Sunday, December 28, 2008

Top 10 issues in hospital medicine for 2008, issue 10: How should hospitalists respond to the pseudoscientific invasion?

Suppose an integrative medicine consult service is introduced at your hospital with plans to offer Therapeutic Touch, Reiki, acupuncture and Tai Chi. You are the medical director of the hospitalist program. The CEO, knowing that your program accounts for most of the consult requests and hoping for a nice revenue stream from the new service, asks for your support. What do you do?

While integrative medicine programs commonly offer harmless treatments whose modest benefits are self evident (relaxation modalities, music therapy) these tend to be mixed with other claims which are scientifically unsound. As hospitalists we are (or claim to be) all about ethics and scientific integrity. As quackery spreads throughout mainstream academic and community medical institutions like cancer the individual hospitalist is increasingly likely to confront the issue.

At the organizational level there has been little discussion. I have attended one hospital medicine course sponsored by a large academic institution which promoted non-evidence based alternative medicine. The Society of Hospital Medicine has been silent. It’s time to take a stand.

Tolerance for the promotion of quackery in mainstream medicine is a violation of fiduciary duty.

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