Quacks everywhere

David Colquhoun has posted an excellent series of posts on the Steiner Waldorf schools, 19th century crackpottery that persists even now, by hiding their fundamentally pseudoscientific basis under a fog of fancy invented terms. He discusses their goofy philosophy of anthroposophistry, their devious efforts to get state funding, and their unfortunate buy unsurprising history of racism. It’s wild and crazy stuff, and it’s been sidling under the radar for a while.

What initially drew me to DC’s site was his article on quackery in retreat: the University of Westminster has discarded some of their previous offerings in naturopathy. There is still a fair amount of junk in their curriculum, but there’s hope that those are waning too.

I needed that bit of solace, because my university’s official listserve sent me a wonderful offer earlier this week.

Mindfulness Based Stress Reduction
As part of our ongoing commitment to provide quality, integrated wellness programs, the University of Minnesota’s Center for Spirituality & Healing is pleased to offer a telephone-based version of the highly successful Mindfulness-Based Stress Reduction program (tMBSR). The tMBSR begins with an in-person, all-day workshop. The next six sessions are conducted via a web-based conference call. The tMBSR concludes with an in-person, all-day, mostly silent retreat.
tMBSR will teach participants how to intentionally cope with pain, illness, and the stress of modern life. Participants will learn mindfulness meditation skills, and build upon their own personal strengths to offset the adverse effects of stress by responding more effectively.

The program cost of $385 (*$350 for UPlan members) includes: • Guided instruction in mindfulness mediation practices • Web-based group discussions • Gentle stretching & yoga • Daily “homework” to improve skills • Individual, tailored instruction & support • Hand-outs, CDs & Yoga DVD • All-day workshop and all-day retreat.
*UPlan Members: The tMBSR program reimbursement is available to employees who are covered by the UPlan Medical Program. You must participate in both all-day events and 4 of the 6 conference calls to qualify to be reimbursed $200.00 of the registration fees.

All-Day Workshop & Retreat
September 17th, 2011, 9:00 am to 4:30 pm in Oyate
November 19th, 2011, 9:00 to 4:30 pm in Oyate

Oh, man. Our bogus magic medicine place, the Center for Spirituality and Healing, is sponsoring this garbage — oh, wait, “sponsoring”? No, milking the faculty. They want to charge us individually $385 for a day of “mindful meditation”, for which the university may give us partial reimbursement…which just means they’ve found a way to fleece the suckers and also to get our university to endorse it.

I was cranky. I fired back on the listserve.

I am stunned that the university is subsidizing this bunkum and quackery from the Center for Spirituality and Healing. I shouldn’t be surprised; after all, the university has this New Age crapfest called the CSH in the first place.

And then, of course, I was bombarded with rotten vegetables. People were upset: I was hurtful! I was contemptuous! How dare I question the university’s efforts to help us deal with stress? One person sent me this claim that Linehan’s Dialectical Behavioral Therapy (DBT) fixes a long laundry list of ailments, from anxiety to fibromyalgia to chronic pain, and that it caused “increased immune system functioning”, one of those common buzz phrases that the quacks often use. So I wrote back, for the last time.

I’ve read some of these studies, and am unimpressed. Most of them assess subjective phenomena (“chronic pain” is notoriously amenable to suggestion, for instance), involve very small subject numbers and small effects, and often seize upon random phenomena as significant — one study found that retention in their program was far greater than in the controls, for instance; their DBT program was offered for free to participants, while the control was paid psychotherapy. Surprise!

I think a university sponsored program to help employees deal with stress is a great idea. However, real programs that are effective are built upon evidence-based medicine, not the frivolous and fuzzy nonsense that we get from the Center for Spirituality and Healing. When our institution endorses “mindful meditation”, a procedure that is pretty much indistinguishable from the placebo response, they are literally doing the very least they can do for us.

Mindful meditation may be relatively innocuous fluff, but where do we draw the line? The CSH also endorses reiki, reflexology, aromatherapy, craniosacral therapy, traditional chinese medicine, and unbelievably, “healing touch” — this is tantamount to peddling magic. Here’s an example of how the CSH describes the mechanism behind ‘healing touch.’

Healing Touch blends the energetic techniques of a number of practices, both ancient and contemporary. It is based on the belief that human beings are composed of fields of energy that are in constant interaction with self, others, and the environment (also see the section on Theories and Principles for more information). The Healing Touch practitioner realigns the energy flow, which reactivates the patient’s mind/body/spirit connection in order to eliminate blockages to self-healing.

The goal of Healing Touch is to restore harmony to the energy system so that the patient is in an optimal state for healing to occur. In other words, the goals are to accelerate the recipient’s own healing process and to facilitate healing at all levels of the body, mind, and spirit.

Healing Touch integrates easily with other modalities a practitioner may already be using. These modalities may include conventional medical practice in hospitals, clinics and in home care, or other body-mind oriented therapies such as massage, guided imagery, music therapy, acupressure, biofeedback, and psychotherapy.

This is pure gobbledygook. None of this makes sense. None of this has been demonstrated empirically: it can’t be, because it’s all made up.

None of these ‘therapies’ work. Every time they’ve been tested using objective, clinical outcomes, they’ve been found to be completely ineffectual. Our university is selling us New Age snake oil, and I’m deeply embarrassed to see the credulity and the wastefulness demonstrated by an institution that ought to be dedicated to rigor and reason. Can we please use our health care dollars a little more wisely?

Man, I hate the center for spirituality and healing. I’m ashamed and embarrassed every time I get ads from that place — they are trading on the educational and scientific integrity of our institution of higher learning to make money for quacks and to elevate witch doctors and shamans to the status of medical professionals. I’m hurtful? I think frauds selling overpriced stress-reduction magic to our faculty and staff is what really hurts.

No, I’m not signing up for the Mindfulness Based Stress Reduction classes. Just their existence has increased my stress, and it’s not worth $385 to show up and watch my blood pressure skyrocket.

(Also on FtB)

How good is American health care?

A study in the Journal of the Royal Society of medicine has assessed the effectiveness of health care in 19 western countries and come up with a simple ranking system: a measure of the the number of lives saved relative to expenditures proportional to the GDP. One parameter, called the GDPHE, or GDP Health Expenditure was a measure of how much money the country was sinking into health care per citizen; by dividing this by the mortality rates, they got a measure of the effectiveness of the health care system.

This is a ranking system, and I have mostly a hyper-competitive American audience, so you all want to know whether you win or not, right? You want the data that shows that the US is #1! And here it is, the one result that shows us at the top of the ladder, our average health care as a function of GDP.

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Look at that: we don’t just win, we win big, leaving our closest competitor, Germany, in the dust. We spend 125% of the money Germany does per person. Does it feel good, America? We are tossing bigger buckets of money into health care than anyone else.

But now for the number that really matters, the GDPHE ratio. How many lives are we saving with all that money? Here’s the answer. Look at the last column, which is the ratio of money spent to lives saved.

i-ffac1ad81397e011136cef0833e11b2d-healthcareefficiency.jpeg

Oops. We’re…#17. We’re almost the worst — thanks, Portugal and Switzerland, for neglecting the medical needs of your citizenry more than we do.

Our health care is miserably inefficient, and we pour extravagant sums of cash into it, but you might ask whether it works at all. And the answer is a bit of good news, yes, it does. This study also compared death rates over time and came to the conclusion that, in the US, more than half a million people are alive today who would not have been with the medical care we offered 25 years ago. Medicine in the US is good, it’s just far more economically wasteful than it ought to be.

I’m still thinking I ought to retire to Ireland.

(Also on FtB)

Newage sewage flushed into the Atlantic

The Atlantic published a rather contemptible apologetic for alternative quackery titled “The Triumph of New-Age Medicine, which basically declared victory for the altie wackaloons. The way it did this was devious, and reminded me so much of creationist tactics. First, it declares that “mainstream medicine itself is failing”; it doesn’t really have any evidence of this, it just declares that modern medicine is built around the infectious disease model, and that it hasn’t solved all health problems. Familiar stuff, hey? If a science can’t explain every jot & tittle of every detail of every phenomenon, if there are still open questions and problems, why, it must be wrong!

Secondly, it portrays the altie quacks as nice, caring, sweet people who really, really care about their patients, and their ‘treatments’ as, at worst, totally harmless. Referring to one peddler of holistic care, the author says “Concerns of outright malpractice or naked hucksterism seem grossly misplaced when applied to a clinic like Berman’s.” Why? Because Berman is “gentle” and “upbeat” and has a pleasant demeanor. As everyone apparently knows, con artists must always be rude and pushy and arrogant and nasty and alienating. Oh, wait…no, they’re the opposite of that.

And then, thirdly, is the sly substitution. We’re finding that the best way to manage chronic illnesses like heart disease is with life-style changes that improve nutrition, physical condition, and overall well-being, and reduce the underlying causes. So what does this article do? It credits all that good common sense to the quacks who promote reiki and acupuncture and exotic herbs. You know what my traditional, mainstream, hidebound doctor of real world medicine first prescribed for me at those early signs of heart disease? Changes in diet and more exercise. She didn’t seem to think I needed homeopathic placebos in order to do something that would make a difference.

It was an infuriatingly dishonest article. Now Steven Salzberg, who was also quoted in it, has gotten a good rebuttal published in the Atlantic, and has also been interviewed on MPR on the subject.

I know that when I go to see a doctor, I want to see a commitment to figuring out what works. I am not at all impressed if they’re pushing fraudulent pseudoscientific BS into my treatment, no matter how sweet and smiley and sensitive they are. A good bedside manner is important, but it’s no substitute for incompetence.