The Cleveland Clinic is one of America’s premier medical institutions, consistently ranked at the very top of the nation’s best hospitals. I have little doubt that those rankings are well-deserved and that the care its staff provides to patients is reliably excellent. Were I in Ohio, I’d gladly refer my patients there and go there for medical treatment myself.
But the information the Cleveland Clinic puts out on its website and social media often has no sound basis, nor does the full range of services it offers meet the basic standard of medical practice: that treatments are consistent with the best scientific evidence.
Last week, a prominent physician at the Cleveland Clinic came under fire for penning an ill-informed anti-vaccine article for a local media outlet. The piece by Daniel Neides, who is medical director of Cleveland Clinic’s Wellness Institute, is rife with fundamentally incorrect yet all-too-common tropes about the supposed dangers of vaccination, including the thoroughly debunked association between “toxins” in vaccines and autism.
The institution later issued a statement clarifying that it had not approved Neides’s article, that “appropriate disciplinary action” would follow and that it fully supports vaccination. And Neides, through a Cleveland Clinic spokesman, issued a statement saying he apologized and regretted publishing the article. “I fully support vaccinations, and my concern was meant to be positive around the safety of them,” he continued.
Still, it is troubling that a doctor in his position there (and whose credentials with the institution were prominently displayed) would pen such an article in the first place.
And the problems with what you’ll hear from the Cleveland Clinic extend beyond one anti-vaccine article by an errant doctor. Examples of pseudoscience can be found in the material it provides to the public and the therapies it promotes.
During the Olympics last year, many athletes visibly sported clusters of dark purple bruises. Information on the Cleveland Clinic’s website explained that this was due to cupping, a traditional Chinese therapy purported to alleviate pain and hasten recovery from injury. Yet rather than making clear that there is no good evidence to support these claims (there isn’t), the Cleveland Clinic advised readers to find a skilled acupuncturist to get the benefits of treatment. The only real effect of cupping is to make someone look like they were trapped at the wrong end of a batting cage, and it’s disgraceful that the hospital’s website would say otherwise.
Unsupported medical claims also appear on the institution's Twitter account. Spinach may indeed contain vitamin C, but eating it won’t do anything to firm up your bottom. Use cayenne pepper to give your cooking more oomph, but don’t expect it to lower your blood pressure or prevent infection. It’s bad enough when overblown claims of nutritional benefit come from lifestyle magazines. They have no business coming from one of the country’s premier medical institutions.
The most dismaying deviation from evidence-based practice comes from the way the Cleveland Clinic presents some of the patient services it offers.
Its TRIM-LIFE weight loss program, for example, includes work on mindfulness and relaxation. While on the surface that aspect of care may seem worthwhile, the supposed benefits it promises don’t withstand scrutiny.
“Our mindfulness and relaxation techniques will allow you to change the inner programming that can make sustained weight loss a challenge,” the promotional website reads. “We will help you re-regulate your metabolism to burn ‘hotter,’ releasing unnecessary weight.”
Evidence-based medical providers beg to differ.
“For centuries, unscrupulous charlatans have preyed upon the public's desperate desires to lose weight by making fantastic, evidence-free claims of how they have a magical cure,” said Yoni Freedhoff, an assistant professor of family medicine at the University of Ottawa, author and specialist in weight loss and obesity management.
“This is worse,” he continued. “This is one of the world's most prominent hospitals claiming that they can teach people how to mentally will themselves into becoming fat- and calorie-burning furnaces despite the fact that there is no credible evidence to suggest that mindfulness can affect metabolism, fat loss or weight loss in any meaningful way.”
The Cleveland Clinic also offers “Energy Medicine” therapy, described as “practices [that] are based on the premise that by promoting balance and flow in the body’s electromagnetic and subtle energies, health and well-being are improved.” Among the conditions this supposedly treats, the hospital lists multiple sclerosis and hormone imbalances. Similarly, its Center for Integrative Medicine touts the benefits of reiki, a “hands-on natural healing” technique that redirects “universal life force energy.” According to the Cleveland Clinic, those benefits include enhancing the immune system and improved tissue healing, and its practitioners treat patients with cancer, Parkinson’s disease and other serious illnesses.
As a physician, I am all too aware of how frightening, exhausting, stressful and dispiriting illness and hospitalization can be. I am broadly in favor of hospitals offering a wide range of psychological, emotional and spiritual supports. Though I do not subscribe to it myself, if reiki helps patients cope with being sick, I’m not categorically opposed to it, any more than I would be opposed to a visit from a chaplain or counselor.
But it crosses an extremely important, bright line to call that kind of service “medicine,” or to ascribe a set of therapeutic benefits to it. Describing the manipulation of energy fields as a kind of treatment moves from evidence-based medicine into the realm of faith healing.
For good or ill, I know patients (or, in my work as a pediatrician, their parents) take to the Internet all the time to research their symptoms or get more information about their condition. No matter how comprehensive the material my practice may provide directly, we can’t hope to cover every question that might crop up. People will understandably look for their own answers. Unfortunately, when no less than the president-elect is among those promulgating dangerous misinformation about vaccines, medical providers have to deal with a lot of false, misleading stuff their patients may find.
One way I deal with this is to give patients a list of resources that generally provide good, evidence-based advice. Though I can’t vet every single article they may publish, knowing a few sites that typically give clear, sound information is a valuable resource when patients ask.
Sadly, no matter how glowing its reputation or how superlative the care it routinely provides, I can’t include the Cleveland Clinic on that list. Knowing it promotes treatments that have no grounding in science, or that a patient could stumble upon a fearmongering article that makes baseless claims about the unspecified dangers of environmental toxins on its website, I can’t direct patients there in good faith. Considering its prominence as a renowned medical establishment, that’s a terrible shame.
Daniel Summers is a pediatrician in New England.