Though it’s hardly a traditional way to practice, reputable hospitals all over the country are opening clinics like this, which mix alternative medicine with garden-variety primary care. The unhurried, spalike centers are a refuge for patients who’ve had it with the cold, 10-minute HMO grind, or for those who want to try “natural” remedies before prescription drugs. And they’re often a last resort for patients with chronic pain or a terminal illness. Most of the clinics also have research wings. Even if you don’t believe in alternative medicine–and plenty within the medical establishment don’t–most agree that it needs to be studied, if only because millions of Americans are already using it.
There are now 27 of these hospital- sponsored “integrative” clinics, according to the industry newsletter The Integrator. They range from UCSF’s Stanford clinic, where doctors use hypnosis to treat pain and stress, to Harvard’s Mind/Body clinic, which uses relaxation response to heal. Last year more than 10 percent of hospitals used alternative medicine. And in the six years since the National Institutes of Health opened the National Center for Complementary and Alternative Medicine to fund research in the field, its budget has shot from $2 million to $89 million. But the NIH’s greatest contribution–to a field plagued by charlatans–is legitimacy.
Still, insurance coverage is slim to none at these clinics. Though the centers are working to get under insurers’ umbrellas, the cash now due at each patient visit doesn’t hurt the bottom line. At the Beth Israel center, there’s one doctor out of 16 practitioners who’s covered–and he’s booked until August. Some insurance policies offer partial reimbursement for chiropractic or acupuncture visits, but you’re on your own for the aromatherapy, herbology and visualization.
At the airy Beth Israel center on Manhattan’s Fifth Avenue, awash in $10 million in privately raised funds, you enter a passageway of earth tones that leads to the oval reception area, also known as “the womb.” The calming, feng shui’d “living area” (“You’re not waiting,” says fund-raiser Ann Viney, “you’re continuing to live”) is the first stop on the “circle of health” path that winds up at the cashier. What is the relationship between all the natural fibers in the decor and healing? “Well, it’s a connectedness with everything, you know, with really the planet,” says executive director/guru Woody Merrill, whose pal Richard Gere sits on the center’s board of advisers.
While you look over the 10-page questionnaire–and try to decide whether you’re always, usually, seldom or never happy–the doctor comes out to get you herself. For most of the hour, she asks personal questions (“Are you going to marry your boyfriend?”) and taps the answers into a computer. She needs to know, she explains, what’s going on in your mind to understand your body. She never once touches your coccyx, the main purpose of your visit. In the end, she refers you to the chiropractor ($180) and to the massage therapist ($125) for the stress she’s diagnosed. She also recommends nine remedies, including calcium, kava (without mentioning its side effects) and yoga. It is the most pleasant doctor’s-office visit you’ve ever had, precisely because it did not feel like one.
The public groundswell of interest in alternative medicine is what convinced the hospital to open the center, says Beth Israel’s CEO, Dr. Matthew Fink. A study in the Journal of the American Medical Association was startling proof: it found that the amount spent in 1997 on alternative therapies–$27 billion–was comparable to the amount spent on all physician services that year. With more and more compelling anecdotal evidence feeding the public appetite every day, these centers are a way for hospitals to compete for patients–and revenue.
But opposition within the medical establishment still dogs the movement. The American Medical Association states: “There is little evidence to confirm the safety or efficacy of most alternative therapies.” Some physicians are up in arms over reputable hospitals’ jumping on the bandwagon. “It burns me up that centers like Beth Israel’s are spending dollars on something that is a PR ploy,” says Louis Levy, a San Diego orthopedic surgeon. Fink says they did not open the center to attract patients but, he admits, “it helps us remain successful.” Even Virginia Reese, the center’s physician associate in gynecology (who’s known as the pap-’n’-chat for her long talks with patients) is cautious. “It’s not utopia,” she says. “There are kooky expectations out there.” She worries about patients who say, “Conventional medicine has abandoned me! You will save me!”
Savior or not, this medicine is bound for the mainstream. New pain guidelines requiring health systems to educate patients on several alternative therapies are to be implemented this year. And currently, 64 percent of medical schools offer some education in alternative therapies, according to JAMA. That’s a lot of holistic doctors in our future.
For now, trusting alternative medicine requires some faith, especially with the lack of regulation and conflicting philosophies. Dr. Harris Gellman, a professor of orthopedic surgery at the University of Miami who uses alternative therapies, calls a referral to the chiropractor for your painful coccyx “highly inappropriate.” He says conventional medicine must be applied before resorting to alternative, as opposed to the Beth Israel center’s philosophy of “gentler” first, which could cause greater damage. But if you have faith in alternative medicine–which is more likely now that it’s couched in a hospital–you have a pretty good chance (30 to 45 percent) of getting well, just according to the placebo effect. Not bad for a trip to the spa.
