Practitioners who ignore research want more taxpayer-funded research

Practitioners who ignore research want more taxpayer-funded research

Government largesse has funded CAM research for the last twenty-plus years. This expensive effort has resulted in two important discoveries: (1) not a single CAM treatment (as opposed to one that has been purloined from medicine and rebranded "CAM") is proven safe and effective for anything, and (2) CAM practitioners, as a whole, haven't changed their practices one whit as a result of what the evidence does (or doesn't) show. Chiropractors still detect and correct subluxations, naturopaths still use a bevy of pseudoscientific treatments (e.g., homeopathy), acupuncturists still poke people with needles, reiki masters still manipulate non-existent energy fields, and so on.

That doesn't stop the "Transdisciplinary Academic Consortium for Complementary and Integrative Health and Medicine" from coming back for more of your money, according to a recent article in The Journal of Alternative and Complementary Medicine.

The Consortium, made up of representatives from various naturopathic, chiropractic, acupuncture, Ayurvedic, homeopathic and other CAM organizations and schools, is alarmed because NCCIH (formerly, NCCAM) keeps decreasing their funding. NCCIH awarded 330 grants in 2014, down from 393 in 2010. Yet, of those, only 8 went to CAM institutions in 2014, as opposed to 21 in 2010. Of the over $100,000,000 in NCCIH awards in 2014, only a little over $2 million went to these institutions, a mere 2.27%.

This has caused a "brain drain" in complementary and integrative health institutions, as researchers leave for the greener pastures of "conventional" health centers, according to the article. This impoverishes not only their physical facilities but also the "intellectual infrastructure" (such as it is) of CAM schools.  To remedy this, the Consortium wants money to build research infrastructure at their schools.

One wonders if that is the real reason researchers are leaving. After all, if you are a well-trained researcher, why would you want to stick around in a place that so openly disdains science and research? I imagine these researchers pray their job search for a spot at a conventional institution isn't doomed by a C.V that includes time at a naturopathic or chiropractic school and bolt once the chance presents itself. On the other hand, if you have a CAM degree and are doing shoddy research, you will not be a part of the exodus anyway, because no legitimate institution is going to offer you a job.

But the Consortium doesn't want just any research done on their campuses. "Existing research methodologies" of the kind used at "conventional" institutions (for example, RCTs), pose "methodological challenges" because CAM "often addresses the whole person rather than specific symptoms."

Actually, that doesn't seem to be the real problem.The real problem is that research, not to mention basic scientific principles, doesn't support the diagnostic methods and treatments CAM practitioners use. So, they prefer a shotgun approach to research, throwing together a whole bunch of stuff (whether CAM or conventional) as add-ons to usual care and calling it "chiropractic care" or "naturopathic care." Then, they compare this "care" to conventional treatment.  Of course, when patients get the extra attention lavished on them, they feel better and maybe even do better, so – voila! – the chiropractic care or naturopathic care is declared a success because it "works." 

This is called "whole systems" research and it avoids the pesky problem of singling out individual therapies to see if they actually work by comparing them to a placebo and putting other controls in place to make sure the whole thing is legit, like the schmucks in conventional medicine do. 

According to the authors, NCCIH is really cramping their style.  "[CAM] researchers may consequently frame research questions and methods to satisfy reviewers who are less knowledgeable about CAM, rather than in ways that may best advance science and public health."

That's an interesting argument: By insisting on good science NCCIH is actually inhibiting the advancement of science. Brilliant! And public health? This from a group whose institutions consistently resist the most important public health achievement of the last century: vaccination.

Thus, the Consortium wants NCCIH to put its thumb on the scales and give Consortium institutions an unfair advantage over conventional ones when it hands out money. But the very reason NCCIH shouldn't give them more taxpayer dollars can be found right there in the article itself, where the authors admit that "for many [CAM] disciplines, a body of prior research has often not been established." In other words, they don't have evidence for a lot of what they do but they do it anyway. So, why should NCCIH give them money when it's obvious that they won't pay the least bit of attention to what they find?  In fact, they don't pay any attention to any research, no matter where it's done, NCCIH-funded or otherwise. If they did, most would be out of business. 

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