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More Reflections on the Legacy of Former NCCAM Director Stephen Straus, MD - 1947-2007 PDF Print E-mail
Written by John Weeks   

More Reflections on the Legacy of Former NCCAM Director Stephen Straus, MD - 1947-2007

Summary: Since publishing some reflections of various researchers on the legacy of Stephen Straus, MD, the founding director of the NIH National Center for Complementary and Alternative Medicine, I have heard from three who were out of the country or unavailable when I queried them for their perspectives. Here are comments from: Christine Goertz Choate, DC, PhD, a former co-worker of Straus' inside NCCAM where she headed up health services research; David Eisenberg, MD, the director of the complementary and integrative medicine program at Harvard Medical School; and William Meeker, DC, MPH, the principal investigator for the NCCAM's center grant on chiropractic.
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Stephen Straus, MD - 1947-2007
On May 14, 2007, Stephen Straus, MD, the first director of the NIH
National Center for Complementary and Alternative Medicine died after a multi-year struggle with brain cancer. All who worked with him viewed him as a strong personality who had made a significant mark on the field. Last month, the Integrator published a series of reflections on his legacy for complementary and alternative health care. The Washington Post recently devoted a half-page article to his life. Here are three more recollections from individuals who worked closely with Straus or knew him as investigators.

1.   " ... this illustrates his level of involvement and personal touch ..."

Christine Goertz Choate, DC, PhD was hired by Straus to head up health services research at NCCAM. Choate had worked in research leadership for the American Chiropractic Association prior to her NCCAM position and has served as the deputy director of the Samueli Institute since. An Integrator adviser, Choate is presently executive director for the Palmer Center for Chiropractic Research.
"It is with a sense of both personal and professional loss that I pay tribute to my former colleague Dr. Stephen Straus. I first met him over the telephone when he called to tell me how pleased he was that I had accepted the position of Program Officer at NCCAM and that he was looking forward to working with me. I had no idea at the time that it is not general practice for the Director of an NIH Institute to put in a welcome call to a new program officer. However, I think this illustrates the level of involvement and the personal touch that Steve showed throughout his tenure as NCCAM Director. His total commitment to scientific rigor, acknowledgment of the policy implications and attention to detail were always evident. Under his leadership, CAM science has been taken to the next level. We will see the results of his work for decades to come."

Christine Goertz Choate, DC, PhD
Palmer College of Chiropractic
2.   " ... forever changed the way in which CAM therapy research will be conducted ..."

ImageDavid Eisenberg, MD is known to most in the field as the Harvard Medical School (HMS) researcher who was the primary author of the two studies of consumer use of complementary and alternative medicine. Published in the New England Journal of Medicine in January of 1993 and the Journal of the American Medical Association in November of 1998, the findings prompted the major healthcare stakeholders in the United States - hospitals, insurers, employers, media, political agencies and researchers - to notice that there was something happening here. He is director the Osher Institute at HMS.

"Stephen Straus forever changed the way in which complementary and alternative medical (CAM) therapy research is and will be conducted.

"Before Dr. Straus became Director of the National Center for Complementary and Alternative Medicine, the evaluation of CAM therapies was often perceived as an act of advocacy, not scientific inquiry. To his credit, Dr. Straus convinced his scientific peers that this approach was inconsistent with basic principles of scientific inquiry.  Instead, he insisted that the most up-to-date scientific methods be applied to the systematic evaluation of these therapeutic options.  Now, all institutes and centers of the National Institutes of Health, as well as the majority of research institutions worldwide, see the value of evaluating CAM therapies for their safety, efficacy, mechanism of action and potential for cost-effectiveness.  Thanks to Dr. Straus’ leadership, clinicians and patients will ultimately be able to distinguish useful from useless approaches to the treatment and prevention of common diseases.  Importantly, this approach also provides ample opportunity for scientific discovery.

"Stephen Straus accomplished this Olympian feat because of his unique personal attributes.  His integrity, his scientific excellence and his extraordinary interpersonal skills permitted him to engage stakeholders from all communities.  His untimely passing is a loss for us all.  May his memory always be a blessing."

David Eisenberg, MD
Director, Osher Institute
Bernard Osher Associate Professor of Medicine
Harvard Medical School
3.    " ... in his conventional world, his views made him controversial ..."

William Meeker, DC, MPH, was the principal investigator on an NIH NCCAM center grant on chiropractic. He recently took a new position as president of Palmer College of Chiropractic-West. Meeker was a member of Straus' original NCCAM advisory council.
"Steve Straus will go down in CAM history as one of its most influential individuals, not because he was a proponent for any CAM profession, procedure or substance, but because he passionately believed in the power of science to find the truth.

"Above all, Steve was a scientist. He was proud of his profession and he loved it; his dedication to science imbued his every action and thought. What makes his tenure as the first Director of the NIH National Center of Complementary and Alternative Medicine so important for CAM is that he truly believed that the field deserved to be evaluated in a scientific way. In his conventional world, this view made him controversial and subject to many kinds of undeserved disrespect and abuse, but he handled it well.

"As a member of the Steve's first NCCAM Advisory Council, I soon learned what an intelligent, focused and determined person Steve could be. He was unusually well-equipped for this demanding 'administrator/scientist' role. I found him a master of administrative process, a wise reader of other people, fair in his decisions, and often very funny. I learned much from him. While we did not always agree, there was never a time when he did not have a well-crafted argument for his point of view, backed up with evidence. He was a courageous man, and I respected him very much."

William Meeker, DC, MPH
President, Palmer College-West

Comment: These recollections of Straus, and those published earlier, have been instructive not only about Straus. They've also made palpable the culture of the NIH and CAM's sometimes' precarious place there during Straus' tenure. The federal government's CAM research endeavor was whipped about and bucking wildly when Straus was given the reins; he left it an entity more comfortably housed in the larger stable of NIH activity. No small feat.

I had anticipated seeing more back-and-forth in these comments about the challenges and differences which Meeker alluded to, or issues around advocacy and objectivity referenced by Eisenberg. I' has assumed that maybe we would have seen more about possible downsides to Straus' success in making CAM research respectable to those who were nay-sayers. He helped cool their fire, but did he set a course which best serves the public interest? Has anything been lost by the direction Straus set? Are there course corrections we should consider now? Are there roads not taken or barely opened which should be prioritized now? Is what we are doing with NCCAM's $120-million the highest and best use for research in services of the tax-paying public which funds NCCAM?

What we heard back from those who responded is largely that the man's passion for his own profession of research profoundly helped in securing a foundation for NCCAM. That success created a platform for the living to ask new questions. Those who can may try to make it to the NIH NCCAM Stakeholders Dialogue on June 20th, 2007.

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