers want, Does it work?"

Sampson, in describing the state of physician education in alternative medicine, noted not only a "science gap" but a "knowledge of science gap." He said that there has been enough study of some therapies like homeopathy that have been proven to be "physically impossible and worthless," but both consumers and physicians seldom are made aware of critical evidence. In a survey of American medical schools, he found that only five schools taught students how to analyze unproven health claims, while over 50 had courses that treated such claims uncritically. "At a time when physicians desperately need to know how to scientifically evaluate all the dubious claims that patients are confronted with," he said, "this training is practically nonexistent." Sampson noted that the uncritical courses avoided discussion of evidence that disproves or undermines the claims, and that the result was indoctrination rather than education.

New England Journal Editors Compare Culture of Alternative Medicine to Religious Movement, Criticize Andrew Weil, Other Gurus

Angell described alternative medicine's greatest appeal as religious in nature. Leaders in the field like self-described guru Andrew Weil and Deepak Chopra offer "inspirational testimonials" that "explain the great mysteries" of health. She described Weil's and Chopra's language and writings as metaphysical. "Disease represents spiritual weakness. People can choose to be well or sick." Just as the soul might triumph over the body in religion, the mind triumphs over the body in alternative medicine. Angell points out that in place of offering promises of an afterlife, gurus like Weil and Chopra offer a longer, "fuller" life. She cited Chopra who claims to be able to extend life fifty years to the age of 120.

Though Weil and Chopra might be viewed as "prophets", Angell described one major difference between religion and alternative medicine. "Most religions have an ethical system. This one is blatantly narcissistic." Alternative medicine, said Angell, requires that adherents spend almost all their time and energy devoted to themselves.

In a separate presentation on the topic of Andrew Weil and consumer education, Dr. Arnold Relman, Editor Emeritus of the NEJM, , described the debate over alternative medicine, contrary to the preachings of alternative medicine gurus, as "an empirical question, not a theological question." Following an editorial in the Wall Street Journal, Relman was asked by the magazine The New Republic to contribute a review of Weil's latest book Ask Dr. Weil. Relman began to look into the philosophy of Weil with "horrified fascination." He spent the next year reviewing all eight of Weil's books.

Relman highlighted the seventh chapter of Weil's first book The Natural Mind as "required reading for anyone who wants to know" about Weil's philosophy. Weil advocates "stoned thinking" which relies on intuition and promotes an ambivalence among contradictions in ideas. For Weil, truths are intuitively evident and do not need scientific support. "This philosophy poses serious intellectual problems for the integration of alternative and complimentary medicine," said Relman. He criticized Weil for being a self-appointed leader in the field of alternative medicine though "he's never put any medical claims to test, nor participated in any clinical study."

Organizing Repsonse from the Medical and Scientific Community

Longtime alternative medicine watchdog and psychiatrist Dr. Stephen Barrett is even more emphatic. "I don't think fighting quackery is thought of as important in organized medicine. There is no organized information network." Robert Park of the American Physical Society describes a similar problem among the scientific community. "The scientists aren't speaking up, so anything goes."

Conferences like "Science Meets Alternative Medicine", the continued publication and increased circulation of the Scientific Review of Alternative Medicine, and the participation of medical leaders Angell and Relman are important first steps in stimulating scientific critiques of alternative medicine and sparking consumer and physician awareness. An improved role for the media in providing accurate and science-based health information is also sorely needed. "What you're up against when you pit science versus alternative medicine is the power of the testimonial in the media, " said Angell. "That is the toughest hurdle."

For more information on the Scientific Review of Alternative Medicine, visit their website at http://www.hcrc.org/sram/. Audio tapes of the conference will be made available in the next several months, and Prometheus Books has plans to possibly publish a number of the conference papers in an upcoming book.

Feedback | Reverse links for this page | Translate this page