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The Honolulu Advertiser

Posted on: Thursday, March 15, 2001


Modern medicine uses complementary methods

By Katherine Nichols
Advertiser Staff Writer

Modern medicine is changing. More patients are seeking ways to complement the conventional medical care they receive. But with all of the herbs and supplements and new methods available, how can people make appropriate choices?

At HerStory, a women's conference held recently on O'ahu, experts in the medical community spoke about trends in medical care and how consumers can become better informed. The panel consisted of Dr. Ed Cadman, dean of the University of Hawai'i School of Medicine; Dr. Terry Shintani, director of Preventive and Integrative Medicine at the Wai'anae Coast Comprehensive Health Center; Dr. Susan Steinemann, a general surgeon who specializes in breast cancer; Diana Joy Ostroff, a naturopathic physician and licensed acupuncturist; and Myra Williams, assistant vice president of care management at HMSA.

Cadman, who plans to add a department of complementary/alternative medicine to the John A. Burns School of Medicine, said he dislikes the word "alternative" because it implies the patient will use less proven methods instead of what is known today as conventional medicine, as though the patient were restricted to one or the other. "Complementary" promotes the use of unconventional methods in conjunction with more proven, standard treatments. And Cadman is all in favor of this.

"If you think it will work, go ahead. Because part of healing is believing that what you do will make a difference," Cadman said of unconventional treatments. In his experience as an oncologist, he noted that 80 to 90 percent of cancer patients sought and used some form of complementary medicine. His only hesitation with the myriad of offerings: "People on street corners are taking advantage of people's hope," convincing them that in some herb or supplement lies the cure that eludes them. Though experts agree there is never one answer, many people susceptible to false promises have given up on "proven" methods.

"Conventional medicine is clearly in a crisis," said Steinemann, because of the "aura of distrust" the public has for physicians and the "emphasis on technology over touching."

Complementary medicine, however, tends to focus on the individual and his or her role in wellness in ways that allow patients to feel empowered. Steinemann agreed that the first step in achieving more effective medical treatments is to put a "greater emphasis on the mind/body connection." Still, the fact that some people "readily discard proven therapies for unproven methods" concerns her.

Shintani, who in addition to his medical degree has a master's in public health and is an attorney and a nutrition expert, also believes that many medical problems will remain unsolved until the medical community can combine complementary methods with conventional wisdom. But sometimes seeking multiple therapies can be hindered by finances.

In an effort to solve that problem, Williams said that HMSA has begun offering discounted complementary medical care. Six years ago, the National Institutes of Health established a National Center for Complementary and Alternative Medicine and provided $2 million in financing; last year that figure rose to $90 million. The federal government has brought legitimacy to the field by providing dollars to support research and education, with the goal to make these therapies more widely available to everyone.

Yet Shintani pointed out that insurance companies still will not pay for nutritional counseling, an aspect of good health he deems essential. "I've seen nutrition work wonders," he said. But the more the public demands to have these possibilities available to them and supports research to make new methods more acceptable in the eyes of the insurance companies, the more potential there will be for coverage.

How patients can make more informed decisions:

Ask questions. Take along a note pad and pen to the physician's office.

If a health care professional recommends complementary medicine, demand data that proves its efficacy. Â Know that any herb or supplement you take could potentially have side effects or interact in a harmful manner with other medications. Ask a doctor or pharmacist about possible interactions.

Remember the power of good nutrition. Â Do not rely on promotional literature for information. Internet sources: www.nccam.nih.gov (National Center for Complementary and Alternative Medicine at the National Institutes of Health); www.naturopathic.org

Integrate expert opinions from a variety of sources into your evaluation process.

Trust your instincts.

In their zeal, however, even Ostroff admitted that people seeking additional therapies go to extremes. They occasionally come into her office with bags full of supplements, wondering why they are ill. "The supplements are making them sick," she said. "(The supplements) are full of fillers and additives that often cause more harm than good." She urged people to use supplements in minimal doses so the body can take over and employ its own inherent regenerative properties.

Cadman further cautioned the audience about unregulated herbs and supplements. St. John's Wort, for example, has been shown to work effectively as a mild anti-depressant. Yet it interacts with the liver and can reduce the effectiveness of blood thinner medications. This is an example of why patients should inform their physician about everything they are taking. And even if the physician doesn't recommend the supplements, he or she should be knowledgeable about potential interactions. Nearly all medications - even herbs at certain doses - have side effects.

Everyone on the panel recommended patients research information from a variety of areas, search for unbiased sources, filter the data they receive and make the best decisions for themselves.


How patients can make more informed decisions:

Ask questions. Take along a note pad and pen to the physician's office.

If a health care professional recommends complementary medicine, demand data that proves its efficacy. Â Know that any herb or supplement you take could potentially have side effects or interact in a harmful manner with other medications. Ask a doctor or pharmacist about possible interactions.

Remember the power of good nutrition. Â Do not rely on promotional literature for information. Internet sources: www.nccam.nih.gov (National Center for Complementary and Alternative Medicine at the National Institutes of Health); www.naturopathic.org

Integrate expert opinions from a variety of sources into your evaluation process.

Trust your instincts.