‘Harry Pot­ter’ medicine en­ters US schools

Uni­ver­si­ties open doors to teach­ing al­ter­na­tive ther­a­pies as ex­perts de­bate pros and cons, writes MAR­I­LYNN MAR­CHIONE

Weekend Argus (Saturday Edition) - - LIFE -

FU­TURE doc­tors and nurses are learn­ing about acupunc­ture and herbs along with anatomy and phys­i­ol­ogy at a grow­ing num­ber of med­i­cal schools. It’s an­other ex­am­ple of how al­ter­na­tive medicine has be­come main­stream. And it’s of­ten done with Un­cle Sam’s help.

The US gov­ern­ment has spent more than $22 mil­lion (R168m) to help med­i­cal and nurs­ing schools start teach­ing about al­ter­na­tive medicine – but crit­ics say they are bi­ased to­ward un­proven reme­dies.

Ad­di­tional tax money has been spent to re­cruit and train doc­tors to do re­search in this field, launch­ing some into ca­reers as al­ter­na­tive medicine providers.

Doc­tors need to know about pop­u­lar reme­dies so they can give com­pe­tent ad­vice, the gov­ern­ment says, and many uni­ver­si­ties and med­i­cal groups agree.

“Pa­tients are us­ing th­ese things” whether doc­tors think they should or should not, and safety is a big con­cern, said Dr Vic­tor Sier­pina, an acupunc­tur­ist at the Uni­ver­sity of Texas Med­i­cal Branch in Galveston who heads a group of aca­demics who favour such train­ing.

But to crit­ics, it’s like teach­ing Harry Pot­ter medicine. Stu­dents are be­ing asked to close their eyes to sci­ence prin­ci­ples that guide the rest of their train­ing in or­der to keep an open mind about pseu­do­science, they say.

“I’m con­cerned about the teach­ing of il­log­i­cal think­ing to med­i­cal stu­dents” and lend­ing cre­dence to im­plau­si­ble the­o­ries like dis­tance heal­ing and en­ergy fields, said Dr Stephen Bar­rett, a re­tired physi­cian who runs Quack­watch, a web­site on med­i­cal scams.

Teach­ing about al­ter­na­tive medicine im­plies ac­cep­tance and “cre­ates more gulli­bil­ity and less crit­i­cal, ob­jec­tive think­ing”, said Dr Wal­lace Samp­son, ed­i­tor of the jour­nal Sci­en­tific Re­view of Al­ter­na­tive Medicine. “This will be felt in many in­di­rect ways,” he said, in­clud­ing judg­ment er­rors, mis­guid­ing peo­ple with se­vere dis­eases, and lax stan­dards and laws.

The real is­sue is not whether al­ter­na­tive medicine should be taught, but how, said Dr Joseph Ja­cobs, for­mer head of the fed­eral Of­fice of Al­ter­na­tive Medicine.

“The par­al­lel here is cre­ation­ism ver­sus sci­ence,” Ja­cobs said. “If the topic is taught ob­jec­tively, to help stu­dents com­mu­ni­cate with pa­tients, it’s a good idea. If it’s be­ing taught as part of an ad­vo­cacy, for ac­cep­tance among physi­cians, I think that’s a lit­tle bit bo­gus.” Some­times the line is blurry. Some schools have close ties to al­ter­na­tive medicine providers or ad­vo­cates who shape in­for­ma­tion on the schools’ web­sites or classes. Two ex­am­ples:

The Uni­ver­sity of Ari­zona’s Cen­tre for In­te­gra­tive Medicine has med­i­cal res­i­dency pro­grammes in hos­pi­tals, partly spon­sored by well­known ad­vo­cate Dr An­drew Weil, the cen­tre’s founder. A pri­vate group that pro­motes such care, the Bravewell Col­lab­o­ra­tive, gives schol­ar­ships for dozens of the Ari­zona school’s stu­dents to get hands-on train­ing in clin­ics.

The Uni­ver­sity of Min­nesota of­fers med­i­cal stu­dents an elec­tive course in al­ter­na­tive heal­ing meth­ods at a Hawai­ian med­i­cal cen­tre founded by a phi­lan­thropist ad­vo­cate of such care, al­though stu­dents pay their trans­porta­tion and liv­ing ex­penses. In in­ter­views, sev­eral stu­dents raved about things they had tried first­hand, and said they re­turned more will­ing to rec­om­mend acupunc­ture, med­i­ta­tion, yoga, herbal reme­dies and other non-tra­di­tional care.

“Con­sumers are de­mand­ing it” and more re­search is needed to see what works, said Mary Jo Kre­itzer, who di­rects the Min­nesota school’s al­ter­na­tive medicine cur­ricu­lum. “Ul­ti­mately we need to align pol­icy” so that in­sur­ers pay for th­ese ther­a­pies, she said.

The field got a boost 10 years ago with cre­ation of the Na­tional Cen­tre for Com­ple­men­tary and Al­ter­na­tive Medicine. It made merg­ing al­ter­na­tive and main­stream medicine “a cen­tral and over­ar­ch­ing goal” and gave $22.5 mil­lion to 12 med­i­cal schools, two nurs­ing schools and the Amer­i­can Med­i­cal Stu­dent As­so­ci­a­tion to de­velop cur­ricu­lum plans. Kre­itzer’s and Sier­pina’s uni­ver­si­ties got grants, and both are ac­tive in the Con­sor­tium of Aca­demic Health Cen­tres for In­te­gra­tive Medicine – 42 cen­tres in­volved in re­search­ing or ad­vo­cat­ing for com­ple­men­tary and al­ter­na­tive medicine, or CAM.

How­ever, a re­view of some of those teach­ing plans by Drs Don­ald Mar­cus and Lau­rence McCul­lough of Bay­lor Col­lege of Medicine in Hous­ton con­cludes that they are “strongly bi­ased in favour of CAM”, cite poor-qual­ity re­search, and were not up­dated af­ter bet­ter stud­ies re­vealed a ther­apy did not work.

The sec­tion on her­bals in the Med­i­cal Stu­dent As­so­ci­a­tion’s plan was writ­ten by the head of the Amer­i­can Botan­i­cal Coun­cil, an in­dus­try-sup­ported re­search and ed­u­ca­tion group, their ar­ti­cle says.

Sier­pina, the head of the med­i­cal school con­sor­tium, de­nied that the pur­pose of th­ese les­son plans was pro­pa­ganda.

“We are not try­ing to make stu­dents CAM prac­ti­tion­ers” but to train them to be “sen­si­tive to where peo­ple come from, their folk medicine, their home reme­dies”, he said.

Just as there are true be­liev­ers who ig­nore ev­i­dence that some­thing doesn’t work, there are true doubters who are guilty of “ar­ro­gant think­ing that we’ve got it all fig­ured out”, Sier­pina said.

Dr Mehmet Oz agreed. The Columbia Uni­ver­sity heart sur­geon and fre­quent Oprah Win­frey guest, now with his own TV show, has long shown an open mind to­ward com­ple­men­tary and al­ter­na­tive medicine.

“Medicine is very pro­vin­cial. We grow up think­ing the way oth­ers have taught us to think. We are nat­u­rally bi­ased. It is im­per­a­tive that we look at what al­ter­na­tive cul­tures of­fer us, that we at least are fair in our scep­ti­cism of their im­pact.” Oth­er­wise, “we run a risk of lock­ing out new­com­ers” with fresh ideas, he said.

That would be peo­ple like Jimmy Wu, a newly grad­u­ated doc­tor from the Uni­ver­sity of Wis­con­sinMadi­son. Raised in a fam­ily orig­i­nally from Tai­wan, Wu said tra­di­tional heal­ing prac­tices were “very much in­grained” in how he thought about ill­ness and health.

“It’s just a very dif­fer­ent way of ob­serv­ing” a pa­tient to de­cide on treat­ments, rather than re­ly­ing so heav­ily on lab tests and other tra­di­tional med­i­cal tools, he said.

The Madi­son med­i­cal school of­fered an op­tional course in al­ter­na­tive medicine. Seek­ing more than that, Wu spent a sum­mer in Bei­jing with a uni­ver­sity fac­ulty mem­ber ob­serv­ing tra­di­tional Chi­nese medicine and acupunc­ture, and hopes to in­clude th­ese in a fam­ily medicine prac­tice some day.

With so many peo­ple us­ing al­ter­na­tive care, “it is im­por­tant that it be treated more than just as an af­ter­thought” by med­i­cal schools, Wu said.

Of­fi­cials at sev­eral top schools say they teach re­spect for pa­tient choices, but do not teach un­proven reme­dies or the­o­ries.

“All med­i­cal treat­ments ought to be held to the same stan­dard”, whether a pre­scrip­tion drug, a herbal pill or a mode of care, said Dr Philip Grup­puso, Brown Uni­ver­sity’s as­so­ciate dean for med­i­cal ed­u­ca­tion.

For ex­am­ple, acupunc­ture comes up in sev­eral places in the cur­ricu­lum where there is ev­i­dence that it may help cer­tain types of pain. How­ever, stu­dents are not taught about body merid­i­ans that al­legedly chan­nel en­ergy, which acupunc­tur­ists claim to af­fect.

Whether a school is pro­mot­ing mag­i­cal think­ing about a ther­apy de­pends “more on how it’s taught than what’s taught”, Grup­puso said.

At Har­vard Uni­ver­sity, stu­dents have a cou­ple of elec­tive cour­ses in such top­ics as mind-body medicine, but a spokes­woman said the uni­ver­sity did not ad­vo­cate or teach al­ter­na­tive medicine.

Ge­orge­town Uni­ver­sity, which started Amer­ica’s first grad­u­ate de­gree pro­gramme in com­ple­men­tary and al­ter­na­tive medicine, strives for ob­jec­tiv­ity, said pro­gramme di­rec­tor Hakima Amri.

“We are giv­ing the facts, teach­ing what we know to­day. We are not pro­mot­ing any­thing,” she said.

That means straight talk about con­tro­ver­sial fields like home­opa­thy, or the en­ergy medicines qi gong and reiki, which claim to heal through a healer’s pow­ers, even at a dis­tance.

“The sci­ence is not there to sup­port that,” Amri said.

Ge­orge­town’s goal is “to train a new gen­er­a­tion of open-minded but crit­i­cal physi­cians or sci­en­tists”, she said. “We have seen stu­dents who come who are all en­thu­si­asm about CAM be­cause they’ve seen it work on their grand­mother or some­one like that. Then they go through the pro­gramme and they see it dif­fer­ently. We want them to be re­ally crit­i­cal, able to sep­a­rate the good from the bad.” – Sapa-AP


PRICKLY POINT: This pa­tient is one of a grow­ing num­ber in Amer­ica who be­lieve in the ef­fi­cacy of acupunc­ture and other al­ter­na­tive ther­a­pies.

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