“Wishing wellness” (Cleveland Clinic)

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Last month, the director of the Cleveland Clinic’s Wellness Center, Daniel Neides, publicly condemned vaccines. This brought a quick response from clinic leadership that vaccination is effective and that Neides would be disciplined.

Good for them. However, the Clinic has become synonymous with the embrace of supplementary, alternative, and complementary medicine (SCAM). It makes an exception for the anti-vax positon not because it is a dangerous notion, but because of public relations and profit reasons.

The Neides screed was bad publicity for the Clinic because, despite the terrifying increase in anti-vaccine illogic, pro-vaxxers remain strongly in the majority. As to the profit motive, the academic and medical institutions that embrace SCAM tout it as an avenue for offering more choices to the customers. But the only alternative to taking a vaccine is to not take it. There is, for instance, no sage root recipe that these institution’s resident witch doctors offer to prevent whooping cough. Even hard-core anti-vaxxers usually have no product to sell, but instead encourage allowing children to “naturally” encounter typhus, mumps, and polio.

So while distancing his organization from Neides’ proclamation, Cleveland Clinic CEO Toby Cosgrove makes it clear that he and his doctors will continue to embrace SCAM.

He parrots one of the most hackneyed SCAM lines about mainstream doctors failing to practice preventive medicine. He writes, “Smoking, poor diet, and lack of exercise were the leading factors that placed patients under my scalpel.” Clearly, no one would counter by recommending a steady diet of cigarettes, pork rinds, and the couch, so Cosgrove seems to take a reasonable position. 

However, he next writes, “The goal of the Wellness Institute is to focus on health care, not just sick care. Historically, health care has not done a good job of promoting disease prevention.”

Most untrue, insists Dr. Steven Novella of the Yale University Medical School. He writes, “All of the principles of preventive medicine, including the risks of smoking, the benefits of exercise, and the relationship of nutrition and diet to health and disease, were discovered and promoted within the paradigm of mainstream scientific medicine.”

Not only is Cosgrove’s accusation false, he uses that position as a justification for embracing quackery. To wit, Cosgrove wrote, “Acupuncture, yoga, Chinese herbal medicine, guided imagery, and relaxation techniques have scientific backing. We have heard from our patients that they want more than conventional medicine can offer and we believe it is best that they undertake these alternative therapies under the guidance of their Cleveland Clinic physician.”

Cosgrove does not provide us with any clinical trials or studies to support his claims about scientific backing. Acupuncture is in fact based on the quite unscientific notion of qi flowing through meridians. Yoga works well for increasing flexibility and can be an intense workout, but there is nothing to suggest it fights or prevents disease and sickness. Guided imagery and relaxation might well make one more mellow, but these techniques have no value when it comes to fending off eczema, dyspepsia, backaches, or any other condition.

Herbs might help in some situations, but ascertaining what effect they can have requires clinical trials and double blind studies, followed by an isolating of the active ingredient and putting it in cream, pill, or syrup form. Just swallowing some jasmine in hopes it will relieve rheumatism is guesswork.

As far as it being what the patients want, most businesses should indeed match their products with their customers’ desires. But medicine is an exception because the focus should be on making persons healthier. Doctors should strongly encourage patients to take what they need, not give them whatever unproven treatment they want. 

Cosgrove, however, happily does the latter. For instance, he embraces energy medicine, praising these “methods of healing that involve balancing and restoring the body’s natural energies for the purposes of increasing vitality, balancing emotions, and improving health.”

This describes vitalism, which reputable medicine discarded with the advent of Germ Theory. The clinic website specifically praises the Eastern faith healing practice or Reiki since its customers “find it helpful.” Promoting unscientific healing with anecdotes like this is a SCAM staple, and the clinic’s patients suffer for this line of thinking.

Cosgrove’s reason for offering these treatments is that “doing so is justified by the magnitude of the disease challenge. Not so, says Novella.

“Needing to prevent disease does not justify embracing pseudoscience,” he writes. “As we solve simpler medical problems, we are left with more and more complex ones. This requires an increased dedication to medicine that works. We know what is safe and effective because of careful, rigorous, thorough, and unbiased assessment of all available evidence.”

Indeed. The standard for determining what works remains laboratory research, clinical trials, and the metadata of double blind studies. Despite Cosgrove’s insistence, that standard has not been changed to a feel-good embrace of acupuncture, Reiki, untested herbs, and ocean sounds CDs.

 

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