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 NCCAM Curriculum Grants over $1 million to 24 Mainstream Organizations (2000–201 2) $6.85 million a “continuing education certificate” $7,000,000 $6,500,000 through NIH’s NCCAM site (www. $6,000,000 nccam.nih.gov/health/decisions/cre- $5,500,000 $5,000,000 $4.47 million dentialing; www.nccam.nih.gov/train- $4,500,000 $3.96 million ing/videolectures). $4,000,000 $3.24 million $3,500,000 $2.93 million $2.67 million $3.09 million These websites are presented with- $3,000,000 $2.49 million $2,500,000 out any critique of CAM protocols $2,000,000 (Sampson 2001; see also www.science $1,500,000 $1,000,000 basedmedicine.org/index.php/yes- $500,000

n e ) n s o o r R n o e N ty ty C. ty er es es ill on to to ag bo to nt FD si si si nt CT ania v we-can-we-can-abolish-the-nccam). ativ ucky I gt gele ic Ar ro er er er Citi lv ienc N, IN Ce nt es ion iv School iv iv l Bos n SC To An ancisc Ch in apel Hill tt Sc al Bos FD oper al ca ty s Ke An Galves of lo it Un at Tw Ch TH si n Fr nnsy Worse, NCCAM also de scribes how to th Co ch e Un Lo of at a ar ty sp HL Washin sociat ins Un er Pe th edic ia Sa ty lina l BR si Ch Medi iv of town of Heal As Ho (M sear ienc rn ia si esot ro ca er t ty xas ty ’s ge fo rn Illinois er iv ina obtain CAM certification from a pri- of ty Sc si Ca Te ty si li l Re s Un of iv rg en fo h si Un ty si er ft li h er uden ca Ca ty Michigan Minn rt rt er Vi si Geor oup Heal er and iv Tu Un iv ildr Ca si of of iv er iv of of l St Gr Johns Hopk th No No xas Medi Un vate organization, the National Certi- iv Ch of er ty ty ty Un ty of Te ca iv si of si ty si si d Un ush Un Heal er er ty ty of ar R er si Un er ill Un si si iv iv iv ty iv fication Commission for Acu punc ture rv er St er er iv Un Un si an Medi egon Un Un .T. Ha iv iv er A ic Or Un Un Un iv er Minneapolis Medi and Oriental Medicine (NCCAOM), Un Am which issues diplomas in acupuncture, Figure 1. Total of all fifty-three mainstream organizations 2000-2012 (to date) = $67.1 million. (twenty-four Chinese herbology, Asian bodywork organizations with awards of over $1 million displayed here) therapies, and oriental medicine. Cur- rently forty-three states plus the Dis- NCCAM Curriculum Grants to CAM Organizations (2000–201 2) trict of Columbia license practitioners of acupuncture and oriental medicine. $2.21 Million Almost all of these states require com- pletion of NCCAOM’s national writ- ten exam, and some states also require $1.38 Million $1.38 Million a practical exam. There is no mention $964 Thousand $975 Thousand on NCCAM’s website of the failure of $827 Thousand $804 Thousand any of its research grants to discover any scientific validation of these protocols. Starting in 2002, only four years $45 Thousand

ic ty es es ct si ates after its inception and before any of its er ra ienc ienc iv op n St Sc Sc ir l Medicine er th th al Medicine ra Ch st research grants showed positive re sults yr Un nt tu st of -Body Medicine ie We Heal Heal e Ba Na Or of of of rn eg for CAM, NCCAM decided to fund of ll ty e ty te r Mind e si si Co fo eg eg er $ ll er ll er hwes iv Co iv teaching CAM. It awarded 28.5 mil- rt Co lmer nt Un Pa Ce No onal ti egon lion in R25 education grants to fifteen onal Un Or Na ti Na organizations: twelve medical schools, Figure 2. Total of eight awards to CAM organizations (2000–2012) = $8.6 million. two nursing schools, and one founda- tion. The program’s “immediate goal was to encourage and support the in- PROGRAM/PROTOCOL FUNDING corporation of CAM information into Botanicals $193 million medical, dental, nursing, and allied Mind-Body $157 million health professional school curricula, res- Acupuncture $78 million idency training programs, and continu- CAM Curriculum Development and ing education courses. A longer-term Training $76 million goal was to accelerate the integration Distance Healing* $22 million of CAM and conventional medicine” Mushroom Extract $3 million (www.nccam.nih.gov/grants). The R25 awards plus the inclusion of CAM Magnetic Fields $2 million curriculum under other programs to Maharishi Vedic Medicine $0.4 million medical schools, previously regarded as stellar proponents of science-based Table 1. CAM Curriculum Development and Training funding compared to several CAM protocols also funded education, became a springboard that by NCCAM since the late 1990s. *Included in Distance Healing: Reiki, Qigong, Therapeutic Touch, and prayer.

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. to medical schools in metropolitan areas and clinical programs of [its] Academic such as Minneapolis-St. Paul, Boston, Health Center (AHC).” Minnesota’s Washington, D.C. Washington, D.C., Char lottesville, Academic Health Center includes the From 2001 to 2006, Georgetown Medi- Chapel Hill, Baltimore, San Francisco, Schools of Medicine and Nursing, with cal School received $3.2 million (Hakima and Seattle. Practicums required for its Center for Spirituality and Heal- Amri and Aviad Hara mati, P.I.s) to es- students and resident training are part ing providing “the infrastructure for tablish a center for Complementary of a medical school’s services to com- drawing together CAM practitioners, and Alternative Medicine. In 2003, munity hospitals and clinics. It’s fair to medical school, and nursing faculty”; a Georgetown be came the first medical ask: What have we gained in commu- comprehensive program that included school in the country to offer a master’s nity health by funding teaching of un- mentoring both medical school and degree in CAM (http://som.george- tested medical practices? Did NIH’s es- nursing faculty, and hospital grand town.edu/about/prospectus/facilities/). tablishment of well-funded curriculum rounds. Dr. Kreitzer is currently the Courses include mind-body studies, centers of non-science based protocols director of the University’s CAM Pro- legal issues associated with CAM, and affect these communities? gram “Center for Spirituality & Heal- a course in Western and Eastern phil- We answered this question by track- ing and the Life Science Foundation.” osophical concepts: “verify[ing] the ing the flow of CAM offerings from Featured on the latter’s website importance of the link between mind, the initial grant to the medical school is an interview with Russell Targ, a body, and spirit in health and heal- into several communities. proponent of psychic abilities and re- ing.” Courses in acupuncture, yoga,

34 Volume 37 Issue 3 | Skeptical Inquirer and meditation purportedly address the mechanisms by which these modalities BOSTON improve health and promote healing. The center’s website advertises: “grad- Other Boston Area NCCAM Curriculum Grants uates are employed by NIH, and alter- Harvard University Medical School Children’s Hospital, Boston native medicine foundations.” Adjunct $2.9 Million $1.6 Million faculty includes directors of homeo- pathic institutes and energy medicine Boston University School of Medicine and mind-body institutes. They serve as Teaching Hospitals $901 Thousand chairs of the accreditation commission for acupuncture and oriental medicine. Tufts University School of Medicine One faculty member has served as pres- Osher Clinic $700 Thousand Brigham and Women’s ident of the International Society for the Study of Subtle Energies and En- Harvard School of Public Health ergy Medicine. Georgetown’s medical Newton Wellesley $214 Thousand school has an institutional relationship with two CAM institutions: Bastyr and Massachusetts General Hospital the National University of the Health Spaulding Rehabilitation $175 Thousand Sciences (NUHS). Bastyr University, a naturopathic institution in Washing- ton State, had received $800 thousand in curriculum grants from NCCAM. Acupuncture, Reiki, Therapeutic Touch, Energy Healing, Homeopathy The academic affiliation (between Ba- styr and Georgetown) is intended to Figure 4. NCCAM funded training in a number of institutions is reflected throughout the Boston metropolitan area. “. . . break down the silos that hold the disciplines apart and create relation- Hospital and the Washington Hospital she was funded to study whether mag- ships between the disciplines and the Center also offer CAM services. netic mattress pads were effective for educational institutions that prepare pain relief for patients with fibromy- the nation’s future healthcare provid- Boston algia (Alfano et al. 2001). From 2000 ers.” In 2011, Georgetown agreed to to 2011 she was funded $2.5 million to Harvard Medical School received $2.9 share students and faculty with the Na- train health professionals in CAM, cur- million from NCCAM for training tional University of Health Sciences, riculum and clinical training. Recently, in CAM (Russell Scott Phillips MD, which offers degrees in chiropractic, a five-year K07 NCCAM Academic naturopathic medicine, acupuncture, P.I.). Some examples of elective courses Career Award program “. . . enables her and oriental medicine. The National offered by Harvard Medical School in- to study leadership training” at the Uni- University of the Health Sciences also clude: Spirituality and Heal ing in Med- versity of Virginia Darden School of has received almost $1.4 million in icine (ME726M.0), Mind-Body Med- Business. Her focus is “directed toward NCCAM curriculum funds. icine (ME 729.0), and Interdisciplinary sustaining a program of CAM-related A member of Georgetown’s faculty Rehabilitation of Patients with Chronic re search that investigates mind-body practices integrative medicine in North- Pain (ME554M.27) that includes acu- interventions, body-based practices, ern Virginia (Kaplan Integrative Med- puncture as a protocol (http://www. and electromagnetic and other en- icine), offering services in Reiki and medcatalog.harvard.edu/). ergy modalities.” A recent publication acupuncture (http://www.kaplanclinic. Other institutions in the greater (Ander son and Taylor 2012) stated com). Inova health care in Northern Boston area receive NCCAM training “Biofield Therapies are CAM modali- Virginia, affiliated with Georgetown, funds as well. Figure 4 tracks how this ties that involve the direction of energy offers CAM. Inova’s service for Reiki, training is reflected in clinics serving healing through the hands to facilitate located in its Children’s Cancer Clinic, patients in the Boston metropolitan well-being by modifying the energy is listed on the hospital’s website. It area. field of the body.” Their paper gives a is one of the services offered by Inova history of five energy therapies: Healing Charlottesville Cancer support groups that meet at the Touch, Johrei, Polarity Therapy, Reiki, Inova Loudon medical campus (http:// The University of Virginia’s School of and Therapeutic Touch. It urges, “On- www.inova.org/healthcare-services/ Nursing includes the Center for Study cology nurses should familiarize them- cancer/locations/inova-loudoun-hos- of Complementary and Alternative selves with biofield therapies.” There is pital/support-groups-and-programs. Therapies; Ann Gill Taylor is the direc- no recognition in their paper of studies jsp; http://www.centerforreikiresearch. tor of the Center. Originally awarded by scientists that human physiological org/Downloads/HospitalListTable. funds in 1993 for a specialty center fields are many thousands of energy pdf). George Washington University aimed at pain, from 1995 through 1998 units below the natural energy of the

Skeptical Inquirer | May/June 2013 35 Chapel Hill noise level of the cell and thus the fun- UNC Mindfulness Program. He has damental laws of physics preclude the North Carolina’s population is nine received NCCAM funding for clinical initiation of any chemistry (Adair 1991, million; 15 percent are below poverty research and educational projects relat- 1992, 1998; Bennett 1994). level. Its health care system spans the ing to CAM for the past seven years state, reaching both mountainous and totaling $2.5 million for research and Baltimore metropolitan areas, including the highly training fellowships, research in Korean educated Research Triangle area. The Brian Berman, professor of Family acupuncture, and clinical trials in treat- system serves 253,000 patients. Its ex- Medicine at University of Maryland ing migraines using magnets (Mann et penditures include $276 million in un- Medical School in Baltimore, received al. 2008). $20 million from 1999 to 2010 from compensated care. The University of The consult service provides “. . . NCCAM for the Center for Integrative North Carolina’s medical school grad- short- and long-term support to in- Medicine (CIM), an interdepartmental uates physicians who serve all counties patients as well as outpatients. . . . Pa- center within the University of Mary- of the state (www.unchealthcare.org/ tients and families can request a team land School of Medicine (www.com- site/aboutus/unc-health-cares-impact- assessment and CAM therapies such pmed.umm.edu/default.asp). The Cen- across-north-carolina.html). as acupuncture, homeopathy, hypno - ter was founded in 1996 under Berman’s The University of North Caroli- therapy, biofeedback, nutrition and leadership. Its offices and integrated na’s Medical School was awarded a $ supplements counseling, mindfulness medical clinic are based at the James 1.6 million R25 five-year curriculum training, and energy healing” (www. grant to train CAM Physicians. Prin- L. Kernan Hospital (www.kernan.org/ med.unc.edu/phyrehab/pim/clini- cipal Investigators were Peter Curtis, cim/index.htm). “A core component of cal-services). These clinical services in- MD, and Susan Gaylord. Its Integra- CIM’s mission is to evaluate the con- clude six faculty in mind-body services tive Medicine program is housed in tribution of complementary therapies and four in acupuncture. One “mind- the Department of Physical Medicine to patient care and healing in an out- fulness” faculty member lists, in addi- and Rehabilitation at UNC’s Medical patient, integrated medical clinic.” The tion to mind-body-spirit medicine, her School at Chapel Hill (www.med.unc. Center’s “highly qualified staff of prac- credentials in ancient mystical ethno- titioners and medical doctors is dedi- edu/phyrehab/pim/). Director of the graphic traditions, shamanic counsel- cated to providing an optimal therapeu- Program on Integrative Medicine, As- ing, energy healing, and harmonizing tic environment.” Faculty at the Center sociate Professor Susan Gaylord has a (http://www.med.unc.edu/phyrehab/ includes specialists in treating illness PhD in psychology and is a specialist in faculty/). Tuition for nine two-and-a- with acupuncture, Qigong, reflexology, Tibetan meditation practices. half-hour lecture courses in the mind- Reiki, mind-body medicine, homeop- The program includes an Inte gra tive fulness program range from $200 for athy, and Holographic Sound Heal- Medicine Consult Service. John Doug- $ ing (http://www.compmed.umm.edu/ las Mann, MD, director of Clinical graduate students to 395 for the gen- patient_pract.asp; http://www.comp Services for Integrative Medicine and eral public. ). med.umm.edu/pathways/index.asp the Consult Service, also codirects the The UNC’s Medical School Inte- grative Medicine in Residency (IMR) is incorporated over the three years of residency (www.carolinashealthcare. org/integrative-medicine-medical- education). The program is a com- One “mindfulness” faculty member lists, bination of web-based curriculum, program-specific exercises, and group in addition to mind-body-spirit medicine, process-oriented activities. Required her credentials in ancient mystical ethno- courses include Mind-Body Medicine and Spirituality Energy Medicine. graphic traditions, shamanic counseling, UNC’s Integrative Medicine pro- energy healing, and harmonizing. gram’s 200-hour curriculum is part of the Arizona Center for Integra- tive Medicine, University of Arizona. From 1999 to 2012, the University of Arizona has received $3.2 million in training grants and $25 million in re- search grants that include homeopathy and Reiki for animals.

36 Volume 37 Issue 3 | Skeptical Inquirer San Francisco SAN FRANCISCO Between 2000 and 2012, the Uni- versity of California at San Francisco Stanford University $ University of California at San Francisco School of Medicine (UCSF) received nearly 4.5 million $4.5 Million rship rtne in NCCAM grants to augment its cur- Pa ricula for health professionals. These grants included R25 funding to help Osher Center School of Medicine Schools of Nursing, Dentistry, and Pharmacy instill “awareness of the self as an in- strument of healing” in medical edu- cation, and to fund the Collaborative 9 Required Courses in e.g. Complementary, Alternative and Integrative Advances in Clinical Health Educa- Integrative Medicine Medicine; CAM and the Clinical Encounter tion (CACHE) program in partner- ship with Stanford University School 13 Elective Courses in e.g. Complementary Paths of Healing; of Medicine. Other grants fund a five- Integrative Medicine Massage and Meditation; Spirituality and Medicine year project to “develop, implement, evaluate, and disseminate a multi-dis- ciplinary, interprofessional curriculum e.g. Mindfulness and Meditation; Tai Chi; Public Classes in integrative medicine.” Healing Through Dance; Laughter Yoga UCSF established the Osher Center for Integrative Medicine in 1997, and Figure 5. Integration of CAM into UCSF Medical, Nursing, Dentistry, and Pharmacy programs and into the San it is this center that offers to the public Francisco community. classes such as those shown in Figure 5. The core curriculum of UCSF School close alliance with Bastyr Uni versity in CAM curricula” of R25 grant recipi- of Medicine includes nine required Kenmore, Washington, about one-half ents. They based their evaluations on courses in integrative medicine as well of the funds granted were used by the web-published curricula with respect to as thirteen elective courses; examples UW School of Nursing to educate the four popular CAM therapies—herbals, of the latter are shown in Figure 5 nursing faculty so they could, in turn, chiropractic, homeopathy, and acu- ( http://www.lanterntec.com/preview/ “value and integrate CAM content into puncture. Specific findings regarding osher/p1/education/integrative-medi- the nursing curricula.” This integration the UW curricula included that UW cine-curriculum/elective-courses/). of unproven therapies included required seems to encourage “open-minded- While public classes and professional courses and clinicals at undergraduate, ness” regarding homeopathy and a courses such as these are not unique in master’s, and doctoral levels. A pro- measure of support for acupuncture. our society, offering them through a gram to evaluate program effectiveness Their general findings were that these mainstream university medical school, was included as were a number of initia- curricula “were strongly biased in favor partially funded by taxpayer dollars tives to link the school with community of CAM,” that “many of the references via the National Institutes of Health assets in order to enhance the integra- were to poor-quality clinical trials,” and (NIH), conveys an impression of credi- tion of CAM content into the nursing that, even so, these referenced studies bility for these unproven techniques. curricula, but with no apparent parallel “were five to six years out of date.” focus on actual efficacy of the CAM Based on what they found, the authors Seattle therapies chosen to be taught. concluded that these integrative med- Between 2001 and 2006, the Univer- The other half of the funding went icine curricula represented “an educa- sity of Washington (UW) in Seattle to the UW School of Medicine and tional failure.” re ceived nearly $3.1 million in curricu- was intended to achieve, among other And yet the integration continues. lum grants to “enhance the integration goals, better communication between In the case of cancer, UW maintains of information about CAM therapies UW medical students and CAM stu- an online “Guide to Integrative Oncol- into UW health sciences curricula” and dents and practitioners in order to ogy” for clinicians and patients. Their to establish a CAM Curriculum at UW “initiate a respectful interchange of “About” page (http://depts.washing- (www.son.washington.edu/research/ information and ideas between practi- ton.edu/integonc/clinicians/about. grants/ShowAbstract.asp?Project tioners of these different paradigms of shtml) reveals the collaboration among ID=106&Refer=FCN). healing.” a UW physician who also is an officer Asserting (without evidence) that A paper published in Academic at the Seattle Cancer Care Alliance “important but under-exploited adjuncts Medicine (Marcus and McCullough and CAM practitioners, including a to conventional health care” and insti- 2009) evaluated “… the quality of the psychologist who “has designed and tutionalizing, up front, an apparently evidence cited in the evidence-based taught courses in mind/body medicine,

Skeptical Inquirer | May/June 2013 37 cross-cultural healing modalities, con- ries, and five Canadian provinces. The Sciences (Jonas and Jacobs 2009; Gor- sciousness-based healing modalities, and alternative medicine industry is actively ski 2001) In 1999, Congress legislated spirituality in medicine” and a naturo- pursuing expanded licensing of CAM that OAM should be elevated to an path, both of whom are faculty members practitioners. NIH Center, the NCCAM, with Ste- at Bastyr University with concurrent phen E. Straus as its director. Josephine consultant or affiliate research positions Background Briggs, its current director, has served at UW School of Medicine. Some anti- since 2008. From its beginning in 1992 cancer therapies touted in this guide are How did American taxpayers become to present, its annual budget has in- listed at http://depts.washington.edu/ part of a two-decade fiscal morass of creased sixty fold at a cost of $2 billion integonc/clinicians/act/. mythological non-evidence based de- in federal funds. The close ties between UW and livery of medical care? Congress’s enthusiastic endorsement nearby Bastyr University are dis- From OAM’s inception in 1992, of alternative medicine as a medical turbing because they confer a scien- the medical and science community protocol was matched by the executive tific respectability on Bastyr—a de- questioned the politics, board appoint- branch. Under the leadership of Presi- gree-granting institution that features ments, and initial funding awards. Pol- dent Clinton, ostensibly in “response to programs in Naturopathic Medicine, icy perspectives were published in Sci- public demand,” a White House Com- mission was created in 2000 (Report White House Commission 2002). Its mandate was “to develop legislative rec- How did American taxpayers become ommendations to maximize potential benefits to consumers and American part of a two-decade fiscal morass of health care of therapies such as chiro- mythological non-evidence based delivery practic, acupuncture, massage, herbs, nutritional and mind-body concepts as of medical care? ... Congress’s enthusiastic well as other approaches.” The commis- sion expressed concern about ensuring endorsement of alternative medicine as the safety of products and practices but a medical protocol was matched by demonstrated ignorance of science by not reporting on their efficacy. Its pri- the executive branch. ority was that “people looking for ther- apies that are both more helpful and less burdened by side effects” (a holistic per- spective related to traditional systems of healing) would be recognized by federal Acupuncture and Oriental Medi- ence (Marshall 1994; Stone 1997) and funding. cine, Midwifery, and Herbal Sciences JAMA (Eskinazi 1998). A recounting The commission of twenty members (http://www.bastyr.edu/academics/ of the politics of congressional pressure included a chiropractor, medical doc- areas-study). An accredited program from Senator Tom Harkin, Congress- tors, acupuncturists, a nurse, a grand- called Perma culture leads to a Cer- man Berkley Bedell, and Congressman master of Qigong, a dentist, a naturo- tificate in Holistic Landscape Design Jim Moran was published in the New path, a social worker, herbal healers, (http://www.bastyr.edu/academics/ar- Republic (Satel and Taranto 1996). and a business man, Thomas Chappell, eas-study/certificate-holistic-landscape- Scrutiny by the National Council president of Tom’s of Maine. The chair- design). Bastyr is expanding. From person, James S. Gordon, MD, a psy- against Health Fraud and the testimony 2000–2012 Bastyr has received over chiatrist, was director of the Center for of OAM’s first director, Joseph Jacobs, $12 million in research and curricu- Mind-Body Medicine in Washington, MD, demonstrated how congressional lum grants from NCCAM, and a San D.C. (Quackwatch Archives: William Diego campus was added in Fall 2012. interference forestalled any objections Jarvis and Patrick Curry). Gordon’s Of even more concern from the stand- from medical scientists. This inter- credentials included being a proponent points of both science-based public ference was responsible for Jacobs re- of homeopathy and orgone therapy and health and the unbridled growth in fu- signing after two years (Atwood 2003; being a believer in UFOs. The creden- ture health care expenditures, as of this http://www.sciencebasedmedicine.org/ tials of the commission were questioned writing Doctors of Naturopathic Med- index.php/yes-we-can-we-can-abol- by journalists and physicians familiar icine are licensed or regulated as health ish-the-nccam). The second director, with aberrant medical practices (Curry care professionals in sixteen states, the Wayne B. Jonas, MD, 1995–1999, was 2001; Gorski 2001). District of Columbia, two U.S. territo- a homeopath with interest in Noetic Conspicuously absent from the

38 Volume 37 Issue 3 | Skeptical Inquirer commission were Nobel Prize win- a caricature of community health care. controlled trial. The Journal of Alternative and ners in medicine, officers of scientific These curriculum grants continue as an Complementary Medicine 7(1): 53–64. Anderson, Joel G., and Ann Gill Taylor. 2012. research societies, and members of the expensive endeavor with no perceptible Biofield therapies and cancer pain. Clinical science research community. None of increase in health in these communities. Journal of Oncology Nursing 16(1): 43–8. its members were physicists, biochem- The reality is, after almost twenty Atwood, Kimball, 2003. The ongoing problem $ with the Center for Complementary and ists, biologists, or teachers of core sci- years and almost 2 billion, there is no Alternative Medicine. SKEPTICAL INQUIRER ence curricula required for entrance to evidence of CAM improving the health 27(5): 23–29. medical school. of a community. When will Congress Bennett, William R. 1994. Cancer and power The Commission recognized that recognize that no evidence exists to sus- lines. Physics Today 47(4): 23–29. Curry, E. Patrick. 2001. Notes on James S. Gor- “most CAM modalities had not yet tain these adventures into mythology? don, MD, Chair of the White House Com- been proven safe and effective” and rec- How will these services in unproven mission on Complementary and Altern ative ommended training health care practi- beliefs, some of which violate the laws Medicine policy. The Scientific Review of Al- tioners to ensure the safety of CAM. of science, which are now mandated to ternative Medicine 5(4): 226–228. Eskinazi, Daniel P. 1998. Policy factors that shape The report emphasized that conven- be covered by the nation’s health care alternative medicine. Journal of the American tional and CAM systems of health and laws, add to our health care costs? The Medical Association 280(18): 1621–1623. healing should be held to the same rig- executive and legislative branches of a Green, Saul. 2001. Stated goals and grants of orous standards of good science. Some seemingly intelligent government nur- the Office of Alternative Medicine/National ■ Center for Complementary and Alternative of the members, with established fidu- ture this waste. Medicine. The Scientific Review of Alternative ciary interests in homeopathy, orgone Medicine 5(4): 205–207. therapy, acupuncture, and the myth of Notes Gorski, Timothy. 2001. White House Com- 1. mission on Complementary and Alternative bioenergy healing, might not have been Recent publications relating to this subject by the authors include: Medicine. The Scientific Review of Alternative appropriate to evaluate the unsubstan- Medicine 5(4): 211–222. Eugenie V. Mielczarek and Brian D. Engler. Jonas, Wayne B., and Jennifer Jacobs. 2009. tiated claim that American taxpayers 2012. Measuring Mythology: Startling Con- were insisting on federal funding of cepts in NCCAM Grants. SKEPTICAL IN- Healing with Homeopathy: The Complete QUIRER 36(1) (January/February): 35–43. Guide. Grand Central Publishing/ Hachette CAM. The committee asked for fed- Eugenie Mielczarek and Derek Araujo. 2011. Book Group USA. eral support, publication of results in Power Lines and Cancer, Distant Healing and Marcus, Donald, and Laurence McCullough. Health Care. SKEPTICAL INQUIRER 35(3) (May/ 2009. An evaluation of the evidence in ‘evi- peer-reviewed journals, and reimburse- June): 40–44. ment for CAM therapies based on pub- Eugenie Mielczarek and Derek Araujo. 2009. dence-based’ integrative medicine programs. A fracture in our health care: Paying for Academic Medicine 84(9): 1229–34. lished evidence. Its recommendations non-evidence based medicine (September 28). Mann, John D., K.R. Faurot, L. Wilkinson, et implied that reports would be publicly Available online at www.centerforinquiry.net/ al. 2008. Craniosacral therapy for migraine: uploads/attachments/A_Fracture_in_our_ Protocol development for an exploratory con- issued on the efficacy of these non-sci- Health_Care_Paying_for_Non-Evidence_ trolled clinical trial. BMC Complementary and ence based protocols. Based_Medicine.pdf . Eugenie Mielczarek. 2010. Fields, Alternative Alternative Medical Journal 8(28). Congress and the executive branch Medicine, and Physics (May 27). Available on- Marshall, Elliot. 1994. The politics of alterna- had forced NIH to respond to a so- line at www.sciencebasedmedicine.org/?cat=11; tive medicine. Science 265 (September 3): accessed August 6, 2011. cial phenomenon incompatible with 2000–2003. 2. Data from grants referred to in this paper Report White House Commission on Comple - extending the best in medical care to can be accessed from http://projectreporter.nih. mentary and Alternative Medicine Policy communities, an expensive legacy. Sur- gov/reporter and http://clinicaltrials.gov/. Final Report, March 2002. prisingly, the premier research center 3. A major source on the history of the es- Satel, Sally, and James Taranto. 1996. Bogus bee of our federal government, intended tablishment of the Office of Alternative Medi- pollen. The New Republic 214(2–3): 24–27. cine and the establishment of NCCAM are the Stone, Richard. 1997. Science scope. Science 277 to improve the health of Americans, archives of Quackwatch, accessible online, pub- (July 11): 169. complied by assuming that protocols lished by the National Council against Health Sampson, Wallace. 2001. The need for educa- Fraud. of alternative medicine were a foregone tional reform in teaching about alternative medicine therapies. Academic Medicine 76(3): conclusion. Instead of waiting for the References 248–250. results of initiatives in research, which Adair, Robert K. 1991. Constraints on biologi- Eugenie V. Mielczarek is emer- might have negated the concept, NIH’s cal effects of weak extremely-low-frequency itus professor of physics at NCCAM generously funded installa- electromagnetic fields. Physical Review A 43: George Mason University. Her tion of these concepts into the curric- 1039–48. background is in materials re- ———. 1992. Reply to “Comment on ‘Con- search and biological physics. ulum of medical schools and funded straints on biological effected weak extreme- non-MD organizations. Congress, ly-low-frequency electromagnetic fields.’” NIH, and some academic institutions Physical Review A 46: 2185–87. ———. 1998. Comment on “Extremely low fre- Brian D. Engler is affiliate fac- pursued this integration with mission- quency electromagnetic fields do not inter- ulty at George Mason Univer- ary zeal. act directly with DNA.” Bioelectromagnetics sity. A retired U.S. Navy Com- NCCAM’s funding for teaching en- 19(2): 136–37. mander, his fields of study are Alfano, Alan P., Ann Gill Taylor, Pamela A. operations research and busi- ergy medicine (e.g. Reiki, acupuncture, Forseman, et al. 2001. Static magnetic fields ness administration. and mind-body therapies), has created for treatment of fibromyalgia: A randomized

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