Embracing Alternative Care - Top hospitals put unorthodox therapies into practice

Embracing Alternative Care
Top hospitals put unorthodox therapies into practice
By Avery Comarow - US News

"To be blunt, if my wife and I didn't think it was helping him, we wouldn't have continued with it," says Dan Polley. He's talking about Mikey, the Polleys' 2½-year-old in the next room, who was diagnosed with acute lymphocytic leukemia when he was 6 months old. Chemotherapy, radiation, and a bone marrow transplant have been crucial elements of Mikey's treatment. But the "it" his father speaks of is nothing like these aggressive, costly, and heavily researched exemplars of western care—it is a kind of touch therapy, from the camp of alternative medicine. Gentle and benign, "healing touch" is intended to rebalance the energy field that its practitioners believe surrounds the body and flows through it along defined pathways, affecting health when disrupted. Several times a week, therapist Lynne Morrison spends 20 minutes unblocking and smoothing Mikey's energy field, which energy healers like Morrison say they can feel and correct.

Before a recent session, Mikey was grouchy, drawing up his legs and issuing periodic yowls. His stomach hurt, said his father. But as the little boy nestled in his father's arms and Morrison moved her hands around his body, lightly resting them here and then there, his tenseness loosened and he quieted for a few minutes at a time. The Polleys believe that the therapy not only calms their son but is aiding his return to health.

The setting for the unorthodox therapy—an academic medical center—would have been startling just five or 10 years ago. Morrison is on the staff of Children's Memorial Hospital in Chicago, a hard-nosed, tough-cases, research-oriented emblem of western medicine. It perennially ranks among America's premier hospitals and is the principal pediatric teaching hospital for Northwestern University's Feinberg School of Medicine. And Mikey is only one of many children there receiving care that not long ago was called alternative medicine. Now it is more often called CAM, for complementary and alternative medicine, or integrative medicine, to avoid the loaded "alternative." The message the new labels are meant to convey is that the therapies more often go hand in hand with traditional medicine than substitute for it.

Children's Memorial is just one of many academic hospitals where unconventional therapies have found a home. Elite centers like the Mayo Clinic, Duke University Medical Center, and the University of California-San Francisco now offer acupuncture, massage, and other CAM services. All 18 hospitals on U.S. News's most recent "America's Best Hospitals" superselective Honor Roll provide CAM of some type. Fifteen of the 18 also belong to the three-year-old Consortium of Academic Health Centers for Integrative Medicine, 36 U.S. teaching hospitals pushing to blend CAM with traditional care.

Thicket of therapies. Each center has its own notion of CAM and how best to fit it into the medical mix, which can be challenging. "There is rarely a consensus among CAM experts on the optimal product, dose, or intended users," states a report from the National Center for Complementary and Alternative Medicine, an arm of the National Institutes of Health charged with doling out research funds and tidying the thicket of therapies deemed to fall within CAM's broad reach.

At one extreme are found techniques such as yoga and massage, acknowledged by the most hard-line skeptics to have some benefit, if only to lower stress and anxiety. At the other are therapies that even many who applaud CAM's newfound academic popularity call "woo-woo medicine" because of the sheer implausibility of their rationale. Homeopathy, which involves remedies often lacking a single molecule of active substance, is the poster child; some would add energy therapies such as healing touch. The broad middle takes in acupuncture, herbal medicine, and other CAM approaches that seem to benefit some people with certain conditions.

Until the mid-1990s, most academic centers treated CAM like a pack of scruffy mutts, noisy and unworthy of notice. A large pot of federal and foundation research funds—now close to $250 million per year just from NCCAM and the National Cancer Institute, plus tens of millions more from private donors such as the Bravewell Collaborative—helped turn that sniffy attitude into solicitous attention, says longtime CAM commentator Donald Marcus. "The funding gave them respect from the medical school community," says Marcus, a professor of medicine and immunology at Baylor College of Medicine in Houston, where he has long taught a CAM course. A survey of hospitals found that 27 percent offered CAM in 2005, up from 8 percent in 1998. At the Cleveland Clinic, for example, NIH money is behind a clinical trial to see whether reiki, another energy therapy, can reduce stress and anxiety in prostate cancer patients.

The integrative medicine program at Children's Memorial got off the ground in 2003 with $1.7 million in foundation seed money and is now chasing NIH grants. David Steinhorn, a pediatric intensivist and medical director of the hospital's CAM program, says several privately funded trials, including Mikey's, are underway or in the works. Steinhorn is a passionate champion of investigating CAM therapies, no matter how unlikely, if he believes they may help patients and are safe. "I'm a very serious, hard-core ICU doctor, but I have seen these therapies benefit my patients, even if I don't know how," he says.

Patient access. CAM's ascendance isn't entirely driven by money—researchers make frequent references to obligation. "We want patients to have access to these therapies in a responsible fashion," says Lisa Corbin, medical director of the Center for Integrative Medicine at the University of Colorado Hospital. That implies a public clamor for such services, and patients may indeed talk about and ask for CAM more than they used to (although that isn't clear). But surveys showing widespread use—like one issued by the Centers for Disease Control and Prevention in 2004 reporting that 62 percent of adult Americans had used some form of CAM in the previous year—are highly misleading. The big numbers reflect activities such as prayer, which few would consider CAM, and meditation, now routinely prescribed to help lower high blood pressure. The Atkins and Zone diets ("diet-based therapies") were counted in the CDC survey, too. A more selective reading indicates that about 5 percent used yoga, 1.1 percent acupuncture, and 0.5 percent energy therapy, to pick three more-representative offerings.

The purpose of Mikey's trial is to put his touch therapy to the kind of test demanded by CAM critics: Prove that it can produce medical results beyond simply reducing stress or anxiety. Children having a bone marrow transplant are being divided into two groups. One will receive the therapy before and in the weeks after the marrow transplant. The other group will be visited on the same schedule by staff or volunteers who talk, read, or color with them. (The investigators won't know which children are in which group.) The working presumption, says Steinhorn, is that the energy-therapy group will take up the transplanted bone marrow stem cells more readily and with fewer complications, allowing those children to leave the hospital sooner. Early findings should be available by the end of this year.


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