LAUSR

Arecent announcement in the United States of a $200 million integrative health investment from philanthropists Susan and Henry Samueli at the University of CaliforniaIrvine academic health center called the question on some historic baggage that alternative, holistic, complementary, and integrative health and medicine have faced. For most of the past 40 years of fits-and-starts toward integration of multiple natural therapies and traditions with biomedicine, members of the media have pitted the assertions of advocates with lambastes from antagonists. ‘‘Quack,’’ ‘‘fraud,’’ and ‘‘snake-oil salesmen’’ are among the memorable aspersions. A special epithet was concocted by antagonists to describe the academic institutions such as that at University of California-Irvine and led by the 70-member Academic Consortium for Integrative Medicine and Health that have been examining and offering some of these practices and practitioners: ‘‘quackademic medicine.’’ This term provided the dominant narrative at the Los Angeles Times and at STAT that emerged following the announcement of the investment and was picked up again at Inside Higher Education and MedPage Today.3–6 The nearly quarter billion investment was tarred with negativity and as ‘‘delegitimization’’ of medicine, as others put it. The problem with members of the media choosing to feature this narrative is that science has proven it wrong. ‘‘Quackademic medicine’’ is science denial and fake news. For members of the media to continue to condemn the field that the Samuelis are advancing—and the science that this journal explores—in such a way is akin to greeting news of a quarter billion investment to diminish negative human impacts on climate by quoting a series of individuals who deny the science of climate change. Journalistic balance is not putting evidence on one side and then letting evidence deniers have their say. The job of responsible science writers is sometimes to realize that an issue is resolved in such a way that there are no longer grounds for self-respecting media to give voice to such roundhouse judgments. We have consensus on human impact on climate. While the science on individual therapies can and should continue to be debated, a positive consensus has now arrived for the value of integrative health and medicine. In the past 3 years, a series of powerful reviews raised a unanimous front against the ‘‘quackademic’’ allegations. Those I am about to cite are all pain related. Although it is true that not all of what is done in integrative health and medicine is for pain conditions, it is also true that patient interest in new options for pain treatment stimulated the exploration of alternative methods and the development of the chief fields of integrative practice: chiropractic, acupuncture, massage, yoga therapy, mind–body, and others. A survey of the clinical centers in academic medicine—including that at University of California-Irvine sponsored by the Samuelis—found, not surprisingly, that pain is the main reason that patients come in for care. Here is the combined front against the naysayers trumpeted by these media: the Joint Commission that accredits hospitals and other medical pain guidelines from the delivery organizations (2015); a team of authors from the National Institutes of Health published in Mayo Clinical Proceedings (2016) on pain treatment for multiple conditions; guidelines from the American College of Physicians (ACP) (2017) on acute and subacute back pain; and again, recent recommendations to the U.S. Food and Drug Administration from the National Academy of Medicine (2017), relative to efforts to combat opioid addiction. The ACP’s evidence-based recommendation was that ‘‘physicians and patients initially select non-drug therapy with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction, tai chi, yoga, motor control exercise, progressive