Medical Schools Struggle to Integrate "Integrative Medicine"

Medscape posted a thought-provoking essay on how medical schools are integrating "integrative medicine" into their curriculae. Its take home message: bad idea.

I agree. Find our why here.Medscape posted a thought-provoking essay on how medical schools are integrating "integrative medicine" into their curriculae. Its take home message: bad idea.

I agree.

The article discusses the Flexner Report which was indeed a remarkable document in its day. The authors make the point that it is no less relevant now. The original report published in 1910 covered a lot of ground but a central point was that medical education needed to be based on data-driven scientific knowledge. Flexner eschewed hokey, unproven, unquestioned dogma and established that modern medical education needed to do better than that.

While I have not studied the extent to which medical schools of today are getting away from that paradigm, it seems that we are to some degree. Integrative medicine is the new big thing. Traditional western medicine is increasingly being viewed as dogmatic, uncreative, and narrow-minded. Alternative modes of healing are seen as more holistic and somehow more natural.

I don't object to anyone following the call of their own belief system. But it is becoming less politically correct to argue against the incorporation of nonwestern therapies in modern medical practice.

Don't get me wrong. I would whole-heartedly embrace the most bizarre witchcraft imaginable...if it made people better and alleviated suffering. I wouldn't even demand that such therapies actually cured anyone. Unfortunately, so many of these treatments (herbology, accupuncture, magnets, crystals, magical incantations, channeling through my neighbor's beagle, etc.) have not been proven effective.

So why give these treatments the prestige that explicit support by allopathic medical schools engenders? It would be one thing if the principles of integrative medicine were being presented simply as information med students need to be aware of. It can be argued that such knowledge will facilitate communication with their patients (many of whom are using or considering such therapies). But that's only part of it. As the article discusses, fewer and fewer judgments are being made as to their validity and they're being presented as legitimate alternatives to standard treatments.

I remember a committee meeting of one of the two major private hospitals in a community where I used to practice (a highly regarded institution with a solid medical staff). A family practitioner on staff outlined a marketing push to promote our institution's support of alternative medicine (it wasn't called integrative medicine at the time). Some of us on staff were stunned that this hospital would risk its reputation on something so obviously non-evidence-based.

When she was asked about this, her response was simply, "Well, everyone is doing it and if we don't get on the train now, we'll be left behind." What an inadequate, wishy-washy excuse. Ultimately, the hospital caved. It's disturbing to read that (as documented in the article) these same changes are happening in our nation's medical schools as well.

And now, a personal anecdote. I once tried to learn accupuncture. I signed up for a very sophisticated, very rigorous course (that involved many hours of training). I read the textbooks, memorized the meridians and the accupuncture points (it was harder than gross anatomy). I learned the different diagnostic protocols, the personality types, etc. I practiced "feeling the Qi" when placing the needles in my classmates.

I failed miserably. I simply couldn't do it. I've asked myself many times why this discipline so thoroughly eluded me. The bottom line was that I just couldn't "let go". I just couldn't get away from the ludicrous silliness. It was like watching a movie where the characters were so poorly drawn, the storyline so utterly absurd that I couldn't achieve the suspension of belief needed to enjoy it.

I am an integrative medicine failure. I am a philistine.

Update: Read this post by Orac.