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Straus Steps Down as NIH NCCAM Director, Transition Under Way PDF Print E-mail
Written by John Weeks   

Straus Steps Down as NIH NCCAM Director, Transition Under Way

Summary:  The first director of the NIH National Center for Complementary and Alternative Medicine Stephen Straus, MD, has stepped down from his position due to health reasons. A former acting director of the NIH, Ruth Kirschstein, MD, has been named acting director of NCCAM. A committee is exploring candidates for the director position. Does the NIH have the courage and maturity to appoint a director who unites research expertise with practical knowledge and expertise in the CAM/IM field?
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Stephen Straus, MD, first NCCAM director
Stephen Straus, MD,
the first director of the NIH National Center for Complementary and Alternative Medicine has been struggling with brain cancer for many months. Much of day-to-day-operations have recently been in the hands of Straus' deputy director, Margaret Chesney, PhD. On November 7, the NIH announced that Straus would step down from his role with the agency, which he has led since 1999.

In the NIH release, NIH director Elias Zerhouni, MD, celebrated Straus' work:
“Steve Straus has done a tremendous job in creating and leading NCCAM. His total dedication, superb intelligence, extraordinary vision, high energy, and singular wit are all qualities that make him an extraordinary leader.” The release noted the following accomplishments:
"During his tenure as NCCAM’s first Director, Dr. Straus built a comprehensive research enterprise, championing the efforts to establish the safety and efficacy of complementary and alternative medicine (CAM) practices while upholding the rigorous standards of science for which the NIH is known. Under his term of leadership from 1999-2006, CAM research at NIH grew threefold.

"Dr. Straus led the evolution of CAM science beyond the advocacy and skepticism and polarization it once engendered to earned legitimacy as a research area.  Studies encompassing a wide range of CAM practices including mind-body medicine, biologically based and manipulative practices, whole medical systems, and energy medicine have resulted in more than 1500 papers published in peer-reviewed journals.  Results of NCCAM’s first large clinical trials showed the effectiveness of acupuncture and glucosamine/chondroitin for osteoarthritis of the knee."
Zerhouni, who called Straus' "one of my most trusted advisors," plans to keep Straus on as a senior advisor to him, the NIH director.

Kirschstein to Serve as Acting Director

Ruth Kirschstein, MD, acting NCCAM director
Zerhouni named Ruth L. Kirschstein, MD to be the acting director of NCCAM.  Kirschstein is a respected NIH insider who was acting director of the NIH for a period in 1993, after serving as director of the National Institute of General Medical Sciences (1974-1993).
Kirschstein played important roles in the response to the AIDS outbreak in the 1980s. She also served a period with the Office of Women's Health and has been awarded many times for her public health contributions. For more on Kirschstein, click here.

A time table has not been announced although the Integrator has learned that Zerhouni has already assembled a committee to search for the new NCCAM director. According to sources, standard practice at the NIH is that acting directors cannot apply to be the director.

Comment: In the midst of the other pressures on NCCAM reported here, this changing of the guard is clearly both opportunity and risk. Kirschstein, who is roughly 80 years old, will be a place-holder, and a respected one, inside the institution.

Interestingly, the brief period in which Kirschstein served as NIH acting director coincided with the award of the first two NIH Office of Alternative Medicine "center grants." (The Office, later directed by Wayne Jonas, MD, was the precursor to the NCCAM.)  One of these grants went to an institution then led by naturopathic physicians, Bastyr University, for AIDS/ARC research. The other went to Hennepin Faculty Associates, to look at addiction treatments based on work of acupuncturist Patricia Culliton, MA, LAc. Kirschstein needed to sign-off on each of these awards, suggesting she carries no anti-CAM bias.

Will NIH Have the Courage to Appoint an NCCAM Director with Expertise in CAM?

Image Straus' tenure has been full of a lot more than the two paragraphs in the NIH release, of course. I have heard him commended many times by researchers, and also heard over the years that some doors to potentially useful research directions have been pretty-well shut down due to Straus' biases. Comments on the NIH NCCAM's value posted recently in the Integrator speak to conflicting views of NCCAM's direction under Straus.

Straus was an NIH insider, with no CAM experience, prior to taking on the directorship. I recall a New York Times story which followed his appointment. Straus shared that he hadn't tried CAM and didn't plan to. Some defended Straus' viewpoint, saying experience is not needed in a researcher (do you have to have cancer to study it?). And besides, this keeps out bias. Indeed, the politics of CAM at that time may have required that such a bundling board of non-experience be in place between the director and the newborn but already mongrel CAM center. Some said that Jonas' chance to gain the original NCCAM appointment was harmed by his deep personal and professional interest and expertise in the fields NCCAM is charged to explore.

I wondered back then, and still do, at what kind of dis-association allows a person to take on such a job and not have the human curiosity to get needled, use massage, experience a whole person first office call, have your homeopathic case taken, get adjusted. The left brain can learn from touch, from taste, from feel and from immersion,
though such a journey may seem like wearing leather-soled street shoes only to find oneself on a hike into a deep and muddy woods. But isn't that initial inquiry and desire to experience a natural part of a healthy scientific process? Isn't this particularly so if we are talking about a shift in a paradigm of treatment, from reduction to w/holism?

I join many in honoring Straus for the good work that NCCAM accomplished during his tenure.  And here is hope that Zerhouni, his exploratory committee, and the NIH have the maturity and courage to appoint a new director who unites some of Straus' research expertise with a passion and understanding of the field. The highest promise of so-called "alternative medicine" was never in single agents to combat diseases. Rather, the promise has been in treatment of chronic conditions that have multiple origins through clinical and behavioral change practices which take advantage of the whole of the human capability to respond. Troubling as the research questions are, and muddy as the way may be, this is where NCCAM can make its most significant contribution to human health.

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