Complementary and alternative medicine Medicine Quackery

There’s no woo like Harvard woo

I’d start out by saying that here’s another one for my (in)famous Academic Woo Aggregator, except that this institution is already a part of the Woo Aggregator. The only thing I can say is that Steve Novella (who’s from Yale and has had to manage an influx of woo at his home institution) might get to feel a bit of schadenfreude over this, because the institution in question is Harvard University.

And boy is this a doozy. In fact, it’s a $6,500 dose of continuing medical education doozy! Check out Structural Acupuncture for Physicians:

Date: 10/2/2008 — 6/7/2009
Course #: 00292317
Areas of Interest: psychiatry, physical medicine & rehabilitation, pediatrics, pain management, internist, family practice, neurology, obstetrics, anesthesiology
Physicians $6,500.00
Location: The Joseph B. Martin Conference Center at Harvard Medical School, 60 Avenue Louis Pasteur, Boston, M
Director(s): Joseph Audette, MD|David Euler, Lic. Ac.|Kiiko Matsumoto, Lic. Ac.
Offered by: Spaulding Rehabilitation Hospital, Department of Physical Medicine & Rehab.

Now that’s some serious tuition for continuing medical education (CME). How on earth could this class cost so much? A couple of years ago, I took a course for surgical educators that was nearly a week long and included hotel and meals for only around $3,500. Even the Harvard name isn’t enough for such tuition for a course of this nature. Well, maybe it is, but it wouldn’t be enough for me. Let’s take a look at the brochure for the course to see what woo-trainees get for their money:

This unique course provides practical, hands-on training in acupuncture. The training program is designed to bring together Eastern and Western views of health and disease into a result-oriented acupuncture style. You will learn to evaluate and treat patients using modern Japanese acupuncture techniques that link classical Chinese theory to concrete, understandable clinical diagnostic and treatment techniques. Strong emphasis is also placed on developing a neuroanatomical understanding of pain modulation with acupuncture.

“Neuroanatomical understanding of pain modulation with acupuncture”? Are they serious? Remember what the supposed basis of acupuncture is. It has nothing to do with neuroanatomy. It has everything to do with prescientific notions of “life energy” or qi, and how sticking needles in into various “meridians” is able to “unblock” the flow of qi. It has nothing to do with science or scientific medicine. Don’t believe me? Take a look at the course objectives:

  • Integrate acupuncture diagnostic and therapeutic techniques for managing pain and other medical conditions into your clinical practice.
  • Apply neuroanatomical approaches to pain modulation with dry needling as an adjunctive treatment technique.
  • Understand the methodological problems with current clinical research in acupuncture.
  • Advance your clinical research skills with a solid grounding in both the practice and science of acupuncture.

Understand the methodological problems with current clinical research in acupuncture? I don’t need, nor does any clinical researcher who takes the time to pay attention and learn, what the methodological problems with current clinical research in acupuncture are. I’ve written about them extensively, for example, here. Inadequate blinding, inappropriate placebo controls (or, all too often, no placebo controls at all, and bad design are rampant in trials of acupuncture, and the more poorly-designed the trial, the more likely it is to be positive. And, again, I ask: What on earth is the “neuroanatomic” basis of acupuncture? Even if acupuncture were effective above and beyond placebo effect, you could scratch the “anatomical” part and just call it neurological. That’s because sham acupuncture in which the needles are placed in areas that are not “meridians” through which qi flows. Worse than that, neither sham acupuncture or “real” acupuncture are any more effective than placebo acupuncture, in which special retractable needles are used that fool the patient into thinking he’s having acupuncture but don’t actually penetrate the skin.

That it refers to the “science” of acupuncture is perhaps the most irritating part of this brochure. There is nothing that I can see that’s the least bit scientific as far as the concepts underlying acupuncture. It’s possible that it may have some effect as a counterirritant or through causing the release of endorphins, but the evidence supporting such concepts are fairly weak. Not that that stops Harvard:

This course will include an introduction to traditional Chinese medicine with special emphasis on developing an understanding of its practical application to clinical care from a Western perspective. Emphasis is given to “hands-on” point location and needling techniques based upon palpatory feedback, familiarization with the meridian pathways and organ pathology. The topics of this course will include the following:

  • Pain Control
  • Hormonal Imbalances
  • OB/GYN Problems
  • GI Disorders
  • Scar Treatments
  • Structural and Orthopedic
  • Problems
  • Cardiac and Vascular Disorders
  • Autoimmune and Autonomic
  • Disorders
  • Mood Disorders
  • Auricular Acupuncture
  • Myofascial and Neuroanatomic Treatment

Yep, that’s right. Even though there’s no scientific basis or suggestion that meridians even exist, Harvard’s going to teach about them.

If this course actually taught a skeptical, scientific, and critical approach to complementary and alternative medicine (CAM) modalities such as acupuncture, I’d have no problem with them. That would be great. Unfortunately, what this course is is yet another in a line of courses taught by practitioners and credulous believers. No critical thinking towards acupuncture appears likely to be taught. After all, no one’s going to spend $6,500 for a course, even if he can write it off on his taxes, to learn skepticism for woo. No, people taking this course want to learn how to practice woo, so that they can “integrate” scientifically highly implausible modalities for which there is little or no data to support them with scientific medicine.

Actually, even though I’m not at a hoity-toity, Ivy League university and medical school, I can feel a bit of schadenfreude too. While it’s true that I may be at a mid-level to upper-mid-level medical school, I can now proudly say that my university has it over both Harvard and Yale in one thing.

I’ve yet to be able to find anywhere near as much quackademic medicine here.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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