I knew that Jann was thinking of writing about reiki and fraud, but did not know the details of her most excellent discussion from yesterday until I had finished my penultimate draft for today. Think of them as a match set, two perspectives on the same elephant.

Fraud: a person or thing intended to deceive others, typically by unjustifiably claiming or being credited with accomplishments or qualities.

There are numerous activities that one human will offer another in exchange for money that are completely divorced from reality.

Astrology. Total bunkum.

There is no force, known or unknown, that could possibly affect us here on Earth the way astrologers claim. Known forces weaken too fast, letting one source utterly dominate (the Moon for gravity, the Sun for electromagnetism). An unknown force would allow asteroids and extrasolar planets to totally overwhelm the nearby planets…
Study after study has shown that claims and predictions made by astrologers have no merit. They are indistinguishable from chance, which means astrologers cannot claim to have some ability to predict your life’s path.

Although 48% of Americans think astrology is a science, as best I can tell astrology is not part of the curriculum at any astronomy division or program. Astronomers know it is bunkum and avoid it .

Alchemy. Total bunkum. Outside of a nuclear reactor, you cannot turn base metals into gold. And, as best I can tell, alchemy is not part of the curriculum at any chemistry division or program. Chemists know it is bunkum and avoid it.

Parapsychology. Total bunkum. There is no ESP, no ability to read minds, talk to the dead, move objects with thought etc. etc. While as many as 75% of Americans believe in one form of parapsychology, as best I can tell, parapsychology is not part of the curriculum at any psychology division or program. Psychology departments know it is bunkum and avoid it.

Offering astrology or alchemy or talking to the dead for money seems to me to not quite meet the dictionary definition for fraud since I assume for most practitioners there is no intent to defraud. But they do anyway. Just not intentionally.

The legal definition of fraud? Those are waters I will not swim in. Why there are palm readers and astrologers and psychics who perform their services for money when there is no basis in reality for their services is beyond me. Like the lottery, those practices are for entertainment value? The law has limited resources and has to pick and choose?

What about pseudo-medicines? Isn’t that fraud? Jan Bellamy has a nice discussion of the issue. It is a complex issue under the law. Whether pseudo-medical providers taking money from the sick and desperate for therapies that have no basis in reality is legal fraud, I leave to lawyers. In my moral-ethical calculus, offering pseudo-medicines, such offerings may not be legal fraud, but are no different from astrology or talking to the dead.

I don’t see NASA joining up with the American Federation of Astrologers. While astronomers avoid astrology, psychologists avoid parapsychology and chemists avoid alchemists, how does the medical field respond to magic? They form Integrative or Alternative Medicine programs.

One would think that leading medical institutions, major hospitals and universities would know better. What hospital wants to offer imaginary therapies to their patients? Quite a few, evidently.

Take, for example, reiki. An energy ‘therapy’ that is nonsense has no effect on any disease in well done studies. It is, like homeopathy, 100% pure bunkum.

Much to my surprise, while I have done a Quackcast on reiki, I have never written on the topic. A quick summary of the pertinent features.

1) It was just made up. So many SCAMs have a origin story that is on par with gamma ray exposure or being hit by lightening when bathed in chemicals. In this case reiki was created, not unlike the works of Stan Lee, by Mikao Usui as part of a midlife crisis.

2) Its precepts are:

There is a universal and inexhaustible spiritual energy which can be used for healing purposes.

Through an attunement process carried out by a Reiki Master, any person can gain access to this energy.

This energy will flow through the Reiki Master’s hands when he/she places his/her hands near the patient.

As this energy has human-like intelligence, there is no need for diagnosis — the energy will automatically judge the disease and heal the patient.

This energy is, like all energy in SCAMs, has nothing to do with the concept of energy as understood by reality-based sciences like physics. Unmeasured and unmeasurable, this energy is not Kinetic, Potential, Mechanical, Mechanical wave, Chemical, Electric, Magnetic, Radiant, Nuclear, Ionization, Elastic, Gravitational, Intrinsic, Thermal, Heat or Mechanical work. And I suppose Dark, whatever dark energy may be.

This energy can only be detected by the reiki or other energy practitioner unless, of course, they are being tested by a fourth grader. Odd. We can detect the Voyager spacecraft transmitting with the power of a refrigerator light bulb from 10 billion miles away but cannot measure the human ‘energy’ field.

Watch the videos. The reiki practitioners sometimes touch the patient and sometimes they wave their hands over the patient. At least when the patient lays down, relaxes and is touched by a practitioner, you get a bit of the social grooming. It is probably why people feel good with a Reiki treatment. But hand waving the ‘energy’ away? Really. They are serious. And taking money from people to do it.

And what is kind of creepy, and I did not look at every video on the YouTubes, but every person being reiki-ed is female. Someone should do a survey of SCAM videos on the YouTubes. I bet 95% of those being SCAMed upon are thin, young females and most of those performing the SCAM are older males. Or maybe that’s a touch of confirmation bias on my part.

3) There are zero quality studies to demonstrate that reiki is effective beyond that of beer goggles.

To summarize reiki is an invented fiction with no basis in physical reality that has no proven efficacy beyond placebo effects, and you know if you read this blog what I think of placebo effects. If I had a drug I wanted to have on formulary with those characteristics, I would be laughed out of the P&T committee. But intellectual rigor is not always a prized characteristic.

So here is a sobering statistic:

More than 60 U.S. hospitals have adopted Reiki as part of patient services, according to a UCLA study, and Reiki education is offered at 800 hospitals.

That includes, with their description of reiki:

  • Sloan Kettering. Along with reflexology and Restorative Facial Acupuncture.
  • Yale-New Haven

    healing energy lulls you into a deeply relaxed state. It is this deep relaxation that increases energy as the body rests and becomes revitalized during the session

  • Dana-Farber/Harvard Cancer Institute

    Based on the belief that an unseen “life-force energy” flows through us and helps keep us alive, Reiki is a Japanese technique for stress reduction that is safe, natural, and easy to learn….You simply lay down on a table, fully clothed, while a licensed Reiki master (teacher) places his or her hands on various parts of your body. In addition to making you feel more relaxed, safe, and secure, a proficient instructor can facilitate energy flow to the areas where you need it most – often creating a warm feeling in those locations.
    Reiki treatments offered to all by the university health services (well-being)

    Through healing touch, your energy level is balanced and immune system enhanced.

  • Brigham and Women’s Hospital. At least it is a volunteer program; they offer magic for free.
  • Columbia University

    Reiki is an ancient, gentle hands-on healing technique that originated in Japan in which a Reiki practitioner allows energy to pass through him/her to another person, for the recipients higher good. This energy flow can realign, recharge and rebalance an individual’s energy field, which creates the conditions needed for an integrated functioning of the body’s healing ability

  • Johns Hopkins Hospital

    Reiki is a very specific form of energy healing, in which hands are placed just off the body or lightly touching the body, as in “laying on of hands.” Reiki can also be done “long-distance,” as a form of prayer…In a Reiki session, the practitioner is seeking to transmit Universal Life Energy to the client.

  • University of Maryland

    Reiki is a powerful yet subtle healing practice used as a support for wellness on a body, mind and spiritual level. It is offered through non-invasive, light touch to a clothed client on a massage table. Reiki energy work helps to restore balance, increase energy flow, improve sleep and relieve pain. One of the greatest benefits of Reiki is stress reduction and relaxation which triggers the body’s natural healing abilities!

  • University of Pennsylvania Health System
  • University of Maryland Medical Center

    Therapeutic touch is a kind of healing that uses a practice called “laying on of hands” to correct or balance energy fields. Despite the use of the word “touch,” the hands usually hover over the body and don’t physically touch it.

  • The Cleveland Clinic

    Reiki is a form of hands-on, natural healing that uses universal life force energy. The term comes from the Japanese words “rei,” which translates into universal, and “ki,” which means vital life force energy that flows through all living things. This gentle energy is limitless in abundance and is believed to be a spiritual form of energy. It is not tied to any specific religion or nationality.

    The Reiki practitioner is the conduit between you and the source of the universal life force energy. The energy flows through the practitioner’s energy field and through his or her hands to you. The energy does not come from the practitioner; it comes through the practitioner from the universal source.

  • New York University Medical Center

I only mentioned some of institutions that are involved with medical education or are considered one of the best US medical institutions. Many more community hospitals are offering reiki and lists can be found on the net (I could not, in good faith, click on their ‘agree’ button). If you Google reiki and hospitals you can find various lists of hospital that offer this and other forms of magic to the ill. And proudly I might add. And it seems that this particular form of pseudo-medicine has a real East coast popularity; and here I thought it was the West Coast that was the center of all things flakey.

One would think if the fundamental thesis of a human energy field could he disproven by a fourth grader, Harvard or the Columbia could figure out that reiki was bunkum. Guess not.

Usually when patients receive ministrations from those representing a higher energy and belief systems (I am thinking clergy here), it is a free service for the patient. Belief systems are usually provided free, or at least should be. And, to point out, with no little irony,

a Catholic who puts his or her trust in Reiki would be operating in the realm of superstition, the no-man’s-land that is neither faith nor science

I have this semi-pateralistic idea that health care providers and institutions are not supposed to offer worthless and imaginary therapies to ill people for money. We have a higher standard to follow.

Well, we did. Past tense.

I cannot find much on the medical ethics of offering worthless alternative therapies by health care providers, universities, hospitals and other institutions. Kimball Atwood has discussed the issue, but most of the references speak to SCAM issues that surround the patient-physician relationship: how to respond to a patient who desires a SCAM. I can nothing on the ethics of offering reiki, homeopathy or other fantasies.

The day of the private practice doctor is on the wane and most of us work for or will work for large institutions. I can also find nothing on the ethics of institutionalizing magical therapies outside of Hogwarts.

Offering reiki may not be legal fraud, although given the right set of circumstances evidently it can be, but it is not right. Evidently that ethical standards and integrity are not important to the major medical institutions in the US.

And energy therapies do not even make the patient feel better as is so often thought. As a recent study on energy healing showed:

Whereas it is generally assumed that CAMs such as healing have beneficial effects on well-being, our results indicated no overall effectiveness of energy healing on QoL, depressive symptoms, mood, and sleep quality in colorectal cancer patients. Effectiveness of healing on well-being was, however, related to factors such as self-selection and a positive attitude toward the treatment.

Similar to acupuncture, and probably all of SCAM, energy therapies have effects on subjective outcomes only if patients think it will work. While I often refer to these interventions as beer goggles, they are also self-fulfilling wishful thinking.

If you want a litmus test to see if your local medical institution may not by particularly concerned with reality, that their Board of Directors is not paying much attention to quality, and the institution prefers money and magic, see if they offer reiki. Or acupuncture, reflexology, craniosacral therapy, or has a naturopath on staff who provides homeopathic nostrums.

As I think about, it would probably be harder to find a large hospital that doesn’t offer at last one of these pseudo-medicines.

I will finish with the following quote, from The Ethics of Alternative Medicine: An Alternative Standard?

When we offer alternative treatments, we advise our patients, treat them and then cash their checks. We respond to a demand in the marketplace, hoping to help patients and then profit from it. We might help our patients, but there is no proven benefit to the treatment we offer. We assume we will not hurt them, but the safety of what we do is not really proven to today’s randomized, controlled standards, either. Aren’t we more like snake oil salesmen when we pitch alternative medicine to our patients?

To be sure, we all have much to gain by embracing change in medicine. Other cultures and non-Western medical traditions have much to teach those of us who are open-minded enough to listen. The list of “traditional” medical advances that have grown out of “alternative” avenues is long and important. In this environment, it is more crucial than ever not to lose sight of our responsibilities. Patients come to us for help in filtering. They trust that our traditions of integrity and scientific inquiry will help us to help them navigate a bewildering array of health care offerings. They could go to an herbalist or an acupuncturist or a massage therapist for alternative treatments alone. Instead, some of them visit us for a “scientific” seal of approval.

We must respond to our patients’ trust with integrity. Let’s do more soul-searching before we advise patients about untested therapies. Let’s make sure we are not administering acupuncture needles or gingko to patients just because of market demands. We must insist that clinical trials test alternative approaches before we embrace them. We would not place our patients on methotrexate before learning that it was safe and effective. Let’s not give them magnetic treatments without the same standard. That’s not “alternative medicine,” or even “traditional medicine”; it’s just good medicine.

As I have said before, Sisyphus had it easy.



  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, from 1990 to 2023. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His multi-media empire can be found at