Prevention - Alternative Medicine In The Mainstream

With so many people apparently using alternative medicine, something jogged the political system into action. In 1998, Congress voted to expand the already existing Office of Alternative Medicine, a part of the National Institutes of Health (NIH), into a National Center for Complementary and Alternative Medicine (NCCAM). According to the NCCAM, this marked "a watershed in medical history in America. Not only was the founding of the Center an acknowledgment that Americans are increasingly receptive to forms of healthcare outside Western medicine, it was an acknowledgment that rigorous research on these forms could enrich Western medicine."

The chart shows budget appropriations for alternative medicine research grants. Funding rose from $2 million in 1992 to $105 million in 2002. This is small potatoes compared to the total NIH budget of $23 billion — but enough to generate grumbling by some about this use of finite research funds. One particularly controversial award in FY 2000 went for research into "Distant Healing Efforts for AIDS by Nurses and 'Healers'." In 1997 Duke got $4.3 million to study St. John's Wort in the treatment of depression.

In 1998, the Journal of the American Medical Association published the results of a survey about American medical schools' alternative medicine offerings. Sixty-four percent of 117 medical schools responding offered elective courses in complementary therapies. Close to one-third of the classes were part of required courses; 68% were stand-alone electives. The most common topics were acupuncture, chiropractic care, herbal therapies, homeopathy, and mind-body techniques.

Like it or not, the medical establishment understands that it must learn alternative medicine — if only to be aware of what its patients are up to. Therapeutic touch is now taught in nursing schools. And more than 75 American and Canadian medical schools now teach students how to blend alternative therapies and conventional medicine — a new technique called integrative medicine.

According to a survey by the American Hospital Association, the number of hospitals offering alternative therapies nearly doubled from 1998 to 2000, to 15.5% of all hospitals. They offer therapies that some doctors believe have some efficacy, such as acupuncture, chiropractic, herbal medicine, and massage. The American Medical Association's lukewarm response is: "There is little evidence to confirm the safety or efficacy of most alternative therapies."¹¹

But patients are enthusiastic. Surveys of individuals who combine conventional and alternative medicine are revealing. Some doctors seem unaware of how popular alternative remedies have become. Eisenberg and Kessler found a "Don't Ask-Don't Tell" pattern in their survey of 831 people; nearly two-thirds did not mention their alternative therapy to their doctor, because "It wasn't important for the doctor to know," "The doctor never asked," and "It was none of the doctor's business." A survey of cancer outpatients in New Zealand showed that 46% were using alternative therapies. More than half of that 46% didn't tell their doctor about the therapies. They used four or more alternatives, unaware that some therapies could have side effects or could interact adversely with chemotherapy or radiotherapy treatments.

CAM proponents claim that America can cut out-of-control heath care costs by focusing on alternative medical care. Maybe so, maybe not. Both CAM and the scientific medical community agree on at least one issue: Diet and exercise play an important role in an individual's wellbeing. We will look next at trends in diet and exercise.

Sources: Budget of the United States Government. Online. Available: http://www.whitehouse.gov/omb/budget/fy2003/pdf/hist.pdf. July 2, 2002. Villarosa, Linda. "Verdict Is Still Out on Some Alternative Therapies." New York Times, 13 April 2002 p.C3. Clark, Charles S. "Alternative Medicine." CQ Researcher 31 January 1992. Eisenberg, D.M., R.C. Kessler, et al., "Perceptions About Complementary Therapies Relative to Conventional Therapies Among Adults Who Use Both: Results of A National Survey . Ann Intern Med, p. 135, 344. "Cancer Patients Using Alternative Therapies." Natural Life Magazine. Online. Available: www.life.ca. May 23,
2002. National Center for Complementary and Alternative Medicine. Online. Available: http://nccam.nih.gov. May 24, 2002. Abelson, Reed. "Alternative Medicine Is Finding Its Niche in Nation's Hospitals." New York Times, 13 April 2002, p.C1.