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WHCCAMP Chair James S. Gordon, MD, is is upset that his 2-year pet project is under attack. On March 26, 2002, the Washington Post printed a letter in which he defended his irresponsible behavior. This letter is a response.
To the Editor:
Chairman Dr. James Gordon recently protested the criticism of his White House Commission on Complementary and Alternative Medicine Policy (Tuesday, March 26, 2002; Page HE02). The Post's "uncritical" acceptance of the so-called accusations dismayed him. What dismays a lot more people who examine the report and the credentials of the commission is the completely uncritical acceptance of some vague entity called "CAM," and more requests for money than Carter has little liver pills. (CAM, an eclectic mash of everything from esoteric spirituality to megadoses of vitamins, apparently is like pornography - beyond definition. You know it when you see it.)
Dr. Gordon claims the commission was only doing its job. After all, it was a "presidential mandate" (Clinton Executive Order # 13147) to make recommendations about how to implement the vague entity of CAM thoroughly into every biopsychosocial aspect of America. There is, however, no "bipartisan congressional" mandate on record. It is worthy to point out that this may be much ado about nothing. After all, if CAM is real medicine, it does not need special treatment. It will be absorbed for its science, without politically motivated executive orders or policy.
But perhaps this commission which Dr. Gordon defends vigorously (as well as himself) is about something more than science and health. According to the Gordon Commission report, throwing several hundred million dollars at folks who will help the public be able to access this unnamed, undefined CAM and to fund others (friends and fellow travelers) to research subtle psychic energy fields, distant AIDS healing (as in telepathy or prayer, take your pick) and coffee enemas, will require a new agency in addition to the National Center for Complementary and Alternative Medicine. The NCCAM has an increasing budget now well over $100 million annually and has yet to educate the American public on the uselessness of alternative practices like iridology, "muscle response testing" and Bach flower remedies. Duplication of services is hardly cost effective, duplication of non-services less so.
In a "cart before the horse" move this commission -- composed of alternative medicine advocates -- was told to decide where and how to propagate and promote practices without having to turn the light of critical judgment on their own beliefs first. Their recommendation for well done scientific examination of CAM practices is disingenuous and could be seen as hypocritical in light of some of the practices the commissioners promote. If science really is a critical factor, for starters that should have eliminated Effie Poy Chow for her telephone qigong healing (do long distance charges apply?), Don Warren for his "diagnostic" muscle testing nonsense, and Veronica Gutierrez for her anti- childhood immunization stance based on the claim that scientific research, as well as "overwhelming clinical reports," have indicated that the effectiveness of "many" vaccines for childhood diseases "has not been adequately proven."
How was it that these folks were given the task of telling the government how to implement CAM into policy?
Apparently a couple commissioners had similar questions. Dr. Gordon wrote, "The 'dissent' on the commission referred to in the article was not, in fact, a dissent." Really? I found the "dissent" at the very end of the report labeled as "Statement from Commissioners." It is, in fact, a dissent. That Dr. Gordon can't acknowledge this is curious. That he claims that "the other points of view" were repeatedly heard makes the point that they were repeatedly ignored in the final report all the more intriguing. As for Dr. Gordon's protest that Drs. Low Dog and Fins' did, indeed, publicly assent to "all" of the findings, he seems to be trying to marginalize them by discrediting the concerns they expressed quite clearly in their letter to Secretary Tommy Thompson. Perhaps this is why the commission hired the public relations firm of Fenton Communications? (Question: Why does a commission charged with reporting to the President and DHHS need a PR firm? Is this about marketing or medicine?)
In Dr. Gordon's response to the Post's article he tries to distance himself from Bhagwan Rajneesh (the unnamed "religious cult leader") and claims to uphold his professional oaths. As others have pointed out Gordon was closely involved with Rajneesh in the US and in India. Surely going through a "rebirthing" experience at the guru's ashram in India indicates a more than passing clinical curiosity. At the least, referring homeless men to the local branch of the group and gathering others to live in the Hindu guru's community which was involved in the bioterrorism might represent a lack of good judgment or ethical conflict with regard to a group he was "researching."
WHCCAMP is a politically conceived end run around good science which seeks to fund its own industry using tax dollars with the consequence of pressuring the private sector. Spending precious health care dollars on researching implausible theories or providing ineffective CAM will harm and delay the ongoing process of finding better ways to improve health and treat illnesses. The $860,000 "Creative Wellness" program offered through HUD which was terminated last year as reported in the Washington Post (June 1, 2001; A29) needs to be revisited as a cautionary tale about integrating CAM. To remind the readers, there health and wellness was to be imparted through incense burning, color coded wardrobes and home decor and decision making based on esoteric personality readings based on New Age spirituality.
A number of the recommendations of the commission are in inherent conflict. Dialogue works if you speak the same language. Science and psychic energy haven't got much common ground. Plugging in buzzwords ("wellness," "chronic illness") and anointing CAM as the answer is just plain presumptuous. The healthcare issues we face as a nation are not going to be fixed by meditation, burning incense, embracing spirit guides and talking out of both sides of our mouths. Abandoning reason and accountability while claiming to corner compassion and trying to reinvent science is not a formula for successful health and wellness policy. Nor is it fiscally responsible.
That CAM believers are a passionate and committed lot is not a question. But the uncritical endorsement and implementation of practices and policies without sensible, evidence based data and strong ethical guidelines is irresponsible and inappropriate.
The real story is why only two of the WHCCAMP commissioners could figure that out.
Janice A. Lyons, RN, MAEd
Arden, North Carolina
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