As a Medical Doctor for almost 30 years, now involved with Integrative Medicine, I was asked by Dr. Neims to share some thoughts about alternative medicine with the physicians of the Alachua County Medical Society. In the early 1970′s I experienced an illness after a scuba diving trip to an island off the Yucatan peninsula. After three hospitalizations at Shands and a complete evaluation by Dr. Jim Cerda, who was head of tropical disease at the time, I was told “Bob, we don’t know what you have. Your brush border enzymes from your small bowel biopsies are absent. You have something similar to non-tropical sprue, endogenous to the island you were on, that is unknown to medical science. We don’t know how to treat it.” This was a major shock for a young doctor who thought modern medicine had most of the answers. After months of treatments with different antibiotics the symptoms did not resolve. It was only after taking a home remedy made by my Swedish Grandmother, using the leaves of a certain grass from Sweden that transformed milk into a yogurt-like drink, that I slowly recovered.

Twenty years later I underwent a laparoscopic hernia repair. The anesthesia stressed my immune system, reactivating the disorder. Extensive lab tests were again Anormal, and it was only after the urging of a close friend that I saw an acupuncturist/herbalist in Sarasota, FL. Through the use of an electrical device to analyze acupuncture energies, I was found to have multiple different parasites. Six months later, after taking different herbal mixtures, the parasites were eradicated for the first time. My health returned and I have studied alternative therapies ever since. I have also been back to Mexico several times without problems. The point of this story is that a person’s reality is based on personal experiences.

For the past decade a major paradigm shift has been going on in health care. More and more Americans are seeking alternative and complementary therapies. What was once viewed as a foreign or counter-culture activity is now a part of mainstream American life. A study done at Beth Israel Deaconess Medical Center in Boston found that Americans made more visits to alternative practitioners than regular doctors in 1997. And they spent about 27 billion dollars out-of-pocket on alternative therapies. A survey done at Stanford University found that 2/3 of Americans now use unconventional medical therapies. This is the first time in Western medical history that we have a consumer-driven change in the delivery of health care. The reasons for this movement are multiple. Managed care has alienated patients and doctors. People are demanding gentler, more cost-effective therapies and they want to be healthier, not just treat symptoms. The high costs of traditional medicine, where a person pays a year’s wages for a hospital stay, are unacceptable to most Americans. Another reason is the Internet. Patients come into our offices better informed, asking about new therapies, and they have the world’s medical library at the click of their mouse. Their viewpoint is no longer just accepting the “paternal” or physician-centric model of health care, but is a patient-centric model where the patient plays a major role in determining his or her own therapies.

During my medical school years and residency training at Shands, there were no courses given in health or nutrition. I studied the anatomy and pathophysiology of disease and how to treat it with drugs, surgery, or radiation. This is one end of the spectrum. On the other end of the spectrum is health or wellness, and how to elevate it with proper lifestyle changes, nutrition, and natural supplements or other complementary therapies such as meditation, massage, acupuncture, etc. This is a very different viewpoint along oriental medicine philosophy lines that health and healing comes from within, and not from drugs or surgery. Only the body/nature and the higher spirit can heal, we just facilitate things. One example of this is how a person well trained in yoga can lower his or her pulse rate or breathing to almost zero, or stop the bleeding from a cut. Another example is spontaneous remission of a cancer in someone who has not undergone surgery, chemotherapy, or radiation. This may be a difficult reality for a traditionally trained physician to accept as traditional medicine places very little emphasis on the spiritual aspects of a person, unless he or she is near death or dying from a terminal illness. My personal viewpoint is that we are spiritual beings with an earthly experience, not earthly beings with a spiritual experience. Spiritual events can impact health in both a positive and negative way.

I opened the doors to the Preventive Medicine Center in March 2000. The Center is an outpatient facility where alternative therapies are integrated with the traditional therapies a patient comes in with. The majority of my patients are college educated, middle to upper middle class including business owners, physicians, attorneys, and university professors. 80% are female. Most have sought answers to their health problems with multiple physicians or have been to Shands or the Mayo Clinic and have gone through extensive, traditional medical evaluations by very good physicians. My first observation was, unlike my previous family practice, almost all of the new patients coming to the Center have significant health problems such as chronic fatigue syndrome, thyroid system dysfunction, fibromyalgia, severe allergies, or hormonal imbalance. Often, these patients tell me their doctor has invalidated how they feel when they were told nothing is wrong because their lab tests were “normal” or it was implied they had a supratentorial problem. Is it possible traditional medicine has come to rely too heavily on high tech tests and procedures and no longer demands enough time be spent in listening carefully to a patient’s history before formulating a diagnosis? An energy imbalance or “block” in the body’s energy channels can create symptoms or illness even if it is not apparent on a lab test. This is why “energy medicine” techniques such as acupuncture, massage therapy, chiropractic, homeopathy, etc. can improve health by restoring a balance in body energies. In traditional medicine energy therapy with ion beams can kill cancer cells, lasers (light energy) can perform surgery, and magnetic energy can treat pain and other conditions.

One of the methods of patient evaluation I use is acupuncture meridian analysis of bioenergy flows using muscle reflex testing called CRA (Contact Reflex Analysis). This is different than evaluation of biochemical reactions that occur within our bodies using lab tests, and is in the realm of physics, much in the same way MRI scan analysis is based on the fact that we are composed of atomic particles and have energy flows. I use CRA to help adjust doses of medications or supplements a patient takes. For instance, in hormonal replacement therapies often the lab reference range is very wide, but an individual patient’s “optimal” range is narrow. Using CRA findings in addition to lab findings, I am able to prescribe custom, compounded bioidentical hormonal replacement therapies for men and women. Another technique we use at the Center is NAET (Nambudripad Allergy Elimination Technique), which is a way of eliminating many allergies through the treatment of acupressure points. I have successfully treated patients with food allergies or environmental allergies and chemical sensitivities, even some who have had previous anaphylactic reactions. The results are usually permanent and are often dramatic.

One of the criticisms of alternative therapies by traditional medicine is that these types of therapies have not been proven by randomized, double blind, placebo controlled multicenter studies. My answer is there in no “one” correct reality. For the past 50,000 years on this planet effective therapies using herbal remedies and alternative therapies have evolved by trial and error. Every time an indigenous healer administered an herb or treatment to a sick individual, a data point was added and the knowledge grew. In my opinion, it is pure arrogance to summarily dismiss this accumulated wisdom. 80% of the world does not have access to Western medicine and if we look at the facts of how America stacks up with epidemics of cancer, Type II D.M. in children, heart disease, etc., the results place in question how well our system of medicine is doing, even among many traditional physicians. Gerard Anderson, PhD, director of the Center for Finance and Management at John’s Hopkins University and Jean-Pierre Poullier of the World Health Organization compared 29 industrialized nations, including Australia, Canada, Japan, Mexico, the US, and most of Europe. They found the United States spent close to $4,000 a person on health, more than twice the median per capita expenditure of other countries. When the researchers compared the measures of health status [e.g. rates of infant mortality, life expectancy, etc] the U.S. fell into the bottom half of nations. “. . . relative to the rest of the world, we’ve gotten worse, “Anderson said. This is also the reality of those seeking or using integrative or complementary therapies. These patients want to be proactive in preventing health problems before they occur.

Another criticism of alternative medicine is that supplements and herbs are unregulated by the FDA. I agree that potency and purity issues may be present, just as is found in traditional drugs such as Synthroid recently. It is also true that improper use of herbs can be dangerous, especially in children. But this argument is unbalanced given the fact that we have a whole new category of disease – ” Aiatrogenesis” where the third leading cause of death in this country according to a recent JAMA article is due to pharmaceuticals resulting in the deaths of more than 100,000 hospitalized Americans annually. The reality of patients seeking alternative therapies to drugs is they are not benign. They feel, unlike natural supplements or therapies that elevate health, drugs just treat symptoms of disease.

I would hope that the readers will understand I am not anti-traditional medicine. Quite the contrary. For an acute, life threatening emergency such as major trauma, MI, stroke, etc., there is no better country to be in. But for chronic diseases, all of us who are trying to improve patient outcomes recognize we do not have all the answers, and that it is important to keep an open mind to all new therapies. It used to be that traditional Western medicine and alternative care were rivals. We are now entering an era of integration. Congress created the Office of Alternative Medicine in 1991 to evaluate alternative therapies, and in 1998 this was upgraded to the National Center for Complementary and Alternative Medicine, and given a 68 million dollar budget and broader responsibilities. The Florida Legislature several months ago passed a bill that was signed into law guaranteeing patients freedom of choice of alternative therapies as long as they received informed consent. The other side of this coin is that traditionally trained physicians must now incorporate alternative therapy information as a part of informed consent as well. The bottom line is patients are demanding freedom of choice of therapies, whether they be homeopathy, Chinese herbal medicine, chiropractic, nutritional therapies, or standard medicine. The silver lining in all of this is that some funding has been appropriated for research of alternative therapies in cancer and chelation therapy, and clinical trials at major universities (including the University of Florida) and among private physicians are planned. The funding is very limited, but at least it’s a first step. Another step is the training of physicians in nutrition, environment illness, CAM, and the like so that there can be real integration of therapies with newer models of medical education that lead to evolution of medical care. A number of major Universities such as Harvard are doing this. Just as there are certain spectra of light we cannot see, certain frequencies of sound we cannot hear, let’s keep an open mind that there is more out there that works than many of us have experienced in non-traditional medicine.