The polarization in US medicine has never been so front and center as it is with COVID-19. Natural agents are off the table. Despite early clarity that the state of the host matters big time in susceptibility to the virus, natural strategies focusing on host susceptibility are routinely denigrated and dismissed. So it was remarkable that within the course of 24 hours in late April, two colleagues independently sent news of a formal medical center protocol associated with a medical school that includes multiple natural agents. These are inlaid with conventional measures into a series of stages that the institution’s medical staff is following. Who are these people and how did this come to be? I was able to reach the primary author of the institution’s Critical Care COVID-19 Protocol, a South Africa educated internist, Paul Marik, MD, FCCP, FCCM. Marik is a professor of medicine and chief of pulmonary and critical care medicine at Eastern Virginia Medical School (EVMS) who has previously stirred controversy for unorthodox approaches. The non-conventional reasoning that drove the COVID-19 protocol Marik calls “uncommon common sense.”
The easy access by medical doctors to accredited continuing medical education in integrative medicine is an engine of the field’s growth. So as stories emerged of what was believed to be an Accreditation Council on Continuing Medical Education (ACCME) clamp down, I engaged a series of interviews and reports. I reported direct and indirect assurances from ACCME’s CEO Graham McMahon, MD, MMSc that integrative medicine is not being targeted. Yet a recent commentary from leaders of the Osher Collaborative for Integrative Medicine raised the question again. I decided to review evidence to this date. I cannot but conclude that integrative medicine is, in fact, at the center of the bullseye in ACCME’s recent push for new standards of “content validity” regarding “controversial areas”. Here is the evidence.
Amidst of the waves of information on local, national and global developments related to COVID-19, efforts stand out of a few organizations to capture and bundle content that targets the integrative practice communities. Among the entities that have established resources pages are the University of Arizona Andrew Weil Center for Integrative Medicine, the American Association of Naturopathic Physicians, and the American Nutrition Association. In contradistinction to the advisories of the United States’ federal agencies and state governments, these organizations have in common that their leaders believe that there is more that an individual can do than “healthy waiting” (sleep, exercise, don’t smoke, limit sugar) as the virus continues its course through their communities. Each organization directly suggests multiple steps that might be indicated, and the science supporting it.
When members of Congress established what is now the NIH National Center for Complementary and Integrative Health, they cared about whole things. Eight times in two pages, the new Center was charged to examine not just basic research or reductive trials on individual modalities. They pointedly sought to turn the NIH’s attention to the value of complementary and alternative “systems and disciplines … in health care delivery systems in the United States.” This shift of focus was resisted. The first director Stephen Straus, MD famously shouted down his former NCCIH advisory council member Carlo Calabrese, ND, MPH when Calabrese courageously asked for research whole disciplines and whole practices like those of licensed naturopathic and traditional Chinese medicine practitioners. All integrative disciplines urged Straus’ successor Josie Briggs, MD to focus her 2011-2015 strategic plan on “researching the way we practice”. Briggs showed interest but showed no one the money to engage these questions. So when the NCCIH’s current director Helene Langevin, MD opened the NCCIH 2021-2025 strategic planning process with a February 18, 2020 video-cast webinar by focusing on “whole person health,” there was, among many, a great deal of anticipation and pent-up-demand. What might this mean?