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Perspective: The media once again misses the boat with biased coverage of integrative medicine

Perspective: The media once again misses the boat with biased coverage of integrative medicine

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A rendering of the planned Susan and Henry Samueli College of Health Sciences at UC Irvine, part of a $200 million gift that will fund a new college devoted to integrative medicine. The announcement drew fierce criticism from many media outlets.

In September, the University of California at Irvine received the largest gift in its history: $200 million to establish a "College of Health Sciences focused on interdisciplinary integrative health." The funders, Susan and Henry Samueli, have been major benefactors in the research and clinical application of integrative therapies such as acupuncture and massage therapy since the early 2000s. Their Samueli Institute has partnered with the U.S. military to research the potential benefits of such therapies for PTSD, traumatic brain injury, and pain for soldiers returning from the wars in the Gulf.

While the Samueli gift reflects a growing acceptance of whole-person approaches to health care in the U.S., the resulting news coverage reinforced the limited understanding that newsrooms large and small have about this important trend. Too often the news about the adoption of integrative medicine, even by the most highly regarded U.S. medical institutions, is expressed with ill-informed, disparaging language that distorts the truth.

The Samueli gift to UCI was no exception. The Los Angeles Times and other publications gave space to voices that went beyond informed skepticism. A few sample headlines:

LA Times: "A $200-million donation threatens to tar UC Irvine's medical school as a haven for quacks"

Inside Higher Ed: "Does $200 Million Quack? ... UC Irvine is advancing junk science ..."

STAT News: "A $200 million gift promotes alternative therapies at a California medical school — and critics recoil"

This language reflects a bias that has been badly out-of-step with the evolution of U.S. health care since the mid-1990s at least. It is also painfully familiar to anyone advocating for more access to integrative care over the last two decades.

What is missing in such opinions and reporting is a basic awareness of the role of integrative medicine in contemporary U.S. health care. UC Irvine is one of more than 55 U.S. medical schools that operate integrative medicine centers, in which treatments are provided and where NIH-funded research has often been conducted. A number of the nation's leading independent systems — Cleveland and Mayo clinics, Allina, MedStar, Inova, and Sutter — have also incorporated integrative care into their medical systems.

But to aggressive critics, this steady acceptance represents a capitulation to voodoo and magic. As they assert that UC Irvine is moving away from evidence-based medicine, critics often dismiss both the actual state of the evidence and the statements by med school leaders explaining the purpose of these investments. For example, UC Irvine CEO Dr. Howard Federoff, a board-certified internist, told STAT News:  “We take patient safety as our highest calling and we will never deploy any approach — integrative or not — that put patients at risk … Any non-proven or non-evidence based approach? We will not deploy it.”

The Los Angeles Times columnist Michael Hiltzik was little moved by such assertions. He wrote: "Among the approaches with little or no scientific support that get 'integrated' are acupuncture, herbal concoctions, and homeopathy and naturopathy." Acupuncture and naturopathic medicine are supported by significant scientific evidence. Hiltzik might look up "battlefield acupuncture" to learn how this pain management technique has moved from forward combat outposts in Afghanistan to VA clinics across the U.S. Or consider the $81 million joint initiative that Health and Human Services, the Department of Defense, and Veterans Affairs announced in September as a "multi-component research project focusing on nondrug approaches for pain management addressing the needs of service members and veterans." These "nondrug" approaches include acupuncture, chiropractic and other therapies.

Dr. Federoff's sentiment — a greater openness to non-traditional therapies that are backed up by scientific evidence — has been asserted scores of times in the last 15 years as medical institutions of all kinds have added "complementary and integrative" therapies. But as the Samueli gift makes clear, when it comes to reporting on these developments, too often the media still parrots the loudest skeptics without considering the evidence or the widespread adoption of such therapies across the country.

Meanwhile, integrative approaches continue to gain acceptance. In October, the inaugural Integrative Pain Care Policy Congress was held in San Diego. For the first time, leading medical, insurance, education, regulatory and patient groups met with integrative pain management and health care organizations: 50 in all. The purpose was to establish a coherent way to deal with the opioid crisis that reflects the changes in pain and prescribing policies that have occurred in the last three years. The American Medical Association, Oregon's Medicaid program, the Joint Commission and others have concluded that non-drug pain treatment options belong in every physician's toolkit. And that they should be reimbursed. As the American College of Physicians (ACP) told its members in early 2017:

For patients with chronic low back pain, ACP recommends that physicians and patients initially select non-drug therapy …with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga…spinal manipulation (i.e., chiropractic)…

Just prior to the Congress, the National Association of Attorneys General (NAAG) sent a September letter to America's Health Insurance Plans (AHIP). Signed by attorneys general from 37 states, the association wrote: “When patients seek treatment for any of the myriad conditions that cause chronic pain, doctors should be encouraged to explore and prescribe effective non-opioid alternatives, ranging from non-opioid medications (such as NSAIDs) to physical therapy, acupuncture, massage, and chiropractic care.”

It has taken decades for conventional medicine to acknowledge the need for integrative care treatment options. It has taken, regrettably, a national epidemic that is depleting state treasuries and crippling public health. It’s past time for reporters to take a look at the therapeutic value UC Irvine's Dr. Federoff and his peers see in alternative models of care. There are clinics offering these treatments in almost every media serving area in the country. Try giving them a call to get the fuller story.

Comments

Picture of <span class="username">Guest (not verified)</span>

Taylor Walsh’s blog zeroes in on one of the most important issues of our time for healthcare. Why would we shun or avoid a type of care patients are asking for, doctors are starting to incorporate into their practices, and, especially for pain conditions, research has proven effective? Good integrative health is simply a team approach that looks at the whole person, not just their disease or injury. It incorporates only proven methods of conventional and complementary care, but attends to the behavior and lifestyle seeking to prevent as well as treat disease. The care doesn’t end at the doctor’s office door. Illness is not just about our cancer or our injury, but concerns deeper issues of social, emotional, mental and spiritual wellbeing. As caregivers it is our responsibility to unravel the puzzle and help patients heal. In today’s healthcare system our prescriptions for pills have become the easy way out, and all we have to do is look at the newspapers to see that one of those pills has led us down a deadly path for our patients. This STAT piece explains why the answer to avoiding the next drug crisis is to change the way we deliver care. The next generation of medical professionals is already headed for integrative health, and we should be thankful that universities are taking this seriously in their educating and training. It is the right thing to do.

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