T

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.”

Newsletters

Sign up for our Daily Recap newsletter

Please enter a valid email address.

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.”

Leave a Comment

Please enter your name.
Please enter a comment.

  • According to the WHO studies, third world countries that treat psychiatric disorders with witchdoctor-like methods have a far better recovery rate than countries with modern “psychiatric” treatment (ie drugs). Western medicine sometimes throws out the baby with the bathwater.

    • For sure, Mary. Coming from Africa, I can assure you that most Africans have never heard of a psychiatric disorder, or a psychiatrist. Why would Big Pharma go to Africa and other poor countries to get little kids on things like Ritalin? NO MONEY.

    • It is not so much Western medicine as Allopathic medicine, which is conventional medicine controlled by the pharmaceutical industry and invented by modern science which believes all can be reduced to the material and mechanical.

      Modern medicine, Allopathic, has only the knife and the toxic drug. Many non-allopathic forms of medicine, Homeopathy for instance, are rejected because the opportunity for profit does not exist in their use.

      Of course medicine will fail if it begins from a position that the body and mind are no different to a washing machine or computer.

    • Sounds to me like STAT and its writers need to wake up and smell the coffee. Face it, guys. Alternative medicine is here to stay. It’s been around a heck of a lot longer and with more people than allopathic medicine, which gets its best results with infections and conditions that respond to surgery. Cheaper and less invasive alternative medicine can often be more effective for chronic conditions and for maintaining basic good health. What’s wrong with having both kinds of medicine? Do we have to keep bowing down to Big Pharma and its stockholders forever?

  • Look at our sick society and tell me modern drugs have made us better? They kill more people than illegal drugs and people are “sick” of the modern chemo and drugs that kill. They know there must be something better…something natural…not something made by secular, God hating scientists. Herbs and fresh squeezed juices saved my life after the drugs were killing me. These, along with coffee enemas and other natural remedies, healed my friend of breast cancer. Praise God for His amazing, natural healing. Nature was made to heal us and it’s been taken away by synthetic science…ultimately harming us.

  • Surely patients should be offered all medical modalities? Allopathic medicine is pretty much reliant on surgery and toxic drugs.

    A lot of its medicine is not properly understood, nor properly researched, nor properly validated – witchcraft in essence, snake oil, so why point the finger?

    Former editors of The Lancet and The New England Journal of Medicine have both said much research is just plain wrong, and the work of Dr John Ioannidis conclused most research was false.

    Why should Homeopathy and other medical modalities be held to higher standards of research when they don’t even apply to conventional medicine?

    Iatrogenic, (Allopathic) medical deaths are now the third biggest killer in the US, most of it from prescribed medication. For that reason alone, exploring other medical modalities is not only vitally necessary it is ethical.

    • I agree. We’ve been dooped into taking the establishments word for the safety of synthetic drugs mixed within our natural, carbon based bodies and it’s why every 5th commercial is a class action law suite against drug companies who are killing us…with their “snake poisons.” Drug companies are a trillion dollar empire who “forces” way too many vaccines, on children, to line their pockets. Many people are on to them and their self serving, lucrative but humanly harmful ways.

  • No surprise that a pharma mouthpiece is against change like this. Hard to make a profit when people can actually remove illness from their lives. A wonderful new development in our world!

  • I find it fascinating how this article purports to speak in the name of medical science while simultaneously demonstrating extreme anti-holistic bias. Two people quoted, Novella and Salzberg, are notorious for their rabid opposition to all things that do not fall within the purview of mainstream medicine. This is nothing more than a territorial defense of conventional medical turf, one that scoffs at the notion that anything alternative could possibly help “serious” disease. For many alternative therapies, including homeopathy, acupuncture, and herbal medicine, there are large databases of positive research. Mainstream medicine simply denies the existence and value of that research. The catch-22 is purposeful. If there’s no positive research on some alternative therapy in a mainstream American medical journal ( journals that have a clear bias against publishing alternative health research findings), then that therapy can’t possibly be of any value. The ivory tower of academic medicine is sealed tight, impervious to new or old ideas that might be of value to helping patients. All the while, the world moves forward, patients discover alternatives for themselves, find them to be of practical use, and recognize their value especially when contrasted with the well advertised hazards of pharmaceuticals. Mainstream medicine is petrified, frozen in time, incapable of innovating because it is slave to its corporate master, Pharma. As if we are all to believe that the only viable healing agents on the planet come in the form of synthetic chemicals with long lists of dangerous side effects. It is also remarkably hypocritical to imply that these reputable medical institutions are embracing alternatives for the money (which they are), as if the conventional therapies they offer are not about profit. Gimme a break. Research trials are rigged in the sense that they serve as a litmus test for mainstream medical approval. The far more important criterion is whether individual patients actually get better without some horrific tradeoff that gets justified by science as risks that come with the benefits. The ultimate arbiters of what works best are patients themselves, not some critic like Novella whose mind is closed like a steel trap.

  • So much emphasis is placed on evidence based then they turn around and say well that’s not correct anymore. Cholesterol an eating eggs, case in point.

  • When I burn myself and do Reiki on it right away, it doesn’t blister and the sting goes away within a few minutes. I’ve seen amazing results with Reiki and that’s all the evidence I need!

  • As usual fear of change creeps in. Whoever opposes an attempt at complementary/integrative medicine is keeping their head in the sand probably out of fear of losing their high cost paying patients – which is one reason people seek alternatives. Yet they accuse those practitioners as being in it for the money. Western medicine does some things well and other things terrible. One thing is doctors being arrogant and not listening to their patients; plus many diagnoses being wrong; plus high cost; plus the invasive nature of the treatment; plus prescription drug excesses; plus hospital mistakes and so on! And remember that the US has the costliest health care in the world and from OECD data we rank about 25th in regards to caring about all aspects of our citizens health. Furthermore there are 7 billion people in the world. They did not eveolve this far because of western medicine. We’ve been around @2 million years and 200,000 as a species and only 10,000 as a civilization. I wonder how we got this far?
    C’mon Docs open your minds; there is more to health care than drugs and surgery! “When the only tool you have in your tool box is hammer then everything tends to look like a nail!”

Sign up for our Biotech newsletter — The Readout

Your daily guide to what’s new in biotech.

X