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Jill
Eisner lay still as an acupuncturist pushed thin needles
into her face and feet, with soft music playing in the
background. In another room, an herbologist studied his
antidote for severe acne: a concoction of 12
ingredients, including dandelion roots, tangerine peel
and dried raspberries. A few doors down, Linda Lee,
dressed in a white lab coat, used the tools of
conventional medicine to treat a patient for digestive
problems.
The
Johns Hopkins Integrative Medicine and Digestive Center,
which opened on September 2, is the latest indication
that alternative medicine is making its mark in
mainstream health-care settings.
“We
conventional doctors need to acknowledge that some of
our therapies don’t always work,” said Lee, a
gastroenterologist with 20 years of experience. In
addition to Lee, the center has 12 specialists,
including acupuncturists, nutritionists, massage
therapists and a psychotherapist, who uses hypnosis and
touch therapy.
After
spending four years together in private practice in the
Baltimore region, Lee and her colleagues realized they
needed more space, so they approached Hopkins. Housing
the center under the umbrella of a prestigious
institution will raise public awareness about
complementary and alternative medicine (CAM), Eisner
said. “The Hopkins name is important” to patients, she
said. “People will be much more receptive to it.”
For
Hopkins, the center is a way to capitalize on a
burgeoning patient base, Lee said. “I can’t tell you the
number of patients who come in and say they’ve been
getting acupuncture for 10 years,” she said.
The
center’s link with Hopkins is part of a trend toward
integrating CAM with conventional medicine. In a survey
of 1,400 hospitals, 27 percent offered some sort of
alternative or complementary treatment, according to a
2006 American Hospital Association study, up from 8
percent in 1998. Last fall, Hopkins—a bastion of
mainstream medicine — joined the Consortium of Academic
Health Centers for Integrative Medicine. This group of
41 medical centers has pledged to invest in CAM research
and to introduce integrative models of clinical care.
Investment in research is key to any true alliance
between the two schools of care. Conventional
practitioners often decry the subjective nature of many
CAM treatments, which have not proved their worth
through the controlled, randomized trials that are
considered the gold standard of medical research.
“The
kind of medical school training we get, we’re taught to
reject many other types of training,” Lee said. Efforts
are under way to remedy the lack of solid research,
according to Richard Nahin, a senior adviser to the
director of the National Center for Complementary and
Alternative Medicine, a branch of the National
Institutes of Health (NIH).
An NIH
study of 380 advanced cancer patients at 15 US hospices
published recently in Annals of Internal Medicine finds
that massage therapy may have immediate, though
short-term, effects on pain and mood among patients with
advanced cancer.
Some
treatments, such as touch therapy, which is used to calm
patients, are tough to measure. The Cleveland Clinic is
currently studying how one form of touch therapy, reiki,
affects anxiety levels and cancer progression in men
with prostate cancer. Despite a lack of data on its
effectiveness, many doctors are willing to give such
treatments a shot, because gentle touching does no harm,
Nahin said.
The same
cannot be said of herbal supplements because of their
potential to interact with conventional drugs. “Over the
coming 10 years there is going to be substantial
literature on the interaction of different herbal
medicine and pharmaceutical drugs,” Nahin said.
A lack
of research has not stopped a few alternative practices
from becoming standard treatments in some high-tech
settings.
At the
University of Maryland Medical Center’s Shock Trauma
Center in Baltimore, nurse Donna Audia often gives
patients and their families a bowl-shaped instrument
called a crystal bell. When tapped, it produces soothing
sounds that its proponents consider therapeutic.
Audia
also offers reiki treatment. Though it is not a
substitute for narcotics, reiki has become a critical
component in patient care, said Audia, who has 11 years
of nursing experience. She believes that it helps
prevent such problems as posttraumatic stress disorder.
“These
patients have emotional and spiritual pain,” she said.
“At some point they realize ‘I could have died.’” Audia
started performing reiki two years ago when a doctor in
the center asked her to research techniques to calm
traumatized patients. She found a course in reiki—something
she knew nothing about—and trained to become a reiki
master.
Now, as
part of the pain-control treatment that Shock Trauma
patients routinely receive, Audia follows the Japanese
practice of gently touching patients and moving her
hands along their bodies while they keep their eyes
closed. After a reiki session, Audia reports that
patients’ self-selected pain scores usually drop three
or four points on a scale of 10.
News of
Audia’s skills spread through the center, and she soon
had nurses and doctors across the hospital asking her to
perform reiki on their patients. The response was so
overwhelming that the University of Maryland School of
Medicine’s Center for Integrative Medicine is offering a
new course for health-care professionals that includes
training in reiki, yoga and meditation. Twenty nurses
have signed up so far for the six-week course.
“This is
what Florence Nightingale would have wanted,” Audia
said, reflecting the view that as modern medicine has
become more high-tech it has lost some of the personal
touches that can promote healing. “When she talked about
nursing,” Audia said, “it was holistic care.”
Last
year the George Washington University Medical Center
launched a reiki program for patients, as well as for
their families and for staff members in need of stress
relief. Dressed in neon-green jackets, reiki volunteers
make daily rounds in the hospital, offering their
services to all.
Joel
Rosenberg, GWU’s director of clinical cardiology, says
he is not waiting around for a landmark study on reiki.
He is already convinced that it works.
“The
heart rate goes down. The respiratory rate goes down.
The required sedation goes down. Inflammation goes
down,” Rosenberg said. “I’ve seen it in hundreds of
patients. And, they are happier.”
Elsewhere, the lack of insurance coverage for CAM
treatments makes it prohibitively expensive for many.
“One of the limitations of what we’re doing is what
insurance companies are paying for,” Lee said.
Price
and the lack of research are not the only concerns;
conventional practitioners also worry that too much
reliance on CAM could backfire.
“In some
cases, it may reinforce the desire not to see a
mainstream caregiver,” Rosenberg said.
Insurance coverage and mainstream acceptance of CAM will
come with time and research, said Margaret Chesney,
associate director of Maryland’s integrative medicine
center.
“We will
find out things we didn’t anticipate,” she said. “But
that’s part of what health and medical research is all
about.”
She sees
the intersection of conventional and alternative
medicine as an exciting new frontier.
“Three-thousand-year-old treatments are being brought
into the most modern setting you can imagine, where
people are flown to the hospital by helicopter,” she
said. “Why not?” |
