Originally created 09/25/01

Integration of East and West could be future of medicine



DERBY, Conn. -- They come to the Integrative Medicine Center as a last resort, believing conventional medicine has failed them.

A woman with chronic pain syndrome. A man with progressive heart disease. A young person dying of cancer. All frustrated and hurting, some desperate, others merely curious.

What gives patients hope is the center's unconventional approach and the attitude of its caregivers - one a medical internist, one a naturopath who uses homeopathic or herbal remedies, massage therapies and acupuncture.

"They sometimes come here expecting miracles," said Dr. David Katz, the center's director. "We're good, but we're not that good."

Katz, an internist and preventative care specialist, has teamed up with Christine Girard-Couture, a naturopath, to offer what may well be the next big thing in health care - integrative medicine, the combination of ancient healing arts with modern science.

At a time when more Americans are choosing alternative therapies, integration can be very beneficial, said Dr. Stephen Straus, director of the National Center for Complementary and Alternative Medicine at the National Institutes of Health.

"I think it's a good idea when multiple health care practitioners put their heads together to come up with the best course of treatment for a patient," he said.

The emerging field is "absolutely the wave of the future," said Larry Kopelman, a naturopath and a member of the board of directors of the year-old American Association of Integrative Medicine.

"It's really coming from a groundswell of people who have found a great deal of dissatisfaction with Western medicine," he said.

The reason integrative medicine works, Kopelman said, is because it combines the knowledge of two philosophic hemispheres and treats the patient as a whole.

"Western medicine is at its best for acute trauma," he said. "But when it comes to more everyday ailments, Western medicine has failed miserably."

On the other hand, Straus cautions that alternative therapies are still undergoing rigorous study, and patients should remain cautious.

"These are unproved treatments," he said. "They may have side effects. They may interact with other mainstream treatment. An herbal medicine may negate the ability of traditional drugs to be effective."

Integrative medicine is also struggling to find its identity and a universal definition. Simply putting a chiropractor and a Chinese herbalist under the same roof does not constitute integrative medicine, Kopelman said.

"It's much greater than that," he said. But Katz and Girard-Couture seem to have the right idea, he added.

Naturopaths are not licensed, but they are trained, with four years of pre-med courses and four years of post-graduate studies. It is not clear how many physicians are adding alternative medicine to their practices.

At the Integrative Medicine Center, patients are led to one of two exam rooms where they spend 40 minutes each with a medical doctor and a naturopath in a tag-team examination.

While the patient is headed home, the two caregivers consult with Katz and Girard-Couture and the group comes to a decision about what treatment to recommend, based on the patient's preference. Sometimes the doctors recommend antibiotics. They might recommend acupuncture or homeopathic remedies.

For Girard-Couture, who as a naturopath is prevented by state law from prescribing medication, the advantage of having a medical doctor available means she has access to his ability to prescribe drugs, when necessary.

For Katz, the advantage of having a naturopath on staff means he has a walking encyclopedia of homeopathic and botanical remedies at his disposal.

"No one individual can know it all," Katz said.

"The bottom line is to have an open mind," Girard-Couture added.

Though integrative treatment gives patients a sense of control over their own health, Straus said he's afraid people might abandon effective traditional treatments in favor of radical treatments that might not work.

But that doesn't mean doctors should write off what appear to be primitive techniques.

"That bias is as unhelpful to the development of medicine as is the bias that just because people have used these in Africa and China they must be safe," he said.

As long as it's been proven safe and effective, Straus agreed with Katz and said it doesn't matter where a drug or treatment originates.

"Medicine is a constantly evolving discipline," he said. "It had always incorporated ideas that have proven themselves over time. There really is only one medicine, and that's good medicine."

On the Net:

Integrative Medicine Center: http://www.imc-griffin.org

National Center for Complementary and Alternative Medicine: http://nccam.nih.gov

American Association of Integrative Medicine: http://www.aaimedicine.com