In Part I of this series† we saw that in 2001 Dr. David Eisenberg, the Director of the Harvard Medical School Center for Alternative Medicine Research and Education (CAMRE), and Atty Michael Cohen, the CAMRE’s Director of Legal Programs, had contributed to a report commissioned by the Commonwealth of Massachusetts that would, if accepted as valid by the legislature, provide state protection for a group of quacks to practice ‘medicine.’ We also saw that Dr. Eisenberg had accepted funds from this very group, without having disclosed that information to the relevant state Commission. We saw examples of the quackery that the group espouses, including methods advocated by Thomas Kruzel, the Chief Medical Officer of the school that had contributed money to Dr. Eisenberg’s Harvard “Complementary and Integrative Medicine” course.
We continue now with the essay that I sent in the spring of 2002 to Dr. Dan Federman, the Senior Dean for Alumni Relations and Clinical Teaching at Harvard Medical School (HMS). As before, I’ve provided hyperlinks to many of the citations that I included in my original essay; some, however, are no longer available.
The American Association of Health Freedom
Kruzel and Harvard’s Michael Cohen are listed as key figures—Kruzel the Secretary, Mr. Cohen the only lawyer on the Advisory Board—in a lobbying organization known as the American Association of Health Freedom (AAHF). Formerly known as the American Preventive Medical Association (APMA), it was founded by Julian Whitaker, MD, a former orthopedic surgical resident who decided that “natural therapies” offered a more lucrative career path. Its purpose, as suggested by the standard euphemism, is to convince government of the validity of dubious medical claims through political influence rather than science. The AAHF lobbies heavily for the passage of the annually defeated federal “Access to Medical Treatment” act, which would allow quacks to prey freely on unwary consumers.
The organization has prepared numerous statements favoring the reckless marketing of implausible “health” products and methods, including “emergency petitions” to block the FDA from promulgating regulations of “dietary supplements.” One of these petitions argues against the regulation of ephedra products such as ma huang, which contain dangerous drugs and have been associated with thousands of adverse events, including many deaths, over the past few years. The AAHF has also filed an amicus curiae brief supporting a California lawsuit in which the plaintiffs, parents of a child with brain cancer, seek damages from an oncologist because he failed to recommend “antineoplastons,” a dubious “alternative” cancer treatment backed by neither biology nor experimental evidence.
The list of AAHF sponsors, dubbed “Angels,” reveals the basis for the organization’s lobbying preferences. The top twenty contributors are “dietary supplements” companies and commercial “labs” that market fraudulent tests such as “hair analysis.”
An examination of the Board of Directors and the Advisory Board of the AAHF is equally revealing. In 1999 the President, Murray Susser, M.D., was the chairman of the medical advisory board of Gero Vita International, a lucrative “supplements” company whose bogus claims have been the targets of numerous investigations by the FTC, FDA, U.S. Post Office, and congressional hearings. Susser’s practice, the “Longevity Medical Center” in Los Angeles, “uses Acupuncture, Homeopathy, Nutrition, Chelation Therapy, Heavy Metal Detoxification, Physical Therapy, Stress Management, Weight Management, Oxidative Therapies, and Detoxification Therapy.” Susser’s advertisements suggest that he knows the secret to halting the aging process and that he has “solved the mystery of chronic fatigue syndrome.” In 1995 he was disciplined by the California state medical board for “unprofessional conduct, gross negligence, incompetence, repeated negligent acts, and excessive use of diagnostic procedures.” He paid $15,000 and spent three years on probation. He does not mention this fact in the “professional information” section of his website.
Another member of the board of directors of the AAHF is Woodson C. Merrell, M.D., the Executive Director of the Center for Health and Healing at the Beth Israel Medical Center of New York and a regular speaker at Harvard “CAM” conferences. According to the Center’s website, Dr. Merrell’s “acquaintance with complementary medicine began at the age of one, when a neighborhood doctor cured his croup by placing three pellets of homeopathic aconite under his tongue.” The Center considers itself a showcase for “integrative medicine.” On its website one finds the following: suggestions that autism, ADHD, and learning disorders are caused by routine childhood vaccinations; suggestions that “craniosacral therapy” and homeopathy are useful treatments for these and other diseases; the alarmist claim of ubiquitous but ill-defined “toxins” that is common to naturopaths and other “alternative” practitioners; claims of chiropractic being useful for various visceral conditions, such as PMS and asthma; glowing recommendations of Therapeutic Touch, Ayurveda, Traditional Chinese Medicine, and other unlikely or untested methods; and more.
Of the eleven remaining physician members of the two AAHF boards, at least nine advocate fraudulent methods similar to those above, as do several among the non-physicians. Recurring themes are “anti-aging” claims, homeopathy, anti-vaccination hysteria, “immune boosters,” the hawking of “dietary supplements” and other dubious products over the Internet and directly to patients, “detoxification” claims, and the claim that EDTA “chelation therapy” can reverse coronary artery disease by leeching calcium out of atherosclerotic plaques (a well-known form of quackery that has existed for more than 30 years, though lacking in both biological basis and supportive studies).
According to the National Council Against Health Fraud, AAHF founder and board member Julian Whitaker makes $300,000/yr on “chelation” alone). Several AAHF board members have been in trouble with the federal government for misrepresentations of one sort or another [Jonathan Wright, for example]. At least three of the advisory board members have promoted Laetrile, the notorious, illegal quack cancer “remedy.” One of these, pharmacist Earl Mindell, claims to have a Ph.D. from a university that lacks accreditation, a campus, and a laboratory. Another, Robert Rowen, M.D., still recommends Laetrile through the Cancer Control Society, whose website carries the following warning:
The Cancer Control Society Does not believe in the Traditional methods of Surgery, Radiation and Chemotherapy for the treatment of cancer by doctors in California hospitals. This treatment is proving to be flawed, ineffective and destructive to the immune system. More and more patients are seeking alternative methods.
It is clear that most of the “health professionals” on the AAHF boards have significant financial interests in dubious products, and several are smarting from having been inconvenienced by regulatory agencies. They seem to have found a sympathetic ear in fellow board member Michael Cohen, J.D., Harvard’s Director of Legal Programs for “CAM.”
The AAHF has several friends in Congress, including Rep. Dan Burton, who fought for the legalization of Laetrile in his home state of Indiana during the 1970s. Rep. Burton has used his chairmanship of the House Committee on Governmental Reform as a bully pulpit for the advocacy of numerous bogus methods, including the aforementioned “antineoplastons” and EDTA chelation “therapy.” The AAHF applauds his sponsoring of a bill that would prohibit the FDA from interfering with the promotion, sale, and administration of agents that, like Laetrile, are both scientifically baseless and dangerous.
According to the course brochure, Rep. Burton was scheduled to give a Key Presentation at the fall, 2001 “Models of Integrative Care: Present and Future” conference in San Francisco. Michael Cohen and fellow AAHF board member Woodson Merrell were listed among the other speakers. The conference was co-sponsored by Harvard Medical School and co-directed by Dr. Eisenberg.
The NCCAM, the Fetzer Institute, ‘CAM’ Hype, and More Conflicts of Interest
Harvard Medical School is the recipient of several grants from the National Center for Complementary and Alternative Medicine (NCCAM). This organization is a branch of the federal government, so it might come as a surprise to some that its granting decisions are largely based on ideological prejudice. In November 2000, the month that Dr. Eisenberg began his tenure as the representative of the Massachusetts DPH to the naturopathic licensing issue, there were three naturopaths among the 17 members of the NCCAM National Advisory Council. Such representation on a federal advisory board is remarkable, not only because of the naturopaths’ pseudoscientific views (one on the Council is the recipient of an NCCAM grant to study psychic “healing”; another recommends coffee enemas for cancer and multiple sclerosis), but also because of their tiny numbers: there are only about 1500-2000 NDs nationwide. By comparison, there are about 30,000 MDs in Massachusetts alone.
Another member of the NCCAM Advisory Council is Ted Kaptchuk, the Associate Director of the Harvard Medical School CAMRE. Does it seem likely that the Harvard “CAM” project can be publicly critical of naturopathic claims and still hope to receive funds from the NCCAM?
Dr. Eisenberg’s main private funding source prior to Osher was the Fetzer Institute, a promoter of “CAM.” Fetzer funded Dr. Eisenberg’s telephone surveys on the use of “unconventional medicine” by Americans. Dr. Eisenberg and others have used these surveys to exaggerate the real demand for “alternative” methods by over-defining “unconventional,” including within this category, for example, “self-help groups,” “commercial diet,” “lifestyle diet,” “relaxation techniques,” and “massage”; by mentioning rarely-used methods (e.g., acupuncture, homeopathy, and naturopathy: all <1% in these studies) in the same context as common ones, thus inflating the apparent popularity of the former; and by minimizing the distinction between casual self-treatment and the use of practitioners, which are quite different issues. Nor was the conclusion of Eisenberg et al, that “the frequency of use of unconventional therapy in the United States is far higher than previously reported,” accurate. Dr. Eisenberg is also aware of a contemporary study that is much larger and more inclusive than either of his, but that shows far lower rates of use. He cites this study for other reasons in several articles but fails to mention that it disagrees with his own.
Although its website has stated that Fetzer “supports the application of rigorous scientific approaches to these therapies,” it also describes
efforts…underway to assist health care professionals in effectively integrating complementary therapies through continuing medical education courses, survey research on prevalence of use…and a program for producing standardized credentialing…”
The “credentialing program” would seem to further explain what Dr. Eisenberg and Mr. Cohen were doing at the Mass. Special Commission on Complementary and Alternative Medical Practitioners. But what about “integrating complementary therapies,” and why should “prevalence of use” have anything to do with it? Precious few “complementary therapies” have been shown to have any value, certainly not enough to serve as the basis for any course, clinical practice, or “credentialing program.” The statement fails to acknowledge that “integration” shouldn’t even be considered until safety and efficacy have been established.
Another Fetzer publication provides the explanation for this paradox. In his “Overview of Legislative Development Concerning Alternative Health Care in the United States: A Research Project of the Fetzer Institute,” David Sale ponderously concludes:
Given the synergistic momentum that arises from a high level of consumer usage of alternative therapies, the continuing interest of alternative providers in securing professional practice rights, and other patterns of activity in this field, it seems likely that the legislative arena will experience intense pressure in the coming years to accommodate alternative modes of care. If new enactments are predicated on a patient-centered ideal that accords the individual substantial freedom to select a mode of personal care, the interests of health care in the United States would indeed seem well-served.
In other words, let exaggerated popularity trump validity. This, with its attendant financial incentives, is the driving force behind the “CAM” movement. It is reflected in the report of the White House Commission on Complementary and Alternative Medicine Policy, currently in its “draft recommendations” stage, which calls for numerous efforts to shoehorn CAM into mainstream health care by increasing “CAM activities” in federal agencies, creating CAM lobbyists within federal agencies, mandating “coverage and reimbursement” for CAM, declaring CAM practitioners to be “primary care providers,” subsidizing their training, and much more.
The chairman of the White House Commission, James Gordon, has frankly admitted that CAM isn’t about evidence. In a recent quotation for The Scientist, he said: “The reason there is as much interest in complementary medicine as there is, is not because of the science. The moving force has been us.” Gordon, a 1967 graduate of Harvard Medical School, is a Fellow of the Fetzer Institute and a member of the advisory board of the Program for Extraordinary Experience Research, John Mack’s “alien abduction” organization. He was a Keynote speaker at last year’s Harvard Complementary and Integrative Medicine course.
Harvard Medical School is involved in a joint venture with Aetna, Inc., to provide health information to consumers at a website called “InteliHealth.” Aetna describes the mission as follows:
InteliHealth’s mission is to empower people with trusted solutions for healthier lives. We accomplish this by providing credible information from the most trusted sources, including Harvard Medical School…
How much trust can InteliHealth’s readers place in Harvard Medical School for information regarding “CAM”? In an article entitled “Finding a Doctor who Understands Complementary and Alternative Medicine,” written by a faculty member of HMS, the reader is advised to find such a doctor at one of two sources: the American Holistic Medical Association and the American College for the Advancement of Medicine. A perusal of a newsletter from the first group reveals that numerous childhood diseases are explained by “toxic load,” “fungal dysbiosis,” heavy metals, immunizations, and zinc deficiency: the same fraudulent, alarming misinformation that naturopaths and many other “CAM” advocates preach. The second source is the organization founded more than 25 years ago to promote quack EDTA “chelation therapy” for coronary artery disease. Is the article’s author, who is not a physician, aware of these facts?
Elsewhere on InteliHealth, with the HMS logo prominently displayed above it (“Veritas”), is a fawning treatise [no longer available in Wayback; the link is to the identical essay] on “naturopathic medicine” that is boilerplate AANP propaganda: “NDs are trained as family physicians”; they “treat the whole patient, not just the disease symptoms”; they “successfully combine so many therapies,” etc. The article suggests that if the reader is already consulting an N.D., she may reasonably choose not to see an M.D. A bibliography entitled “Supporting Research” twists an embarrassing fact: it cites an FDA warning about the unfavorable interaction between St. John’s wort and HIV protease inhibitors, implying that this constitutes “supporting research” for naturopathic claims. In fact, naturopaths have promoted St. John’s wort to HIV+ patients as an antiviral agent for years, without plausible evidence, and continue to do so in spite of this dangerous interaction. How many patients may have developed AIDS or suffered relapses because of this is unknown, because naturopaths don’t look. The FDA warning should have been cited as non-supporting research.
InteliHealth offers similar treatises for several other “CAM” methods, in each case backed by the Harvard logo, and in each case making unsubstantiated claims for efficacy. The following examples are from the homeopathy and chiropractic treatises, respectively:
Conditions that respond well to homeopathic treatment include arthritis, migraines, asthma, eczema, attention-deficit disorder, depression, anxiety, ulcerative colitis, Crohn’s disease, chronic-fatigue syndrome, fibromyalgia, multiple sclerosis, back pain, gastritis, peptic-ulcer disease, ear infections, and strep infections.
Chiropractic has shown to be effective for acute and chronic low back pain, neck pain, headaches (including migraines), inflammation of the middle ear, digestive problems, menstrual and premenstrual pain, frozen shoulder, tennis elbow and other sports injuries, carpal tunnel syndrome, arthritis, and asthma.
No homeopathic treatment has ever been shown to help any medical condition, and none will, because the basis for the practice is contrary to fact. The great Harvard physician Oliver Wendell Holmes eloquently debunked homeopathy in 1842. All that has changed since then is that we are even more justified, after 160 years of progress in physiology and pharmacology, the discovery of the placebo effect and more, in concluding that homeopathy is nonsense.
Manual therapy may be helpful, in a limited way, for back and neck pain. There is no evidence that chiropractic is effective for any of the other conditions on the list, and no biological basis for predicting that there ever will be. Pediatricians might be alarmed to know that chiropractors claim to prevent and cure otitis media by repeated “adjustments” of the cervical spine, which they recommend even for infants. There is no basis whatsoever for this practice, which has resulted in vertebral artery lacerations and death. Nevertheless, a recent article by a Harvard pediatrician—the director of Boston’s Center for Holistic Pediatric Education and Research at Children’s Hospital—includes a photograph of a chiropractor performing this maneuver on a nine-month old boy. There is no discussion and no critique, only a caption blandly referring to it as “chiropractic care.”
Final note: Several of the InteliHealth articles, including those on naturopathy, homeopathy, and chiropractic, were replaced in March 2002 after this essay was written. The new articles lack some of the more outrageous therapeutic claims but are still misleading. See the accompanying essay on homeopathy for an example.
Next: Homeopathy at Harvard
†The Harvard Medical School series:
- Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.3: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (concluded)