Australasian Science Magazine

By Loretta Marron

With their financial resources under threat, Australia’s universities need to resist the temptation of offering lucrative courses that rebadge complementary therapies as “integrative medicine”.

Universities accept that they face long-term sustainability problems, with vice-chancellors arguing that they need an increase in public investment if they are to maintain their relative positions in the World University Rankings. Without this increase in funding, universities will be forced to make “difficult decisions” on campuses, staffing levels and the courses they offer.

Estimated at $4 billion per annum, the AltMed industry is well-funded in Australia. Chiropractic, osteopathy, naturopathy and traditional Chinese medicine associations target debt-ridden universities that do not have medical faculties. These pseudoscience-based courses are run by academics, many with inferior qualifications and vested interests in the promotion of AltMed. While arguing that their courses are based on bioscience, they include unscientific interventions and deliberately avoid undertaking credible research that could challenge their belief systems.

With public opinion turning against them, the AltMed industry is fighting back. Now in league with a small group of medically trained doctors and pharmacists, they are moving into our most prestigious universities to introduce medical and pharmacy students to “integrative medicine”.

Sponsored by the manufacturers of complementary medicines, their lectures and conferences offer uncritical evidence about the risks and benefits of complementary medicines to students who have not had any exposure to evidence-based clinical trialling and do not understand the limitations of Australia’s regulatory system.

Referring to it as a holistic approach to patient care, integrative medicine is promoted as a blending of conventional and evidence-based complementary medicines and therapies. Integrative medicine has co-opted solid nutritional approaches from legitimate medicine, along with mindfulness-based interventions such as meditation, yoga and massage. However, integrative medicine also includes a wide range of implausible interventions including homeopathy, naturopathic medicine, reflexology and energy therapies.

Integrative medicine promotes “evidence-informed medicine”, which is based primarily on the intuitive clinical judgement of the practitioner supported by their patients’ values and expectations. Evidence may include “expert” opinions, case reports, case series and observational studies. Randomised control trials are considered only as an aid to informing rather than dictating practice, and are frequently ignored.

The recent National Health & Medical Research Council review into a range of “natural” therapies failed to find any evidence from systematic reviews that any of them worked. AltMed and integrative medicine also include biologically-based interventions such as the use of herbs and dietary supplements, where claims of efficacy are usually misleading as they lack credible research and may be based solely on traditional or anecdotal evidence. .

In reality, integrative medicine is just a re-badging of AltMed, an umbrella term that masks uncritical information about complementary medicine and supports a range of unproven or disproven interventions. Courses in integrative medicine promoted for experienced health practitioners attract continuing professional development hours and are sponsored primarily by high-profile manufacturers of complementary medicine and others with vested interests.

Universities, concerned about threats to research funding, changes to higher education legislation, increasing debts and lured by the temptation of easy money, now look set to follow the US, where integrative medicine training is becoming widespread. Universities continuing to teach AltMed or embracing integrative medicine will fail the nation in their responsibility to produce critically thinking evidence-based health practitioners as their graduates.

Australians will not thank universities for teaching pseudoscience, which will only degrade health care and waste taxpayer’s dollars. Courses that include pseudoscience also harm universities by devaluing bioscience. It is nothing less than academic prostitution – and should be recognised for what it is.

Loretta Marron is the Chief Executive Officer of Friends of Science in Medicine. A three-time winner of Australian Skeptics’ Skeptic of the Year award, she was a recipient of an Order of Australia Medal “for service to community health” in 2014.