Dismantling NCCAM: A How-To Primer

Once upon a time in Bethesda, Maryland, Congress looked at the growing world of herbs, homeopathy, energy fields, and coffee enemas and thought,
“Sure, let’s study that.” The result was the Office of Alternative Medicine, which later grew up into the National Center for Complementary and
Alternative Medicine (NCCAM) and, after a strategic rebranding in 2014, the National Center for Complementary and Integrative Health (NCCIH).
Same building, same mission, slightly shinier name.

From the start, science-based medicine advocates have asked a simple question: if a treatment works, why does it need a special “alternative”
corner of the National Institutes of Health (NIH)? Why not just test it like everything else and, if it passes, call it medicine?
That question sits at the heart of the original Science-Based Medicine essay “Dismantling NCCAM: A How-To Primer” and still matters today, now
that NCCAM has been rebranded but not really rethought.

In this article, we’ll unpack what NCCAM/NCCIH is, why critics see it as a taxpayer-funded monument to bad incentives, and what “dismantling” it
would actually look like in practical, policy-focused terms. Along the way we’ll keep the tone light, but the standards firmly rooted in
evidence, not wishful thinking or magical energy fields.

What NCCAM (Now NCCIH) Actually Is

NCCIH is one of 27 institutes and centers that make up the NIH. It started in 1991 as the Office of Alternative Medicine with a small budget and a
congressional mandate to explore “unconventional” therapies. By 1998 it had been elevated to a full NIH center as NCCAM, and in 2014 it was
renamed the National Center for Complementary and Integrative Health to focus on “integrative” rather than “alternative” care.

That name change wasn’t just a branding tweak. “Alternative” suggests something outside mainstream medicine; “integrative” suggests something cozy
and compatible with it. Critics argue that this shift makes it easier to market unproven practices as gentle, holistic add-ons rather than
fringe ideas that haven’t passed scientific muster. In other words, the new label softens skepticism without fixing the underlying scientific
problems.

NCCIH divides the world of complementary and alternative medicine (CAM) into three broad buckets:

• Natural products: herbal supplements, botanicals, vitamins, and various plant-based concoctions.
• Mind and body practices: yoga, meditation, tai chi, qigong, spinal manipulation, acupuncture, and similar practices.
• Other approaches: homeopathy, naturopathy, Traditional Chinese Medicine systems, Ayurveda, and energetic or spiritual
  healing practices.

Over the decades, NCCAM/NCCIH has received billions of dollars in cumulative funding to study these modalities. Some of that work has looked at
plausible questions (for example, whether mindfulness training helps chronic pain or anxiety). A lot of it, however, has chased highly implausible
claimslike distant prayer changing hard clinical outcomes, or magnets curing arthritisthat clash with basic biology and have repeatedly produced
negative or inconclusive results.

When Taxpayer-Funded Science Becomes a Parallel Universe

If NCCIH were a small side unit quietly running a few studies, it would probably not attract much attention. But it isn’t. It sits inside the
world’s premier biomedical research agency, with its own budget, leadership, advisory council, and strategic plans. That structure has created a
kind of parallel research universe where certain ideas get protected and funded not because they’re especially promising, but because they fall
under the “CAM” umbrella.

Over the years, NCCAM/NCCIH has funded or co-funded trials on topics such as:

• Prayer and “distance healing” for serious diseases.
• Magnet therapy for pain conditions like arthritis and carpal tunnel syndrome.
• Energy healing for animals and lab models.
• Coffee enemas and other detox regimens for cancer.
• Homeopathic preparations, which by design contain little or none of the original substance.

These projects are not fringe YouTube experiments; they are federal grants that go through peer review, consume time and talent, and result in
published papers. The consistent pattern, documented by skeptics who have followed these trials for years, is that high-quality studies largely
fail to confirm the bold claims made by CAM advocates. In other words: the more rigorous the research, the less impressive the results.

That wouldn’t be a problem if the center’s mission were to test a wild idea once and move on. But critics argue that NCCIH has often kept
returning to the same implausible wells, even when earlier studies were negative. If the rest of NIH behaved this waypouring money into
repeatedly disproven hypotheseswe’d call it a scandal.

Why Science-Based Medicine Advocates Call for Dismantling

Dismantling NCCAM wasn’t a phrase invented lightly. When Science-Based Medicine and other skeptical organizations talk about “dismantling,” they
are pointing to several recurring problems that have persisted despite leadership changes and strategic plans.

1. No Unique Scientific Mission

The central objection is simple: there is no scientific reason to carve out a separate center for CAM. If a therapy is plausible enough to
warrant studysay, mindfulness for chronic pain, or yoga for back painit can be studied by existing institutes such as the National Institute of
Neurological Disorders and Stroke, the National Institute of Mental Health, or the National Institute of Arthritis and Musculoskeletal and Skin
Diseases. NIH already has the infrastructure, expertise, and peer review systems in place to evaluate behavioral or non-drug interventions.

Creating a separate center implies that CAM is a coherent scientific specialty rather than a marketing category. It also creates pressure to
maintain a pipeline of CAM-specific projects just to justify the center’s existence. That’s backwards: the science should determine what gets
funded, not the survival needs of a politically created office.

2. Extraordinary Claims, Ordinary or Negative Results

Many of the interventions that drew NCCAM’s early attentionlike homeopathy, energy healing, and distant prayerrest on mechanisms that flatly
contradict chemistry, physics, or physiology. When such claims are tested rigorously, they almost always fail. The problem is not simply that they
fail, but that the negative results often do not lead to a clear public message of “this doesn’t work; don’t waste your money.”

Instead, reports may emphasize how “more research is needed” or highlight small, clinically unimportant differences. Meanwhile, marketing for
these same therapies often cherry-picks the most flattering phrases from government documents to lend credibility: “studied by the NIH” can be a
powerful sales tool, even if the underlying trial found nothing clinically meaningful.

3. Politics Over Evidence

NCCAM was born out of political pressure, not scientific demand. Members of Congress sympathetic to alternative medicine advocates pushed for a
dedicated office and later a full center, often over the reservations of mainstream researchers. That political origin still matters. It means
NCCIH is structurally insulated from the normal “survival of the most useful” pressures that shape NIH research priorities.

Critics have noted that the center’s agenda and survival are tied to keeping certain constituencies satisfiedpractitioners, industry
stakeholders, and voters who like the idea of “natural” medicinerather than simply asking, “Where can these dollars do the most good for
patients?” When politics rather than plausibility drives what gets funded, the result is often look-busy science with low impact.

So What Would “Dismantling NCCAM” Actually Look Like?

The phrase can sound dramatic, like a wrecking ball swinging through NIH headquarters. In practice, dismantling NCCAM/NCCIH would be more like a
careful reorganization of responsibilities, with a strong emphasis on scientific standards and patient welfare.

Step 1: Absorb Plausible Research into Existing NIH Institutes

Not everything NCCIH touches is nonsense. Studying physical activity, stress reduction, and cognitive-behavioral techniques for chronic pain,
depression, or insomnia can absolutely be worthwhile. The issue is where that work lives and under what rules.

A science-based dismantling plan would:

• Move studies of exercise, mindfulness, and other plausible behavioral interventions into appropriate disease-focused institutes.
• Subject those studies to the same standards of trial design, preregistration, and replication as any other clinical research.
• Eliminate the artificial requirement that they be branded as “integrative” or “complementary” to be funded.

In other words, if a yoga-based program looks promising for back pain, it should compete directly with other pain treatments for funding. No
special category, no parallel peer-review universe.

Step 2: Stop Funding Implausible and Disproven Modalities

Dismantling also means drawing firm lines. There is no scientific justification for continued federal funding of homeopathy, energy healing,
distant prayer as a medical intervention, or magnet therapy for systemic disease. These ideas either violate basic science or have already been
tested and failed in controlled trials.

A concrete policy step would be to:

• Explicitly deem certain categories “no longer a research priority” after repeated high-quality null results.
• Redirect funds previously used for such trials into more promising interventions, including underfunded areas of conventional care.
• Publish clear summaries in plain language stating that these modalities have not demonstrated meaningful benefit.

This isn’t “close-minded.” It’s how science normally works: hypotheses that repeatedly fail get deprioritized so new ideas can be tested.

Step 3: Raise the Bar for All Non-Drug Therapies

Critics sometimes worry that shutting down NCCIH would mean ignoring non-pharmacologic treatments. It’s actually the opposite. The goal is to hold
all non-drug therapiesacupuncture, chiropractic, meditation, manual therapy, dietary supplementsto the same standards any drug or
device would face.

Whether a trial is run inside NCCIH or another institute, science-based medicine calls for:

• Biologically plausible mechanisms.
• Solid preclinical or preliminary data before large, expensive clinical trials.
• Preregistered protocols, appropriate controls, and meaningful clinical endpoints.
• Transparent reporting, including null or negative results.

The problem is not that NCCIH studies non-drug interventions; it’s that it has historically funded too many poorly grounded ideas and sent mixed
messages when they failed.

Step 4: Revert NCCIH to a Small Evaluation Officeor Close It

One practical dismantling option is to shrink NCCIH back into a small office within the NIH director’s purview. That office could:

• Coordinate occasional methodological workshops on studying behavioral interventions.
• Serve as a clearinghouse summarizing evidence about popular non-drug therapies for other institutes and the public.
• Have no independent grant-making authority, preventing it from becoming a protected silo.

A more decisive option would be to abolish the center entirely, transferring its staff and ongoing plausible projects to other institutes and
winding down the rest. Either way, the key is that “CAM” stops being a protected funding category.

Step 5: Fix Public Communication

Finally, dismantling isn’t just about budgets; it’s about language. Any government communication about CAM should be brutally clear about what
works, what doesn’t, and where evidence is lacking. That means:

• No “careful” wording that sounds like an endorsement for therapies that failed trials.
• Prominent statements that “no benefit was found” when that’s what the data show.
• Patient-facing materials that actively warn about opportunity costs, financial harm, and the risk of delaying effective treatment.

If a treatment has repeatedly failed in well-designed research, the most integrative thing we can do is integrate that failure into patient
counseling.

Common Counterargumentsand Science-Based Replies

“But people love CAM. Shouldn’t we study what they use?”

Yes, popularity matters, but it doesn’t override plausibility or opportunity cost. People also love fad diets and detox cleanses; that doesn’t
justify unlimited federal trials on lemon-juice cleanses. Studying widely used therapies is reasonable, but only within a framework that prioritizes
likelihood of benefit, not marketing buzz.

“NCCIH is improving and focusing on whole-person health.”

NCCIH’s recent strategic language emphasizes “whole-person health” and non-pharmacologic strategies for pain and chronic disease. Some of that is
aligned with mainstream priorities, like reducing opioid reliance and improving self-management. The criticism is that these goals don’t require a
separate CAM-branded center. Every major NIH institute already has to think in “whole-person” terms; slapping a CAM label on it doesn’t add
scientific value.

“Getting rid of NCCIH would prove scientists are biased.”

The opposite is true. Science-based critique is not about protecting the status quo; it’s about matching resources to reality. When
high-quality trials show a therapy helps, science-based physicians adopt iteven if it started life as an “alternative” idea. What skeptics object
to is funding that continues long after evidence has turned against a treatment.

What Clinicians, Researchers, and Citizens Can Do

Dismantling NCCAM/NCCIH in the policy sense would require congressional action and pressure from scientific and medical organizations. But you
don’t need a Senate seat to nudge things in the right direction.

• Clinicians can prioritize honest conversations about evidence, gently but firmly discouraging patients from abandoning
  proven care in favor of unproven CAM therapies.
• Researchers can push for higher standards in trial design, resist “tooth-fairy science” (studying detailed mechanisms of
  something that probably doesn’t work), and advocate that plausible non-drug research live in mainstream institutes.
• Citizens can support organizations that promote science-based health policy, contact their representatives about responsible
  research funding, and vote for leaders who value evidence over anecdotes.

In short: Dismantling NCCAM is less about smashing something and more about cleaning up how we think, study, and talk about medicineno quotation
marks needed around the word.

Experiences from the Front Lines of Science-Based Medicine

To understand why people get fired up about NCCAM/NCCIH, it helps to look at what this all feels like on the ground. The stories below are
composites based on recurring experiences reported by clinicians, researchers, and policy watchers.

Imagine you’re a primary care physician in a busy clinic. You see a patient with poorly controlled diabetes who proudly announces they’ve stopped
their medication because they’re “going natural.” They show you a printed packet from a supplement company, complete with quotes about NIH-funded
studies on “ancient botanical remedies” and “integrative approaches” to blood sugar. The company’s marketing has latched onto the fact that
something vaguely related was once studied under an NIH CAM grant. The nuancethat the study was small, negative, or not reproducednever made it
into the brochure.

You now have to do three jobs at once: manage the diabetes crisis in front of you, dismantle misleading claims without shaming the patient, and
gently explain that “NIH studied this” is not the same as “NIH proved this works.” When you later discover that the study in question was funded
through NCCAM and produced no meaningful benefit, you understandably wonder why such work is still being used as a halo for products that don’t
help your patients.

Now shift to the viewpoint of a young researcher. You’re passionate about pain management and fascinated by how exercise, cognitive-behavioral
strategies, and mindfulness can help people function better. You notice that many grants in your area are routed through NCCIH rather than the
traditional neuroscience or musculoskeletal institutes. That sounds fine at firstmoney is moneybut then you sit on a review panel and realize
the portfolio is a weird mix of solid behavioral science and projects on energy fields and “bio-information transfer” that feel more like
science-fiction than science.

You start to worry that your own respectable work will be lumped together with highly implausible projects simply because they share the CAM
label. That can make collaborations awkward and may even affect how seriously some colleagues take your research. You’d rather your trial on
physical activity and pain live in a mainstream pain institute, judged by the same criteria as every other treatment.

Finally, picture a staffer on Capitol Hill tasked with reviewing NIH spending. You’re not a scientist, but you’re reasonably savvy. On your desk
are budget lines showing that one centerNCCIHhas poured substantial resources into studies that have not changed guidelines, improved standard
care, or produced widely adopted therapies. Meanwhile, you’re hearing from cancer and infectious disease researchers who struggle to get highly
promising projects funded.

When you dig into the history, you discover that NCCAM was created and expanded largely due to political pressure, not because the scientific
community desperately needed a CAM silo. You also find critical reports pointing out that many NCCAM-funded trials are of lower priority or
weaker design compared with the rest of NIH’s portfolio. At some point, the question “Should we keep funding this?” stops being edgy and starts
sounding like basic fiscal responsibility.

These kinds of experiences help explain why dismantling NCCAM/NCCIH is not a niche crusade. It’s a reflection of deeper frustrations with how
pseudoscience, politics, and wishful thinking can distort research priorities in even the most respected institutions. For clinicians, it shows up
as confusion at the bedside. For researchers, it shows up as mixed signals about what counts as serious work. For policy staff, it shows up as
a line item that is increasingly hard to justify.

None of this means we should ignore non-drug approaches, dismiss patients’ lived experiences, or cling blindly to the status quo. It means we
should demand that every therapyherbal, high-tech, ancient, or brand newplay by the same scientific rules. Dismantling NCCAM is ultimately
about dismantling the double standard that has allowed weak ideas to hide under the comforting umbrella of “complementary and integrative health.”

Conclusion: One Standard of Evidence, No Special Islands

NCCAM, rebadged as NCCIH, represents a well-intentioned but deeply flawed experiment: carve out a special island for “alternative” or
“integrative” medicine inside the world’s leading biomedical research agency and hope that good science emerges. Decades later, the main legacy is
a trail of negative or inconclusive trials, a confusing public message, and a persistent double standard about what deserves federal funding.

Dismantling NCCAM doesn’t mean ignoring yoga, meditation, exercise, or nutrition. It means treating them as what they arepotentially useful
interventions that should live in the same ecosystem as everything else, judged by plausibility, evidence, and patient outcomes. When we stop
protecting categories and start protecting patients and scientific integrity instead, everybody winsexcept, perhaps, the sellers of magic
magnets.