Intended for healthcare professionals

Feature Christmas 2010: Reading between the Lines

Integrative medicine and the point of credulity

BMJ 2010; 341 doi: (Published 08 December 2010) Cite this as: BMJ 2010;341:c6979
  1. John C McLachlan, professor of medical education
  1. 1School of Medicine and Health, Durham University, Stockton-on-Tees TS17 6BH, UK
  1. j.c.mclachlan{at}

So called integrative medicine should not be used as a way of smuggling alternative practices into rational medicine by way of lowered standards of critical thinking. Failure to detect an obvious hoax is not an encouraging sign

It is a common, and rarely unsuccessful, ploy to change the name of something unpleasant in order to give it greater acceptability. However, changing the name of Windscale nuclear plant to Sellafield after an accident in 1981 made it no less radioactive, and the new name quickly acquires all the connotations of the old.

Increasing concern has been expressed about the presence of complementary and alternative medicine (CAM) on the NHS. For instance, the House of Commons Science and Technology Committee recently reported critically on the evidence base for the use of homoeopathy in the NHS.1 Nationally and internationally, there has been a move to disguise the nature of CAM by renaming it “integrative medicine.”2 3 Of course, it is something of an insult to medical practitioners to suggest that they do not take into account their patients’ individuality, autonomy, and views as part of their daily practice. It is certainly a key tenet of evidence based medicine4 and to suggest that so called integrative medicine is somehow confined to the alternative world is a canard.

It is sometimes possible to test the status of a notion (the terms hypothesis and theory should be reserved for ideas that are related to at least some form of evidence) by a process of opposition. This involves testing the status of the notion by looking at the limits to which it can be pushed.5 Furthermore, there is an excellent tradition of testing research areas of dubious authenticity by means of a hoax. In 1996, Alan Sokal had a paper accepted in …

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