Alternative Medicine Goes Mainstream

How did things get this way?
Fifteen years ago, Congress decided to allow dietary and herbal supplements to be sold without federal Food and Drug Administration approval. The number of products soared, from about 4,000 then to well over 40,000 now.
Ten years ago, Congress created a new federal agency to study supplements and unconventional therapies. But more than $2.5 billion of tax-financed research has not found any cures or major treatment advances, aside from certain uses for acupuncture and ginger for chemotherapy-related nausea. If anything, evidence has mounted that many of these pills and therapies lack value.
Yet they are finding ever-wider use:
- Big hospitals and clinics increasingly offer alternative therapies. Many just offer stress reducers like meditation, yoga and massage. But some offer treatments with little or no scientific basis, to patients who are emotionally vulnerable and gravely ill. The Baltimore hospital, for example, is not charging for Reiki but wants to if it can be shown to help. Other hospitals earn fees from treatments such as acupuncture, which insurance does not always cover if the purpose is not sufficiently proven. The giant HMO Kaiser Permanente pays for members to go to a Portland, Ore., doctor who prescribes ayurvedics -- traditional herbal remedies from India.
- Some medical schools are teaching future doctors about alternative medicine, sometimes with federal grants. The goal is educating them about what patients are using so they can give evidence-based, nonjudgmental care. But some schools have ties to alternative medicine practitioners and advocates. A University of Minnesota program lets students study nontraditional healing methods at a center in Hawaii supported by a philanthropist fan of such care, though students pay their own travel and living expenses. A private foundation that wants wider inclusion of nontraditional methods sponsors fellowships for hands-on experience at the University of Arizona's Program in Integrative Medicine, headed by well-known advocate Dr. Andrew Weil.
- Health insurers are cutting deals to let alternative medicine providers market supplements and services directly to members. At least one insurer promotes these to members with a discount, perhaps leaving an incorrect impression they are covered services and medically sound. Some insurers steer patients to Internet sellers of supplements, even though patients must pay for these out of pocket. There are networks of alternative medicine providers that contract with big employers, just like HMOs.
A few herbal supplements can directly threaten health. A surprising number do not supply what their labels claim, contain potentially harmful substances like lead, or are laced with hidden versions of prescription drugs.
"In testing, one out of four supplements has a problem," said Dr. Tod Cooperman, president of ConsumerLab.com, an independent company that rates such products.
Even when the ingredients aren't risky, spending money for a product with no proven benefit is no small harm when the economy is bad and people can't afford health insurance or healthy food.
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