Recently, doctor and television star Michel Cymes co-signed a column in favor of “integrative medicine”. It is a question of calling, according to the authors of this text, “to rethink human health, including for example alternative medicine practices, but in a structured and regulated way”. Yet in the realm of alternative therapies, few topics are more misleading than the much-hyped topic of “integrative medicine.” For its proponents, integrative medicine is based primarily on two principles. The first is that of “whole person care”, and the second is often called “the best of both worlds”. Attractive concepts? Only for those who don’t bother to examine them with a critical eye.
Global care or “holism”
Integrative health care practitioners, we are told, do not just treat a patient’s physical complaints, but care for the whole individual: body, mind and soul. This sounds appealing to patients and, on the face of it, this approach is quite commendable. Yet a closer look reveals major problems.
The truth is that all good medicine is, was, and always will be holistic: today’s family physicians, for example, should care for their patients as whole individuals, treating as best they physical problems as well as medically relevant social and even spiritual issues can. I said “should” because some doctors seem to overlook the holistic aspect of health care. If so, they are, by definition, not good doctors. And, if this deficit is widespread, we should consider reforming conventional health care, or revising its training.
To delegate holism to integrative medicine practitioners would be to abandon an essential element of good health care and do a disservice to today’s patients, at the expense of tomorrow’s health care. It follows that promoting integrative medicine under the banner of holism is complete nonsense. Either it is superfluous because it misleads patients into believing that holism is an exclusive characteristic of integrative medicine, when in fact it is a characteristic of any good health service. And if this comprehensive care is neglected or absent in a particular branch of conventional medicine, it distracts us from the important task of remedying this deficit.
The best of both worlds
Integrative medicine is often described as “the best of both worlds”. Its advocates claim to use the “best” of alternative medicine and combine it with the “best” of conventional medicine. Again, this concept seems laudable. But, on closer inspection, serious doubts appear.
They revolve around the use of the term “best”. We need to ask ourselves what the term “best” means in the context of health care. It certainly can’t mean the most popular or the most fashionable – and the term “best” is certainly not decreed by Charles III, who is probably the strongest advocate of integrative medicine in the world.
The term “best” can only refer to “the most effective” or, more precisely, “associated with the most positive and convincing risk-benefit balance sheet”. If we understand the “best of both worlds” in this way, the concept becomes virtually synonymous with “Evidence Based Medicine” on which modern healthcare is based. According to the principles of this evidence-based medicine, treatments must be shown to be reasonably safe and effective. When treating their patients, doctors must, according to the principles of evidence-based medicine, combine the best scientific evidence with their own experience as well as with the preferences of their patients. And if “the best of both worlds” is synonymous with evidence-based medicine, then clearly we don’t need the confusing duplicity that is integrative medicine; it would only deflect the promising efforts of “real” medicine to continually improve health care. In other words, the second axiom of integrative medicine is as absurd as the first.
The practice of integrative medicine
Based on these considerations, integrative medicine is therefore an unnecessary, misleading, counterproductive and ineffective distraction. But the most powerful argument against integrative medicine is actually a purely factual argument: namely all the insane, quackery, and dangerous things that are done every day in its name and under its banner.
If we look around, go on the internet, read relevant literature, or walk into an integrative medicine clinic in our neighborhood, we are sure to find that behind all these politically correct slogans of holism and “Brave New World” hides from pure charlatanry. If you don’t believe me, then go see for yourself. I promise you’ll discover every unproven and disproved therapy you can think of, from crystal healing to Reiki, and from homeopathy to urine therapy.
Already more than 20 years ago, I warned that integrative medicine could become a “carte blanche” for the use of “untested nonsense” in conventional health care; today, I sadly realize that my prediction turns out to be correct.
The dangers of integrative medicine
One could, of course, argue that using a little harmless quackery does not endanger anyone. Unfortunately, it is not the case. First of all, the often considerable expenditure for unnecessary treatments inevitably damages consumers’ bank accounts. Second, doctors practicing integrative medicine can put our health at risk in more direct ways. They have been shown, for example, to endanger public health by their often irrational and irresponsible attitudes against vaccinations. Another danger is that these practitioners replace effective conventional treatments with ineffective alternative therapies, for example when advocating the use of homeopathic products against infections, in the hope of combating antibiotic resistance. It is undeniable that such behavior can cost lives.
Conclusion
The conclusion to all of this is simple: integrative medicine is a facade behind which hides endless quackery and bogus treatments, which can endanger the health and well-being of unsuspecting consumers. A recent memorandum on the subject puts it succinctly: “Integrative medicine has no discernible potential for improving medicine; on the contrary, it creates confusion and entails considerable dangers. It cannot be in the interest of patients”.
Edzard Ernst, Emeritus Professor, University of Exeter, UK.