The Rise of Complementary Medicine

A guest column, by George J. Bryjak, in Monday's Adirondack Daily Enterprise is reprinted below.

According to the National Center for Complementary and Alternative Medicine (NCCAM), a significant number of Americans are experimenting with or using “complementary and alternative medicine” (CAM) as their primary health care treatment.

Working alongside conventional Western Medicine (WM), complementary medicine includes acupuncture, homeopathic medicine, naturopathic medicine and massage therapy. Alternative medicine rejects much if not all WM and its treatments. For example, some alternative practitioners prescribe special diets to combat cancer in lieu of surgery or chemotherapy.

A 2002 U.S. Department of Health and Human Services survey of 31,144 adults found that 36 percent of respondents had utilized some form of CAM therapy in the past 12 months. The number of people using CAM either in addition to or in place of WM will increase dramatically in the coming years for a host of reasons.

1. Rising cost of WM — Both the cost of medical insurance and prescription drugs continue to climb. This is a powerful incentive for many people to try CAM, especially energy enhancing techniques such as tai chi, qi gong and yoga that are relatively inexpensive to learn and practice.

And would'nt the health insurance companies love for everyone to get treated using practitioners of alternative medicine. Think of the money insurance companies could save.

2. The number of uninsured increases — As of 2004 (the latest government data available), about 46 million Americans lacked health insurance, with more middle-class individuals and families inflating that number every year. Whereas 70 percent of all employers offered workers health care insurance in 2000, that figure declined to 60 percent in 2005. Unable to afford WM for anything more than minor health problems, this segment of the population will increasingly explore CAM options.

3. Popularization of nontraditional medicine — In recent years, WM practitioners such as Andrew Weil (M.D., Harvard University) and molecular biologist Jon Kabat-Zinn (professor of medicine emeritus, University of Massachusetts Medical Center) have been on a crusade extolling the benefits of numerous CAM treatments. Weil’s “integrative” approach, combining what he believes are the best aspects of WM and complementary medicine, is currently taught at 31 academic medical centers including Duke University and the Mayo Clinic. Because of their mainstream medicine background and credibility, Weil and Kabat-Zinn reach a wide, receptive audience.

It's only right yet interesting that Andrew Weil is brought up as a major proponent of "complementary medicine". Dr. Weil makes his living being a proponent of "complementary medicine". He is also very careful to be ambiguous in his writing about scientific (Western) and alternative (New Age) medicine. What bothers me about people like Weil is he doesn't necessarily believe that scientific evidence is necessary when truths are self evident. By his own admission he "dropped out" of Western Medicine shortly after completion of medical school. After spending time with a Sioux medicine man in S.D. learning herbal medicine and ritual healing, Weil started practicing yoga, meditation and vegetarianism. Weil claims that much of what knows about disease and healing was learned while he was stoned on psychodelic drugs. An extensive article on Weilman by Dr. Arnold Relman was published in The New Republic in 1998.

Kabat-Zinn is another odd example. Here's a guy that receives training in molecular biology under the tutelage of Luria then basically gives it up to study Buddhist meditative practices and Asian martial arts and yoga. I find it hard to believe that either of these guys have a "wide, receptive audience. At least they are making bucks selling cd's and books.

4. A kinder, gentler WM — Modern medicine’s condescending view of nontraditional healing modalities has been tempered by research demonstrating the efficacy of some CAM treatments. For example, although results of acupuncture studies have been mixed, this ancient Chinese healing practice has proven effective in relieving some forms of pain. A recent University of Texas study found that compared to a control group, women with breast cancer who practiced yoga in conjunction with standard radiation treatments “were in better general health, were less fatigued and had fewer problems with daytime sleepiness.” In short, the quality of life of these women during a difficult period was enhanced.

Accupuncture works by inserting needles into "meridians" (which do not exist) thereby unblocking stoppages in chi (which does not exist). Have some experiments shown that accupuncture alleviates pain - probably. Has a cause and effect been shown? I doubt it.

5. An aging population — With the first wave of baby boomers (individuals born between 1946 and 1964) turning 60, more than 80 million Americans will become senior citizens over the next 25 years. Millions of people in the most educated, affluent generation in American history will attempt to prolong their lives and mitigate the negative consequences of old age and disease using CAM. According to Dr. Andrew Weil, to date, the overwhelming majority of life-extending interventions advocated by practitioners of “anti-aging medicine” lack scientific validation. While most of these methods “may be relatively harmless except to the bank accounts of clients; some may not be.”

6. The powerful vitamin supplement industry — Traditional Chinese medicine (TCM), a major component of alternative medicine, relies heavily on herbal remedies for treatment. This is music to the ears of the $20 billion-a-year in sales and largely unregulated (by the FDA) vitamin and supplement industry. As interest in TCM, Auyervedic medicine (from India) and Native American treatments that utilize herbs increases, supplement manufacturers will do all they can to fan the flames of this segment of the CAM movement. With its well funded and highly effective army of Washington, D.C. lobbyists, there is virtually no chance that the vitamin and herbal supplements industry will do anything but grow bigger, stronger and wealthier in the coming years.

Lobbying is the key word here. The lobbies pay the politicians to approve bills written by the lobbyists. An era of patent medicine is upon us again.

7. The body-mind-spirit connection — By the 17th century, Western science had separated the emotional aspects of humankind from the physical body, choosing to cure the latter while all but ignoring the former in the healing process. Likewise, the spiritual component of our well-being was dismissed by WM. By contrast, for more than 2,000 years, TCM and Auyervedic medicine have viewed illness as a fundamental disconnect of body, mind and spirit, with a proper integration of these components the only true way to restore health. In other words, the “whole person” and not just the physical body must be treated. As Americans are among the world’s most religious people (measured by self-proclaimed belief in God and church attendance), they are open to treatment philosophies that accommodate spirituality.

If CAM practitioners are ever to be accepted by Western-trained physicians and scientists, they (CAM practitioners) must play by the rules of the game. That is, their treatment regimes and interventions must be demonstrated to be effective by way of clinical studies. For CAM practitioners to balk at this criteria is both disingenuous and counterproductive. One can’t criticize the ineffectiveness of WM (as many CAM practitioners have done), then fail to demonstrate the efficacy of their own regimens in a controlled setting. The public has a right to know what works and what doesn’t, as well as understand the side effects of both Western medicine and CAM treatments.

Some CAM enthusiasts dream of the day when their healing techniques will supercede WM, relegating modern medicine to “alternative medicine” status. This is not likely to happen, nor should it. If I get hit by a truck or suffer a heart attack or stroke, please take me to the Adirondack Medical Center as opposed to a local acupuncturist. Conversely, as Dr. Andrew Weil notes, patients with a host of maladies including auto-immune diseases (chronic fatigue and fibromyalgia, for example) may receive more long-term benefit from complementary treatments than from Western-style interventions.

WM has been a significant factor in extending life expectancy at birth in this country from 47.3 years in 1900 to 78 years today. Complementary medicine has the potential to make a significant contribution to the well-being of Americans in the 21st century. Hopefully, the public will obtain the best of both curative systems.

George J. Bryjak, resides in Bloomingdale. His wife, Diane, is a licensed marriage and family therapist and a certified yoga instructor.