Leave the Sinking Ship

Andrew Weil, MD and Rustum Roy, PhD also contributed to this article.

On December 26, 2008, the Wall Street Journal published "The Touch that Doesn't Heal," an article by Steve Salerno. Without discernible professional credentials in health reportage, the writer opened his piece by pledging allegiance to "scientifically proven, evidence-based medicine." He next declared opposition to integrative medicine, and characterized as "gurus" two proponents of integrative medicine, Deepak Chopra and Andrew Weil, choosing to overlook that we both are highly trained MDs with almost 40 years of clinical-experience. Joining us in our response is Rustum Roy, an internationally known scientist, and member of five major National Academies of Science Engineering, who has spent ten years researching a wide range of health technologies, both ancient and modern. We predict that while they may try to dismiss us, the Wall Street Journal writer and editors will find they can't dismiss a burgeoning field of medicine currently saving and improving millions of lives worldwide.

We believe that Salerno's piece is the opening salvo from the right aiming to influence the incoming administration as it strategically allocates resources for improving the U.S. health and wellness system. Fortunately, Tom Daschle, the upcoming Health and Human Services Secretary is better informed than either the WSJ writer or those who dictate WSJ editorial policy. The co-author (along with Jeanne Lambrew) of Critical: What We Can Do About the Health Care Crises, Daschle names the principal challenge to true reform, "[S]pecial interests are especially numerous and influential in the health-care system. Health care comprises one-sixth of our economy... since cutting costs is tantamount to cutting profits for many of these special interests, it is reasonable to expect (an) all-out war to defeat reform."

As in Mr. Salerno's article, this war extends to advancing ill-informed pseudo-scientific arguments to discredit effective low-cost health care options precisely because they compete with the current high-cost system.

"There are many factors driving up health care costs," writes Daschle. "One problem is that 'supply side' forces exist in our health-care system. Physicians both diagnose and treat illness - in economic terms, they create and satisfy demand. . . . Conditions such as 'restless leg syndrome' weren't conditions until drugs were developed to treat them."

In his article Mr. Salerno acknowledged several factors in America's present health care crisis: "disenchantment" over spiraling costs, a bloated bureaucracy, and ''possible drug side effects."

While these clearly demand attention, he overlooks the crisis' principal cause: The poor results of the present health care system. Numerous surveys show that for all its bank-breaking expense, the American medical system lags behind the rest of the developed world in most health indicators.

Nor does it sustain a doctor's sworn duty to "first do no harm." Abundant evidence uncovers high-tech medicine, with its powerful drugs, as a major, possibly the leading, cause of death in this country. The National Academy's data attributes 100,000 deaths per year to physicians' errors, added to well over 100,000 deaths due to severe drug interactions and another 100,000 fatalities from hospital-based-infections. (For a detailed analysis, see Death By Medicine, by Gary S. Null, et al.)

Why is the allegedly "scientifically proven" health care that the WSJ writer champions so dangerous to health? The blind allegiance to "evidence-based medicine" overlooks how readily this form of research can be manipulated. It was first developed to isolate patentable agents for drug formulations. In scientific arenas outside of mainstream medicine, this "statistics-based medicine" is regarded as dubious science at best. Narrowly confining itself to costly, selectively published, industry-sponsored clinical trials, to promote pharmaceutical products, "evidence based medicine" is the marketing "icon" used by the current system to squelch lower cost competitors.

Science's only gold standard are facts derived from reproducible results, however unpalatable those facts are to current theory. When theories fail to explain the facts, they lose viability. The spectacular failures of "evidence based" medical theories include the millions spent on ineffective AIDS vaccines, the collapse of interferon as the wonder drug for cancer, and the marginal decrease in cancer deaths despite billions wasted during decades of fruitless research. Many once-standard treatments devised via this theoretical model now stand discredited, like the use of Thalidomide and Thorazine.

As Mr. Salerno and his editors stand bullish on the persistent investment of health care dollars into a model with runaway costs, poor results, lack of available personnel, and questionable science, we are convinced America can do better. Over the last three decades, millions of Americans, and a dedicated group of physicians and practitioners have front-line, hands-on experience with integrative health care. Via concerted research and clinical practice, international scientists and practitioners, have progressively uncovered the root causes and the most effective treatments for health maintenance and restoration. This is science's cutting edge.

Yet like both the mainstream medicine and media, Salerno remains stubbornly ignorant of this vast field, which Daschle and the Obama Administration will undoubtedly consider before allocating billions more to the present, failed, high-cost medical system.

One sine qua non for any future sustainable U.S. health system is the necessity to empower, rather than undercut each citizen's right to choose health care and take responsibility for his/her own wellness. Countless chronic diseases result from the neglect of basic wellness measures. The blame for underutilizing such proactive, cost-saving approaches lies directly with the official policy of blind reliance on drugs and surgery, whatever the cost. The public has been lulled into medical apathy on the false assumption that if something goes wrong, fix-it mechanics will tune up your body the way a garage tunes up your car.

A new integrative medicine system would marry the superb options of high tech emergency care, its brilliant surgical achievements, the tried and least harmful pharmaceuticals, by empowering and educating its citizens to maintain wellness and prevent disease, through improved nutrition, exercise, stress-management, and a wide range of other proven integrative approaches. Sadly, mainstream medicine largely ignores these viable health approaches, because they're not financially lucrative.

To increase competition, reduce costs, and improve outcomes, we recommend that Daschle and his team move toward a more humane, sustainable, and effective health system through the wider adoption of integrative health options. And we invite the Wall Street Journal and its staff writers to board the lifeboat of integrative health, rather than go down with the Titanic, in yet another failing business sector--healthcare.

Comments

[juliaschopick]

Thanks for exposing the downside of so-called “scientifically proven” healthcare: the frequent manipulation of “evidence-based” research, and the fact that “‘evidence based medicine’ is the marketing ‘icon’ used by the current system to squelch lower cost competitors.” You’re right: “Science's only gold standard are facts derived from reproducible results, however unpalatable those facts are to current theory.”

My late husband and I had a terrifying experience in 2001 with his non-healing suture line, following brain tumor surgery. After his doctors performed eight additional surgeries in vain attempts to effect healing, I found (through a physician colleague) a treatment, FDA-approved for all non-healing wounds, that worked. Unfortunately, by then, my husband was already severely brain injured, as a result of having undergone the additional surgeries.

His doctors' response? They refused to believe it was our “ANECDOTAL” treatment that had worked! A few swore it was Vancomycin (my husband had been on it for six weeks) finally “kicking in.”

I wrote about this, and three other treatments with “reproducible results.” In all four cases, the patients' doctors REFUSED to believe the treatments work, because they have not undergone double blind randomized clinical trials. (Of course, all four treatments were too INexpensive to warrant pharmaceutical companies funding trials.)

My article, “Four Lifesaving Medical Treatments: Not So ‘Anecdotal,’ After All!” is at http://www.honestmedicine.com/2008/05/four-lifesaving.html .

Julia Schopick
http://www.HonestMedicine.com

[blood1]

As a retired healthcare worker, I was always amazed at the number of large ziplock bags of medicine that were brought by patients being admitted to the hospital.

American healthcare has been co-opted by the nature of our culture - we want "instant cures" and don't want to take any responsibility for what ails us.

Big Pharma has come in to fill that void, but they are not alone, radiology has developed technologies and laboratories have developed new tests to meet these real or perceived needs - all at a huge costs.

As a proponent of universal healthcare, individuals need to take some responsibility for their own health, nothing to dramatic, just some common sense like cutting down / out junk food, walking around the block or instead of driving through a parking lot for 20 minutes looking for spot close to the door, turn off all your Ipods, cell phones, etc and listen to the quiet for an hour a day - hear yourself think!

There are good ways and bad ways to receive healthcare and it starts with individuals taking some responsibi­lity...and when offered "tests" or "drugs", ask if it is REALLY necessary. Once individuals understand that much of the medical information "you think you need to know" will have no effect on treatment, why should anyone but YOU pay for that? - not insurance providers of any kind!

[CommonSense-Paine]

A Key Element for personal success is "First, Do no Harm," Hippocrates's Law. So upon reading of this in the article, I found the following which is a fantastic summary of the art of medicine with perfect relevancy to the current sad state of affairs...
The Law of Hippocrates: Medicine is of all the arts the most noble; but, owing to the ignorance of those who practice it, and of those who, inconsiderately, form a judgment of them, it is at present far behind all the other arts. http://www.geocities.com/everwild7/noharm.html
The Wisdom of Thomas Paine is also relevant and poignant. "A long habit of thinking a thing not wrong gives it a superficial appearance of being right."
So, my dear friends, it's human nature to deny the truth but we must push on. This has always been the struggle of the day, since the dawn of inspiration. As Ghandi said, "The Truth is always revealed, ALWAYS!"
And finally, again from Paine. "It is error only, and not truth, that shrinks from inquiry."
So PRESS ON!!! We are approaching critical mass, the Tipping Point, the 100th Monkey!

[LaniMuelrath]

Hi Deepak, and all....

This sentence jumps out at me:

"Conditions such as 'restless leg syndrome' weren't conditions until drugs were developed to treat them."

It simply underscores how modern "health" care in our country is driven by the pharmeceutical companies.

It has long been a frustration for me that, as a wellness educator and holistic fitness coach, all that I do and encourage others to do regarding self-care in health is actually undermined by the lack of support from the health care industry. Putting legitimacy on Integrative Medicine - a great term, I might add - and social support can only help create a better balance in our system.

We continue to face the obstacle of the fact that there is "no money" in advising good, simple food and solid, regular exercise along with rest and stress reduction.

Thanks for an article well written - and I appreciate as always one that digs for the truth!

Lani Muelrath
http://www.thetruthaboutfatlossforwomen.com

[schatsie]

Thank you for this wonderful article...please consider reading the STATUS SYNDROME by Marmot... The Whitehall study is a goldmine of epidemiology and very interesting with regard to the chronic diseases...

[Artemis34]

I immigrated to Canada. I could not wait for my homeland to change, I changed my homeland.

I was amazed; I felt a great weight was lifted off of me knowing I had care I could count on. I felt melt away the worry of losing health care due to a job loss. I was no longer frightened of seeing every penny I’d worked so hard for all my life disappear in trying to treat an illness or injury. We all know people who’ve had their lives shattered.

Just knowing that I had national heath care that would not be denied me or jerked away from me when I most needed it was itself healing!

The tremendous relief from stress that I felt and continue to feel has significantly contributed to my health and I’m feeling better and healthier each day.

I wonder how many Americans could be healed by being released from this onerous burden. I wonder how many people, knowing they could get care when they need it, would feel they don’t need it.

[Artemisinthecity]

Hi Deepak - I started a holistic health and nutrition services business last year and I want to thank you for writing this article.

In 1996, I was chronically ill. That year I saw over 20 different physicians looking for help. During that time I was treated with multiple medications. Nothing helped me get well. I gained over 20 pounds and felt awful!

Eventually I was diagnosed with connective tissue disease and then I was later diagnosed with fibromyalgia. I was given no other hope but medications to try to alleviate the painful symptoms.

But I did not give up. I chose to take control of my own health and conducted my own research into alternative dietary theories. Within two months of changing my diet all of my severe arthritic pain was gone.

For more than 10 years I have experienced excellent health. Successfully healing myself forever changed my relationship with food.

I firmly believe in the healing properties of whole foods. I am hopeful of an integrative health care system, but we are far from that. I am a former employee of a leading hospital in the US. I have contacted many of the physicians that I knew while there. They have been non-responsive to my communications. It is a shame because there are many people that need services like mine that can help them recover from serious illness.

I mentioned your article in my latest blog!
http://www.artemisinthecity.com/node/182

Thank you!
Danielle Heard, MS, HHC

[Bellanova]

Salerno also wrote an interesting response to Chopra's response to his WSJ article--it can be found here:
http://blog.beliefnet.com/choprafamily/2008/12/leave-the-sinking-ship-an-open.html

[Bellanova]

The author of the Wall Street Journal piece, Steve Salerno, has an interesting blog you may want to visit:
http://shambook.blogspot.com/

While I agree with many of Chopra's arguments, I think that Salerno's call for evidence in the "alternative" medicine sector is justified and should not be dismissed. Any kind of "cure" needs to be studied and documented and replicated if we are to consider it seriously. The risks of adverse reactions are equally applicable to the "alternative" methods, so these methods should not be accepted uncritically.

As to the awesome power of the mind that some have remarked upon here, well, there appears something to it, to be sure, but let's not lose perspective. One poster quoted Chopra saying that "if one doc tells you you are going to die, find another doc." That may have a nice ring to it, but eventually we are all going to die of some disease/bodily malfunction, no matter how many "positively thinking" docs may tell us otherwise. There are limits to positive thinking's powers.

[Artemis34]

There is a ton of science based evidence and research around the world on what we call things like "alternative" medicine.

The Germans use natural and herbal remedies in the standard practice of medicine and no one accuses the Germans of bad science.

While we're looking at scientific methods, let's not leave out a proper cost - benefit analysis. Solutions in the US are improperly skewed toward the higher cost solution that can be patented or supply artificially curtailed.

[mcostello]

There is some great research out there for alternative medicine, but there is not the financial backing for it that leads to the larger studies. As long as there is not a multi-million dollar profit motive for alternative medicines like acupuncture we will just have to depend on the word-of-mouth and "voting with their feet" methods that are driving the market now.

and mainstream medicine will continue to shoot themselves in the foot with the profit driven model that causes so many tragedies today.
Unfortunately, we all pay the bill through medicare, insurance costs, and other hidden costs like the $2500. per car that GM pays in medical cost for their employees and retirees.

[schatsie]

Mainstream medicine has sat on the sidelines with regard to the increase in Autism and the increase in Asthma...both are environmental and we need universal healthcare to track what is happening to these precious children...I in 80 families has an autistic child, how many asthma families... This is a tremendous drain on the parents and siblings...and is a drain on the working families productivity at work... and then our corporations take away the 2 weeks of sick care so that these children can be taken to the doctors...

We need to know now what is causing the autism??? this is worse than Love Canal...

[squinky]

Acupuncture has been PROVEN to be nothing more than the placebo effect. How? These best study was using "sham" needles that were covered with a sheath such that the patient couldn't tell whether the needles pierced the skin or not. Result: authentic acupuncture was the same as sham acupuncture.

I won't go into why the placebo effect should not be exploited as a therapy even though it has real and measurable benefit to patients.

Meditation is proven to relieve stress and make people happier, but treat disease? I'm not so sure. Anyway, why should insurance pay for your meditation--do it yourself!!! Why should insurance pay for massage or homeopathy or any of this stuff when they won't reimburse for proven treatments or over-the-counter medication for that matter?

People like yourself mistakenly think that ancient Chinese "remedies" are still used in China today because they are effective. This is erroneous thinking. Much of China doesn't have modern health care so desperate people seek desperate measures and hand down BS over generations. We have our own: honey for a cold, put a steak on your black eye, etc. Iron age medicine practiced in antiquity by shamans on desperate, suffering people is hardly a convincing testimonial to the effectiveness of a treatment. Double-blind placebo-controlled clinical studies will dispel the myths and already has: nearly all of them!

[Artemis34]

In the study you mention, no qualified acupuncturists were involved, so it is not surprising that their results with real and 'control' needles are the same. If you have an interest in the outcome (if you are biased), you can design the experiment to 'prove' your point.

I'd like you know where you have lived around the world. I bet you have not lived outside the US. If you had been exposed to health care in Europe, Asia, Latin America, etc. I would bet you would have enlightened ideas. Not the bias you display here.

If the US methods were so clearly superior, they'd be adopted around the world which they are not.

[squinky]

I have not lived outside the US but being a scientist, I can judge the merits of scientific inquiry by reading journal articles and decide for myself what treatments are on firm footing and which are not. That's the beauty of science: it doesn't matter if you live here or in Sri Lanka or Ireland--facts are reproducible. Acupuncture's claim to treating people is at BEST, minimal. See: http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html

"You can design the experiment to prove your point". This is rubbish. Extraordinary claims require extraordinary evidence. Thousands of testimonials do not formulate the truth. Wishful thinking is part of human nature.

"If the US methods were so clearly superior, they'd be adopted worldwide"
There are Arty, but it requires a lot of money to do high end medicine and not all countries can afford it. MRI was invented in the US (nobel prize winning) and transformed medicine. How many countries can maintain and pay (and screen patients) using such expensive technology: few. Actually, I would turn your inane argument on its head: if cheap and scientifically proven dietary supplements or acupuncture or massage was so effective, Americans would be clamoring for it rather than spending so much on health care but they are not.

I believe America does have lessons to learn from other countries health care systems including cost containment measures, much better maternity management, and better engagement with patients. Countries should be considered on a case by case basis (not China).

[SharonWantsToTalk]

You really don't know anything of which you speak. You mock meditation as only a reliever of stress. Stress breaks down the bodies ability to fight disease. There is plenty evidence of this fact in the journals of the conventional medicine you defend here.

[dctackett]

my mother-in-law is a nurse practitioner, and the clinic she used to work at would always have drug reps showing up, providing catered lunches, bringing birthday and holiday gifts... I always thought, this is one small clinic out of thousands, they are just wasting billions of dollars...

it's a good think that my mother-in-law is the type that is very suspicious of these people and always does what's best for the patient.

we need universal health care... health, basic food and basic shelter should be universal.

[Skeetshooter]

I've spent a few years overseas and been exposed to the socialized medicine of Europe. With somewhat limited resources, they heavily emphasize preventive medicine in order to forestall or prevent catastrophic illness. They see health care not as a privilege but as a right, and take a skeptical view of for profit medicine.

In the US I find the drug companies, whose profits are primarily in treating chronic illness, have steered national health policy toward treating the symptoms of disease rather than it's causes. This may be profitable for those companies, but do we really want them profiting from our chronic suffering?

Clearly, what is good for big pharma is not always good for the public at large. Now that we have limited resources like the rest of the developed world, we must accept that and act in accordance with our new reality.

[squinky]

Articles like these are annoying because they villify "Western" medicine (which is proven) in lieu of "Eastern", homeopathic, natural, holistic, mind-body-healing claptrap. What's the life expectancy in India, Deepak? Which chakra is misaligned when you don't take your tumeric or is it Chi that is out of balance requiring a few acupuncturists to work on you?

Nutrition only takes you so far in human disease. There are foodstuffs that are positively good for you: omega-3 fats, for example but the vast majority are pure B.S. Evidence the failed clinical trials of: vitamin C for cancer, green tea for cancer, ginkgo biloba for dementia, St. John's wort for depression, antioxidants for cancer, etc. While massage, aromotherapy, warm baths, chiropractice, and work-outs make you feel better, healthier , and happier they do not treat your disease.

There is much wrong with American healthcare but integrating a bunch of fluff-masq­uerading-a­s-remedy is not the answer. I don't want a single payer system. I don't want my insurance premiums paying for preventable disease: overeating (obesity, heart disease, diabetes, hypertension), smoking (lung cancer), lack of exercise (obesity, heart disease), etc.

Fast driving gets your insurance cancelled, so should fast-food eating!

[sfn8iv]

Let's not throw the baby out with the bath water. While I am a strong advocate of Western medicine there are Eastern practices that have merit. The Chinese have been using herbs and accupuncture for centuries. My healthcare provider, Kaiser Permanente which is the largest HMO in the US, is now offering accupuncture and meditation classes as treatment options.

[sfn8iv]

Read "Health Care Reform Now" written by George Halvorson, CEO of Kaiser Permanente. A quote from the book, "We really cannot achieve total health care reform in America until we have health care coverage for every American."

[coldwatermd]

If your regular doctor dismisses alternative medicine methods and practitioners, change your doctor. If your alternative practitioner does not want to work together with your regular physician, drop the practitioner.

Chopra and Weil are excellent examples of Western-trained physicians who dare to look the limitations of Western medicine in the eye. We need both kinds of knowledge - and compassion.

Alexa Fleckenstein M.D., integrative physician (board-certified internist), author.

[CindyMax]

Thank you, Dr. Chopra for your continuing efforts to broaden the public's knowledge concerning health. Many Americans have been brainwashed into an unhealthy dependence on the so-called health care system we have now.

Offering tax incentives and easily accessible guidelines for citizens to take a more proactive approach to wellness could induce more of them to take responsibility for their health.

I have several family members who take many prescribed medications that they admit do more harm than good. They are also completely dependent on their doctors for solutions to their chronic ills which invariably include more medication and hospitalization. At present there are no incentives for them to change -- they do not trust "alternative" means to address their problems. They see that I'm healthy, having sought information and taken responsibility for my health, but they need a more tangible incentive to overcome their inertia.