For the sake of completeness though, I’ll point out that David Gorski has pointed out that Murthy has connections to “complementary and alternative medicine.”
What worries me about Dr. Murthy is his connection to so-called “complementary and alternative medicine” (CAM), otherwise known these days as “integrative medicine.” My skeptical antennae started twitching when I saw that Dr. Murthy has been serving on the U.S. Presidential Advisory Council on Prevention, Health Promotion, and Integrative and Public Healthsince 2011, along with Dr. Dean Ornish. (Come to think of it, it’s disturbing that President Obama would have appointed Ornish to such a committee.) Also on the council is Janet R. Kahn, PhD, who is described as a having been a “Faculty Preceptor in the Fellowship Program in Complementary, Alternative, and General Medicine at Harvard Medical School” since 2000 and having served on the National Advisory Council for Complementary and Alternative Medicine at the National Institutes of Health since 2009. You know who also serves on that particular advisory council? Brian Berman. There’s also an acupuncturist, Charlotte Kerr, on the U.S. Presidential Advisory Council on Prevention, Health Promotion, and Integrative and Public Health.
And Murthy has spelled it out.
More concerning is what Dr. Murthy said in this article, published in Harvard Magazine in 2003:
Murthy’s combined expertise in medicine and business (and he still might pursue an advanced degree in public health) makes him well qualified to follow through with one of his dreams: to develop a system that provides proven, affordable, integrated (traditional and alternative) healthcare in a standardized fashion.
His interest in alternative medicine stems from his own cultural background—both his parents emigrated from India. Although he grew up in Miami, Murthy’s frequent visits to his parents’ homeland allowed him to witness that country’s ancient art of healing, Ayurveda (Sanskrit for “the science of life”). “I have tried various alternative medical therapies myself,” he reports, “and I have found that many alternative modalities are based in principles that make sense, and seem to frequently be effective with patients.” Research in recent years has made important strides in investigating alternative medicine in the United States, Murthy says, but much more needs to be done, and he would like to be a part of that process.
Oh, dear. “Based on principles that make sense?” That’s the sort of thing no physician whose practice is science-based should ever utter about Ayurveda or other “alternative medicine.” He also seems to have been prone to the same sorts of deficits in reasoning that lead all too many people to confuse correlation with causation or placebo effects for real effects.
So he should be questioned about that. Seriously questioned; probingly questioned.
In my perfect world, if I were a Senator asking Dr. Murthy questions, I wouldn’t ask so much about Medicaid, Medicare, the ACA, or other health policy. Well, I would, but that wouldn’t be my primary line of questioning. I figure that Dr. Murthy has political views compatible with those of President Obama, otherwise President Obama wouldn’t have appointed him. Presidents rarely appoint people with highly incompatible views to theirs to positions that are very public, like that of the Surgeon General. What concerns me more is that the Surgeon General should be a voice of science-based medicine, even if it means bucking the prevailing views, existing government policies, the pharmaceutical companies, whatever. Think of the Surgeon General in 1964 warning that cigarettes cause cancer, even though cigarettes were popular (not to mention extremely profitable) and the tobacco companies were doing everything they could to bury or counter the developing body of evidence linking smoking tobacco to lung cancer and heart disease. What we don’t need is a Surgeon General who will be a voice in favor of the ongoing pollution of science-based medicine with quackery.
I’m down with that.
Ophelia, for what it’s worth, I know Janet Kahn personally. She contributed a chapter to my book and I’ve worked with her on some committees and such related to massage therapy research and such.
You know I’m critical of so-called “CAM” but the fact of the matter is if one wants to do any work on a topic that NIH has designated as CAM, such as massage therapy, the grants one might pursue are going to come from NCCAM.
There is a lot more I could say about the problems associated with the CAM label, but mostly I wanted to point out that not everyone who has worked in or with an organization containing the “CAM” label is a quack.
Okay, I’m sorry, but I have to call BS here. Not all alternative medicine is quackery. Treatments born outside a lab, midwifed by people not wearing white lab coat, can be effective.
Homeopathy? Granted, placebo effect. (Note about placebo effect: it’s free of side effects and worth harnessing if we could do so harmlessly and reliably.)
Dandelion tea? Measurable effect on liver function (as in, measurable in a lab). Not remotely woo. But would it be labelled alternative? Yes, it would. Aspirin started its life as an old wives’ tea made from willow bark.
Acupuncture: measurable effects in the lab. Explanation? None. “Alternative”? Yes. So what? Who cares what the label is? It works for some conditions and some people. Which, by the way, is all you can say for many clinical drugs, where the doctor has to find the treatment that works for you.
A lot of Ayurvedic medicine is herbal, with obvious, lab-measurable, effectiveness. A lot of it is lifestyle advice to get better nutrition. That part is not woo. Other parts are highly woo.
And so forth and so on and so forth. It is in the finest tradition of foolish skepticism to say, “Not scientific! Off with its head!” without paying attention to the actual treatment involved. (That, by the way, is a classically non-scientific attitude.)
You do actually have to know something about the subject to be able to evaluate the medicine, alternative or otherwise. That’s why a place like Harvard actually pays someone to do just that. They don’t have a Dept. of Astrology. They don’t study pure bunk. But they do study alternative medicine. That’s because, if you know anything about the history of medicine, many of the best remedies and treatments have come out of what were originally “alternative” traditions. Bunk has come out too, of course. One has to distinguish between the two. It is not enough to say, “ZOMG! Tainted by something I think is woo! Throw him out.” Any more than it would work to say, “ZOMG! Alternative! Must be good.”
@1 You know what they call alternative medicine that’s been proven to be safe and effective? Medicine.
If something is still under the alternative banner, it has either never been tested for safety and effectiveness (often because practitioners refuse to participate in or pay for such testing) or because it has been tested and failed spectacularly.
Any treatment that relies on the placebo effect is lying to patients. Deception of patients is a violation of medical ethics regardless of the motive. In the case of homeopathy, it rise above deception to outright fraud.
Not to mention that, as Dr. Gorski often points out, the trend to branding perfectly valid nutrition, dietary, and exercise suggestions as forms of ‘alternative’ medicine is part of the problem, allowing them to claim far more people are using ‘alternative’ treatments than actually are.
Christopher – oh, thanks for that. Point taken.
It seems bizarre to treat items like massage therapy and homeopathy as the same kind of thing.
Ophelia: Chalk it up to politicians Not Getting Science. If they did, they’d be aggressive about funding research into common CAM claims, and then following up that research with appropriate bans on practice where the procedure has been demonstrated as ineffective.
There’s a fuzziness to the common-use definition of the placebo effect that needs to be addressed here. There’s two broad sorts:
1: Purely subjective experiences, such as pain, fatigue and mood-alterations, can be heavily affected by patient attitude in some cases. There’s some evidence that some people can benefit in this arena by placebos.
2: Objective measures of healing, however (say, bone density in an osteoporosis patient, or tumor size) have NOT been shown to be affected by such things. Instead, any improvement in them actually turns out to be the first category–the patient thinks they should be better, their experience of the pain and fatigue is thus reduced, but the underlying condition is still in the same situation.
There’s almost no way to effectively harness Type 1; Type 2 is simply ineffective.