Fw: Sensing profit and public mood, orthodox medicine starts to examine alternative therapies

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Subject: Sensing profit and public mood, orthodox medicine starts to examine

alternative therapies

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Aug. 10, 2001. 02:00 AM

A cautious embrace

Sensing profit and public mood, orthodox medicine starts to examine

alternative therapies

Judy Gerstel

HEALTH EDITOR

RAFFI ANDERIAN/TORONTO STAR ILLUSTRATION

We're on the brink of going back to the future in medicine.

Stem cells, genes and transplants are getting the headlines, but the

bigger story may be that medicine is advancing beyond the biomedical model

and embracing medical pluralism.

The overwhelming trend is the integration of orthodox medicine, defined by

its pharmaceuticals and invasive techniques, with other ancient,

old-fashioned and unconventional healing practices.

The future of medicine, it seems, is not only in the high-tech laboratory

and the surgical suite but also on the chiropractic and massage tables, at

the herbalists and the health food store, behind the therapist's closed

door, but most especially in the cerebral hemisphere ã the mind.

This week's edition of ls Of Internal Medicine, the august journal of

the conservative American College of Physicians-American Society of

Internal Medicine, kicks off an unprecedented series on complementary and

alternative medicine. And they take the subject seriously, referring to

" postmodern medical diversity. " It's probably the first time that Haitian

" vodun " , hair analysis, crystals, magnets and charismatic healing have all

been mentioned without derision in the pages of ls.

Authored by Eisenberg, MD, and Ted Kaptchuk, OMD (Doctor of Oriental

Medicine) of Harvard Medical School and its division of complementary and

integrative medical therapies, the series considers everything from

acupuncture to iridology to chicken soup to Reiki to vitamins to

" ethno-medicine. "

" The alternative medicine `boom' is not new, " Kaptchuk says. " What's new

is that orthodox medicine has abandoned the crusade against alternative

medicine and is trying to accommodate widespread patient belief and

acceptance of these practices. "

MDs are unlikely to suddenly start recommending copper bracelets to combat

arthritis or stopping a nosebleed by placing a a red string around the

neck, but they are acknowledging that a patient's belief in healing

properties may be just as powerful in many medical situations as the

interventions of the physician.

In today's issue of the journal Science, there's stunning testimony from

University of British Columbia researchers about how the mind can heal the

body. Their study suggests that the placebo effect in Parkinson's disease

produces the same neurological outcome as active drugs used to treat

Parkinson's: an increase in dopamine release by neurons impaired by the

disease.

The placebo effect occurs when individuals take an inactive substance,

rather than an active drug, and experience beneficial effects only because

they believe they're receiving beneficial treatment.

" The magnitude of the placebo effect was surprising, " admits UBC

researcher Ra¶l de la Fuente-Ferny¥ndez. " The greater the expectation, the

greater the effect of the mind's healing power. "

He adds, " This paper shows that there must be a bridge between traditional

medicine and natural medicine. "

In studies of the impact of psychological therapies on longevity in

patients with metastatic cancers, Ontario Cancer Institute senior

scientist Alastair Cunningham found an association between intense

spiritual work and longer survival.

" The psychological dimension offers promise for the treatment of many

physical diseases, " writes Cunningham in the forthcoming issue of Advances

In Mind-Body Medicine, an innovative, peer-reviewed scholarly journal

published in the U.S.

" Modern medicine is conservative, " says Cunningham. " My approach is to try

to play on the medical playing field and give evidence. "

Scientific, evidence-based proof of the placebo effect and the

psychological dimension is only one reason for the dramatic shift right

now toward inclusiveness and away from the historical antagonism to

alternative practices by the medical establishment, say the ls

authors.

Another reason is that, quite simply, alternative practices are a reality

throughout the industrialized world. From 1990 to 1997, the number of

people who used at least one alternative therapy during a 12-month period

increased from 34 per cent to 42 per cent, according to a U.S. study.

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More than half of Canadians use Chinese medicine or other homeopathic

remedies

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Here at home, it's estimated that more than half of Canadians use Chinese

medicine or other homeopathic preparations such as gingko biloba or

echinacea. Two million Canadians visited massage therapists, homeopaths,

naturopaths, acupuncturists and other providers of alternative medicine in

1998/99, and another 2.5 million visited chiropractors.

" People generally adopt multiple healing practices, even when biomedicine

is generally available, " note the ls authors.

This sheer force of numbers comes at the same time as a trend toward

consumer-oriented medicine and away from " doctor knows best. "

" It's being pushed by the public, " says Scarborough psychiatrist Ted Lo,

who founded Toronto-based Friends of Alternative and Complementary

Therapies Society (FACT). The Web site is http://www.thefacts.org.

Lo believes that, after the materialism and high-tech culture of the '80s

and '90s, people are swinging back to New Age thinking, to " more

naturalistic, environmental, global thinking. "

And more and more, the increasingly sophisticated patient is an educated

partner in medical decisions. Knowledgeable health consumers are letting

the medical profession know they want inclusive medicine.

The medical profession is responding for two reasons, Lo suggests. First,

there's money to be made from patients, since most alternative services

must be paid for privately.

But with the U.S. leading the way, there's also more funding for

alternative and complementary medicine. American researchers vie for

grants from the prestigious National Institutes of Health's Office of

Alternative Medicine. And insurance providers such as HMOs in the U.S. are

beginning to realize that alternative practices can be just as effective

and a lot cheaper than expensive high-tech interventions.

Here in Canada, Lo is readying his CAMLINE Web site, to be launched this

fall, with scientific, evidence-based content about complementary and

alternative medicine. It's supported by, among others, the Ontario College

of Family Physicians and the University of Toronto Family and Community

Medicine division.

But what may appear to be new and cutting-edge is only a change in

perception and attitude by orthodox medicine, maintains Harvard's

Kaptchuk, co-author of the ls article.

" I'm so bored with people being hypocritical and pretending that all this

is new, rather than saying that they've changed standards, " he says.

" That's a kind of distortion, not looking at the reality of the phenomena.

It's the response that's different. What is new is that conventional

medicine has to redefine its relationship to this phenomena. "

Kaptchuk claims that orthodox medicine's nascent inclusiveness of

complementary and alternative medicine is " a breathless attempt to co-opt

it.

" It's market-driven, " he says, with distaste. His cynicism is

understandable.

" In 1970 I was arrested in Cambridge (Mass.) for prasticing medicine

without a licence, " Kaptchuk says. " Now I'm a professor at Harvard Medical

School.