What not long ago was considered "alternative" medicine -- quackery to some Western tradition hard-liners -- is now undergoing a moniker transition to "complementary" medicine and is being used in concert with more mainstream health care. Part of the switch is being powered by patients trying to find affordable alternatives to a doctor's visit and others looking for alternatives to pharmaceutical treatments or seeking a state of well-being that goes beyond simply being disease-free.
Even Blue Cross and Blue Shield of Louisiana last year initiated a free alternative health services resource directory called Healthyroads that includes a library with a listing of alternative health services, a store with health and wellness products, and even an interactive program that helps a person assess their health risks.
"Many Americans use some form of alternative health service each year, including taking vitamins and herbal supplements," says George DeVries, chief executive officer of American Specialty Health, which administers the Healthyroads program for Blue Cross.
Such acknowledgment of the prevalence and potential benefits of alternative and complementary therapies by the mainstream medical professions illustrates a new open-mindedness.
"It's a wonderful adjunct to traditional medicine," says Helen Ruiz, director of outpatient services at Touro's Alternative Therapy Center. "Patients can come through a self-referral, but we always call their physician -- unless they ask us not to." Opened in September 1999, the center opens a range of therapies, including acupuncture, massage therapy, meditation, aromatherapy, yoga and Healing Touch. The center's intent is to offer the services as a complement to -- not a substitute for -- traditional Western medicine. The center became popular shortly after opening, but Ruiz says some doctors were apprehensive to embrace the center, fearing they would be considered witch doctors.
"When we opened, we got kudos from medical staffs all around the city," she says. "It's funny, our medical staff was probably the last to come on board. I think part of it was peer pressure; they were afraid their peers would think they were wacko."
That fear is being assuaged somewhat as doctors examine the benefits of therapies designed to relieve stress and pain as well as anxieties. Now, Ruiz says, doctors will send patients in for a Healing Touch treatment before some surgeries and inpatient procedures. This procedure operates on the theory that the body possesses an energy field that flows in balanced patterns in health but becomes unbalanced or depleted when a person is ill or injured. The Healing Touch treatment endeavors to restore health by adjusting out-of-whack energy fields.
Other alternative therapies, many that have been practiced in some form since ancient times, also deal with balancing human energies; they include yoga and Qi Gong (also called Chi Kung), both of which use stretching and breathing exercises to improve health and nurture an overall sense of harmony. Aromatherapy now is widely used in households across the country, whether it comes through candles, heated essential oils or more formal approaches.
Although patients seem open to new approaches to improving their overall health as well as treating specific conditions, the holistic approach still isn't embraced by the medical profession in the South overall, according to one Northshore practice. Dr. Robert Fortier-Bensen of the Center for Functional Medicine (with offices in Mandeville and Gulfport, Miss.) has a "regular" medical degree as well as a doctorate in integrated medicine, a combining of all the healing arts.
"He's a few years ahead of his time, especially in the South," says Carl Hanson, lifestyle education assistant for the center. Bensen also is a certified acupuncturist, a nutritional specialist and takes the old-fashioned approach of spending lots of time with a patient to determine what is causing the symptoms they want to defeat. Hanson joined the practice after he came to Bensen, a pain specialist, for a debilitating back problem he had been unable to correct. For him, the pain was linked to a food allergy and disappeared after the offending foods were removed from his diet. Many of the Center for Functional Medicine's patients come to Bensen after more traditional medical treatments have failed.
"The majority of our patients who see us for the more natural side of our practice come from word-of-mouth," Hanson says. "The majority of patients who come to us are the severe cases. They've exhausted all the options in traditional medicine. Many physicians haven't yet embraced some of the alternative methods, although many of them have been around longer than traditional medicine."
This gap between patients' willingness to try alternatives and physicians' willingness to accept their validity has led to patients trying things on their own without telling their doctors. This can be counterproductive, especially for patients who are on pharmaceutical drugs for conditions such as depression, hypertension, heart disease, liver disease or a host of other conditions. Adding herbal or even herbal supplements to the diet can sometimes hinder the efficacy of the prescription drugs and can even have side effects of their own.
Dr. Clem Eiswirth of Cardiology Consultants of Louisiana in Metairie says it's dangerous for patients to take over-the-counter medicines and nutritional supplements without telling their physicians.
"All these over-the-counter medications and even herbal and vitamin supplements are available everywhere," he says. "People take all these things and don't realize they're medication and that they're interacting with everything else you're taking. You can end up taking a combination of things that work against each other and can even be harmful."
A proliferation of advertisements touting the virtues of alternative and over-the-counter products have sent consumers to the shelves. They hope Vitamin C will keep away colds, Vitamin E will help their skin, and a potent stress tab will give them energy. Unlike prescription drug ads, which all tell patients to discuss the drug with their doctors and warn against use if patients have certain health conditions, over-the-counter products aren't required to warn against interactions or possible harm and often consumers don't ask.
"[The potential harm] never gets into the paper (or other media)," Eiswirth says. "The only thing that gets in the paper is the good stuff, the possible benefits, and it never gets stated that these things can be harmful. If a person wants to supplement their Vitamin C and E intake, for instance, they could eat more oranges and vegetables. There's no problem with that. But if you take a supplement to get those vitamins, there can be things used in the supplement compound that are harmful to your particular condition or work against other medication you're taking."
The other problem remains communication between the patient and doctor, many of whom hold alternative therapies at arm's length and may never mention to patients that they exist or are valid.
"Patients are afraid to talk to their doctors," says Hanson of the Center for Functional Medicine. "They should be open, because the doctor may know reasons they should not take a supplement or whether something else would be beneficial. Patients should give the doctor the chance to work with them. If he doesn't understand or approve of the alternatives, maybe the patient should look for another doctor."
Rapid technological and technique advances over the past half-century have led medicine to become segmented into specialties in order to adequately keep up with the specialized training needed. In the course of this progress, the way doctors and patients themselves viewed their bodies also became segmented. Primary care physicians once served as a repository for overall health information, but over time, patients' health history became as segmented as their care, and their various doctors didn't necessarily know what each other was prescribing. To make matters worse, patients often don't mention the herbs, supplements or over-the-counter products they're using.
"Everything you put into your body is going to affect you in some way ... on a molecular level," Hanson says. "It may have a beneficial effect, or it may work counter to what your doctor is trying to accomplish."
Doctors may be slowly closing the gap that separates traditional and complementary medicine, and patients undoubtedly are building a bridge between the two. The popularity of day spas with services such as massage and aromatherapy as well as yoga classes and even an emphasis on feng shui, which in its most complete use combines ancient Chinese arts of placement, natural environmental and human energy flows, and the chi. Complementary medicine offers a return to combining treatment of the body, mind and soul for overall well-being.
"Traditional medicine is not holistic, and this is," Ruiz says of the Alternative Therapy Center at Touro. "Traditional medicine treats just the body. But the body, mind and spirit go together. It makes treatment whole." The center also emphasizes lifestyle changes not only for patients who already have health problems,but for those with risk factors.
"Everyone is trying to balance everything: family, career, taking care of their parents," she says. "People have got to learn to cope with these things without taking drugs. Sometimes I think the whole world is on Paxil, Prozac or Xoloft."
Getting back to the basics of a balanced, nutritious diet and adequate exercise would go a long way to keeping people healthy and happy, most doctors agree. And it has been scientifically proven that depression can have a huge detrimental impact on the recovery of heart patients and that a positive attitude can aid in recovery. Today's modern society, however, prefers instant gratification and quick fixes instead of the slower, more tedious work required to stay fit.
"People have an attitude of 'Let's just pop a pill for everything,'" Ruiz says. "They say 'I don't have time to exercise; I don't have time to eat right. I only get four hours of sleep at night. I'm tired. Fix me.' Well, there's no pill for that. If you don't have the time for yourself right now, wait until you have some chronic illness like diabetes."
Consumers may well head the move to integrated medicine as they try to look and feel younger longer and attempt to sidestep the expense and other hurdles of the managed care health system. Ruiz says doctors should endeavor to understand the benefits and embrace those therapies that can help their patients achieve overall well-being.
"Being in medicine for 25 years, I can really see a need for it," says Ruiz, a registered nurse. "I saw the depersonalization of medicine, and now we're back to touching the patient. I feel it's a doctor's duty to advise patients that there are alternative therapies out there."
The president of the center agreed and recently issued a message in the center's newsletter stating that doctors had an obligation as part of their "due diligence as a practitioner" to inform patients of all medically sound treatment options, even those with such New Age-sounding names as Ayurvedic, aromatherapy, acupuncture or Healing Touch. Clinics such as Positive Changes in Metairie have integrated traditional and complementary services, using hypnosis combined with counseling to help people overcome health-threatening habits such as overeating and smoking.
Greater openness to a range of health care options by doctors might also compel patients to tell their doctors about everything they're taking and doing to their bodies so the physician, in turn, can make more informed decisions and warn the patient of any interaction problems.
"People intent on being well, especially those with serious health problems, will try a lot of things," says Dr. Judith Falloon, a researcher at the National Institute of Allergy and Infectious Diseases. "There are so many products on the shelf and so many of them look beneficial, or at least harmless, that [people] don't think a lot about taking them, sometimes several together."
Falloon was among researchers who last year found garlic supplements blocked the effectiveness of the anti-HIV drug saquinavir in the body by more than 50 percent, prompting the National Institutes of Health to issue a warning to HIV patients against taking such supplements. Similarly, an American Heart Association survey concerning hypertension patients and over-the-counter cold and flu medications prompted the medical group to issue a warning against the use of decongestants by patients with high blood pressure. Decongestants contained in many non-prescription drugs can block the effectiveness of hypertension medications and can elevate blood pressure even in some healthy people, the warning says.
Until the systems become integrated, it's up to the patient to learn of alternatives and discuss them with their doctors. For smart patients, it will mean including their doctor more fully in the treatments they initially sought to help them sidestep the traditional health care system.