Author's Response to the Letter Regarding the Book Review “Complementary and Alternative Medicine in the United States”

Mr. Stone's[1] letter contains raw assertions that show very little understanding of the “CAM” [complementary and alternative medicine] marketplace. In addition, he has misrepresented what I said by taking statements out of their full context. Plausible methods should get funding priority because research funds are limited and should be used where the probability of useful findings is highest. Although methods that seem improbable are occasionally demonstrated to be effective, there will never be enough funds to test every harebrained idea that gets marketed. As far as I know, no CAM method that I refer to as irrational has ever been proven effective. Unfortunately, NCCAM [NIH National Center for Complementary and Alternative Medicine] has wasted many millions of dollars on studies that serve no useful purpose.[2] The IOM [Institute of Medicine] report discussed what criteria could be used to allocate funding, but it (1) failed to state which ones are most important, (2) did not illustrate how the criteria should be applied, and (3) did not identify a single method that deserves no further research support. Why, for example, did the IOM mention palmistry, crystal therapy, iridology, and trepanation (drilling holes into people's heads) without indicating that they are too irrational to deserve government research support? I didn't merely point out that many of the IOM CAM committee members had a conflict of interest. I noted that 6 of them either espouse, directly promote, or engage in pseudoscientific practices and had previously overstated CAM's value or promise. Conflict of interest would not be sufficient reason to rule out an expert's participation. However, IOM's CAM committee was a stacked deck. Nobody who was generally critical of CAM methods was permitted to serve on the committee or even to provide significant input during the public hearings. Nor did the committee include anyone with expert knowledge who did not have a conflict of interest. These shortcomings are described in detail in a report on Quackwatch.[3] Mr. Stone claims that medical schools are teaching CAM in an “unprejudiced manner,” but he supplies no supporting data or citation. The largest survey that I know of concluded that only 4 out of 56 courses included appropriate criticism.[4] Mr. Stone also asked whether I receive any support from the pharmaceutical industry. The answer is no. Sincerely, Readers are encouraged to respond to George Lundberg, MD, Editor of MedGenMed, for the editor's eye only or for possible publication via email: ten.epacsdem@grebdnulg