Alternative Medicine (Complementary Medicine)      6/97

by Del Meyer, MD

A recent USA Today study showed that in the United States, patients make more visits to complementary care givers than to family doctors and internists. The National Institute of Health (NIH) has created the Office of Alternative Medicine to begin researching some of the newly emerging techniques and methodologies in this rapidly growing new field of medicine.

In ancient Greece, "doctors" worked under the patronage of Asklepios, the god of medicine, but "healers" served Asklepios’s daughter, the radiant Hygeia, goddess of health. Rene’ Dubos, medical writer and philosopher wrote:

"For the worshipers of Hygeia, health is the natural order of things, a positive attribute to which men are entitled if they govern their lives wisely. According to them, the most important function of medicine is to discover and teach the natural laws which will ensure a man a healthy mind in a healthy body. More skeptical, or wiser in the ways of the world, the followers of Asklepios believed that the chief role of the physician is to treat disease, to restore health by correcting any imperfections caused by accidents of birth or life."

Andrew Weil, MD, graduate of Harvard Medical School and Director of the program in Integrative Medicine at the University of Arizona in Tucson, has written extensively on Alternative Medicine. In his sixth book, Spontaneous Healing, Weil develops the above opposing philosophies. I was given the opportunity to review this best seller for Sonoma Medicine in March when they did an issue on Alternative Medicine which they titled "Integrated Medicine." Weil points out that the political debates about how to cover the costs of medical care mostly take place among followers of Asklepios. In the West there is no argument about the nature of medicine or people’s expectation of it, only about who is going to pay for its services which have become inordinately expensive because of doctors’ reliance on technology.

The major focus of scientific medicine has been the identification of external agents of disease and the development of weapons against them. An outstanding success story of this century was the discovery of antibiotics and the subsequent great victories against infectious diseases caused by bacteria. Such victories were a major factor in winning hearts and minds over to the Asklepian side, convincing most people that medical intervention with modern technology was worth any price. However, weapons are dangerous and can backfire causing injury to the user. Just consider articles such as "Resistance to Antimicrobial Agents: the New Plague?" We have reviewed other books in this Journal (July/Aug 94, p 28) such as Frank Ryan’s THE FORGOTTEN PLAGUE - How the Battle Against Tuberculosis was won--and Lost. Organisms are rapidly developing new resistance mechanisms, sometimes outpacing pharmaceutical research in their quest for new drugs less susceptible to current resistance mechanisms. In TB, we’re even re-considering techniques used in the Sanatoriums in the 1930s such as mutilating thoracoplasties in patients with cavities containing resistant organisms. Some infectious disease specialists are now discussing when we might have to revert to the strict quarantine rules of the 1920s and 1930s.

Weil is a dedicated follower of Hygeia and interjects that viewpoint into any discussions of the future of Medicine. He points out that the medicine of the East, especially in China, focuses on internal healing, increasing internal resistance, and avoiding harmful external influences. They use herbs and other natural substances to provide a tonic for the body. Resistance never develops to tonics because they’re never directed to external forces such as germs, but act within the body’s defenses. He begins with very basic biological organization from DNA, and progresses to the healing process we all observe. Dr Weil suggests that if Eastern practices of strengthening internal defenses were more prominent in Western medicine, we would not now have an economic crisis in health care. Weil’s current best seller, Eight Weeks to Optimum Health, is reviewed in this issue.

Although Alternative Medicine is practiced by physicians with solid scientific credentials as Andrew Weil, MD, and Isadore Rosenfeld, MD, there are numerous practitioners which physicians consider on the fringes. "Alternative Medicine" encompasses medical practices in the areas of holistic medicine, homeopathy, biofeedback, acupuncture, herbal medicine, naturopathy, hypnotherapy, and a host of variations on these general themes. Many of the books on these subjects are written by lay people, who write as authorities. Gary Trudeau recently noted in his Doonesbury "strip" that in California "aroma therapist think of themselves as primary caregivers."

This may, however, then challenge the medical cost containment problem. As long as patients are willing to pay for this out of their own pocket, it won’t create a financial problem. If "alternative medicine" visits exceed all other primary visits as the above poll suggests, and if it becomes reimbursable, costs could go off the radar screen.

The editor’s position continues to be that health insurance should be similar to other insurance in that it should cover the unexpected costs. Repairing or maintaining our house or car is not covered by our house or car insurance. Neither is a basic office visit an appropriate expense to be insured. We need health insurance to cover us for surgery, hospitalizations, and major illnesses just as we carry house and car insurance for the catastrophes that hit our house or car. As chiropractors have been included in health plans; as podiatrists are trying to become "pelvologists;" as psychologist are thinking they are medical psychiatrists; and as physician assistants are practicing medicine; and all are bidding for the lawmakers’ votes, it is only a matter of time before every herbologist and aroma therapist will influence his lawmaker to obtain coverage for his services. Unless we convince people that office calls are worth digging into their purses for, health care costs in this country will double to $2 trillion rather than being contained. A patient told me last week she was happy that she could see me for five dollars since she had just spent $900 for an operation on her dog and didn’t have any money to spend on herself. As long as we allow people to relegate their own health care the lowest priority in their personal budget, with the intense hostilities against physicians, lawmakers should have no difficulty convincing the public that their action to legitimize "smelling oil therapists" was only for the common good, to keep doctors in line. For after all, why should doctors have a monopoly on medical practice?