Most “alternative” advocates, including Sierpina, Phillips,1 and Astin,2 have only recently arrived on the aberrant medicine scene. They have little to no background in sectarian medical system history, or knowledge of the basic and clinical sciences that disprove most anomalous claims. We whom they accuse of bias have studied sectarian, anomalous medicine for decades—since before the concept of “alternative” was invented. That was when misrepresentation was frowned upon or illegal. The simple fact is that what is called alternative medicine is a misrepresentation of established medical quackery.
Space disallows answering all of their accusations. I will answer a few, and give readers my qualifications for making the statements below.
Sierpina and Philips ask:
How many times in the history of science and medicine has premature fore-closure of inquiry led to unwarranted prejudice against life-enhancing and life-saving alternative or novel therapies and resulted in unnecessary delay in their adoption into the mainstream of medicine?1, p. 863
How many times indeed? I often ask this question of medical students and physicians attending my classes. Sierpina and Philips do not state any. Can anyone? Perhaps one—vegetarian diets. S. pylori as a cause of ulcer was adopted within a few years of discovery. Arsenic and retinoic acid for promyelocytic leukemia were accepted immediately. British and North American physicians accepted the communicability of puerperal sepsis decades before Semmel-weiss's reported difficulties. Many at first doubted Pasteur's findings, as they should have. They requested more evidence and Pasteur developed more evidence. That is the way science works. Laetrile for cancer? Vitamin C for cancer? Vitamin E for aging? Sugar toxicity? These were all proposed with levels of evidence similar to those for acupuncture, chiropractic, and homeopathy. They all failed in large field trials.
Dr. Sampson's objectivity is belied by his well-publicized bias toward a negative, “quack-buster” view of alternative therapies. He makes the a priori assumption that these therapies are predominantly fraudulent and highly suspect, despite evidence to the contrary, some of which is published in the most respected medical journals.1,p. 863
Those accusations and a similar one by Astin (“Sampson's approach is to simply dismiss all of the evidence in CAM …,” etc.2) are erroneous. Knowledge and educated opinion are not bias. What Sierpina and Philips call my “quackbusting” consists of knowing the science of aberrant methods and testifying against incompetent practitioners. I make only one a priori assumption—that valid claims are supported by valid evidence.
I do not assume that all erroneous claims are predominantly fraudulent, which means that those who make them intend to falsify, although some claims are fraudulent. Most “alternative” claims are simply erroneous, based on ignorance and cult-like belief.
The National Council Against Health Fraud, of which I was a co-founder and board chairman, has made no false statement or accusation, and has not had to withdraw a statement. Its members have served as experts for the Postal Service, the FDA, the FTC, and attorneys general, and as witnesses for medical boards. So far, I have not been on the losing side as an expert witness.
I have taught the study and analysis of false and anomalous claims for over 20 years at Stanford University, represented Stanford on the Cancer Advisory Council of the State of California, and served as its chairman. The Council helped rid the state of Laetrile and other quackery until the “CAM movement” arrived to change the ground rules for evidence.
I am also founder and editor of The Scientific Review of Alternative Medicine and Aberrant Medical Practices. The journal publishes analyses and back-grounds of the kinds of unsound claims and implausible results that Drs. Sierpina, Philips, and Astin support. Five Nobel recipients serve on our council, and two former editors of the New England Journal of Medicine are consulting editors.
All statements in my article on education in Academic Medicine3 were based on valid evidence. The conclusion was that “alternative medicine” education in medical schools supports error and unreason and is uncritical and doctrinaire.
Sierpina's and Philips' “evidence to the contrary”1, p. 863 is unreliable. Serious errors and misrepresentations abound in “alternative” articles in major journals, including Pediatrics, Annals of Internal Medicine, New England Journal of Medicine, JAMA, and the AMA's Archives series. Editors and peer reviewers have failed to detect them. To reveal these errors, a number of us have published our analyses in major journals as well.
Most systematic reviews and meta-analyses show that the evidence for homeopathy, acupuncture, chiropractic, and naturopathic practices is either negative or severely defective. The most reliable of those reviews reveal that poorly done studies show the most effect, while the best controlled studies show the least or no effect.
Research grants and educational support from Congress and the NCCAM and from private ideologically motivated foundations such as Fetzer, Laing, Rosenthal, Osher, and Templeton are corrupting medical school education. Chiropractic and acupuncture employment groups (e.g., American Specialty Health Plans) and ideologically committed corporations (e.g., Medtronics) sponsor continuing education programs at major medical schools and add to the corruption.
Medical schools face the greatest challenge to rational education since 1911. Sectarian and cultic medicine is being taught as valid and useful. Education about them without rationality and critical thinking is indoctrination.
1. Sierpina VA, Philips B. Need for scholarly, objective inquiry into alternative therapies. Acad Med. 2001;76:863–4.
2. Astin JA. Complementary and alternative medicine and the need for evidence-based criticism. Acad Med. 2002;77:864–8.
3. Sampson W. The need for educational reform in teaching about alternative therapies. Acad Med. 2001;76:248–50.