Tuesday, December 5, 2023

#2711: Ian Coulter

We’ve said it before, but it’s worth repeating: Naturopathy is bullshit. Ian Coulter, PhD, is nevertheless a firm defender of naturopathy. And the disconcerting thing about that, is that Coulter is a senior health policy researcher at and (long-time chair and) codirector of the RAND Center for Collaborative Research in Complementary and Integrative Health, a branch of the RAND corporation. He is also professor emeritus at UCLA and research professor at the Southern California University of Health Sciences, and no: his background is of course not in medicine.


Now, the RAND corporation has, indeed, done a lot of solid stuff, too, but in 2008 the prospect of receiving money from billionaire quack advocates became too hard to resist, so they teamed up with the legendary pseudoscience and woo-promoting Samueli Institute to create a center devoted to bridging the gap between mainstream and “complementary medicine” (ostensibly through research), which might sound nice to those who pay too little attention to realize that mixing science-based approaches with pseudoscientific handwaving based on anecdotes is not going to create a better end result. Of course, one substantial barrier to achieving the desired integration is mainstream medicine’s focus on rigorously testing whether the treatment options they offer are safe and effective, and the regimes the RAND center is willing to consider (like energy chelation) are clearly unable to pass such tests; the RAND center accordingly seems to recommend using a double standard: mainstream medicine can continue to use their standards, and alternative practices be measured by the standards they are able to pass, such as handwaving and flimsy anecdotes – and popularity, of course: One of Coulter’s crucial arguments for why quackery should be integrated with mainstream medicine is that customers are willing to pay for it: “We know that patients appreciate CAM, we know they give it very good satisfaction scores, we know they're willing to pay for it [just like psychics, tarot readers and MLM products!]. We should start paying attention to this. This is worthy of attention.” 


Despite having a background in sociology rather than medicine, Coulter has, according to his bio, long “experience conducting both qualitative and quantitative research on complementary and alternative medicine (CAM) and integrative medicine (IM)”; he has at least published a number of books and articles (in sociology journals as well as very dubious altmed journals like Alternative Therapies in Health and Medicine). And there is money to have thrown at you for such things; Coulter is for instance a recent recipient of a Center of Excellence grant “to study the appropriateness of care in CAM”, a grant to “study the use of Crowdsourcing with CAM patients”, a DoD grant to “conduct comparative effectiveness trials of chiropractic in military facilities”. We’re confident he’ll get the results he wants; CAM research usually does.


Diagnosis: A central and powerful figure in the movement to undermine the safety and efficacy of medical care in the US, no less. Coulter has spent a lot of money to try to free medicine from the constraints of accountability and evidence, and given the slew of licensures of naturopaths and their ilk across the US, he hasn’t been entirely unsuccessful.

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