Kimball Atwood

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Kimball Chase Atwood IV
Kimball Atwood.JPG
Atwood at CSICon in 2012
CitizenshipUSA
Occupation(s)Anesthesiologist, Internal Medicine, Assistant Clinical Professor
Known forScientific skepticism and criticism of naturopathy
Relatives Kimball C. Atwood III (father)
Medical career
ProfessionAnesthesiology, Assistant Professor
Institutions Newton-Wellesley Hospital and Tufts University School of Medicine

Kimball C. Atwood IV is an American medical doctor and researcher from Newton, Massachusetts. He is retired as an assistant clinical professor at Tufts University School of Medicine and anesthesiologist at Newton-Wellesley Hospital.

Contents

An active skeptic, Atwood has served as an associate editor of the journal Scientific Review of Alternative Medicine and as associate editor at Science-Based Medicine . He is also co-editor of Naturowatch, one of Quackwatch's affiliated sites. [1] [2] [3] In 2010, Atwood was elected as one of sixteen Fellows of the Committee for Skeptical Inquiry. [4]

Atwood is best known as a critic of naturopathic medicine. His long term interest in pseudoscience was piqued in 2000 by a nursing conference held at his hospital where therapeutic touch and other alternative healing practices were promoted as effective treatments for pleural mesothelioma. Atwood represented the opposition to naturopathic physicians licensing in his state and was the primary author of the minority report opposing such licensure in Massachusetts. [5]

Education and career

Atwood is the son of Barbara Frances Drew and Kimball Chase Atwood III, a geneticist. [6] He has four siblings. [6] He attended Harvard Medical School and did his internship and residency at Beth Israel Deaconess Medical Center. He holds board certifications from the American Board of Anesthesiology and the American Board of Internal Medicine. He received his Massachusetts State Medical License in 1981 and retired as an anesthesiologist in 2019 from Newton-Wellesley Hospital. [7]

Atwood is a Founding Fellow Board of Director for the Institute for Science in Medicine. [8] In 2010, he was elected as one of sixteen Fellows of the Committee for Skeptical Inquiry, an honor granted for "major contributions to science and reason, critical inquiry, and public education". [4] He has served Citizens For Responsible Care and Research Incorporated (CIRCARE) as a board member from 2009-2014 and as vice president from 2013-2015. [9] He has been affiliated with Massachusetts Medical Society. [10]

Opposition to naturopathy licensure in Massachusetts

Atwood was a member of the Massachusetts Special Commission on Complementary and Alternative Medical Practitioners, which convened in 2000 after six attempts by naturopathic groups to become licensed as health care providers. The Special Commission generated two reports in 2002. The majority report [11] recommended licensure for naturopaths. Atwood coauthored the minority report [12] which opposed the licensure. The minority report stated that there was no point in pursuing the goal of naturopathic licensure until the field radically changed, otherwise healthcare in the state would suffer in terms of safety and reputation. In 2003 Atwood, who was at the time chair of the MMS Committee on Quality of Medical Practice, [10] gave testimony opposing naturopathic licensure in Massachusetts to the Joint Committee on Health Care on behalf of the MMS. [13]

Naturopathic licensure did not succeed in the state of Massachusetts until 2017. [14]

Criticism of naturopathy

Atwood is especially critical of naturopathic medicine and is concerned about the extent to which medical institutions have accepted naturopathic practices. [5]

In an interview on the podcast The Skeptics' Guide to the Universe, Atwood explained why he concentrates his efforts on naturopaths. Atwood said that, although some naturopaths have "the trappings of legitimacy", such as advanced degrees from naturopathic institutes, and may seek state licensure or recognition as primary healthcare providers, they are not trained in modern medical techniques. [15]

In the interview, Atwood described the "hodgepodge" of techniques promoted by naturopathic physicians. [15] He indicated the dangers of state and federal officials and Medicare legitimizing alternative medicine, and said that, while naturopaths may claim that their teachings are based on science, they are not supported by clinical research. [15]

Science-based medicine advocate

Atwood is an advocate of science-based medicine (SBM) rather than evidence-based medicine (EBM). In a series of blog posts, Atwood said that EBM falls short in evaluating the claims of complementary and alternative medicine (CAM). [16]

Atwood uses homeopathy as an example to illustrate the weakness of EBM. Under the guidelines of EBM, all health claims should be subjected to randomized controlled trials, including those of pseudoscientific "alternative medicine" practices like homeopathy. Atwood says this is inappropriate because homeopathy is a health claim with no prior plausibility. [16]

Atwood writes that clinical trials to investigate homeopathic claims are often backed by proponents of the practices, and tend to be small and of poor quality. He says that equivocal or weakly positive results are wrongly interpreted as evidence for the validity of homeopathy, or of the value of further homeopathic research. Eventually, he believes, these studies will be superseded by larger, better-designed ones disproving homeopathic claims. He urges skepticism of clinical results which contradict established knowledge or basic science. [16]

In the abstract of Atwood's presentation to the European Skeptics Congress in 2003, he wrote that the claims of naturopaths "are so implausible that to study them is a bad idea.... [I]t gives a scientifically-naïve citizenry the misleading impression that legitimate scientists think such claims have merit, thus encouraging health fraud and waste. It is bad ethics because it wastes resources and exploits human subjects." [17]

Criticism of chelation therapy

In 2008, Atwood was the lead author of "Why the NIH Trial to Assess Chelation Therapy (TACT) Should Be Abandoned", [18] a Medscape article criticizing the National Institute of Health (NIH) and the National Center for Complementary and Alternative Medicine (NCCAM) for spending US$30 million on the Trial to Assess Chelation Therapy (TACT). Chelation therapy is a high risk (including death), medical procedure used to remove heavy metals from the body.[ medical citation needed ] The original study started in 2003. The criticism by Atwood is summarized:

We have investigated the method and the trial.... We present evidence that chelationists and their organization, the American College for Advancement in Medicine, used political connections to pressure the NIH to fund the TACT. The TACT protocols justified the trial by misrepresenting case series and by ignoring evidence of risks. The trial employs nearly 100 unfit co-investigators. It conflates disodium EDTA and another, somewhat safer drug. It lacks precautions necessary to minimize risks. The consent form reflects those shortcomings and fails to disclose apparent proprietary interests. The trial's outcome will be unreliable and almost certainly equivocal, thus defeating its stated purpose. We conclude that the TACT is unethical, dangerous, pointless, and wasteful. It should be abandoned. [18]

The Chicago Tribune indicated several problems with the study including difficulty in finding enough patients, improper consent by failing to include death as a risk, the expense and a congressional push in 1999 by Representative Dan Burton of Indiana. [19]

Proponents of the procedure pointed out a statistical significant difference in the results. 26% of the chelation patients went on to suffer a heart attack, stroke, or other heart problems compared with 30% of the patients on placebo. Medical researchers question the results because:

30% of participants dropped out of the trial, undermining comparison between the treatment and placebo. Critics also note that nearly two dozen trial co-investigators have been disciplined by state medical boards for infractions ranging from insurance fraud to providing ineffective treatments. "They offer aromatherapy, crystal therapy and every imaginable wacky form of medicine. You can’t do high-quality research at sites like that", says Steven Nissen, a cardiologist at the Cleveland Clinic in Ohio. "We wasted $30 million and 10 years on an unreliable study". [20]

Atwood said in 2012 that the results of TACT research agreed with his 2008 prediction: they were ambiguous and the authors could not recommend chelation therapy for CAD. While the authors recommended further research, Atwood disagreed, saying the study "convincingly demonstrates that the claims of chelationists have been bogus all along. That's because those claims have been far more dramatic than even the small effect that the TACT may appear to support." Atwood alleged that many of the investigators had criminal records. He said that medical journals should not publish this study due to alleged ethical violations of misleading the subjects in the consent form, which he said were a violation of the Helsinki Declaration. [21]

Related Research Articles

Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of medical science and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.

<span class="mw-page-title-main">Homeopathy</span> Pseudoscientific system of alternative medicine

Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths or homeopathic physicians, believe that a substance that causes symptoms of a disease in healthy people can cure similar symptoms in sick people; this doctrine is called similia similibus curentur, or "like cures like". Homeopathic preparations are termed remedies and are made using homeopathic dilution. In this process, the selected substance is repeatedly diluted until the final product is chemically indistinguishable from the diluent. Often not even a single molecule of the original substance can be expected to remain in the product. Between each dilution homeopaths may hit and/or shake the product, claiming this makes the diluent "remember" the original substance after its removal. Practitioners claim that such preparations, upon oral intake, can treat or cure disease.

<span class="mw-page-title-main">Naturopathy</span> Form of alternative medicine

Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as naturopaths. Difficult to generalize, these treatments range from the pseudoscientific and thoroughly discredited, like homeopathy, to the widely accepted, like certain forms of psychotherapy. The ideology and methods of naturopathy are based on vitalism and folk medicine rather than evidence-based medicine, although practitioners may use techniques supported by evidence. The ethics of naturopathy have been called into question by medical professionals and its practice has been characterized as quackery.

<span class="mw-page-title-main">Bach flower remedies</span> Solutions of brandy and water used as a homeopathic remedy

Bach flower remedies (BFRs) are solutions of brandy and water—the water containing extreme dilutions of flower material developed by Edward Bach, an English homeopath, in the 1930s. Bach claimed that the dew found on flower petals retains the supposed healing properties of that plant. Systematic reviews of clinical trials of Bach flower solutions have found no efficacy beyond that of a placebo.

<span class="mw-page-title-main">Quackery</span> Promotion of fraudulent or ignorant medical practices

Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, knowledge, qualification or credentials they do not possess; a charlatan or snake oil salesman". The term quack is a clipped form of the archaic term quacksalver, from Dutch: kwakzalver a "hawker of salve". In the Middle Ages the term quack meant "shouting". The quacksalvers sold their wares at markets by shouting to gain attention.

<span class="mw-page-title-main">Bastyr University</span> Alternative medicine university

Bastyr University is a private alternative medicine university with campuses in Kenmore, Washington, and San Diego, California. Programs include naturopathy, acupuncture, Traditional Asian medicine, nutrition, herbal medicine, ayurvedic medicine, psychology, and midwifery.

<span class="mw-page-title-main">Allopathic medicine</span> Term for science-based, modern medicine

Allopathic medicine, or allopathy, is an archaic and derogatory label originally used by 19th-century homeopaths to describe heroic medicine, the precursor of modern evidence-based medicine. There are regional variations in usage of the term. In the United States, the term is sometimes used to contrast with osteopathic medicine, especially in the field of medical education. In India, the term is used to distinguish conventional modern medicine from Siddha medicine, Ayurveda, homeopathy, Unani and other alternative and traditional medicine traditions, especially when comparing treatments and drugs.

The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), and renamed the National Center for Complementary and Alternative Medicine (NCCAM) before receiving its current name in 2014. NCCIH is one of the 27 institutes and centers that make up the National Institutes of Health (NIH) within the United States Department of Health and Human Services.

<span class="mw-page-title-main">Chelation therapy</span> Medical procedure to remove heavy metals from the body

Chelation therapy is a medical procedure that involves the administration of chelating agents to remove heavy metals from the body. Chelation therapy has a long history of use in clinical toxicology and remains in use for some very specific medical treatments, although it is administered under very careful medical supervision due to various inherent risks, including the mobilization of mercury and other metals through the brain and other parts of the body by the use of weak chelating agents that unbind with metals before elimination, exacerbating existing damage. To avoid mobilization, some practitioners of chelation use strong chelators, such as selenium, taken at low doses over a long period of time.

<span class="mw-page-title-main">Quackwatch</span> American alternative medicine watchdog website

Quackwatch is a United States-based website, self-described as a "network of people" founded by Stephen Barrett, which aims to "combat health-related frauds, myths, fads, fallacies, and misconduct" and to focus on "quackery-related information that is difficult or impossible to get elsewhere". Since 1996 it has operated the alternative medicine watchdog website quackwatch.org, which advises the public on unproven or ineffective alternative medical remedies. The site contains articles and other information criticizing many forms of alternative medicine.

<span class="mw-page-title-main">Edzard Ernst</span> German academic physician and researcher (born 1948)

Edzard Ernst is a retired British-German academic physician and researcher specializing in the study of complementary and alternative medicine. He was Professor of Complementary Medicine at the University of Exeter, the world's first such academic position in complementary and alternative medicine.

<span class="mw-page-title-main">National University of Natural Medicine</span> Private school n Portland, Oregon

The National University of Natural Medicine (NUNM) is a private university of naturopathic medicine and Classical Chinese medicine located in Portland, Oregon. The school has approximately 553 students.

<span class="mw-page-title-main">Naturopathic Physicians Licensing Examinations</span>

The Naturopathic Physicians Licensing Examinations (NPLEX) are professional licensing exams administered by the North American Board of Naturopathic Examiners (NABNE). Graduates of naturopathic programs accredited by the Council on Naturopathic Medical Education (CNME) are required to pass the exams before being permitted to practice naturopathic medicine in a U.S. state or Canadian province that licenses naturopaths.

The Ministry of Ayush, a ministry of the Government of India, is responsible for developing education, research and propagation of traditional medicine and alternative medicine systems in India. Ayush is a name devised from the names of the alternative healthcare systems covered by the ministry: ayurveda, yoga & naturopathy, Unani, Siddha, Sowa Rigpa, and homeopathy.

<span class="mw-page-title-main">David Gorski</span> Science-based medicine advocate

David Henry Gorski is an American surgical oncologist and professor of surgery at Wayne State University School of Medicine. He specializes in breast cancer surgery at the Karmanos Cancer Institute. Gorski is an outspoken skeptic and critic of alternative medicine and the anti-vaccination movement. A prolific blogger, he writes as Orac at Respectful Insolence, and as himself at Science-Based Medicine where he is the managing editor.

<i>Science-Based Medicine</i> Website covering issues in science and medicine, focusing on quackery

Science-Based Medicine is a website and blog with articles covering issues in science and medicine, especially medical scams and practices. Founded in 2008, it is owned and operated by the New England Skeptical Society, and run by Steven Novella and David Gorski.

<span class="mw-page-title-main">Friends of Science in Medicine</span> Australian association which supports science-based medicine

The Friends of Science In Medicine (FSM) is an Australian association which supports evidence-based medicine and strongly opposes the promotion and practice of unsubstantiated therapies that lack a scientifically plausible rationale. They accomplish this by publicly raising their concerns either through direct correspondence or through media outlets. FSM was established in December 2011 by Loretta Marron, John Dwyer, Alastair MacLennan, Rob Morrison and Marcello Costa, a group of Australian biomedical scientists and clinical academics.

Robert Sears Baratz is an American dentist and skeptic who practices in Braintree, Massachusetts. Baratz has practiced dentistry since 1972 and emergency medicine since 1991. He was formerly the executive director of the National Council Against Health Fraud (NCAHF).

<span class="mw-page-title-main">Britt Marie Hermes</span> American former naturopathic doctor and blogger (born 1984)

Britt Marie Hermes is an American former naturopathic doctor who became a critic of naturopathy and alternative medicine. She is the author of a blog, Naturopathic Diaries, where she writes about being trained and having practiced as a licensed naturopath and about the problems with naturopaths as medical practitioners.

<span class="mw-page-title-main">Stephen Straus</span> American virologist and science administrator

Stephen E. Straus was an American physician, immunologist, virologist and science administrator. He is particularly known for his research into human herpesviruses and chronic fatigue syndrome, and for his discovery of the autoimmune lymphoproliferative syndrome genetic disorder. He headed the Laboratory of Clinical Investigation of the National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH), and served as the founding director of the NIH's National Center for Complementary and Alternative Medicine.

References

  1. ↑ "Naturowatch.org home page". November 14, 2013. Archived from the original on May 5, 2017. Retrieved December 21, 2013.
  2. ↑ "Editors: Kimball C. Atwood IV, MD". Science-Based Medicine. October 5, 2008. Archived from the original on September 1, 2023. Retrieved December 21, 2013.
  3. ↑ "ISM Fellows: Kimball C. Atwood, IV, MD, Founding Fellow, Board of Directors". Institute for Science in Medicine website. 2010. Archived from the original on September 1, 2023. Retrieved December 21, 2013.
  4. 1 2 "Center for Skeptical Inquiry". January 12, 2010. Retrieved August 21, 2019.
  5. 1 2 "Naturowatch.org". June 16, 2002. Archived from the original on September 1, 2023. Retrieved January 26, 2019.
  6. 1 2 Saxon, Wolfgang (October 21, 1992). "Kimball C. Atwood 3d Dies at 71; Developed Way to Analyze Genes". The New York Times. ISSN   0362-4331 . Retrieved January 27, 2023.
  7. ↑ "Doximity, The Medical Network" . Retrieved January 31, 2019.
  8. ↑ "Institute for Science in Medicine" . Retrieved January 30, 2019.
  9. ↑ "Citizens for Responsible Care and Research" . Retrieved January 30, 2019.
  10. 1 2 "Mass Medical Society Report" (PDF). Archived from the original on August 4, 2020. Retrieved August 21, 2019.
  11. ↑ "Majority Report of the Special Commission on Complementary and Alternative Medical Practitioners" (PDF). Archived (PDF) from the original on September 1, 2023. Retrieved March 28, 2019.
  12. ↑ "Minority Report of the Special Commission on Complementary and Alternative Medical Practitioners" (PDF). Archived (PDF) from the original on June 17, 2016. Retrieved March 28, 2019.
  13. ↑ "Testimony Opposing Naturopathic Licensure in Massachusetts" . Retrieved March 28, 2019.
  14. ↑ "Naturopaths get their own licensing board in Mass". The Boston Globe . Archived from the original on March 28, 2019. Retrieved March 28, 2019.
  15. 1 2 3 "SGU Podcast #58 - August 30th, 2006". August 30, 2006. Archived from the original on November 30, 2017. Retrieved March 28, 2019.
  16. 1 2 3 Atwood, Kimball (February 8, 2008). "Homeopathy and Evidence-Based Medicine: Back to the Future Part V". Science-Based Medicine. Archived from the original on September 1, 2023. Retrieved March 30, 2019.
  17. ↑ "The 11th European Skeptics Congress, London, September 5-7, 2003" (PDF). Retrieved March 4, 2019.
  18. 1 2 Atwood, KC; Woeckner, E; Baratz, RS; Sampson, WI (2008). "Why the NIH Trial to Assess Chelation Therapy (TACT) Should Be Abandoned". The Medscape Journal of Medicine. 10 (5): 115. PMC   2438277 . PMID   18596934.
  19. ↑ Tsouderos, Trine. "Troubled study at heart of therapy debate". ChicagoTribune.com. Chicago Tribune. Archived from the original on September 1, 2023. Retrieved August 18, 2019.
  20. ↑ Callaway, Ewen (November 1, 2012). "Chelation-therapy heart trial draws fire". Nature. 491 (7424): 313–315. Bibcode:2012Natur.491..313C. doi: 10.1038/491313a . PMID   23151555. S2CID   4398212.
  21. ↑ "The Trial to Assess Chelation Therapy: Equivocal as Predicted". November 5, 2012. Archived from the original on September 1, 2023. Retrieved March 3, 2019.
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