By Edvard A. Hemmingsen
Alternative medicine has caught some more wind in its sails. Nationally, news of note - and regret - is that Congress has elevated the status of NIH's Office of Alternative Medicine to Center for Complementary and Alternative Medicine, with a budget of $50 million for its first year of operation. This is a dramatic increase from the $2 million budget for its first year of operation, in 1992.
The change in status occurred despite fierce opposition from leaders of NIH and other prominent scientists, including the director of NIH, Dr. H. E. Varmus. The objections were not as much to the budget increase as they were to the change in grant-reviewing procedures. The grant proposals will now be reviewed by people of the Center's choosing. In the past, such proposals were reviewed by scientists at other NIH institutes and centers, to ascertain that each proposal met rigorous scientific standards. Also, half of the Center's advisory council will be composed of people who practice alternative medicine. The other half will include three or more consumer representatives. The details regarding how they would be nominated and selected are not clear. There seems to be a strong anti-science element in this new direction of the agency.
How could this happen? According to an article by P. W. Campbell in The Chronicle of Higher Education (Nov. 6, 1998), Senator Tom Harkin, a strong believer in alternative medicine, was the driving force; he was apparently aided by Senator Arlen Specter, who heads the panel that drafts the budget for NIH. Senator Specter has discussed possible therapies for a benign tumor found in his brain some time ago, with the present director of the Office of Alternative Medicine.
Locally, the Scripps Hospitals, part of a major health organization in our community, are in the process of establishing an Integrated Medicine Center. Purportedly, it will integrate alternative medicine with traditional medicine. According to the Center's Director, Dr. Erminea Garner (in promotional material dated Fall, 1998), the center will combine "the best of both worlds." Few specifics have been provided about the program, but alternative therapies listed in the promotional material include acupuncture, homeopathy, healing touch and herbal medicine.
Who will be paying for these unproven therapies? HMOs (that is, the public) in the form of insurance payments, and the government (that is, the public) in the form of Medicare, Medicaid and other subsidies. This is one troublesome matter.
Another one is that most of the alternative therapies are totally useless, and some can have harmful side effects. Real scientific tests made over the last few years show this to be the case. Most critics of alternative medicine would welcome more research in these matters. For example, further research is needed on those therapies that seems reasonable and have the support of strong anecdotal evidence. Unfortunately, it is not only a question of resources, but also genuine participation in the research by those who perform and promote the new therapies; this frequently does not happen.
We are concerned that with the apparent drift away from hard science approaches in the new NIH Center, the test for effectiveness of therapies will be pseudo-scientific and even fraudulent; certainly, alternative medicine will get more free rides than it deserves.
But this being mandated, or at least encouraged and promoted by the
Congress, should not be a surprise. The spectacle of lack of reason and
common sense which we observe in that forum these days explains a lot about
its operation, and it does not bode well for the future.