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March 28, 2000 (Washington) -- Using their best bedside manner, some of America's best-known practitioners of alternative medicine told a sympathetic panel of U.S. senators Tuesday that patients are becoming increasingly disenchanted with the traditional approaches to treatment.
"The vast numbers of patients who are seeking care outside of conventional medicine represent a crisis of confidence with American medicine today," Andrew Weil, MD, director of the University of Arizona Program in Integrative Medicine, told the appropriations subcommittee. Weil, the author of eight books, including one currently atop the best-seller lists, is arguably the nation's most prominent advocate of alternative treatment.
He says that nearly half of U.S. health-care consumers have tried some form of alternative therapy. "They want doctors who will not laugh at them if they bring up questions about Chinese medicine or homeopathy or other forms of treatment that are not taught in medical school. I think those are very reasonable requests, but the fact is that's not how we're training physicians today," Weil says.
The solution, Weil says, is creating an "integrative medicine" curriculum that focuses on the body's self-healing abilities along with mainstream therapies. He said he's been building such an educational program at the University of Arizona since 1996, assisted by about $5 million in NIH grants.
Weil's comments were warmly received by subcommittee Chairman Sen. Arlen Specter, R-Pennsylvania, as well as Sen. Tom Harkin, D-Iowa, the ranking minority member, who pushed hard in the early 1990s to create what has become the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health.
Harkin said that though he was not "shilling" for Weil, he was using a CD produced by Weil with positive results. "It is an amazing thing, how it puts you in the deepest kind of relaxation mode," Harkin said.
"It is true that mainstream medicine has to some extent resisted some of these new ideas, but medicine has always been an evolving discipline," NCCAM Director Stephen Straus, MD, told the subcommittee. Straus noted that Americans spent $27 billion on alternative treatments in 1997 and that his agency's budget has grown to $68.4 million in the current fiscal year.
As an illustration of the pluses and minuses of alternative treatments, Straus pointed out that research on the plant St. John's wort shows it to be the equivalent of an older-generation anti-depressant. However, another study indicates that the alternative remedy reduces the effectiveness of some medications, including an AIDS treatment and an immunosuppressive drug.
Other physicians at the hearing included Herbert Benson, MD, of the Harvard Medical School and Dean Ornish, MD, of the University of California, San Francisco. Benson's research suggests that it's possible to reduce visits to physicians by up to 90% by using a learned relaxation response to reduce medical disorders such as pain. "As long as we focus on simply what we can do to patients rather than what patients can help themselves do, I think it's a lose-lose situation," Benson tells WebMD.
Ornish has developed a stringent diet, combined with stress management techniques, which he says can reverse heart disease without surgery. Both researchers say that federal studies should be done to confirm the efficacy of their techniques, and Ornish will begin a 15-center trial of his approach, underwritten by the Health Care Financing Administration, next month. Some 1,800 patients will follow Ornish's regimen and will be compared to others who tried other therapies.
"Medicare already pays for the surgery, the angioplasty, the bypass, and most insurance companies pay for the drugs. So we want to give people a full range of choices, including programs like ours," Ornish tells WebMD.
Weil told WebMD that academic medicine still has a long way to go in teaching nontraditional approaches. "They don't get yet what a high priority this is, that really, this is their future and their salvation," says Weil.
Jordan Cohen, MD, president of the Association of American Medical Colleges, agrees that better communication with patients is important, but not at the expense of basic medical education. "On the matter of alternative treatment, I think American medicine is firmly rooted in the scientific basis of medicine," Cohen says "The touchstone for any therapy ... to be effective is to be subjected to the scientific method."