Back to basics–while NIH parties like it’s still 1998

I showed you how the National Institutes of Health’s Center for Complementary and Alternative Medicine (NCCAM) has turned its back on one of the core tenants of its original mission. To research the cost-effectiveness of integrating complementary/alternative medicine (CAM) into the healthcare system.

And, in fact, according to the source report, published in the British Medical Journal, there’s relatively little high-quality research on this topic world-wide.  While common sense would dictate that simple, safe, non-invasive therapies like CAM would be less costly than dangerous and expensive mainstream medical therapies, the Mandarins of Medicine always demand “where is the proof?”  So, in 1998, Congress gave them the mandate and money to prove it by their own standards. And then they promptly turned their backs…as we reported yesterday.

But, the news isn’t all bad. The report did find over two dozen high-quality studies that prove that complementary and integrative care is more cost-effective.

And it just so happens that those therapies that were found to be most cost-effective are ones that could have a direct and massive positive impact—for patients, their doctors, and the healthcare system overall. The therapies are:

  • acupuncture for breech delivery
  • acupuncture for low-back pain (most common cause of disability in working Americans)
  • spinal manual therapy for neck pain
  • natural products, such as herbal and nutrient dietary supplements for many common medical conditions
  • the “wholistic” practice of naturopathic medicine for management of chronic low back pain—treating the whole person instead of just their spinal columns

So if you or someone you know is struggling with any of the above conditions, the research is clear…it’s more efficient, effective, and affordable to incorporate CAM into your treatment.

This is only a short list. But if all 338 studies that were reviewed in this report were of the caliber that’s demanded by the mainstream…the results in favor of CAM would be even more staggering.

And once again, a quick look at this list immediately brings to mind several other critical questions for the entire direction of NIH research.

For example, the NIH has been laser-focused on trying to understand the mechanism of action of acupuncture. In other words, they’re determined to identify how acupuncture works in the body. Despite thousands of studies observing that it does work, the Mandarins of Medicine still insist, theoretically, that it can’t work.

Researchers have theorized that the micro-skin puncture of acupuncture needles somehow affects pain pathways, or releases the body’s own endorphins. Endorphins are natural pain-killers. And while I respect and share the interest in exploring this theory…it’s not likely to contribute anything of a practical value when it comes to applying whatever is learned on a clinical level.

Consider the top of the list—acupuncture for breech delivery. Research has shown that an acupuncture needle placed in the toe along the bladder meridian will immediately reverse a breech presentation over 80% of the time in women in labor. This saves dangerous complications to the mother and newborn and large costs in terms of obstetric management and dangerous manipulations (which have been a major cause of cerebral palsy for example). 

This has been known to nurse-midwives for decades, and was published in a special issue of the Journal of the American Medical Association in 1998 and has been consistently replicated and now cited in textbooks. But the NIH’s theoretical “mechanism of action” for acupuncture (that it affects pain pathways) couldn’t possibly apply for such cases. And acupuncture is yet to be accepted widely into obstetrical practice.

Of course, the NIH had told Sen. Specter (who was working with me and Sen. Harkin on funding CAM research back in 1998) that they “don’t believe in bio-energy.” So any bio-energetic explanation of acupuncture, which is what most knowledgeable CAM researchers believe around the world, could not possibly be considered in the “real world” according to NIH. 

Or, consider the last on the list—“wholistic” support for low-back pain. That simply caring for the whole person can have health benefits beyond, but including, the chief medical complaint itself. An approach that is still met with skepticism by most of mainstream medical researchers—and shortsightedly dismissed as simply the “placebo” effect. This of course is just another way of dismissing altogether the body’s own powerful self-healing abilities. 

What’s more, I was principle co-investigator on a project from 2002-2007 which analyzed over 700 studies proving that spinal manual therapy (chiropractic) is safer, more effective, and more cost-effective than regular medical or surgical care. This was after a study in the Archives of Internal Medicine in 1998 found essentially the same thing.

As a result of these findings, I tried to help get the ball rolling in an invited editorial that accompanied the published research. My editorial began outlining what the healthcare system would have to do to begin making safer, more effective, and less costly care available to all Americans. Including training more health professionals to use these techniques or to refer to other health practitioners when appropriate. 

But alas, I was premature…and the NIH failed to listen. Since the NIH wants to keep repeating the same studies over and over again when the answers don’t seem to match with their theories or agendas. So, why does it seem like it’s 1998 all over (and over) again?

Fortunately, there is plenty of good news in the list above.

Especially the fourth bullet in the list. This research is essentially consistent with the results of thousands and thousands of studies proving the safety and effectiveness of simple, inexpensive dietary supplements. For all sorts of ailments. And most supplements today are safe, affordable, and in fact something you can’t afford not to do.

Herman PM, Poindexter BL, Witt CM, et al. “Are complementary therapies and integrative care cost-effective? A systematic review of economic evaluations.” BMJ Open 2012;2:e001046.
Mayor & Micozzi, Energy Medicine East and West, London & Edinburgh: Elsevier Health Sciences, 2011