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hey’re among the nation’s premier medical centers, at the leading edge of scientific research.

Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing. They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.)

This embrace of alternative medicine has been building for years. But a STAT examination of 15 academic research centers across the US underscores just how deeply these therapies have become embedded in prestigious hospitals and medical schools.

Some hospitals have built luxurious, spa-like wellness centers to draw patients for spiritual healing, homeopathy, and more. And they’re promoting such treatments for a wide array of conditions, including depression, heart disease, cancer, and chronic pain. Duke even markets a pediatric program that suggests on its website that alternative medicine, including “detoxification programs” and “botanical medicines,” can help children with conditions ranging from autism to asthma to ADHD.

“We’ve become witch doctors,” said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine.

STAT’s examination found a booming market for such therapies: The clinic at the University of California, San Francisco, is growing so fast, it’s bursting out of its space.

Just in the past year, the teaching hospital connected to the University of Florida began offering cancer patients consultations in homeopathy and traditional Chinese herbal medicine. Thomas Jefferson University in Philadelphia launched an institute whose offerings include intravenous vitamin and mineral therapies. And the University of Arizona, a pioneer in the field, received a $1 million gift to boost practitioner training in natural and spiritual healing techniques.

“[If a hospital is] offering treatment that’s based on fantasy, it undermines the credibility of the institution.”

Steven Salzberg, Johns Hopkins

Even as they count on these programs to bring in patients and revenue, several hospitals were reluctant to talk to STAT about why they’re lending their distinguished names to unproven therapies.

Duke Health declined repeated requests for interviews about its rapidly growing integrative medicine center, which charges patients $1,800 a year just for a basic membership, with acupuncture and other treatments billed separately.

MedStar Georgetown quietly edited its website, citing changes to its clinical offerings, after a reporter asked why it listed the energy healing practice of reiki as a therapy for blood cancer. Cleveland Clinic struggled to find anyone on its staff to defend the hospital’s energy medicine program, ultimately issuing a statement that it’s “responding to the needs of our patients and patient demand.”

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And the director of an alternative medicine program at another prestigious hospital declined to speak on the record — out of fear, he said, that his remarks would be construed as “fake news” and stir a backlash.

The rise of alternative therapies has sparked tension in some hospitals, with doctors openly accusing their peers of peddling snake oil and undermining the credibility of their institutions.

By promoting such therapies, Novella said, physicians are forfeiting “any claim that we had to being a science-based profession.”

As for patients? They’re “being snookered,” he said.

Online promotions with little room for nuance

The counterargument: Modern medicine clearly can’t cure everyone. It fails a great many patients. So why not encourage them to try an ancient Indian remedy or a spiritual healing technique that’s unlikely to cause harm — and may provide some relief, if only from the placebo effect?

“Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what’s best for a patient. Who am I to say that’s hogwash?” said Dr. Linda Lee.

A gastroenterologist, Lee runs the Johns Hopkins Integrative Medicine and Digestive Center, which offers acupuncture, massage therapy, and reiki — a therapy that the center’s website describes as laying on hands “to transmit Universal Life Energy” to the patient.

Lee and others who promote alternative therapies are careful to say that they can supplement — but can’t replace — conventional treatments. And they make a point of coordinating care with other doctors so that, for instance, patients don’t get prescribed herbal supplements that might interact badly with their chemotherapy.

“Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what’s best for a patient. Who am I to say that’s hogwash?”

Dr. Linda Lee, Johns Hopkins gastroenterologist

“Here at UF, we do not have alternative medicine. We do not have complementary medicine. We have integrative medicine,” said Dr. Irene Estores, medical director of the integrative medicine program at the University of Florida Shands Hospital in Gainesville, Fla.

But while those cautions may come through in the clinic, the hospitals also promote alternative medicine online — often, without any nuance.

Duke’s Integrative Medicine store, for instance, sells “Po Chai Pills” that are touted on the hospital’s website as a cure for everything from belching to hangovers to headaches. The site explains that taking a pill “harmonizes the stomach, stems counterflow ascent of stomach qi, dispels damp, dispels pathogenic factors, subdues yang, relieves pain.” None of that makes sense in modern biomedical terms.

Thomas Jefferson University Hospital’s website touts homeopathic bee venom as useful to relieve symptoms for arthritis, nerve pain, and other conditions. The site does tell patients that the biological mechanism for the treatment is “unexplained” but asserts that studies “have been published in medical journals showing homeopathic medicines may provide clinical benefit.”

Asked about the therapy, Dr. Daniel Monti, who directs the integrative health center, acknowledged that the data is “largely anecdotal,” and said the hospital offers the treatment only rarely, “when there are few other options.” But those caveats don’t come through on the website.

Novella gets alarmed when he sees top-tier hospitals backing therapies with scant evidence behind them. “Patients only want [alternative medicine] because they’re being told they should want it. They see a prestigious hospital is offering it, so they think it’s legitimate,” said Novella.

“The perpetuation of these practices is a victory of marketing over truth,” said Steven Salzberg, a biomedical engineer at Johns Hopkins who lectures in the medical school. If a hospital is “offering treatment that’s based on fantasy, it undermines the credibility of the institution.”

The debate burst into the public view earlier this year when the medical director of the Cleveland Clinic’s Wellness Institute — which markets a variety of alternative therapies — published an article raising discredited theories linking vaccines to autism.

Cleveland Clinic’s chief executive, Dr. Toby Cosgrove, disavowed the article. And the clinic told STAT last week that it will take down its online wellness store and stop selling homeopathy kits.

But Cosgrove has stood up for the general principle of offering alternative treatments.

“The old way of combating chronic disease hasn’t worked,” Cosgrove wrote in a column posted on the hospital’s website. “… We have heard from our patients that they want more than conventional medicine can offer.”

Aromatherapy

A booming market for ‘natural’ therapies

There’s no question that patients want alternative medicine. It’s a $37 billion-a-year business.

The typical American adult spent about $800 out of pocket in 2012 on dietary supplements and visits to alternative providers, such as naturopaths and acupuncturists, according to the federal Centers for Disease Control and Prevention.

Hospitals have taken note. A national consortium to promote integrative health now counts more than 70 academic centers and health systems as members, up from eight in 1999. Each year, four or five new programs join, said Dr. Leslie Mendoza Temple, the chair of the consortium’s policy working group.

In most cases, insurers won’t cover alternative therapies — there’s simply not enough evidence that they actually work — so patients pay out of pocket: $85 for acupuncture, $100 for reiki, $38 for pills made from thyme and oregano oils that promise to “harmonize digestive and respiratory function.”

To be sure, not all such integrative medicine clinics are big profit centers. Many are funded by philanthropists, and some hospitals say their programs operate at a loss — but are nonetheless essential to woo patients in a highly competitive marketplace. If they failed to offer “natural” therapies, some hospital executives fear they would lose a chance to attract patients who need more lucrative care, such as orthopedic surgeries or cancer treatments.

The integrative medicine center at Thomas Jefferson, for instance, is part of an “enterprise strategy for growth and development,” Monti said.

“The people running the hospitals are doctors, but they also have MBAs. They talk of patients as customers. Customers have demands. Your job is to sell them what they want,” said Arthur Caplan, a bioethicist at New York University’s medical school. Too often, he said, the attitude is, “We’re damn well going to do it if the guys down the street are doing it.”

“We’ve become witch doctors … [forfeiting] any claim that we had to be a science-based profession.”

Dr. Steven Novella, Yale School of Medicine

While most hospitals declined to give specific revenue figures, STAT found indications of rapid growth.

“We’re literally bursting. We have to convert office space to clinic exam rooms,” said Shelley Adler, who runs the Osher Center for Integrative Medicine at the University of California, San Francisco. It offers a wide range of services, including Chinese herbal medicine, massage therapy, and Ayurveda, an ancient healing system from India based on the belief that health results from a balance between the mind, body, and spirit.

The center is on pace to get more than 10,300 patient visits this fiscal year, up 37 percent from 2012. It’s expanding its clinical staff by a third.

Duke University’s integrative medicine clinic, a stunning space with arching wood ceilings and an indoor garden, has seen strong growth: Total visits jumped 50 percent in 2015, to more than 14,000, Dr. Adam Perlman, the executive director, told IntegrativePractitioner.com. (He declined to talk to STAT.)

The center’s membership count also jumped, up 25 percent to 885, Perlman said. If all members paid the list price, that would bring in more than $1 million a year just for primary care.

At the University of Pittsburgh’s Center for Integrative Medicine, meanwhile, “our volume pretty much has increased steadily, even when we’ve had recessions and financial downturns,” said Dr. Ronald Glick, the medical director. The center now treats about 8,000 patients a year.

Many hospitals have also expanded into more general “wellness” offerings, with classes in healthy cooking, tai chi, meditation, and art therapy. UCSF offers a $375 class on “cultivating emotional balance” (and a free class on “laughter yoga”). Mayo Clinic sells a $2,900 “signature experience,” which includes consultations with a wellness coach.

And the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital offers specialized stress management services to help patients deal with conditions including cancer, infertility, and menopause. John Henry, the owner of STAT, has contributed funding to the Benson-Henry Institute.

Wellness programs — which are designed to ease stress and encourage healthy behaviors — are seen by many clinicians and hospitals as key to slowing America’s epidemic of chronic disease. They don’t tend to draw sharp criticism, except for their cost.

It’s the alternative therapies promoted as a way to treat disease that raise eyebrows.

Reiki

‘Energy healing’ takes root

Despite their deep wells of medical expertise, many top hospitals are offering to help treat serious medical problems with reiki — a practice based on the belief that lightly touching patients can unleash a cosmic energy flow that will heal them naturally.

STAT found that it is widely used by academic medical centers, including Johns Hopkins, Yale, the University of Pennsylvania, and Spaulding Rehabilitation Hospital, part of Partners HealthCare in Boston.

So, where’s the evidence supporting it?

There is none, according to a division of the National Institutes of Health that funds research into alternative medicines. It says the practice has not been shown to be useful for “any health-related purpose” — and adds that there is no scientific evidence that the “natural healing energy” it’s based on even exists.

Asked about the Cleveland Clinic’s promotion of reiki, Dr. Richard Lang, the recently named interim director of the clinic’s Wellness Institute, said he hadn’t had a chance to think about it. “I don’t know that I could give you a plus or minus on that,” he said. Lang served as a vice chair of the wellness institute for nearly a decade before taking the top post.

“[Hospital executives] talk of patients as customers. Customers have demands. Your job is to sell them what they want.”

Arthur Caplan, bioethicist at New York University

Pressed for a more substantive answer, the clinic sent a statement saying it offers energy medicine as a complementary therapy, not as a replacement solution. But its website only briefly alludes to a patient’s broader “care team” in describing a “full range of emotional and physical issues” that can be treated with energy therapies, including autoimmune diseases, migraines, hormonal imbalances, and “cancer treatment support and recovery.”

Academic medical centers often boast that they’re more rigorous in evaluating alternative therapies  — and weeding out scams  — than a for-profit wellness center might be.

“The important thing about practicing in an academic center is that we must hold ourselves to certain standards,” said Estores, the medical director at the University of Florida’s integrative medicine clinic.

At the University of Pittsburgh, Glick echoed that sentiment: “We’re an academic institution … [so] we’re offering services that have greater evidence basis [and] scientific explanation.”

But that evidence isn’t always rigorous.

The University of Florida, for instance, is using Facebook to advertise an herbal medicine workshop for providers and the public that promises to answer questions including, “How can we stabilize or reverse Alzheimer’s disease?”

Asked about the evidence for that statement, Susan Marynowski, the herbalist presenting the workshop, cited several papers and a book chapter that she said showed herbs, in conjunction with lifestyle adjustments, could reverse Alzheimer’s-associated memory loss. However, at least two papers were small collections of case studies published in a journal with a reputation for less-than-rigorous review. (Marynowski said she knew the studies’ size and design limited the strength of their conclusions, but that she was not aware of the journal’s reputation.)

At Pittsburgh, the integrative medical center does take care to note on its website that alternative therapies “generally have not been subjected to the same level of research as standard medical approaches.”

But the site then goes on to promote dozens of treatments for everything from ADHD to whiplash, saying they have “appeared to be beneficial in this and other complementary medicine clinics.” (Glick noted that the body of research had grown since he wrote the caveat on the website in 2003.)

Acupuncture

‘It’s not black and white’

Perhaps the most prevalent alternative treatment STAT found on offer is acupuncture. It’s promoted for more than a dozen conditions, including high blood pressure, sinus problems, infertility, migraines, and digestive irregularities.

A 3,000-year-old Chinese therapy, acupuncture is based on the belief that by stimulating certain points on the body, most often with needles, practitioners can unlock a natural healing energy that flows through the body’s “meridians.” Research suggests it helps with certain pain conditions and might help prevent migraine headaches — but it also suggests that the placebo effect may play an important role.

Its value in treating other conditions is uncertain, according to the NIH’s center on integrative medicine.

Several major insurers, including Aetna, Anthem, and regional Blue Cross Blue Shield affiliates, cover acupuncture as a treatment for chronic pain and nausea. But the Centers for Medicare and Medicaid Services won’t pay for acupuncture, dismissing the scientific evidence as insufficient.

Still, it’s important for physicians to keep an open mind, said Lang, the interim director of the Cleveland Clinic Wellness Institute.

He said, for example, that he used to avoid referring patients for acupuncture, until he saw the benefit it provided to some of them. “I have seen it work in some chronic pain situations,” said Lang. “It can be very helpful. If it doesn’t work, I don’t know that you’ve lost anything. If it does, you do get to a better place.”

“If it doesn’t work, I don’t know that you’ve lost anything. If it does, you do get to a better place.”

Dr. Richard Lang, Cleveland Clinic

And while the evidence of its efficacy is not ironclad, neither is the evidence for various pharmaceutical therapies that are routinely provided by hospitals and covered by insurance. Some of those solutions, such as opioids to treat pain, have resulted in addiction and harm to patients.

Advocates of alternative medicine say it’s difficult to test some alternative therapies through rigorous clinical trials, primarily because treatment techniques vary from patient to patient. (The federal government does, however, spend roughly $120 million a year to fund research through the NIH National Center for Complementary and Integrative Health.)

They note, too, that traditional doctors sometimes stray from proven treatments, for instance when they prescribe medicines off-label for conditions the drugs have not been approved to treat.

“We do use things that aren’t necessarily 100 percent evidence-based, but I would argue that’s also true within all of medicine,” said Dr. Jill Schneiderhan, co-director of the University of Michigan’s integrative family medicine program. “I feel like it’s not black and white.”

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  • I take Berberine for mild type II AODM. If admitted for any condition, will the MDs/RNs take away this medicinal herb? It is as effective as Metformin and does not cause diarrhea and impaired keratinocyte function. IOW Metformin can cause foot ulcers.

  • Dismissing “alternative” treatments as mystical root doctor mumbo jumbo because there hasn’t been a study done by research scientists to prove efficacy is ignorant, elitist, and snobby. Now I can support that some of the practitioners offering these services may very well be bs artists. However, in the cultures of origination for the practices have used them for many generations and have FAITH that they work. Faith is important medicine and we can sometimes forget just how important since we rely on technology and western practices. There is a reason these famed medical institutions are opening themselves up to “witch doctor” medicine (beyond the dollar because I wont pretend that doesnt matter!) and its because its healing that relies on the patient and a BELIEF that they can add some positive impact on their treatment beyond taking pills and consenting to surgery. The patient controls this factor, and whether proven by medical research or not, and feeling like the captain of your own ship leads to positive attitude and positive attitudes help to improve outcomes.

    • Plenty of Allopathic doctors are also b/s artists. That seems to be the way of medicine throughout human history.

      I don’t agree that faith is required, or belief. If that were true then Allopathic, as iatrogenic, doctor or medical induced, would not be one of the top three killers, most of it from prescribed medication. More people trust, believe in, have faith in their allopathic doctors than anything else.

      And, in the case of Homeopathy, it works equally well on those who are convinced it cannot work as on those convinced it can.

      Placebo and nocebo effects can play a part but effective medicine requires neither.

  • I think I’ve had fibromyalgia for many years but was diagnosed approximately 10 years ago. I was working at Walmart and was just exhausted. Not the tiredness that sleep helps. I mean totally exhausted, with muscle pain. My primary doctor diagnosed fibromyalgia. I couldn’t move my right arm with out getting a lot of pain. I was taking Lyrica, it helps but I still have to be careful not to over do things. I was trying to have a child-don’t know if I’ll be able to do it! I lost touch with reality.I started on Health Herbal Clinic Fibromyalgia Disease Herbal formula treatment in September 2016, i read alot of positive reviews on their success rate treating Fibromyalgia disease through their Fibromyalgia Herbal formula and i immediately started on the treatment. Just 7 weeks into the Herbal formula treatment I had great improvements, my right hand pain seized and the stiffed, rigid muscle had succumbed. I am unbelievably back on my feet, this is a breakthrough for all Fibromyalgia sufferers, visit Health Herbal Clinic official website www. healthherbalclinic. net or email info@ healthherbalclinic. net.

  • I’m trained and certified by Duke Integrative Medicine as a Health Coach. The training in behavior modification IS evidence based. Sadly the promotion of therapies that are NOT evidence based is definitely a part of the culture.

    My client base is a skeptical lot who won’t stand for magical thinking. The field’s dependency on “guess practices” is hard to navigate around. It’s not easy being heard when you’re surrounded by 100 charlatans with a megaphone.

    • The good thing is that evidence-based requires only one thing – efficacy which is demonstration of healing and cure.

      It is this evidence which has seen Acupuncture survive for three thousand years and Homoepathy for more than two hundred years. Ditto for Holistic/Herbal medical modalities like Ayurveda and Traditional Chinese Medicine.

      There is no thinking or magic required when one has demonstration of efficacy.

      Charlatan’s abound in all things including Allopathic science-medicine where the snake oil factor simply exists in different forms.

      I realise it is cultural but anyone who thinks something called a health coach is necessary for good health is hardly sceptical.

    • Roslyn, this is somewhat off the subject but interesting. Do you remember the FDA claims that Hyland’s teething tablets had been associated with serious adverse evens, seizures and even deaths? The American Institute of Homeopathy was able to obtain the FDA’s database in this situation through a Freedom of Information Act request and had it analyzed. This is what the analysis found: “Data on seizures fails to demonstrate an increased risk. Reports of deaths fail to demonstrate a correlation. Reports of accidental ingestions fail to document serious adverse reactions of any kind.” “According to AIH experts, the FDA’s actions in this matter appear to constitute a gross dereliction of duty and the premature warnings without even rudimentary scientific inquiry suggest prejudicial intent.”

      Hyland’s products have been used safely and successfully for 70 years in the U.S., Australia and Canada. We stood by Hyland’s for good reason and are so pleased that the company has been vindicated.

    • @ChristyRedd,

      Thanks for that information. The teething story is still being spread around but little sign of the vindication which you have posted.

      The thing about it was that if the teething remedy was Homeopathic it was impossible for it to do harm.

      Even a processing failure in Homeopathic medicine could not create such deadly results. And if it was not Homeopathic then it was not a failure of Homeopathy.

    • The cultural difference may go beyond skepticism and include the definition of “evidence based.” My understanding of the term is that it has little to do with efficacy based on longevity and everything to do with patient preference, provider expertise AND empirical research.

      Some of the so-called alternative therapies satisfy this. But others, such as homeopathy, are lacking. It.could be missed the supporting research on that one. I’d love to be wrong about it.

    • The mere fact that Homeopathy is used by MD’s and in hospitals around the world, particularly Europe; taught in universities and even some medical schools and included in State Medical systems indicates that it is effective and those who embrace it, particularly in the current climate, have clearly found enough substantive evidence to resolve any fears they or their legal teams might have.

      Science-medicine is today a rather corrupted system of enquiry as former editors of both The Lancet and The New England Journal of Medicine have said. Much research is wrong, if not false. The work of Dr John Ioannidis concluded most published research was false.

      The prejudice against Homeopathy and the lack of understanding, combined with a refusal to countenance how it might work, limits research outcomes. However, for those of open mind, there is research out there.

      By the end of 2014, 189 randomized controlled trials (RCTs) of homeopathy on 100 different medical conditions had been published in peer-reviewed journals. Of these, 104 papers were placebo-controlled and were eligible for detailed review:

      “41 percent were positive — finding that homeopathy was effective.
      “5 percent were negative — finding that homeopathy was ineffective.
      “54 percent were inconclusive.

      “An analysis of 1,016 systematic reviews of RCTs of conventional medicine had strikingly similar findings:
      “44 percent were positive — the treatments were likely to be beneficial
      “7 percent were negative — the treatments were likely to be harmful
      “49 percent were inconclusive — the evidence did not support either benefit or harm.”

    • The data you provide is an excellent indictment of the state of scientific research in general but can’t serve as an endorsement of homeopathy. You can’t knock the research and support your case using that same research.

      The anecdotes about homeopathy being taught and practiced in medicine for years are less compelling. There are many fallacious concepts taught and practiced in medicine that aren’t supported by evidence (e.g. low-fat diets with emphasis on PUFAs fight heart disease, PSA tests lead to positive outcomes for prostate cancer).

    • I agree completely and it is one reason why I don’t bother posting research. But if one bears in mind that research in general is not reliable, then it remains interesting to read positive research in regard to Homeopathy since a common claim is none exists.

      I am not trying to make a case, simply offering a few avenues of reading if you are interested.

      Another difficulty is that Homeopathic Medicine cannot be studied in the same way that Allopathic medicine is studied, and often that is just what the research tries to do. Having said that, given that Iatrogenic, Allopathic medicine in essence, most of it from prescribed medication is the third biggest killer in the US and fourth in many other developed nations, one could hardly argue that the research approach works well even for the medical modality science invented.

      It is not an anecdote to talk about Homeopathy being taught and practised in many countries, particularly Europe, it is verifiable fact.

      Why it is relevant, I believe, is that in the current climate with the level of hostility toward Homeopathic medicine, logic suggests no-one trained or practising Allopathic medicine would touch it for fear of being sued or mocked. And they do. Ergo, that means they believe it is effective and is not fraudulent contrary to common claims.

      Given the litigious nature of society today, I think it does mean something that MD’s, major hospitals, universities, some medical schools and quite a few State Governments utilise Homeopathy.

      And yes, a lot of Allopathic medicine is used even if it is ineffective or unproven, but the difference there is that such use will not bring lawsuits, ridicule, mockery or the loss of professional prestige.

      Take chemotherapy for instance, a modality which if judged on its success rate would have never lasted on the market except for the power of the pharmaceutical industry and the power of the patient’s fear of death. The irony is that much research shows it kills more than it ever cures, if indeed, remaining free of a disease for a mere five years can ever be called cure.

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