Field of Science

Bad medicine at the University of Maryland


Pseudoscience is insinuating itself into our medical schools across the nation, going by the name "Integrative Medicine." Integrative medicine is just the latest buzzword for a collection of superstitions, myths, and pseudoscience that has gone by various names over the years. First it was Holistic medicine, and once that fell out of favor, it became Alternative medicine, followed soon after by Complementary and Alternative medicine (CAM), and lately Integrative medicine. These names can't disguise the fact that many of the practices lumped together are bad medicine. What disturbs me particularly, as a professor, is that CAM is moving into the medical curriculum at respectable medical schools, including the University of Maryland.

Perhaps the best way to reverse this trend is to call attention to it. Academic freedom allows professors to proclaim all sorts of wild ideas, including nonsensical ones, but we don't have to allow them to teach courses with no basis in reality. That same academic freedom, incidentally, allows me to criticize bad science wherever I find it, including my own university.

So what's going on at Maryland's medical school? UMM is home to one of the nation's premier "integrative medicine" programs, which promotes a wide range of questionable practices. Its clinical services include:
  • Acupuncture
  • Homeopathy
  • Reflexology
  • Reiki
  • Qi Gong
Although each of these has a different history, all of them are, well, nonsense. Let's take a closer look homeopathy, which is perhaps the most ridiculous pseudoscience on the list. Homeopathy is based on two ideas: that "like cures like", and that vanishingly small quantities of medicine are stronger than larger quantities. Both ideas were invented by Samuel Hahnemann in the late 1700s, back when most medicine was pretty bad for you. Unfortunately for Hahnemann, his ideas were no better.

The idea that "like cures like" is used to justify treating (for example) itchiness with extract of poison ivy. I'm not making this up: this is a standard homeopathic preparation, promoted on many homeopathic sites, even (sorry, cycling fans) on Lance Armstrong's Livestrong website.

The second idea is that you dilute these substances so much that instead of causing the symptom, they cure it. Alas, Hahnemann was unaware that when you dilute a substance to the degree that he recommended, you end up with nothing left. Typical dilutions used today go by the abbreviations 10C, 20C, or 30C. One "C" is a dilution of 1 in 100, and 20C means that you dilute the active ingredient 100-fold, and then repeat the process 20 times over. This is a dilution of 100 to the 20th power, a ridiculously large number. If you had a single molecule immersed on a sphere of water the size of the entire planet, it would still not be dilute enough.

That's right: homeopathic treatments are just water. Or rather, water dropped onto a sugar pill, and sold at stores such as Whole Foods, which has a section devoted to homeopathic remedies. And offered up as medicine by the University of Maryland's Center for Integrative Medicine through their clinical services. (Why isn't this malpractice? I haven't figured that out yet.)

The other treatments offered by the UMM Center are no better. Their Qi Gong brochure explains that
"sickness, pain or physical disorders are the result of qi blockage, or unbalanced qi in the body. Qigong practice helps to balance the qi system in the body and break the qi blockage(s) to recover health."
There's no scientific basis for qi - it is simply magical thinking. The brochure, though, claims that Qigong will give you "an increased resistance to illness through a stronger immune system." None of these claims have any good science to back them up.

But it gets worse. The Center for Integrative Medicine is offering lectures and courses in all four years of the medical school curriculum, and it boasts that the "integrative medicine elective has become a top choice for fourth year medical students." How unfortunate that this pseudoscience has infiltrated its way into the medical curriculum, and that the UMM Center is, in essence, mis-training medical students at one of the nation's oldest medical schools.

By providing a respectable home for these pseudoscientific practices, UM Medicine is undermining its own scientific and educational missions. But when the money is coming in, the administration seems quite happy to support it. Last August, the Dean of Medicine issued a glowing press release about the Center, after its Director published a very poor study (see my earlier blog about that one) arguing for the use of acupuncture. I don't know if the Dean believed that press release, but someone ought to tell him that Integrative Medicine has no place in a 21st century medical curriculum. I guess I just told him.

Note: why do I pick on U. Maryland? Primarily because it's my own institution (although I noted previously that UM Medicine is a separate campus from the main campus at College Park where I work). There are plenty of other Integrative Medicine programs at reputable medical schools, most of them just as deserving of criticism.