Agree to Disagree

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In an article on the increase of Complementary and Alternative Medicine (CAM) use for millennials, a fascinating statement was included that explains precisely why Samueli Institute exists:

Steven Salzberg, a professor of medicine, biostatistics and computer science at Johns Hopkins University School of Medicine in Baltimore, has opposed integrating alternative medicine into academic curriculums. He says most alternative modalities and supplements have shown no scientific evidence of success.

While he concedes that yoga, meditation and massage can be helpful, he says many practitioners and marketers use the CAM label to promote bogus claims. He also warns that some herbal remedies can have “nasty” interactions with prescription medicine. His advice to consumers is to take a skeptical view of the CAM marketplace.[1]

I have debated Dr. Salzberg at Johns Hopkins and I disagree. It is precisely BECAUSE many complementary or integrative modalities have not been sufficiently explored through research that CAM should be taught in medical schools. 
By understanding the evidence base—or lack thereof—for each modality, doctors in training can better understand the appropriate role of CAM in a patient’s care. Why would anyone advocate a system that keeps a doctor’s head in the sand?

Without the needed education, CAM is more likely to be viewed with bias, ignorance or fear. Requiring this education will also inspire more researchers to take on these topics and expand the evidence base to determine exactly where and how CAM can contribute to healing.

If the medical world IGNORES CAM, how will it move forward?

Thirty years ago, little was known about the evidence behind chiropractic care, and now it has been well established as an accepted treatment for low back pain in addition to other ailments. In fact, chiropractic care is no longer considered a complementary practice and has been fully integrated within the Veterans Health system. The inclusion of chiropractic care within the VA started in 2004 after a three-year demonstration program launched in 1995 showed successful inclusion of chiropractic services in ten different Department of Defense sites. Chiropractic appointments were maxed out, indicating a high interest in chiropractic care. [2] A similar process is now occurring with acupuncture – more on that in a later article.

Samueli Institute is advancing the field of integrative medicine by:

  1. Introducing evidence-based CAM modalities to graduate nursing and medical students.
  2. Conducting research on individual modalities to expand our scientific understanding.
  3. Synthesizing research on individual modalities through our SEaRCHTM method to provide a balanced, expert assessment of any healing or treatment claim.

Dr. Salzberg does make a great point: the term CAM has been overused by marketers. That’s why it’s essential to judge CAM modalities individually just as we judge pharmaceuticals individually on the specific evidence for each chemical on specific effects. We don’t say all drugs don’t work just because aspirin doesn’t clear up acne or relieve allergies.

The End Goal

Once doctors are educated and CAM researchers are well-funded, CAM modalities can begin to integrate into the health care system to the benefit of individual patients and the system at large by replacing some high-cost treatments with lower-cost CAM modalities. And that can only happen when both doctors and patients alike are educated.

What do you think? Is teaching CAM in medical school going too far? Or do we need more?


[1] http://www.cnbc.com/id/101837090

[2] http://www.research.va.gov/currents/may-june11/may-june11-01a.cfm