Sunday, September 09, 2007

Out with Pharma, in with Woo---AMSA’s agenda for medical education

In researching the activities of the American Medical Student Association I ran across a couple of items highlighting their efforts to influence medical schools with a double standard for evaluating mainstream pharmaceuticals and alternative medicine. An article from DOTmed news and this post from Health Issues Unmasked both appeared within the past couple of weeks.

The DOTmed news piece describes how AMSA is stepping up the efforts of its PharmFree Campaign to try and rid the academic medical environment of the effects of industry promotions:

"It is important that we work to keep our medical schools and teaching hospitals free of the influence of pharmaceutical companies," said AMSA National President Jay Bhatt. "PharmFree medical students become PharmFree doctors and that commitment to evidence-based medicine benefits our patients and our colleagues."

Read that again. Note he said evidence-based medicine. It’s all well and good until you read the Health Issues Unmasked post from just days earlier describing AMSA’s other big initiative for med schools that’s not so evidence based:

The American Medical Student Association (AMSA) Foundation has just ended a pilot study designed to develop a curriculum for including complementary/ alternative medicine (CAM) training in MD and DO programs nationwide. The study, conducted at six medical schools, was financed with a $1.2 million grant from the National Institutes of Health (NIH)-National Center for Complementary and Alternative Medicin (NCCAM).

That’s right, they’re getting support from NCCAM. They trumpet the fact that they eschew all pharmaceutical industry sponsorship, in the name of evidence based medicine, while accepting a $1.2 million dollar grant from arguably the nation’s most organized and powerful promoter of pseudoscience.

The Health Issues blog post links to the AMSA website for its CAM educational initiatives where their guiding principle is explained:

Medicine today is experiencing a paradigm shift that involves the blending of two disparate philosophies of health and disease, the biomedical or scientific reductionist view and the clinical, experiential holistic view.

But you can’t blend scientific methods with “disparate philosophies”. Science is what it is only because certain absolute rules apply to how we interpret observations. The scientific foundations of medical education are undermined when they are blended with pseudoscience and metaphysical presuppositions. Abraham Flexner, almost a century ago, referred to such presuppositions as dogma and warned that medical schools must not compromise science with dogma. Medical education, influenced by the AMSA and its accomplices at NCCAM, is turning its back on Flexner’s warning.


Paige Erin Hatcher said...
This comment has been removed by the author.
Paige Erin Hatcher said...

1 Comment - Show Original Post

Paige Hatcher said...
The intiative you spoke of is actually run through the AMSA Foundation, a completely separate entity. Again, I would encourage you to actually learn about the organization that you continue to attack. Your campaign against AMSA is unfortunate, but I wonder about your motives. Why would you constantly attack an organization filled with people that are really trying to do good? Take the five medical students that take a year off from medical school (no small feat as any med school vet can tell you) because they care that much about what we are doing. The legacy of AMSA officers includes many distinguished and important leaders all over the world. To belittle our organization into two major efforts Pharm Free and CAM ignores the work we do in minority rights, universal health care, environmental justice, and so many other great projects. If you are really concerned about our policies, why not try to contact the people involved instead of running this silly campaign on the web to run our name through the mud. The greater work we do is much more important, for the wellbeing of medical students during their training and our future patients' rights. Please refrain from badmouthing AMSA as a whole, and redirect your comments to the very small body of work we do on CAM education. Your years of negative comments are really starting to look like a crusade or a strategic campaign. As I don't think you are truly concerned with our credibility, I hope that you would not want to intentionally damage the other work AMSA does, like helping students all over the country set up health fairs and free clinics, advocating for debt relief to ensure more equitible admissions to medical school, caring for underserved populations, and fighting the global burden of AIDS.

Robert W Donnell said...

I have no intention of trying to damage AMSA. My public efforts to hold the organization accountable for hypocrisy concerning EBM will not diminish the good work they may do. That will stand on its own merits.

Does the fact that AMSA does good work, or that there are things I don't know about the organization (I'm not involved in their inner workings, but do know quite a bit about them from my reading)disqualify me from criticizing them? Those same considerations didn't stop you from your latest blistering attack on the drug companies.

In order to be credible an organization's messages, as presented on its web pages, must be internally consistent. That is where AMSA has a huge problem when it comes to EBM. For an organization to make a difference in a profession, as AMSA aspires to do, it has to reach people with its message and be accountable for the message. People who are to be reached, and who may have a legitimate interest in criticizing the organization, can not be expected to know its inner workings. The web pages and other public resources should speak for themselves.

If there is something about AMSA you feel I need to know which might impact my comments and criticism I'm more than happy for you to educate me. Perhaps you could start by clarifying your point about the AMSA foundation being "a completely separate entity". According to the web site the NCCAM grant was to fund a project of EDCAM, which is very much part of AMSA. What pieces am I missing?

Paige Erin Hatcher said...

For your information, the AMSA Foundation is independent from AMSA in many ways. They are not staffed by students, and they are not a membership organization as we are. We have a lot of overlap, but truly little control over their contracts. This is my last post for you Dr. RW. After finally reading the "woo book", I kind of like it, and I think it's pretty well supported. As much as I love AMSA, I probably will never convince you, and I really don't have the excess energy to try. I'm not sure exactly what you're afraid of, as I feel there is lots of bad medicine in the traditional allopathic arena as well. But I stand by the efforts of our leaders in CAM and I give up in trying to disuade you from your attack...KS Girl in DC- Signing OFF

Robert W Donnell said...

I am not "afraid" of anything AMSA is doing. And although I am not in denial about the bad medicine which exists in the mainstream ("allopathic" is decades obsolete and no longer descriptive of what mainstream medicine does) I do believe it's fair to insist on a uniform standard across all of medicine, inclusive of Pharma products and Woo.

AMSA has never been the principal focus of my blog. I call out pseudoscience, hypocrisy and disengenuous moral preening wherever I see it in the broad arena of medicine. There's plenty of it in the medical journals, academic medicine and the public media---AMSA is not singular!

If I choose to criticize AMSA from time to time in the future (and I probably will) please know it's not personal and it's not about you. It was never my intent to get into a debate with you, but when you posed questions to me I thought they deserved an answer.

Although I disagree with you on certain points I admire your enthusiasm and optimism, consider you a colleague, and wish you the best.

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