We’re repeating ourselves, but it’s an important topic, so here we go: The intrusion of quackery into academic medicine under the brand name ‘integrative medicine’ continues apace. The guiding ideas, apart from the unstated fact that vague wellness-oriented alternative medicine is pretty lucrative, are often some kind of appeal to ‘the best of two worlds’ and the associated failure to understand that integrating quackery with real medicine doesn’t make medicine better, and appeal to real troubles in and shortcomings with real medicine and the associated failure to grasp that shortcomings in real medicine doesn’t mean that unproven pseudoscientific alternatives have anything going for them (i.e., as Ben Goldacre puts it, that “just because there are problems with aircraft design, that doesn’t mean that magic carpets really fly”).
Doug Irving struggles with getting his head around the fallaciousness of those two ideas in attempts to justify integrative medicine. And that is worrisome, given that Irving is a corporate communications officer at the RAND corporation, and the RAND corporation, a global policy think tank and research institute, is a pretty significant and authoritative player in the world of public policy. As a matter of fact, the RAND corporation has done decent work on e.g. vaccine policy; they have, unfortunately, also delved deeply into the rabbit hole of integrative medicine, having even teamed up with the deranged quack cult the Samueli Institute to form the RAND Center for Collaborative Research in Complementary and Integrative Health, chaired by Ian D. Coulter whom we have covered before, and which, despite the RAND corporation’s otherwise rather firm commitment to science and evidence, has rather explicitly advocated using a double standard: mainstream medicine should continue to use their standards for evidence, whereas alternative practices should be measured by the standards they are able to pass, such as handwaving, anecdotes and popularity.
Here is a discussion of Irving’s thoughts on the issue of integrative medicine, and yes, it is all there: “Modern medicine has a problem. It can fix a damaged heart, battle cancer into remission, and operate on the deepest recesses of the human brain. Yet it continues to struggle with the everyday anguish of an aching back,” says Irving, and immediately concludes that “[u]nconventional medicine, once dismissed as quackery by the medical establishment, might be the missing piece of modern health care” on the grounds that “Americans now spend billions of their own dollars seeking relief from such chronic conditions in alternative schools of health”. And so on.
One important detail about Irving’s rhetoric that should be highlighted – it is, after all, ubiquitous in discussions of alternative medicine – is how he talks about “different models of medicine”: there is Western medicine, but also Eastern medicine and naturopathy and whatnot. And that allows Irving to frame the discussion as concerning issues of distrust and oppression. In reality, of course, there are no different models of medicine. There is no alternative medicine. There is the medical interventions that have been shown to work, the ones that haven’t, and the ones that have been shown not to work. If an intervention is shown to work, then it is medicine. The reason acupuncture isn’t part of medicine is that it hasn’t been shown to work for anything; the reason homeopathy isn’t, is that it has been shown not to work for anything. But framing things this way – the right way to frame it – makes it a bit harder to advocate for integrative medicine, insofar as advocating for integrative medicine is really advocating for integrating interventions that work with those that don’t; and putting it that way is also a better way to describe the challenges that integrative medicine is facing than complaining about narrow-minded legislators or scientists.
Diagnosis: Irving is of course not the main problem here. The whole RAND corporation seems to have bought the Integrative medicine rhetoric hook line and sinker. The conclusion really has to be that in light their demonstrated inability to see through the nonsense in the case of integrative medicine, the RAND corporation really cannot be trusted on anything.
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