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Popularity of Complementary Alternative Medicine Concerns US Medical Establishment - 2004-01-03


Americans spend $48 billion a year on what's known as "Complementary Alternative Medicine." This includes everything from vitamins and herbal supplements, to acupuncture, massage therapy, and even coffee enemas. None of it is covered by medical insurance. Most of it is not regulated by the government, and nearly all of it is scorned by the traditional medical establishment in the United States. But, the popularity of alternative medicine is growing. Some say it's because alternative medicine works. Others blame the trend on the increasingly impersonal nature of America's traditional healthcare system.

Alexandra Vanschie was thirty-eight years old when she got married. About a year later, she and her husband tried to conceive a child. After several unsuccessful attempts, the couple turned to a fertility doctor at Cornell University.

"He just said, 'You know, you never will.' He just said, 'You'll need an egg donor, if you want to give birth to a baby,'" she recalled.

The reasons for the diagnosis are complex, but basically, age thirty-nine, Alexandra Vanschie didn't have many eggs left. When the number of eggs is low, the level of what's known as "follicle stimulating hormone" in a woman's body goes up. Ms. Vanschie's levels were so high that the doctor at Cornell said fertility treatments would be a waste of his time and her money.

"I was heartbroken. Absolutely heartbroken, totally heartbroken," she said. "So was my husband, and actually he's the one who said, 'Well, you know, you work eighteen hours a day. You drink, you smoke, you haven't been exercising lately because you work so hard. You know, maybe you can change it. Maybe you can change your hormone levels.'"

When Alexandra Vanschie brought the idea up with her doctor at Cornell, she was quickly told it was impossible. So Ms. Vanschie decided to seek out the advice of a non-traditional doctor. She went to a specialist in Chinese herbal medicine at the New York Center for Acupuncture and Complementary Medicine.

"I liked him so much. He was so supportive, and he was so encouraging," she said. "We sat there for an hour and a half when I first met him. He asked me millions of questions. He looked at my tongue, he looked at my skin, he looked in my eyes, he felt my hair."

And after changing her lifestyle, participating in several acupuncture sessions, and drinking what she calls an "incredibly disgusting" concoction of boiled Chinese herbs for three months, Alexandra Vanschie's hormone levels were low enough that doctors at Cornell were willing to work with her. Today, she's the mother of a six-month-old son named Huck.

It's been estimated that at least 30 percent of Americans are turning to some form of complementary alternative medicine, either to deal with specific problems or to prevent problems from developing.

Dr. Keith Berkowitz, a traditionally trained, board-certified internist, decided to devote himself to nutritional therapy after his wife revamped his diet, and he noticed a marked increase in his energy level.

"It's really using the best things we learned in conventional or traditional medicine - good clinical exam, good clinical diagnosis, with nutritional medicine and vitamins and supplements," he said. "A lot of people we see are people who've been frustrated - have gone really everywhere else - and haven't gotten the results they've wanted. Especially with chronic problems - fatigue, people with diabetes, thyroid problems, post-menopausal problems are some of the most common we see."

That's precisely what has some medical professionals concerned about the rising popularity of alternative medicine.

"Most alternative medicine has not been demonstrated to be safe and effective, otherwise we wouldn't call it alternative medicine," said Dr. Marcia Angell, a senior lecturer at Harvard Medical School and former editor-in-chief of The New England Journal of Medicine. "So you have to worry that people will be using these therapies instead of proven therapies, and deny themselves treatment that could cure serious diseases."

Anecdotal success stories aside, there's very little scientific evidence that most forms of alternative medicine actually work. The National Institute of Health has begun to take a serious look at alternative therapies. The agency recently concluded that the popular mood-altering herb, St. John's Wort, does absolutely nothing for people with moderate to severe depression.

The NIH is currently conducting a study on acupuncture. So far, researchers believe the treatment is effective at relieving nausea and some forms of dental pain, but that's it. Marcia Angell says Alexandra's Vanschie's experience with her Chinese herbalist, and the attention he lavished upon her, is a classic example of why more and more Americans are turning to alternative medicine.

"People are now pretty fed up with the health care system," she said. "You know, doctors are too busy, they seem too greedy, they seem not to take them seriously, the treatments may be uncomfortable. Many of the things, though, that people are fed up with are really a function of the system, the way we deliver medical care, and not the care itself. Actually, the treatments we have a very, very good. We just deliver them in a system that is unpleasant for everyone… managed care, essentially."

Marcia Angell says experts should be concentrating of fixing the bureaucratic mess that healthcare in the United States has become, rather than investigating the efficacy of speculative therapies like acupuncture and herbal supplements. But Alexandra Vanschie insists that in her situation, at least, the methods used by the traditional fertility doctor were no more "proven" than anything else she tried.

"In my mind, the fertility treatments that I got were speculative," she said. "They don't know for sure how any one person is going to react. They're only guessing, based on their experience, they're guessing. And that's fine. You know, that's all they can do. But they're guessing that their medicine is going to help you as much as any acupuncturist or anybody else. And actually, the acupuncturists have a much longer history of success, presumably."

That history is approximately 2,600 years old. Alexandra Vanschie is currently trying to conceive a second child. She's visiting the acupuncture clinic again, and drinking that "incredibly disgusting" herbal concoction twice a day, every day of the week.