Getting around the 800-pound gorillas

People around the Institute know that I’m no shrinking violet. I speak my mind, I ask tough questions, and occasionally land myself in a little trouble because of my words. But for the most part, these qualities have served me well.

Yet for some reason, when I talk with my doctor, I clam up. In the presence of that white coat, I feel like the little girl who forgot to do her homework. There I sit, listening to him talk at me, and disagreeing in my head with just about everything he says, but the words don’t come out. The few times I have tried to talk to him about alternative approaches, I was met with blank stares. So now I just take the prescriptions he gives me, thank himand stuff them in the trash on the way out. I can’t imagine how the majority of you may feel facing your own doctors, when someone in my position feels this way.

Sound familiar? A lot of us, even those of us who have been successfully using complementary and alternative medicine for years, seem to have this problem. I’ve searched for a family doctor in my area who is well versed in complementary and alternative medicine (CAM), and willing to listen to new ideas. I haven’t found one.

You’d think doctors would be a little more open to CAM by now. Many formerly “alternative” therapies, like St. Johns Wort and Ginkgo biloba, have been supported by research and gone mainstream. And studies show that CAM’s use by the public is increasing–some authorities estimate that about half of all Americans have tried some form of alternative medicine. Medical schools even teach CAM now. According to recent surveys, two-thirds of the medical schools in the United States and Canada now include either electives or required instruction on complementary and alternative therapies. Based on all this progress, I’ve been telling myself that the next generation of doctors will be different.

But just last week I saw a report that makes me think doctors’ attitudes about alternative medicine really haven’t changed that much. During the 1998-1999 school year, researchers surveyed 78 third-year medical students at the University of South Florida Medical School. Only five percent had any formal education in CAM therapies. And when faced with a list of the 10 most common alternative modalities, most of them admitted that they had no basic understanding of the topics.

Ironically, nearly all of the students (89 percent) said they had been exposed to CAM through the media, professional journals, or the experiences of friends and relatives. Yet fewer than one in four students said they would refer one of their patients for alternative treatments such as acupuncture, chiropractic, herbal medicine, homeopathy, or naturopathy.

Granted, University of South Florida Medical School is among the minority of medical schools left in the country that does not offer any CAM courses. So these students may be even less informed than most. But according to some of our Health Sciences Institute panelists, the results are not at all surprising. Even though more and more medical schools are adding CAM courses to their curriculum, some panelists feel this is mostly a PR tactic to divert criticism. Dr. Allan Spreen says, “The mainstream establishment brags about how more and more medical schools are teaching CAM, while they still teach that such disciplines are quackery. That way they get credit for ‘teaching’ the subject matter while assuring that future docs won’t touch it. So, most med students won’t refer patients to alternative disciplines whether they’ve had a course on it or not.”

Jon Barron agrees. “The biggest problem, of course, is ego. As a medical doctor, you’re supposed to be the best-trained healer in the history of the world. If you haven’t learned it, it can’t be true.”

But Barron has another interesting perspective. He believes doctors are under intense financial pressure right now, pressed between managed care restrictions and the reality that people are spending more and more on alternative care. (One widely quoted study published in the New England Journal of Medicine reported that Americans spent $27 billion on alternative medicine in 1997 alone.) “It’s like being in a room with two 800-pound gorillas,” Barron says. “The one place you don’t want to be is in the middle.” Barron predicts this pressure will push more doctors to get behind CAM, since they have little recourse with the managed care gorilla.

The problem is that until that happens, we are all caught in the middle as well. We’re stuck with doctors and insurance companies who know less than we do about our conditions and the therapies we have found to treat them. We’re educating them. And for our trouble, we’re met with skepticism.

But there are ways around the gorillas. Our HSI panel includes more than a dozen brilliant minds from the alternative health community, with specialties ranging from oncology to herbal medicine. These are health professionals who are committed to providing you with access to vital information about alternative and complementary medicine. With their help, HSI continues to publish the latest breakthrough health information, so you can make your own decisions.

You, too, can help make alternative health care more available. Share these e-Alerts with family and friends, ask your insurance company about CAM coverage, and don’t be afraid to ask your doctor about alternatives. On behalf of myself and HSI, I’ll do the same.

But, perhaps most importantly, we should start alerting the American Medical Association (AMA) to our concerns. More and more doctors are complaining about their patients practicing CAM behind their backs. Well, the only way to get patients to be more comfortable in talking with their doctors is to make sure the doctors are educated and open-minded. We need to let the AMA know that we need doctors we can talk to. Contact the AMA to tell them they should be encouraging their doctors to learn more about what their patients really care about. Send your letters to the American Medical Association, 515 N. State Street, Chicago, IL 60610. Or, go to their website at and click on Contact Us, Policy and Advocacy, AMA in Washington.

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