- Alternative therapies are increasingly mingling with
mainstream medicine at some of the nation's leading hospitals.
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- 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.
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- * At the University of Pittsburgh Medical Center, psychiatrists
are prescribing herbal medicines to help patients overcome depression.
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- * Mercy Medical Center in Des Moines, Iowa, offers complementary
treatments for cancer patients, including meditation, massage therapy,
yoga and art therapy.
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- * 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.
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- * And Cedars-Sinai Medical Center in Los Angeles has
just completed testing the potential for alternative programs in heart
surgery.
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- 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.
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- "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.
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- Hospitals are embracing alternative care for several
reasons.
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- For one thing, new scientific studies have validated
some of the practices.
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- 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.
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- Fostering cooperation
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- 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.
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- 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.
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- 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.
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- 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.
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- Some, like Kligler, represent multiple disciplines: He
is a medical doctor trained in acupuncture, Ericksonian hypnotherapy, and
herbal medicine and nutrition.
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- 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.
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- "There are situations where we don't know yet whether
something really works, and realize some skepticism is warranted,"
Kligler notes.
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- Heart patients enthusiastic
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- 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.
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- 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.
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- Fontana speculates the therapies reduce the need for
pain medication in post-operative patients.
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- "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.
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- 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.
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- "Most would," he adds.
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- 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.
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- 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.
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- 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.
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- What To Do
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- 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.
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- 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
access it online at http://nccam.nih.gov NCCAM or write to the NCCAM Clearinghouse
at P.O. Box 8218, Silver Spring, MD 20907-8218.
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- The http://www.pitt.edu/~cbw/altm.html 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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-
-
- The information contained above is intended for general
reference purposes only. It is not a substitute for professional medical
advice or a medical exam. Always seek the advice of your physician or
other qualified health professional before starting any new treatment.
Medical information changes rapidly and while Yahoo and its content providers
make efforts to update the content on the site, some information may be
out of date. No health information on Yahoo, including information about
herbal therapies and other dietary supplements, is regulated or evaluated
by the Food and Drug Administration and therefore the information should
not be used to diagnose, treat, cure or prevent any disease without the
supervision of a medical doctor.
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