Nurturing Non-Science

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Nurturing Non-Science Nurturing Non-Science Startling Concepts in the Education of Physicians Early in its history, the National Center for Complementary and Alternative Medicine awarded grants to incorporate CAM information into traditional medical school curricula. Have these grants had a positive effect on public health? Eugenie V. Mielczarek and Brian D. Engler magine if departments of physics, chemistry, and biol- at many institutions that evolved into CAM training or curriculum awards. ogy of our most prestigious universities offered courses An examination of the first seven years, Iin astrology, crystal-ball gazing, alchemy, and creation- 1993–2000, a detailed review (Green ism. And imagine if these endeavors were funded by the 2001), listed twenty-eight grants of National Science Foundation (NSF) and if the head of which twelve were for specialty centers. NIH’s earliest awardees that tran- NSF appeared at an international conference celebrat- sitioned from specialty awards to cur- ing these endeavors. Would there be an outcry from riculum development were Bastyr Na- the science community? If you answered yes, then you turopathic College, Palmer College of Chiropractic, and Oregon College must be unaware that the paradigm for this is already of Oriental Medicine, an acupuncture in place and there has been no outcry. Since 1998, $76 college (http://xnet.kp.org/permanen- . million in grants for courses and training in non-science tejournal/fall02/editorial.html) These organizations train practitioners who based medical protocols such as acupuncture, magnets, believe they can heal medical problems Reiki, Therapeutic Touch, Qigong, mind-body myths, with non-science based protocols. naturopathic treatments, and Vedic medicine have been This substantial fiduciary encourage- ment of non-science, non-evidence-based funded by the National Institutes velopment with its awards for several curriculum by NCCAM, NIH’s untested of Health (NIH), the federal agency alternative medicine protocols. center, was in direct conflict with its charged with research in medical sci- The absence of an effectively orga- mission “to exemplify and promote the ences. Fifty-three of these awards went nized disapproval from the scientific highest level of scientific integrity, public to academic medical schools and asso- and medical community constitutes an accountability, and social responsibility in ciated organizations. Figure 1 shows indifference to teaching “healing pro- the conduct of science” and with the “mis- funding from NIH’s National Center tocols” that have no place in modern sion of NCCAM . to define, through for Complementary and Alternative medicine and drain our scarce medical rigorous scientific investigation, the use- Medicine (NCCAM) for twenty-four resources. fulness and safety of complementary al- of these fifty-three. Figure 2 shows Even prior to its elevation to an ternative medicine interventions and their funding for organizations teaching NIH center, the Office of Alternative roles in improving health and health care” non-MD specialties. Table 1 compares Medicine (OAM) was committed to (http://www.nccam.nih.gov/about/plans). NCCAM’s funding for curriculum de- funding grants for specialty centers NCCAM’s website also provides 32 Volume 37 Issue 3 | SKEPTICAL INQUIRER education for anyone seeking educa tion in CAM. Units are earned toward a “continuing education certificate” through NIH’s NCCAM site (www. nccam.nih.gov/health/decisions/cre dentialing; www.nccam.nih.gov/train ing/videolectures). out any critique of CAM protocols (Samp These websites are presented with basedmedicine.org/index.php/yes- we-can-we-can-abolish-the-nccam). Worse, NCCAM also de obtain CAM certification from a pri vate organization, the National Certi son 2001; see also www.science fication Commission for Acu and Oriental Medicine (NCCAOM), which issues diplomas in acupuncture, Chinese herbology, Asian bodywork therapies, and oriental medicine. Cur rently forty-three states plus the Dis trict of Columbia license practitioners of acupuncture and oriental medicine. Almost all of these states require com pletion of NCCAOM’s national writ ten exam, and some states also require a practical exam. There is no mention on NCCAM’s website of the failure of - any of its research grants to discover any scientific validation of these protocols. scribes how to after its inception and before any of its - research grants Startingshowed positivein 2002, re only four years - NC for CAM, NCCAM decided to fund $7 CA $6,500,000 ,000,000 teaching CAM. It awarded - $6,000,000 M lion in R25 education grants to fifteen $5 $5 ,500,000 Cu organizations: twelve medical schools, $4 ,000,000 punc $4 two nursing schools, and one founda ,500,000 rri $3,500,000 ,000,000 tion. The program’s “immediate goal $3,000,000 cu $2,500,000 was to encourage and support the in $2,000,000 lum Gr corporation of CAM information into ture - $1 $1 ,500,000 medical, dental, nursing, and allied - ,000,000 $5 health professional school curricula, res 00,000 idency training programs, and continu an ing education courses. A longer-term ts ov goal was to accelerate the integration of CAM and conventional medicine” - $ er (www.nccam.nih.gov/grants). The - Figure 1. Total of all fifty-three mainstream organizations 2000-2012 (to date) = $67.1 million. (twenty-four 3.2 A.T. Still University of Health Sciences $1 R25 awards plus the inclusion of CAM organizations with awards of over $1 million displayed here) 4 milli curriculum under other programs to American Medical Student Association FDN million to 24 Mains medical schools, previously regarded - on as stellar proponents of science-based - NC Children’s Hospital Boston $2.9 education, became a springboard that CA 3 milli M Georgetown University $ $ Cu 3.9 28.5 mil Group Health Cooperative on rri 6 milli sults cu Harvard University (Medical School) on lum Gr tr Johns Hopkins University eam Or - an $8 Minneapolis Medical Research FDN, INC. 27 ts to gani $4 $ 6.8 Th Oregon Health and Science University - .4 ou 7 milli 5 milli za CA sa - Figure 2. Total of eight awards to CAM organizations (2000–2012) = $8.6 million. Rush University Medical Center tions nd M Or on on Bastyr University Tufts University Boston - gani (2 - University of California Los Angeles 000 $4 za 5 tions University of California San Francisco –201 Th ou $9 University of Illinois at Chicago PR Center for Mind-Body Medicine sa 2) 64 (2 nd Th 000 University of Kentucky $2.6 OGR ou CAM Curriculum Development and sa –201 7 milli nd University of Michigan at Ann Arbor $1 AM/ .3 on 8 M University of Minnesota Twin Cities Table 1. CAM Curriculum Development and Training funding compared to several CAM protocols also funded National College of Natural Medicine 2) Botanicals by NCCAM since the late 1990s. *Included in Distance Healing: Reiki, Qigong, Therapeutic Touch, and prayer. Mind-Body illi University of North Carolina Chapel Hill Acupuncture PROT on Distance Healing* University of North Texas HLTH SCI CTR Maharishi Vedic MedicineMushroom Extract Training $9 University of Pennsylvania $2. $ Magnetic Fields OC 75 3.0 National University of Health Sciences 49 Th 9 milli University of Texas Medical BR Galveston milli OL ou sa on nd University of Toronto on $8 University of Virgina Charlottesville Northwestern Health Sciences 04 $2.2 Th University of Washington ou 1 M sa nd illi on Oregon College of Oriental Medicine $1 .3 Palmer College of Chiropractic 8 M illi FU on $193 million $157 million NDIN $78 million University of Western States $76 million G $22 million $3 million $2 million $0.4 million Skeptical Inquirer | May/June 2013 33 mote-viewing (http://takingcharge. MINNEAPOLIS-ST. PAUL csh.umn.edu/interviews/interview-rus- sell-targ-0). In 2009, this CAM pro- gram affiliated with a local clinic, University of Minnesota Hennepin Integrative Health Ser- $3.4 Million vices, offering acupuncture and chiro- practic care. Also associated with the Center for Spirituality and Healing are community college programs at School of Medicine School of Nursing Anoka-Ramsey Community College, whose certificate includes energy heal- ing courses. Some of the center’s courses were Reiki classes for all ages—which Center for Spiritual Healing advertised that even “children can learn to practice” (http://takingcharge.csh. umn.edu/explore-healing-practices/ reiki/what-can-i-expect-typical-reiki- Life Sciences Foundation session). In addition, from 2001–2006 the Minneapolis Research Foundation Anoka-Ramsey (Richard Hugo Grimm, P.I.) was Reiki Classes Hennepin Integrative Community College Northwestern Health awarded $4 million for training CAM Adults* Children** Care Clinic Certifcate in Sciences University clinical investigators. The proposals * Integrative Care Energy Healing Courses emphasized the growing social need ** “Even children can learn to practice” to serve Americans desiring CAM. It detailed the cooperation of six health Figure 3. The reach of non-proven CAM protocols into the Minneapolis-St. Paul community. institutions in the area and graduate degrees in CAM at the University of Minneapolis-St. Paul propelled CAM services into commu- Minnesota. Participating institutions nity hospitals. One of the largest efforts of NCCAM included not only the Hennepin Inte- But NIH does not limit studying curriculum development, $3.9 million, grative Health Services but also a chi- CAM to medical students. From 2000– has been directed to Minneapolis-St. ropractic college, Northwestern Health 2012, the total sum of awards falling Paul. From 2000–2004, the Univer- Sciences University. The total funding under the mantle of CAM pedagogy to sity of Minnesota (Mary Jo Kreitzer, from NCCAM into the Minneapolis P.I.) was awarded $1.5 million from community from 2000–2006 for CAM both mainstream medical schools and $ CAM schools was $76 million. NCCAM “. to integrate comple- was 5.5 million. Figure 3 illustrates Many of the earliest and most largely mentary and cross-cultural care and the reach of these non-proven protocols funded curriculum grants were awarded spirituality into the academic, research, into the Minneapolis community.
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