Source: Oregonian, The Contact: http://www.oregonlive.com Pubdate: 25 Aug 1998 Author: Erin Hoover Barnett (The Oregonian) (1320 SW Broadway Portland, OR 97201) ALTERNATIVE MEDICINE ISN'T JUST ON FRINGES ANYMORE * A convention in Portland underscores the rising profile of acupuncture, herbs and other such therapies -- even among insurers Hundreds of naturopathic physicians converge on Portland this week for a national convention. They arrive as alternative and mainstream medicine, pushed by consumer interest, take bolder steps toward each other: * The Oregon Cancer Center at Oregon Health Sciences University is starting research into alternative therapies for cancer. * Kaiser Permanente plans to offer limited coverage for acupuncture and naturopathic medicine beginning in January. Kaiser already covers chiropractic care, as do most other big health insurers. * Nature's Northwest , a grocery chain with organic produce and health foods, opened a Lake Oswego store this month with a pharmacy for prescription drugs combined with an herbal supplement dispensary. Customers can consult with a pharmacist and/or a naturopath and look up herbs and medications on an online computer network or read about them in a library and bookstore above the pharmacy. * OHSU's medical school will inaugurate an annual lecture on alternative medicine next spring, adding to coursework already offered. The conventional medical world began waking up to the alternative medicine movement in 1993, when Dr. David Eisenberg published a study indicating that one-third of all Americans use alternative therapies, spend $13.7 billion a year on them and generally do not tell their doctors. Consumers, recognizing the limits of conventional medicine, particularly in treating chronic illnesses, are looking for options. In an era of 20-minute doctor appointments at mega-medical office buildings, consumers are drawn to the more personal touch of alternative medicine practitioners. Aging baby boomers, taking charge of their health in ways their parents did not, are fueling the movement. Consumer pressure continues to build. A study released this year by Landmark HealthCare in Sacramento, Calif., found that 42 percent of American adults use some form of alternative medicine, particularly chiropractic and herbal therapies. Portland and the rest of the Northwest have been in the forefront of the movement. "The Northwest is a melting pot of health care modalities," said Clyde Jensen , president of Portland's National College of Naturopathic Medicine. "The Northwestern mentality is a very independent, pioneering mentality that has created a fertile ground for alternative health care measures as well as alternative activities in other areas of life." Jensen, a pharmacologist and past president of three osteopathic medicine colleges, moved to Portland from Tulsa, Okla., in 1996. National College and Bastyr University outside Seattle are the nation's only fully accredited natural medicine schools. Bastyr offers undergraduate and graduate programs in natural health sciences. In addition to National College, Portland is home to chiropractic and Asian medicine colleges and two massage schools. The colleges have fostered the growth of alternative therapies and their integration with conventional medicine. In 1996, for example, Bastyr University and King County, which includes Seattle, opened the nation's first fully integrated, publicly financed conventional and natural medicine clinic. The King County Natural Medicine Clinic offers primary medical care as well as naturopathic medicine, acupuncture, chiropractic and massage. "The rest of the country is now catching up to where Portland and Seattle have long been," said Peter Barry Chowka , public affairs consultant for the American Association of Naturopathic Physicians, based in Seattle. Chowka expects 700 to 1,000 naturopaths and other health care practitioners at the association's five-day professional conference beginning Wednesday. The conference will include seminars on alternative medicine for mental illness and naturopathic treatment for cancer. Cancer is among hot topics Cancer treatment is one of the areas of alternative medicine that is beginning to capture the attention of the medical research community. OHSU's Oregon Cancer Center has begun soliciting research proposals in four areas: diet; exercise; mind/body medicine approaches to cancer, including acupuncture and guided imagery; and preventive approaches for people at high risk for cancer. "Our charge at the cancer center is to try to validate some of the alternative strategies that have been employed in the past and maybe even to develop some for the future," said Dr. Grover Bagby , center director. "My bet is that we're going to be able to do some good validations here. And we may also find that some of the old tried-and-true holistic remedies don't do much except make you feel good, which is also important." Researchers at Bastyr are studying natural treatments for breast cancer as well as for AIDS and respiratory tract infections. Anna MacIntosh , dean of research at National College of Naturopathic Medicine, and Dr. Bruce Goldberg, associate professor of family medicine at OHSU, also are studying upper respiratory illness. They are testing the effectiveness of herbal remedies in preventing colds. Joanne Nyiendo and Mitchell Haas , research professors at Western States Chiropractic College, are collaborating with Goldberg to compare standard medical and chiropractic approaches to low-back pain. In 1994, Western States became the first chiropractic institution to receive federal research financing, a total of $1.8 million so far. Initial results of the study are due in the fall. "People outside the chiropractic profession are looking at us with new vision," Nyiendo said. "It's like this stamp of approval because if the federal government is going to put up your money as a taxpayer to do this, then there must be something to it." The more research, the more comfortable the medical establishment becomes looking at possible uses of alternative therapies. The National Institutes of Health issued a consensus statement in November about which ailments acupuncture can treat effectively. Its findings helped persuade Kaiser Permanente to begin covering acupuncture for certain health problems, such as chronic pain. Starting next year, Kaiser members who work for Fred Meyer and other large regional employers may be referred by their primary doctors to a network of acupuncturists or a network of naturopathic physicians, managed by Complementary HealthCare Plans. Kaiser's challenge has been to respond to members' desire for alternative medicine while ensuring high-quality health care, said Dr. Tom Janisse , associate medical director for Northwest Permanente. "This is all new for everyone," Janisse said. "This isn't like deciding to work with a network of specialists who will deliver cardiology services. Cardiology is a discipline that we know well, that we can evaluate well." In April, Providence Health Plans began offering coverage through the same acupuncture and naturopathic networks as Kaiser. Providence and Kaiser already offer chiropractic care, using the network ChiroNet, also run by Complementary HealthCare. Research led Providence Health Plan to get involved in the Community Selfcare Center of Nature's Northwest, which includes the pharmacy/herbal supplement dispensary. Providence doctors reviewed research presented by a Nature's consultant showing the effect of mind/body medicine -- focusing on stress reduction, diet changes, exercise and lifestyle adjustments -- in preventing and treating heart disease, hypertension and diabetes. Providence is considering paying for classes at Nature's in mind/body medicine for health plan members. "The next revolution" "This really could be the next revolution in health care," said Kurt Ziehlke , a registered nurse who does product development for Providence Health Plans. "Research is coming out that (mind/body medicine) is certainly a treatment option that shouldn't be ignored. It potentially can improve patients' quality of life. It's certainly less invasive." Stan Amy, Nature's president, said the Community Selfcare Center is based on the idea that to help people lead healthier lives, health care needs to be "in the path of everyday living." "The nation's ready," Amy said. "The entire environment around alternative medicine has changed radically. There's just been an explosion in interest, both among the public and the medical community, and we really need both." OHSU's medical school also has begun delving into alternative medicine. Besides starting its annual lecture on the topic, the school gives second-year students a half-day seminar on creating integrative health care by incorporating some types of alternative therapies. An alternative medicine student interest group also is active on campus. "It's very important from my perspective that our medical students are fully aware of what their patients' interests are," said Dr. Edward Keenan , associate dean for medical education at OHSU. "And it's clear that many patients have an interest in alternative medicine." - --- Checked-by: Pat Dolan