The homeopathic crowd meets academic medicine.
Few things rankle doctors more than alternative (aka complementary, integrative, holistic, homeopathic, naturopathic) medicine. First came the misery inflicted by the ever-expanding celebrity of practitioners like Andrew Weil and Gary Null (and, for a while, even Radovan Karadzic). And now there is the arrival at the NIH feeding trough of the alternative medicine crowd, angling for a mouthful of the same research dollars that currently fund investigations like"the structural basis for translation termination on the 70S ribosome."
Though initially caught flat-footed, academic medicine rallied, as it always does when big bucks are on offer. After decades of belittling the alternative folk as a bunch of snake-oil salesmen and sleazeballs, academic medical centers suddenly realized that—guess what—they were big fans of the approach all along. Yale University is one of the latest brand-name institutions to go through the change. Last year, it joined 40 other medical schools in the Consortium of Academic Health Centers for Integrative Medicine, and began the awkward dance that has characterized such mergers.
Viewed one way, the migration of alternative medicine to the academic mainstream is a fine example of the might of popular will. After all, a 2004 survey revealed that 36 percent of adults in the United States have used alternative medicine at one time or another. If megavitamins and prayer are included, the proportion rises to 62 percent.
A darker view, though, is held by hard-core old-schoolers. Some of their objections are hyperventilation: They massage people! To make theme feel better! More seriously, they cast the encroachment of alternative medicine onto academic turf as a threat to American health because it's diverting money for research and care from traditional approaches. For the last six years, alternative medicine has received about 1 percent of the $28 billion annual NIH budget, or $300 million a year. That's the same amount that efforts to combat stroke, improve food safety, and further develop gene therapy each receive. A Brit, lamenting a similar resource shift in his country, has equated this to murder, writing that had money "spent on refurbishing the Royal Homeopathic hospital" been used instead for effective though expensive drugs to treat breast cancer, hundreds of lives a year would be saved.
Who should prevail in this struggle between naturalistic healers and ass-kickers with syringes full of chemotherapy? In a sense, neither side. Both have much to offer and plenty to be embarrassed about. To date, neither has established an all-encompassing operation so wondrous that it should demand monogamy from patients. So far, though, the problem with pairing the two disciplines at your corner medical center is that it mostly serves to diminish each: The West looks spent and flabby, a bully gone to seed, while the East seems like a kid with a new car and no clue how to drive.
The enforcers of the Western orthodoxy are the preening evidenced-based medicine crowd, those notorious killjoys who operate on the almost amusing premise that every square inch of medicine is built upon reason, the product of a rationally ordered stainless-steel world. If no evidence, they insist, then no truth. And if no truth, get thee out of my medical center. They briskly have swept away the entire alternative field, viewing chelation, St. John's wort, and music therapy, for example, as interchangeably absurd.
Kent Sepkowitz is a physician in New York City who writes about medicine.
Photograph of Echinacea purpurea by Jacob Rus.