Living Wellness

Integrative Therapies Blend with Allopathic Treatments in Leading Hospitals

The Unconventional Is In

By Noreen Seebacher
HealthScout Reporter

Alternative therapies are increasingly mingling with mainstream medicine at some of the nation's leading hospitals.

From Los Angeles to New York, physicians and their staffs are giving patients the option to complement their care with procedures that range from aromatherapy, biofeedback and clinical imagery to homeopathy, meditation and naturopathy, a form of health care focused on natural healing methods.

  • At the University of Pittsburgh Medical Center, psychiatrists are prescribing herbal medicines to help patients overcome depression.
  • Mercy Medical Center in Des Moines, Iowa, offers complementary treatments for cancer patients, including meditation, massage therapy, yoga and art therapy.
  • Beth Israel Medical Center in New York City this year opened a specialized Center for Health and Healing, where physicians work alongside chiropractors and practitioners who specialize in homeopathy, clinical imagery and other alternative treatments.
  • And Cedars-Sinai Medical Center in Los Angeles has just completed testing the potential for alternative programs in heart surgery.

Dr. William Jagiello, an osteopathic physician and chairman of the Mercy Center's integrative medicine committee, says the growing popularity of alternative treatment is confirmation that "illness doesn't exist in a vacuum" -- and that good medicine integrates spiritual, emotional and cultural aspects.

"At some point in the future, there won't be conventional and unconventional treatments. They'll all be melded into one system. The important thing will be identifying the best treatment for each patient, rather than whether it's mainstream or alternative care," Jagiello predicts.

Hospitals are embracing alternative care for several reasons.

For one thing, new scientific studies have validated some of the practices.

Beth Israel Deaconess Medical Center in Boston, for example, reports that patients who used self-hypnotic relaxation techniques during surgery needed less pain medication, left the operating room sooner and had more stable vital signs during the operation, according to research published in the British journal The Lancet.

Fostering cooperation

In addition, the National Institutes of Health's National Center for Complementary and Alternative Medicine has worked to foster greater understanding of alternative medical practices by those in mainstream medicine. Last spring, for example, it arranged a meeting between alternative medicine practitioners and mainstream researchers to exchange ideas, report on current studies and discuss ways to increase collaborative research in cardiovascular, lung, and blood treatments.

But hospital administrators and physicians also concede they're responding to patient demand.

Between 1990 and 1997, the number of Americans using an alternative therapy rose from about 33 percent to more than 42 percent, according to a 1998 survey in the Journal of the American Medical Association.

About 83 million Americans in 1997 spent more than $27 billion on such therapies, including herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy, the report found. That total exceeded out-of-pocket spending for all U.S. hospitalizations the same year.

Dr. Matthew Fink, a neurologist and president and chief executive of the Beth Israel Medical Center, says it's foolish for doctors and hospitals to ignore something that will be such a large part of health care for years to come.

"Conventional medicine started to realize it was a little behind what patients wanted," adds Dr. Benjamin Kligler, medical director of Beth Israel's new Center for Health and Healing. The $5 million center, with 17 treatment rooms, pulls together the skills of an eclectic group of professionals, ranging from medical doctors and registered nurses to acupuncturists and massage therapists.

Some, like Kligler, represent multiple disciplines: He is a medical doctor trained in acupuncture, Ericksonian hypnotherapy, and herbal medicine and nutrition.

The goals at the center, and at other institutions that have made alternative practices part of their programs, are to tap into growing consumer interest, and to study whether such therapies work under clinical conditions.

"There are situations where we don't know yet whether something really works, and realize some skepticism is warranted," Kligler notes.

Heart patients enthusiastic

The ongoing research into these questions includes three recent pilot studies at Cedars-Sinai in Los Angeles that confirmed the potential of alternative treatments used after open-heart surgery.

Dr. Gregory P. Fontana, a cardiothoracic surgeon at Cedars-Sinai, says almost all of the 60 patients who were given acupuncture, massage or guided imagery in conjunction with their surgery were enthusiastic about the procedures.

Fontana speculates the therapies reduce the need for pain medication in post-operative patients.

"When patients are hospitalized, they're frightened, anxious and worried. There's one thing they know how to do: ask for pain medication," he says.

But, he asks, "Do they need the medication, or just a way to relax?"

Fontana believes some alternative therapies may provide an option for patients. "If they can allow themselves to relax, accept what has happened, and realize a state of well-being, pain becomes a less important part of their consciousness," he explains.

Fontana says 19 of the 20 patients who received acupuncture and massage therapy, and all 20 who received guided imagery -- a form of hypnosis -- said the treatments made significant differences in their recoveries. The real test, Fontana notes, may be patients' willingness to pay for the services out of pocket.

"Most would," he adds.

Sixteen of those who received acupuncture, 15 who received massage therapy and all 20 who received guided imagery said they'd pay $100, $75 and $35, respectively, to obtain the services, he notes.

Fontana has just started more research involving a randomized group of 200 patients. Half will receive an alternative therapy in conjunction with surgery, and half will undergo the surgery by itself. While Fontana and several others who offer heart-surgery programs have investigated alternative therapies, from yoga to herbal supplements to healing energy therapy, he concedes more scientific study is needed.

Supporters of complementary medicine say more research could break down some of the remaining resistance to alternative treatment within the medical community and open the door to expanded insurance coverage for some procedures. With the exception of chiropractic care, which most insurers have traditionally covered for at least some conditions, few carriers offer payment for massage or aromatherapy, for instance.

What To Do

Alternative therapies and the practitioners who offer them should be chosen as carefully as mainstream physicians, experts caution. Before you agree to any treatment, investigate your options. Ask for referrals from friends and family and physicians, and don't be afraid to shop around for a practitioner who makes you feel comfortable.

The National Institutes of Health's National Center for Complementary and Alternative Medicine offers fact sheets, information about clinical trials and links to other sources of information. You can to the NCCAM Clearinghouse at P.O. Box 8218, Silver Spring, MD 20907-8218.

The Alternative Medicine HomePage, affiliated with the Falk Library of the Health Sciences at the University of Pittsburgh, markets itself as a "jumpstation for sources of information on unconventional, unorthodox, unproven, or alternative, complementary, innovative, integrative therapies." The site has a comprehensive list of resources, including links for information on specific diseases, including cancer and HIV.

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