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The Golden State of Pseudo-Science

The state of California (CA) which is home to the most advanced education and research in biomedical sciences, computational biology, genomics and proteomics, etc, is also home to 19 institutions that have state-approved training programs in Traditional Chinese Medicine (TCM), a pseudo-medicine that is based on ideas and practices sourced by ancient cosmology, mythology, astrology, and a range of other pre-scientific beliefs that have been partially “sanitized” during the Maoist era.

Emerging out of the recent hype about complementary and alternative medicine (CAM), the educational curricula of these institutions include the study of acupuncture’s point-and-meridian system, the health and safety beliefs of ancient and medieval China, humoral pathology, herbalism, Asian massage, and a limited amount of modern biomedical sciences at a level below what is required from vocational nurses. These curricula are supposed to provide the necessary knowledge and skills for the graduates to pass a comprehensive state licensing exam and provide “primary” healthcare in CA. However, pursuant to CA Code of Regulations, Title 16, Section 1399.451(b) it is improper for these “primary” healthcare providers, “to disseminate any advertising which represents in any manner that they can cure any type of disease, condition or symptom!” Nonetheless, both the internet and the local press abound with ads by CA licensed practitioners who claim that acupuncture can cure or mitigate many diseases, ranging from allergies and infertility to stroke and paralysis.

Under the banner of CAM, a handful of these practitioners also advertise that they can communicate with spirits and heal with crystals, colors or sounds; they practice healing touch (reiki) and distance healing (via PayPal!); provide spiritual counseling and ministerial services, and make implausible medical claims such as healing a chronic condition with just one needle!

All 19 programs are approved by the CA Department Affairs’ (DCA) Board of Acupuncture, since CA law requires that the content of an acupuncture training program be assessed and approved by the State.

Baffled by the absurdity of some of the content of these programs and the outrageous claims of some of the graduates, I addressed the DCA’s Board of Acupuncture on June 20, 2008, to request the repeal of state-approved healthcare programs that endorse the teaching of vitalism, metaphysics and snake-oil-science. To clarify the matter, I reminded the Board that vitalism is a doctrine that stipulates that the functions of a living organism are due to a transcendental vital faculty distinct from physicochemical forces, which distinguishes living organisms from non-living matter. Vitalism was the fundamental dogma of natural sciences and medicine in the West until the 19th Century where disease was believed to derive from interruptions to the flow of a vital principle, called pneuma, and imbalances in four humors. Eastern traditions have similar notions such as qi in China, ki in Japan and doshas in India. I also reminded the Board that vitalism was disproved in the 19th Century by Friedrich Wohler who showed that it is possible to synthesize an organic substance in the laboratory. Louis Pasteur disproved a related concept called “spontaneous generation.” More recently, Stanley Miller, during a landmark experiment in 1953, demonstrated that organic substances could be created by very simple physical processes from inorganic substances.

The counterargument presented by the former Chair of DCA’s Acupuncture Board, Dr. Adam Burke, is instrumental in understanding the thought process behind the official legitimization of voodoo science and New Age nonsense in the Golden State. Dr. Burke, who is also a Senior Research Advisor to the American Association of Oriental Medicine and the Co-Director of the Institute for Holistic Healing Studies at San Francisco State University (SFSU), stated that:

If you biomedicalize it all… if we strip the history and the philosophy and the understanding of that, we have shut out millennia of understanding of human illness that could enrich our understanding of healing people. That would be such a historic loss… I don’t think we’ll completely understand these things. The Journal of Alternative and Complementary Medicine, also Mary Ann Liebert, hardcore, very big science journal editor – Distant Healing. They don’t know how but some of the people at the Institute of Noetic Sciences, which was founded by an astronaut, up in Marin, they are doing research on distant healing. They principle investigator is a physicist. They are getting their research published in the best physics journals in the United States. They’re trying to show the physical nature of these phenomena. We don’t understand them but it’s not metaphysics. I mean I wish there had been more metaphysics when I was in school and I don’t imagine schools have gone backwards. I imagine they are going more towards integrative medicine.

Now, does not this sound like the ultimate in anti-rationalism and anti-science coming from the Chair (former) of a State Board with the mandate of protecting the public health, safety and welfare? The entire text is available at the following link:

www.acupuncture.ca.gov/about_us/minutes/20080620.pdf

A few weeks later, I got an official letter from the DCA, stating that after careful review, the Board had not found anything objectionable in the curricula of state-approved TCM schools.

I gather that the dreadful mixture of anti-intellectualism, anti-rationalism and low expectations at the New Age of Unreason is doomed to remain the basis for many public health policies in the Golden State. And as long as Chinese metaphysics and vitalism are perceived as anything but pre-scientific and disproved worldviews, pseudo-doctors and purveyors of TCM woo-woo will continue to provide the community of believers with medical astrology, alchemy, humoral pathology and even dialogue with the dead, heal with incantations, crystals, colors or sounds, remotely or via touch, and make implausible medical claims–all with the full blessing and endorsement of the CA Department of Consumer Affairs.

Posted in: Acupuncture, Politics and Regulation, Public Health

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32 thoughts on “The Golden State of Pseudo-Science

  1. DevoutCatalyst says:

    “…A few weeks later, I got an official letter from the DCA, stating that after careful review, the Board had not found anything objectionable in the curricula of state-approved TCM schools…”

    I looked at the list of these schools and find that more than 3000 hours are required to learn this stuff. What a waste of a person’s time and money. This is massive fraud. Useful minds are being squandered. Your blog entry truly sickens me.

  2. Mojo says:

    I can’t read the quotation from Dr. Burke without hearing the whooshing noise of waving hands.

  3. tarran says:

    I think that the time has come for the people behind Science Based Medicine to explore setting up their own rating agency.

    Rate the schools on various parameters and publicize it. Present an award to the top 5 school and encourage them to use that rating in advertising for new students.

    If shepherded along properly, the program could grow into one that provides an alternative to the inevitably politicized and thoroughly sclerotic state medical boards which focus on implementing various forms of rent seeking to the benefit of special interests rather than protecting the health of the members of the public.

  4. tommyhj says:

    It’s sickening that health fraud is directly encouraged by the state. And it’s not only in the USA – many countried have officially endorsed CAM institutions and modalities. It’s like scientology – if you can’t beat them with your shovel, use the law…

  5. Ben Kavoussi says:

    Hi DevoutCatalyst,

    Yes, I am glad you brought this up. This is definitely massive fraud.

    These schools leach off of Title IV federal financial aid; they dupe people into this, teach useless and non-scientific subjects, and pocket heavy tuitions for a non-academic diploma that does not lead to any real prospects of jobs. All the student is left with is the burden of the loan. This is just like making money by selling worthless stocks.

    There is a long list of fraudulent activities associated with these schools. Some were investigated for financial aid fraud, some have sold diplomas, some were selling clinical hours to people who were not even in the US so they can get licensed upon arrival. The list can go on and on.

    Someone has to file a complaint with Department of Education or with the Attorney General’s office of his/her state, and put an end to this. Without Title IV federal financial aid, they are all gone.

  6. kausikdatta says:

    I don’t have to go to California (the ‘Wrong Coast’! ;)) to get a feel of all-pervading woo-woo seeping into medical schools like the stench of sewage. My own institution, the Johns Hopkins, turns out to be a premier purveyor of woo. Recently, we were regaled by the news of how, for the 15th year in a row, The Johns Hopkins Hospital has topped U.S. News & World Report‘s annual Rankings of American hospitals, ranking in the top 10 in 16 of the 17 speciality categories listed. Hoorah! Rejoice we did, before my eyes fell on the website for the Johns Hopkins Center for Complementary and Alternative Medicine. The index page proudly proclaims:

    It is a new age in medicine, a time to explore the possibilities that complementary and alternative medicine (CAM) therapies have to offer. Through a center grant sponsored by the NIH’s National Center for Complementary and Alternative Medicine, prominent Johns Hopkins physicians and researchers can study a plethora of CAM modalities.

    Hmmm… so NIH’s complicity is well-established in this. Their overview page quotes:

    Use of complementary and alternative medicines (CAM) is on the increase in the United States. A recent survey indicates that
    * 40% of Americans use CAM for chronic conditions;
    * CAM was most frequently used for pain control, and nearly 50% reported using CAM because their prescribed medications were ineffective;
    * more than half of these patients used dietary supplements or herbal therapies, and almost two-thirds of the patients found CAM helpful; and
    * 30% to 70% of cancer patients who are inadequately treated by their physicians turn to CAM in the hope of curing or alleviating their pain.

    In the Mission pages of the CAM center at Hopkins, they state:

    The main scientific goals of the CAM Center are to characterize the neuroendocrine-mediated, immune and oxidative stress mechanisms underlying and linked to various aspects of cancer genesis, metastasis and treatment; and to develop the scientific substrate for expanding the study of CAM interventions relative to these mediators of cancer and concomitants, such as cancer pain.

    So far, so good. They want to scientifically explore the CAM approaches to pain management. Exploring further, I visited their links to ongoing studies. Of the three projects mentioned, one dealt with the role of CAM interventions in reducing oxidative DNA damage in cancer cells, while another dealt with the role of Omega-3 fatty acids (from fish oils) in body weight maintenance as a disease-restricting modality in pancreatic cancer. The third project was associated with animal models of chronic, cancer related pain, with the hypothesis being that pain, by negatively altering neuroendocrine responses, reduces immune protection and fosters the growth of new metastatic lesions.

    I did a double take. So far, everything seemed to be above-board; why were these a part of the CAM center? Cardioprotective effects of Omega 3 fatty acids have been well-studied. Their assertion that:

    Preliminary studies in our laboratories indicate that a soy diet prevents the development of neuropathic pain in an animal model of partial nerve injury and that tart cherries have anti-oxidant and anti-inflammatory effects. This proposal will examine the analgesic effects of soy and tart cherry as dietary supplements in five different well-established animal models of chronic pain that represent different aspects of pain associated with cancer: a model of chronic inflammation, two models of partial nerve injury, a model of cytotoxic neuropathy, and a model of bone cancer pain.

    was not special either, because a lot of natural products have medically active substances, and identification and isolation of those substances have helped in producing medicines from them – medicines that have been tried and tested in pre-clinical and clinical trials through all stages of development. So, where was the woo, and why CAM?

    Finally, I hit pay-dirt. Hidden in one small corner in the description of the pain studies is their plan:

    We also plan to use these animal models of chronic pain to investigate the potential analgesic effects of certain promising Indian, Chinese and Japanese herbal medicines.

    GAAAAAH!!! WHERE is the evidence that Indian, Chinese and Japanese herbal medicines, as prepared traditionally, work at all?

  7. I agree with the point of this post. However, I would like to point out the standards of proof or evidence generally required of a physician in court, when facing a tort case: a physician merely needs to give the evidence that he or she was practicing within a “community practice” level of “standard of care,” (for more info, google “pike v. honsinger”) OR, alternately, in accordance with a “respectable minority” (for more info, google “leech v. brallier”).
    This website has a good overview of the topic:
    http://www.mobar.org/journal/2000/novdec/bradford.htm
    In short, it seems that if an organized group with some sort of professional identity gives their rubber stamp to some curricula, they are “good-to-go” as far as being able to practice. A court in a tort case would generally attempt to figure out if there was a such a recognizable group with recognizable standard training, and would then work to determine if the individual practitioner practicved within the parameters of his or her group (i.e., did you perform reikke per protocol, or was the hands-up-the-blouse technique not a part of reikke training/certification).

    So, in my view, yes, the medical field generally believes that the practice is grounded in science and the natural sciences, but a court generally is not going to pull out a science textbook and evaluate the ontological status of “chi.” Or of “ki.” Or “vital.”

    That is my long way of saying that the point of this article is reasonable, but is not the standard to whcih a mainstream MD would be held. This presents a quandary: why, or how, would a CAM doc get held to some reasonable level of accountability, versus believing and doing almost anything that occurs to the imagination, as long as a few others can be recruited into the same ideas?

  8. Todd W. says:

    Mass General Hospital and the Partners Healthcare Network also endorse non-scientific “treatments” like reiki and acupuncture, even offering CME credits for taking reiki courses offered by Spaulding Rehabilitation Hospital, one of the affiliate members of the Partners network.

  9. kausikdatta says:

    Absolutely. In the Johns Hopkins, for example, the fun doesn’t stop with the CAM center. As proclaimed in the Spring 2007 magazine of the Johns Hopkins School of Nursing (the PDF of the issue here):

    In an effort to broaden their methods for healing, Johns Hopkins nursing faculty and students are increasingly looking outside the scope of conventional training to explore Complementary and Alternative Therapies… Many nurses today are exploring techniques that are outside of the scope of conventional medical training—techniques like massage therapy, acupuncture, meditation, yoga, herbs, Reiki, aromatherapy, and others that fall under a broad category of healing systems and methods called Complementary and Alternative Medicine (CAM). Nursing schools are also taking an interest in CAM. A growing number are integrating CAM or a broader scope concept known as holistic nursing into their curricula. At the Johns Hopkins University School of Nursing, the Introduction to Complementary and Alternative Healthcare has become a popular choice among students since it was first introduced in 1998…

    As an evidence of the extent to which CAM has been institutionalized, faculty and students of the JH School of Nursing may also attend lectures and workshops (‘at reduced rates’) at the Tai Sophia Institute, in Laurel, Maryland, which offers courses and master’s degree programs in acupuncture, herbal medicine, and applied healing arts. Says Lori Edwards, MPH, RN, APRN, BC, who teaches the Introduction to CAM course, “Nursing students should be learning about CAM because the patients nurses are working with are using these modalities.” In a recent study, a faculty member discovered that in patients from certain cultural backgrounds, there was very poor patient compliance for the prescribed medicines, but all patients were using “alternative treatments” – ranging from harmless home remedies like drinking onion syrup to potentially lethal practices like eating mentholated chest rubs. However, rather than discouraging these unproven, unscientific practices, the nurses are encouraged to “…teach patients how to blend alternative practices with conventional medical care, a concept called integrative medicine…”.

    Mentions the magazine article:

    In her course, Edwards discusses the four categories of CAM, as designated by the National Institutes of Health National Center for Complementary and Alternative Medicine: mind-body methods (such as meditation, yoga, and prayer); biologically-based methods (such as the use of herbs or homeopathy); manual healing
    methods (massage, acupuncture, and chiropractic care); and energy therapies (Reiki). Practitioners of several of these methods visit the class throughout the semester.

    I blanched. Prayer as medicine? Homeopathy? REIKI, for goodness’ sake? These, too, under official sanction? WHERE is the bloody evidence that any of this works?

    The magazine has more examples of such hand-waving. Faculty member Carol Libonati, MS, APRN, BC, CS-P, is a practitioner of Reiki, and uses a series of hand positions done either just above or directly on the body to restore “the normal energy flow”. According to her, “a subtle energy flows from the practitioner into the client, and the energy creates a healing effect.” As one of the clinical instructors in the course, Libonati begins by explaining the tenets of Reiki, and then pairs up students to practice gentle touch on each other and to begin to monitor the effect of that touch. And this is quickly taken up by her students, too. Student Karen Lyons (class of ‘08) is a convert. “Once, after a treatment, I felt as if someone had massaged me, but the person never touched me,” Lyons recalls. “I was amazed and had the best sleep of my life that night. In my work, people have a lot of anxiety about dental work, so I will rub my patients’ hands, which really calms them.” Libonati recalls the experience of one patient who had recently undergone a bone marrow transplant. After Reiki, “she said that it was the first time she felt relaxed and calm since the transplant without the side effects of a medicine,” Libonati recalls. “Up to that point she had used anxiolytics to manage her anxiety.”

    The question is: if you ever fall ill, would you like to treated by such a nurse who practices voodoo around you?

  10. Ben Kavoussi says:

    Thank you kausikdatta and MedsVsTherapy for your thought-provoking comments. My view is that a patient or a healthcare provider is free to have his/her own religious and metaphysical views, by all means. After all we have plenty of clergymen in hospitals to address the patient’s religious beliefs.

    But a state government agency, like CA DCA, being populated by individuals with anti-rationalism and anti-science views or representing the non-scientific views of a special interest group is a very serious public health issue that needs to addressed.

  11. Skeptinurse says:

    I cringe whenever I hear about nurses buying into the woo and trying to bring it into their practice. Although I did go to nursing school with one person whose goal was to become a “holistic” nurse. At that time, to me anyway, that term meant taking care of the whole patient. You know, talking to them, getting them to trust you enough that they would tell you why they weren’t compliant with their meds, ie; can’t swallow pills, can’t afford them, etc… helping them to overcome some of the difficulties that their condition was causing that maybe they weren’t comfortable telling their doctor or family about. Unfortunately I see it creeping in everywhere, even in the hospital where I work which is currently couching everything in terms of evidence based practice.

    I’m not sure when massage therapy became “alternative” either, I remember giving back rubs as part of HS care every night.

    I shudder to think what kind of nursing care I have to look forward to when I am in a place to need it. It’s getting scary to contemplate.

  12. sstumpf says:

    The quote attributed to Mr. Adam Burke is embedded in the very thorough minutes of that Nov 08 CAB meeting, which I attended. Burke, CAB Chair at the time, was an active participant in CAB meetings, setting the tone for other members, almost always as a strong advocate of what is known as Traditional Chinese Medicine or TCM. He was essentially an advocate for California’s acupuncture schools as well as the national accrediting agency, ACAOM. My inserts in [xxx].

    In that same meeting, Burke stated the following: “Adam stated since we’re moving potentially towards this [school approval] process being assumed by a National Accrediting Agency, [that would be ACAOM] would we want schools at this point, moving forward, to be able to have capabilities of meeting those standards”

    Burke’s agenda to protect teh acupuncture schools and primacy of teaching TCM have been plainly obvious in every meeting I attended in which he was Chair. This particular CAB meeting may have been the most outrageous in terms of the bald-faced advocacy of a profession and what can I only characterize as scofflaw behavior at the consumer’s expense.

    Before presenting the following excerpt I will note that the CAB has 3 new public members who hopefully will not follow Burke’s whimsical path. I will also point out that following the publication of this indicting record the practice of publishing detailed and accurate minutes was terminated by the CAB.

    The CAB approves all acupuncture training programs. St Luke University (SLU) was being presented for CAB approval. SLU was owned by a church headed by a Dr. Young. The dialogue between CAB members and the school’s owner was animated. I have included my clarification notes below and above in brackets [xxx].

    “Kenny [Cherng, former CAB member] asked what name was the school under in the 2003 application. Young answered that it was the same name, Saint Luke University. Kenny continued asking why did they apply as a DBA in 2006. Young stated that it was under the church name. The Church owned the school but after a member discussion the name was changed for the efficiency of running the school…Charles [Kim, current CAB board member] asked if the school’s goal was to promote a religious purpose. Young responded that they are a religious charity school. Charles then asked what the school’s future plan was. Young said that all the students want to become acupuncturists. Some of them would like to go to third-world countries as missionaries with acupuncture license…Adam [former Chair Burke] stated that personally he always thinks of Acupuncture students as California consumers…Adam then asked where Young imagined, other than missionary activity, his students practicing. Young answered that most of the students want to work as acupuncturists here. Some of them who have Korean Card, want to be missionaries with an acupuncture license.”

    Anyone who reviews the entire SLU passage in the minutes will learn that Dr. Young personally pays for 50% of the student boy’s tuition, the school is non-profit, the students do not speak or understand English (that discussion is especially disingenuous), and funds are very likely co-mingled blurring the lines between Dr. Young’s Church and SLU, which until very recently was owned by the church. The CAB members ask all the right questions to determine what is obvious: the school is a mechanism for bringing would-be missionaries to the US under a student visa so that, once licensed (or not), they might proselityse here and/or in Korea. Golden State of Pseudo-Science? What about Golden State for visa scams?

    The CAB approved the school for three years with an “annual fiscal review.”

  13. Ben Kavoussi says:

    Thank you sstumpf for your comments. Korean and Chinese students coming to the US to learn acupuncture?! This should already ring the immigration-scam alarm! This is like a French man coming to America to learn how to make croissants! And the reality is that we do NOT have a shortage of acupuncturists in the US!

  14. Ben Kavoussi says:

    Dear kausikdattaon,

    Just to clarify that this post is not about the woo-woo seeping into medical schools; it is about TCM schools that teach nothing but woo-woo! This is even worse.

  15. Tsuken says:

    JH nursing school said: “Nursing students should be learning about CAM because the patients nurses are working with are using these modalities.”

    I say WTF and no! Patients might do all sorts of things that make no scientific/medical sense; doesn’t mean we have to sanction them. (Ok, “learning about” doesn’t strictly speaking mean do it or sanction it, but in context …)

    That’s one facepalm for Johns Hopkins.

    CA however warrants a double facepalm. It licenses woo-woo practitioners as primary healthcare providers (facepalm #1) and then says they may not represent themselves as being able to treat any disease or symptoms (facepalm #2 not for the prohibition – which is all well and good – but for the logical FAIL in their actions).

  16. Ben Kavoussi says:

    Here is the short version of the long list of CA acupuncturists who make implausible claims. It was put together by a colleague in Michigan:

    1. Communicate with spirits:

    http://www.nirvanaalternatives.com/about_nini.html

    2. Healing with colors (Colorpuncture!):

    http://www.colorpuncture.org/article_1_mcroke.html

    3. Healing with tuning forks:

    http://tama-do.com/roothtmls/acupuncture.html

    4. Reiki (healing touch):

    http://santarosa-acupuncture.com/acu.aspx

    5. Distance (remote) healing:

    http://www.alternativesforhealing.com/cgi_bin/practitioner-remote-healing.php

    6. Spiritual counseling

    http://www.embodiedhealing.com/spir/kyle-spir.html

    7. Implausible medical claims

    http://www.ichingmedicine.com/services.html

  17. DevoutCatalyst says:

    “Here is the short version of the long list…”

    A tip of the hat, to your tip of the iceberg.

  18. kausikdatta says:

    He-he, Mr. Kavoussi… When you copy-pasted my handle, the ‘on’ next to it tagged along… :D (my name is Kausik, just in case!)

    I understand about the TCM schools in CA. It is just that when I read about them in your post, it increased my discomfiture at the instances of woo-woo at my own institution. Hence the venting!

    @Tsuken: you are absolutely right about the facepalm part! But – as I mentioned – strangely, the JH CAM center seems to be engaged – at least in Baltimore – in legit research exploring medical applications of certain natural products. It is the JH School of Nursing that is neck deep in all sorts of pseudo-scientific hand-waving kind of woo. For me, that was a straightforward headdesk!!

  19. Max says:

    As a practitioner of Chinese medicine, I’d have to agree that entirely too many of my colleagues practice with methods that have little to do with the medicine that is found in the past 2000 years of Chinese medical literature, case studies, and commentaries.

    Being a westerner myself, not particularly drawn to China or so called “energy” medicine, I only became interested in acupuncture because it actually helped me after many other methods failed. Curiosity and inquisitiveness (the very foundation of the scientific method) is what lead me to reading more about the subject. My investigate as to how this stuff actually works eventually lead me to acupuncture school and eventually to China.

    What I found is that serious practitioners both study classical texts and practice diligently in their clinics. I do not know about crystals or distance healing; these are not part of the Chinese medical tradition. There are plenty of treatments in the west that claim to draw on Chinese medical methods, but they are completely absent in Asia. I would agree that in the west there is a rather appalling lack of rigor and some terrible fuzzy thinking by so called CAM practitioners. There are some schools that are scams, but at the same time we have provide a fine and practical education. But, let’s not throw the baby out with bathwater. I’ve seen too many people in my clinic benefit from acupuncture to say that is hoax, smoke and mirrors.

    Just like there are plenty of biomedicine docs that will hand out an antibiotic without really diagnosing a patient’s problem, there acupuncturists that promote woo-woo and magical thinking. But, there are practitioners that can achieve with a needle, what no drug seems to correct.

    Open minded inquiry will take us all further than finger pointing and guffaw.

    Respectfully,
    Max

  20. kausikdatta says:

    Max, in keeping with your admirable sentiment about open-minded enquiry, would you mind pointing me towards a single study or perhaps a few studies where TCM has achieved any better effect than the corresponding placebo-controlled group? Could you perhaps indicate the physiological relevance and correlates of the traditional Chinese meridians and pressure points that acupuncturists are supposed to use, and could you also elaborate on the so-called presence of the ‘qi’ energy since I presume you are au courant with their philosophy?

    And what exactly is it that you claim to achieve with a needle that ‘no drug seems to correct’?

  21. Max says:

    Hello Kausikdatta,

    First of all, I am suspect of the vast majority of so-called research that comes from China. There are some people here in the west that are working on bringing valid research methods to Chinese medicine. This link http://tinyurl.com/nqo293 will take you to one of the more recent books.

    As to some things I seen needles do, various kinds of pain, especially stubborn headaches, neck pain, and back pain often respond well. Does it always work? No. Does it offer an alternative when other options either don’t work, or come with unbearable side effects? Sometimes.

    I have yet to see a cure all. I have yet to see one medicine that can treat all health issues. There is plenty of snake oil out there and practitioners and patients alike should do their due diligence.

    As to “qi”, this one frequently gets thrown around and used in a sloppy way here in the west. In essence, I see it as functionality. When we talk about the “qi” of something, we talk about its function. If there is high functionality, the qi is flourishing, if there is low functionality the qi is either stagnated or deficient. I know it does not help that Chinese medical thinking and diagnosis sounds like a weather report. It is further complicated by the Chinese language itself, which is often purposely imprecise.

    Acupuncture points are simply points of influence. They are similar to trigger points, which are effective in releasing muscle tension.

    Regards
    Max

  22. Ben Kavoussi says:

    Dear Max,

    Thank you for your comments. Kindly read my post on the connection between acupuncture, astrology and bloodletting . It is called “Astrology with needles.”

    http://www.sciencebasedmedicine.org/?p=583

  23. Ben Kavoussi says:

    Dear Kausik,

    So sorry about the spelling of your name! Thanks for sharing the state of woo-woo at Johns Hopkins, which is–I imagine–nothing but medical consumerism. There is an excellent paper on consumerism in medicine by Frank & Stollberg.

    Frank R, Stollberg G. Medical acupuncture in Germany: patterns of consumerism among physicians and patients. Sociol Health Illn. 2004 Apr;26(3):351-72.

  24. kausikdatta says:

    No problem, Mr. Kavoussi. :D

    Thanks for the interesting article. A lot of the information touched several cords in my mind.

    For example, I have seen from close the example of the “…hybrid medical practice where biomedicine is practised alongside heterodox medicine…” with a profusion of “…overarching meta-theories of biomedical or heterodox provenance determining which medical system to use in which case…” Until a certain age I was treated by our family physician who was trained in Edinburgh in regular medicine, and then in Germany, in homeopathy. People in my family placed absolute trust in him (they still talk about him fondly as an epitome of how a family practitioner ought to be), and I do remember his very pleasant and gentle manner during my visits.

    One theme emerged in common from the entire paper. In part of neither the ‘heterodox’ medicine practitioners, nor the patients receiving or insisting on such treatments, was there any premium put on evidence, that pesky little thing. The practitioners are happy to prescribe, and patients, to receive, therapies of extremely dubious provenance (fungal extracts in Chinese medicine!) or illogical principles (homeopathy) – all without ANY evidence whatsoever that they work.

    If this is not fraud, what is? Consider also that some of these practitioners feel compelled to appropriate the diagnostic techniques of modern medicine, knowing fully well that the results cannot comment on the modalities of TCM, such as the ‘flow of chi’ or ‘meridians’ and so forth. Yet, they do it – because using these modern methods establishes their authority in the patients’ eyes, and gives their practice some degree of legitimacy. That IS fraud, by any description!

    Patients may feel that they are making an informed decision by choosing TCM, but what really do they know about its efficacy? Nothing, beyond casual anecdotes and old-wives’ tales!!

    It is like a weird conversation. Patient says: I want to be healed.
    CAM practitioner says: I shall heal you. The rest of the dialog is drowned in a deafening whooshing noise, generated by determined, even desperate, hand-waving!!

  25. daijiyobu says:

    BK wrote:

    “a few weeks later, I got an official letter from the DCA, stating that after careful review, the Board had not found anything objectionable in the curricula of state-approved TCM schools. I gather that the dreadful mixture of anti-intellectualism, anti-rationalism and low expectations at the New Age of Unreason is doomed to remain the basis for many public health policies in the Golden State.”

    I similarly complained to CA about their Board of Naturopathy, http://www.naturopathic.ca.gov per http://www.naturopathic.ca.gov/consumers/faq_complaint.pdf .

    I was told everything was fine with their claims, yet the ‘essentially naturopathic’ is not properly explained / transparently communicated by CA.gov here, http://www.naturopathic.ca.gov/formspubs/brochure_guide.pdf .

    So much for informed consent. In fact naturopathy is an unethical sectarian pseudoscience coding its basic beliefs, misleading the public.

    Caveat emptor [something that should never have to be said about a claimed profession claiming the ethical position of credat emptor].

    -r.c.

  26. skepchick says:

    All of you nursing students and faculty at the Johns Hopkins School of Nursing who abhor the devotion to emotion and senseless lack of scientific objectivity can come across town and hang out with me and Barker Bausell at the U of Maryland School of Nursing. No facepalm, I promise. Just a t-shirt that says “Proud to be woo-free!”

  27. Ben Kavoussi says:

    Dear skepchick,

    I actually might take your invitation since I am now a nursing student. Did you know that besides Barker Bausell, U of Maryland has also another prominent skeptic: Robert L. Park, professor of physics, and the author of “Voodoo Science: The Road from Foolishness to Fraud.” His books covers homeopathy, magnet therapy, therapeutic touch, alien abductions, Roswell, and so on.

  28. kausikdatta says:

    Wow! I am glad that at least one from my family (my wife, no less) is now working at U Maryland School of Medicine, so that I can claim a tie (however tenuous) to that university! :D

    Ben and skepchick perhaps can enlighten me: is there something inherent in the profession of nursing that attracts woo-woo, or is this a special feature in the JH SON? I can understand, absolutely, the need and the importance of ‘connecting’ to the patients, but why does that have to extend to pandering to their brand of unreason?

  29. skepchick says:

    for Kausikdatta:

    I don’t see anything inherent in the nursing profession that ought to attract pseudoscience devotees; after all, Florence Nightingale had mathematical training and used meticulous record-keeping and statistical analysis to demonstrate to the military hierarchy at Scutari that her techniques (better food, sanitation, fresh air, and so forth) vastly improved a wounded soldier’s probability of survival. I can only surmise about why so much alternative nonsense has crept in. Here are my speculations, in no particular order:

    1) Nursing is not a glamorous profession; neither does it pay well or offer much opportunity for recognition. Therefore, it is not likely to attract the brightest minds. I believe nursing students are inadequately prepared to embrace the scientific method and the implications of its findings. Reading research can be very challenging; many nurses aren’t the least bit interested.

    2) Nurses in academia have always wanted nursing to be accepted as both a scientific and a social discipline. Accordingly, they generated theories and paradigms and concepts…some of these are truly bizarre, but the nurses who designed them received enormous recognition and were hailed as innovators. I can’t explain why other nurses didn’t say that the emperor was naked.

    3) Nursing education is about the (caring) relationship between the nurse and the client or patient more than anything else. Woo-meisters also focus on that relationship in place of measures that are scientifically demonstrated to work. Nurses want to help; perhaps that is why they gravitate to scam when allopathy doesn’t have the answers (and often, even when it does).

    4) Nurses in academia seem to like to brag that advanced practice nurses do everything that physicians do (not hardly) but they get better grades for outcomes and on their interpersonal interaction from their patients and clients. (I challenged an instructor who implied that MDs don’t practice prevention and she backed down.) In their zeal to prove this, some may wish to pull every rabbit out of the hat, so to speak, and offer unproven alternative treatments.

    5) Some nurses, even the well-educated, readily accept anything they read or hear. (See Michael Shermer’s “Why People Believe Weird Things.”)

  30. atomato says:

    Dear Ben,

    You’ve written some very fascinating and thought-provoking articles. I’m quite curious to hear a bit more about your background – it’s very interesting to me that you would spend all the time and money to complete a graduate degree in Chinese medicine (not cheap!!), get your license to practice acupuncture, and then expend this effort in trying to eradicate this practice from medicine.

    If your Chinese medical program was in the United States and accredited, it must have consisted of clinical work, right? If so, you must have practiced on many patients – what were your experiences working in this environment, using this modality? I’m assuming that you’ve also received acupuncture yourself. So, I’m curious how your change of heart developed.

    I’ve also noticed that you’ve said very little about the Chinese pharmacopoeia (other than mentioning a forthcoming article on potentially toxic substances in certain herbal formulas) – why is this? You’ve studied this area as well – do you feel that it has more merit than acupuncture?

    Thanks.

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