LOS ANGELES — When billionaires Susan and Henry Samueli this week announced a $200 million donation to the University of California, Irvine to launch a new health program dedicated to integrative medicine, they drew a standing ovation and glowing coverage.
But for those who have been watching the steady creep of unproven therapies into mainstream medicine, the announcement didn’t go over quite as well.
“This is ultimately a very bad thing,” said Dr. Steven Novella, a neurologist at Yale University and longtime critic of alternative therapies. “It’s putting emphasis and the imprimatur of a university on things that have been discarded as medical fraud for 50 years.”
University of Alberta health law professor Tim Caulfield, who has made his name debunking celebrity health fads, has raised red flags about the adoption of alternative therapies — from “energy healing” to homeopathic bee venom to intravenous mineral infusions — at top medical centers including Duke, Johns Hopkins, and UC San Francisco. The new school at UC Irvine “is more of the same, and I find it very frustrating,” he said. “I worry this legitimizes practices that aren’t valid.”
But two physicians at UC Irvine who will lead the new initiative — both with solid pedigrees in traditional medicine and years of experience conducting research funded by the National Institutes of Health — pushed back against those depictions.
They argue that medical schools are too slow to adopt new approaches, including alternative therapies that show clinical promise — and that UCI can do so in a way that is solidly grounded in science.
“We take patient safety as our highest calling and we will never deploy any approach — integrative or not — that put patients at risk,” said Dr. Howard Federoff, a board-certified internist and Ph.D who serves as CEO of UC Irvine’s health system and runs a lab working to develop a blood test for Alzheimer’s disease. “Any non-proven or non-evidence based approach? We will not deploy it.”
The donation — one of the largest ever to a public university in the U.S. — will create the Susan and Henry Samueli College of Health Sciences, which will draw together resources from UCI’s medicine, nursing, pharmacy, and public health programs. UCI plans to build a new facility, buy lab equipment, and endow up to 15 new faculty chairs. Federoff said he hopes the result will be a “national showcase” that other medical schools will study.
The new school will absorb UCI’s existing Center for Integrative Medicine, which offers alternative treatments like acupuncture, homeopathy, and Chinese herbs along with traditional treatments. That center’s director, Dr. Shaista Malik, was trained very traditionally — she has both a master’s and PhD in public health from UCLA, a medical degree from UCI, and is a practicing cardiologist. But her frustration with patients who refused to take their medications even after suffering heart attacks steered her toward a more holistic approach.
“This represents a massive failure of academia. This should be the final line that doesn’t get crossed.”
Dr. Steven Novella, Yale neurologist
At her center, Malik said, she can refer patients to mindfulness classes, stress management, and yoga. “I’ve seen huge changes in patients’ abilities to adhere to their regimens,” she said. She’s also been looking at whether nutritional supplements might help keep some patients on lower doses of conventional medications, such as statins, that can have troubling side effects.
Malik’s center, which treats patients with conditions ranging from acne to infertility to stroke, offers a view into how difficult it can be to walk a line between alternative therapies and evidence-based medicine — and how UCI has been in the forefront of trying to marry the two.
UCI is the first conventional medical school in the nation, Malik said, to offer a residency program to naturopaths, who are often scorned by mainstream physicians. The first class started last fall, rotating through with family physicians. Naturopaths at the center are used for their expertise in nutrition and dietary supplements and are supervised by MDs, she said.
The center does offer Chinese herbal treatments, but Malik said they were used very rarely and, being unproven, would likely be phased out. Acupuncture, which has been shown in some studies to lower blood pressure, would likely remain an active area of interest, she said.
UCI defines integrative healthcare as a combination of conventional medicine and alternative medicine as well as a focus on lifestyle, wellness and “the whole person.” In addition to researching alternative therapies, the new program will use high-tech tools like genomic analysis and blood tests to try to tailor treatments and preventive care to individual patients, Federoff said.
By paying more attention to patients’ full range of needs — rather than just treating their disease — the UCI physicians leading the effort say they hope to transform medicine.
Malik and Federoff said they know their approach raises questions among many of their medical colleagues. But they say the fact that so many patients seek nontraditional care means something about conventional medicine isn’t working.
Medical schools, they say, should pay attention to what patients are seeking and study those treatments — either to embrace them or to decisively debunk them.
“Things that are considered cutting edge by patients need to be tested in an academic environment, because we have the bandwidth,” Malik said.
“Things that are considered cutting edge by patients need to be tested in an academic environment, because we have the bandwidth.”
Dr. Shaista Malik, UCI cardiologist
But critics aren’t buying it.
They point out that there is no biological mechanism behind many common alternative therapies. And they argue that it is a waste of time and money to study therapies that simply are not plausible, such as homeopathic pills, which are made from substances so heavily diluted that they’re basically water.
The way Novella sees it, the very term “integrative” medicine makes little sense.
“You have to ask what are they integrating? Are they integrating things that don’t work? If it worked, we wouldn’t need to integrate it — it would already be part of the system,” Novella said.
The donation comes from Orange County billionaires Henry and Susan Samueli, who own the Anaheim Ducks hockey team. Henry Samueli is an engineer who co-founded semiconductor giant Broadcom. The Samuelis, both UC graduates, have been generous donors to the UC system; engineering schools at both UC Irvine and UCLA carry the Samueli name.
Susan Samueli, a math major, started her career as systems analyst but grew increasingly fascinated with alternative medicine therapies and went on to earn a degree from the American Holistic College of Nutrition, an unaccredited correspondence school in Alabama, and a diploma from the British Institute of Homeopathy, a correspondence school based in New Jersey.
The couple has been promoting and funding research into alternative medicine for years. In 2001, for instance, they founded the Samueli Institute for Information Biology in Alexandria, Va., which has studied the efficacy of prayer and tested homeopathy as a way to protect soldiers from biological attack. Critics at the time called the therapies under study “nonsense,” “faith healing,” and “spa therapy for rich people.”
While the UCI physicians leading the new program used Monday’s announcement to stress their commitment to science-based approaches, the Samuelis made a point of discussing their embrace of alternative treatments, such as taking Chinese herbs to fight off infections.
“You have true believers with a lot of money trying to put their thumb on the scale to influence medicine,” Novella said. “No university is going to turn away $200 million.”
But he said that is exactly what UCI should have done. No biology department would accept money for a center for creationism, he said, nor would an astronomy department accept funding for an astrology school.
“This represents a massive failure of academia,” he said. “This should be the final line that doesn’t get crossed.”