The Integrator article two issues ago on Google’s activities that precipitously gouged traffic at key websites (Self-Interested Whims of the Oligarchs: Google and Facebook Kill Access to Alternative and Integrative Medicine) immediately drew a range of responses. Longtime medical journalist Erik Goldman shared the remarkable diminution of traffic at his Holistic Primary Care site. Some spoke of organizing efforts. At the same time, other good analyses have been published. New information regarding Google’s growing partnerships with members of the medical industry and particularly pharmaceutical giants has come out. And there is an interesting coincidence of Google’s choice of dance partners as it matures and measures it global strategy and the corporate decision to excise its cheeky formative promise to “Don’t Be Evil”. Is it time to wonder whether there is a next level war for access emerging?

Traffic slammed at Holistic Primary Care

The editor of Holistic Primary Care, Erik Goldman, cut his teeth in medical reporting by writing for a series of mainstream medical periodicals. From 1990 to 2000, Goldman was the New York Bureau Chief for International Medical News Group, a division of Elsevier Health Sciences. When he chose to venture into the growing integrative space, his method with Holistic Primary Care was a bridge strategy to reach new audiences. It rested on maintaining a high quality and respect for science. So it is of special note that Goldman reports that the changed search formula at Google that truncated 50% to 90% of traffic at multiple websites (see “Google’s Digital Book-Burn”) also hit his site hard. Goldman says the publication’s traffic is down by roughly two-thirds. Notably, this is virtually the same decline as at the DrWeil.com site, where traffic fell by 66%. The relatively conservative relationship to evidence on both sites makes their decline in traffic all the more worrisome. Google does not appear to be discriminating.

Association not (necessarily) causation: Google gains pharma partnerships as it ends “Don’t Be Evil” motto

It’s not every business that, coming out of the blocks, declares, as it’s motto, “Don’t Be Evil.” But that was so for Google. This is what Wikipedia says about the origins of Google’s motto:

The motto was first suggested either by Google employee Paul Buchheit at a meeting about corporate values that took place in early 2000 or in 2001 or, according to another account, by Google engineer Amit Patel in 1999. Buchheit, the creator of Gmail, said he “wanted something that, once you put it in there, would be hard to take out”, adding that the slogan was “also a bit of a jab at a lot of the other companies, especially our competitors, who at the time, in our opinion, were kind of exploiting the users to some extent”.

What is interesting is that in 2015 when the firm got serious as a global corporate entity whose interests ran from A to Z and restructured as Alphabet, the motto no longer came with it. This is roughly the time the firm began to form multiple partnerships and joint ventures with pharmaceutical companies and other global medical industry players. To be fair, the conglomerate went forward with a Spike Lee inspired “Do the Right Thing” motto – a more positive tone. Still, given the way that Big Pharma is demonized in battles over the future of health and medicine, it was a coincidence of note, and perhaps of honest reckoning, to drop the “Don’t Be Evil” motto when they did.  A quality blog post at Common Dreams by Tom Valovic (“Google Becomes Evil“) explores the general issues and the timing. The Google actions against the alternative and integrative sites are framed as a campaign against “fake news” and “blocking access to ‘offensive’ sites, and to favor more ‘authoritative content.'” One wonders, when the likes of DrWeil.com and Holistic Primary Care were in the cross-hairs just who they are listening to in order to determine what is “offensive”.

Coordinated effort to take make a case to Google – do you have a friend in Alphabet’s high places?

Under my activist hat rather than my reporter hat I have been made aware of multiple dialogues and email streams that – feeling the weight of this apparent attack on the consumer’s access to non-mainstream healthcare information and on their own businesses — are urging coordinated action to directly communicate with Alphabet, and educate the firm about the science that supports many of these practices – the baby that got chucked with the bathwater. Efforts are being made to consider where the most access, highest up, anyone has inside the Alphabet corporation. I have not gotten directly involved other than to contact a friend who was a regular  Google consultant who I learned is no longer there. I do not know what has transpired along these lines in the past month. If you have significant access at Google and would like to put it to work, I will happily link you to the people who I know expressed interest i9n working on this.

The Big Picture – restraint of trade, pincer movements, and other ugly musings

Call it serendipity, but it turned out the the rise of “complementary and alternative medicine” in the dominant politic0-medical-economic structure of the United States directly coincided with the rise of the internet. All that the internet promised – the democratization of news, the empowerment of individuals, for instance – seemed form fit for the rise of healthcare practices that were typically squelched in the mainstream media as charlatanism, quackery and fraud. A significant dose of questionable behavior exists in these fields – counterparts to the greater damage from such players as the Sackler family and the FDA-devices decision to bury public access to information  on 5.7-million adverse effects of medical devices. Yet significant and increasing doses of good science also exist. What is offensive here is in blocking public access to these, and thus keeping practitioners from advertising their wares. The action of Google in this light is pure restraint of trade. Given Google’s multiple partnerships with businesses that represent medicine-as-usual, it is hard not to consider that they have motive for the restraint. The integrative field has reason for more self-regulation, and Google for more discrimination.

A broader concern is that the integrative model has been on the ascendant the last 15 years. Is it possible that the battle for the future of medicine is getting serious. I’ve heard this concern from a few. The concurrent rise of integrative oncology and of non-pharma approaches in pain treatment may look to a pharma partisan like a broad pincer movement to reshape medicine, as they knew it, and paint them into a diminished role. Cutting off access to information for consumers and to the ability of integrative businesses to education and advertise is a snuff job of the first order. That there is concurrent pressure on providers of continuing medical education (more on that soon) that could have a similarly muting effect on the education of  physicians and other conventional practitioners to integrative models adds to the queasiness. If one allows a little bit of paranoia, this dual attack on consumer and practitioner access to information can feel a powerful, reactive pincer movement of its own. I am reminded of the sign that the maverick state senator I worked for in 1979-1981 in Washington State, King Lysen, had on his office wall in Olympia. It was a Joseph Heller quote: “Just because you’re paranoid doesn’t mean they aren’t after you.”