Quackwatch’s Hatred of Acupuncture.

The author of the Quackwatch entry for Acupuncture entitled “Be Wary of Acupuncture, Qigong and Chinese Medicine” is Quackwatch founder Stephen Barrett. It represents Quackwatch’s official position on acupuncture that has served the purposes of Skeptic organizations, including Skeptic editors on Wikipedia, for falsely discrediting this ancient Chinese medical practice. Barrett is sometimes careful to personally call medical practices that have a large following as pseudoscientific. Rather he is fond of referencing others who are more adversely critical. He quotes Harriet Hall (a sitting member of the Quackwatch board of science advisers and one of the four editors of the Quackwatch-related Science Based Medicine blog) to draw the association between acupuncture and “quackery.”

“Acupuncture studies have shown that it makes no difference where you put the needles. Or whether you use needles or just pretend to use needles (as long as the subject believes you used them). Many acupuncture researchers are doing what I call Tooth Fairy science: measuring how much money is left under the pillow without bothering to ask if the Tooth Fairy is real.”

Barrett also quotes GA Ulett from an article written in 1984,

“Certification of acupuncturists is a sham. While a few of those so accredited are naive physicians, most are nonmedical persons who only play at being doctor and use this certification as an umbrella for a host of unproven New Age hokum treatments. Unfortunately, a few HMOs, hospitals, and even medical schools are succumbing to the bait and exposing patients to such bogus treatments when they need real medical care.”

Although the World Health Organization lists 27 medical conditions for which it recommends acupuncture, Barrett states that the list “should have been followed by a statement that the list was not valid.” However, he provides no specific scientific rationale based on studies to refute the WHO’s recommendations. Among Barrett’s 29 cited references to support his arguments to denounce acupuncture’s efficacy, 26 were published over 15 years ago, and 17 are over two decades old. Consequently the article only has historical importance, is horribly outdated and has no value for representing the state of acupuncture research in the 21st century and the advances it has made during that time.

In order to discredit acupuncturists’ diagnostic capabilities, which rely upon Traditional Chinese Medical theory, Barrett cites a single study whereby 6 patients were seen by 6 different acupuncturists on a single day. He notes that each was diagnosed with slight differences.  Despite the tiny participant sampling of this study, Barrett cites it as evidence of acupuncturists’ poor diagnostic skills. Therefore, acupuncture should not be relied upon.

 

 

However, in conventional medicine  misdiagnosis leading to erroneous treatments is far more pervasive and costly.  The same arguments Quackwatch and Skeptics apply to alternative medicine equally apply to standard medical healthcare. In fact, much more so because the evidence-based research on diagnostic error is far more thorough and robust. For example,

• A conservative estimate is that 100,000 Americans die annually or are permanently disabled due to misdiagnosis. Yet a more recent study conducted by the Society to Improve Diagnosis in Medicine found that medical misdiagnosis may actually effect up to 12 million adults, one out of every 20 patients. Half of those erroneous diagnoses were determined to be harmful.
• A Johns Hopkins University study identified cancer, cardiovascular events and infections as the three most misdiagnosed conditions leading to the most severe consequences for patients.
• A study published in the Journal of Clinical Oncology found that physicians miss or misdiagnose certain cancers up to 44 percent of the time.
• A 2013 study in the American Journal of Emergency Medicine reported that over 33 percent of patients with pulmonary emobolism were sent home or admitted to hospitals with a wrong diagnosis.

In 1997, with the federal government’s founding of National Center for Complementary and Integrative Health, acupuncture has been recognized at the federal level and has increased in popularity dramatically. According to Acupuncture.com, there are approximately 18,000 licensed acupuncturists in the US and about 12,000 have a regular full time practices. In many states these practitioners are considered to be “primary care physicians.”

Quackwatch largely relies upon the National Council Against Health Fraud’s “Position Paper on Acupuncture” published almost 3 decades ago in 1990 to discredit its therapeutic value. All of the scientific references cited in the Paper to support their position that acupuncture is an “unproven modality of treatment,” “bears no relationship to present scientific knowledge,” and “fails to demonstrate [it is] effective against any disease,” were conducted in the 1980s. The Paper’s primary goal, based upon a very limited number of outdated studies, is to advance the argument that  insurance companies should not provide coverage for acupuncture services and that acupuncture licensure should be phased out.

The National Council Against Health Fraud (NCAHF) was a nonprofit organization that inaccurately defined itself as a “health agency” to support consumer protection. The NCAHF too was founded by Stephen Barrett who continues to be responsible for its archives, according to the Council’s now inactive website. Despite the NCAHF Manifesto’s claim that “mentally competent adults should be able to choose to follow any health practices they wish or refuse treatment,” over the years the organization has aggressively made efforts to limit patient access to alternative medical therapies, file lawsuits against its practitioners — notably Chiropractors — and launch public relations efforts to undermine non-conventional medical system’s proven benefits by always emphasizing selective and cherry-picked contrary research.

Quackwatch adopts NCAHF’s recommendations regarding accupuncture:

• For physicians, they should be educated that acupuncture is at best experimental and is no better than a placebo. Consequently, the medical profession should on no account recommend acupuncture to patients. The Council’s position for acupuncture being an “experimental procedure” is based upon a 1981 report by the American Medical Association
• For consumers ,they should be made aware that “Acupuncture cures nothing” and “it may be harmful.”
• For legislators the Council recommends that “acupuncture licensing should be abolished.” In addition, “insurance companies, HMOs and government insurance programs should not be forced to cover acupuncture.”

Skeptic organizations such as Quackwatch, the Center for Inquiry and the Society for Science Based Medicine, the latter which grew out of Quackwatch, make their arguments to denigrate alternative medicine based upon the erroneous premise that they represent “scientific consensus.” In almost all instances, this claim is patently false. Per acupuncture, the scientific consensus validates the practice:

• The independent Joint Commission accredits almost 21,000 programs for hospitals and healthcare organizations while establishing standards for patient care, medical safety and protecting consumer rights. The Commission recommends acupuncture as a first line of treatment of pain management.
• The National Institute of Health and Care Excellence recommends acupuncture treating chronic tension headaches and migraines. Upon recommendation from the UK’s National Health Services, the majority of British pain clinics and hospices employ acupuncture treatments.
• Both the American College of Physicians and the American Pain Society recommend acupuncture for low back pain.
• Other professional institutions who have recommended acupuncture for a variety of conditions include the World Health Organization, US Department of Veteran Affairs, the Agency for Healthcare Research, the American Academy of Family Physicians, the American College of Occupational and Environmental Medicine, the US Department of Health and Human Services, the Institute for Health Economics and others.

The Acupuncture Evidence Project reviewed 122 treatments over 14 clinical areas and found efficacy in 117 conditions.  Strong positive effect was determined for allergic rhinitis, chemotherapy’s adverse effects, chronic low back pain, chronic tension-type headaches and migraines, postoperative pain and nausea, and knee osteoarthritis. Other positive evidence was confirmed for acute stroke, obesity, anxiety, perimenopausal and postmenopausal insomnia, asthma, cancer pain and cancer-related fatigue, PTSD, hypertension, irritable bowel syndrome, hot flashes, schizophrenia, smoking cessation, etc.

In effect, Quackwatch and its sister Science-Based Medicine are intentionally censoring with malice of forethought an enormous body of scientific research conducted by groups at Harvard and the Cochrane Database — which is recognized as the international gold-standard for much evidence-based medical meta-analysis — in order to continue promulgating acupuncture as an unfounded pseudoscience.

Curiously, Skeptics, as well as Quackwatch and Wikipedia entries, ignore the lack of efficacy in current conventional biomedical treatments. For example, in 2013, the Mayo Clinic reported that studies examining the evidence that would support standard medical care actually recommended against current practice 46% of the time. In other words, almost half of all standard medical treatments had no evidence to support their use. Similar evaluations conducted by the Cochrane Database and the American College of Cardiology arrived at similar results at 49% and 48% respectively.

 

 

When we consider America’s opioid epidemic, and the overuse of powerful pain medications that are contributing to a national crisis of addiction and deaths from overdose never witnessed before in US history, for the Skeptics on Quackwatch and Wikipedia to be discrediting a far safer, non-addicting and effective treatment represents gross medical negligence that is arguably unethical.

The second sentence in Wikipedia’s acupuncture page states, “Acupuncture is a pseudoscience because the theories and practices of TCM (Traditional Chinese Medicine) are not based on scientific knowledge and it has been characterized as quackery.”  Further in the page it reinforces the intention to have Wikipedia users wrongfully regard acupuncture as fakery. “Many within the scientific community consider attempts to rationalize acupuncture in science to be quackery and pseudoscience.”

The page references the late Wallace Sampson, an aggressive Skeptic who made a career by attacking alternative medicine. Sampson was also a Quackwatch Science adviser, Chair of the Board of Directors of Barrett’s National Council Against Health Fraud, and a faculty member of the Skeptic’s Toolbox — an annual workshop sponsored by the Committee for Skeptical Inquiry to strategize on methods for attacking alternative medicine and parapsychology. Starting in 1997, the program has expanded and offers a three-year academic program in modern skepticism.  Sampson was also the Chief Editor of the defunct peer-reviewed Scientific Review on Alternative Medicine supported by the Skeptics’ Center for Inquiry, Quackwatch advisers and Science-Based Medicine. The publication was rejected on four separate occasions for admittance into the NIH’s Library of Medicine due to unsound articles and gross bias. Other notable Skeptics cited on the page include Stephen Barrett (Quackwatch) and David Gorski (Society for Science Based Medicine). Former professor Edzard Ernst, who Quackwatch adviser Harriet Hall regarded as the “world’s foremost expert” on Complementary and Alternative Medicine, is cited heavily although he has no professional background in acupuncture nor Chinese Medicine.

On the Wikipedia talk page for editors working on the Acupuncture entry, a recent exchange in late October 2019 summarized a systemic problem for alternative medical practices that once labeled as a pseudoscience or quackery on the encyclopedia it is near impossible to have it changed regardless of how much scientific evidence to the contrary is provided:

2001:56A:75CE:1700:7C7D:FD68:F968:2FFF writes:  I am curious what it would take to change the categorization of a Wikipedia article such as this [referring to being labeled pseudoscience]? My assumption is that a credible source would need to say “acupuncture used to be pseudoscience, but it has progressed to a science”? I am not convinced a source would ever say such a thing, because it is kind of a silly statement (I am not aware of any case where an alternative approach has become mainstream and those exact words have been stated) so if this is the threshold then there may be a problem because I do not see a way for a topic that has ever been categorized as pseudoscience from breaking free of that characterization to a level that would satisfy wikipedia criteria.  22 October 2019 (UTC)

Roxy the Dog [a well known Skeptic and Wikipedia administrator]:  Just to note that that is a problem we are unlikely to ever have.  22 October 2019 (UTC)

Alexbrn: It does happen, but it’s very rare. The canonical example (beloved by hopeful pseudoscientists everywhere) is continental drift   22 October 2019 (UTC)

 

This exchange encapsulates one of the most glaring problems of unproven scientific bias that dominates Wikipedia pages related to alternative medical therapies, systems and its leading practitioners and advocates.  Once a person is labeled as a quack or promoter of a pseudoscience the editorial process has been disproportionally rigged in favor of the Skeptic ideology that is almost impossible to break free of this derogatory image.