Confessions of a Quackbuster

This blog deals with healthcare consumer protection, and is therefore about quackery, healthfraud, chiropractic, and other forms of so-Called "Alternative" Medicine (sCAM).

Tuesday, July 26, 2005

Baptist ponders adding focus on alternative care

Baptist ponders adding focus on alternative care

By Mark Tosczak
The Business Journal of the Greater Triad Area
Updated: 8:00 p.m. ET July 24, 2005

Can cranberry juice cure a child's urinary tract infection? Does the spice turmeric lower the risk of cancer? Can massage be used to treat incontinence?

A few years ago, many doctors might have dismissed these questions as quackery or merely old wives' tales. Now, these topics and others like them are becoming the subject of serious science at Wake Forest University Baptist Medical Center.

In fact, there's so much research, teaching and clinical activity going on in what's known as complementary and alternative medicine, or CAM, at Wake Forest Baptist that administrators are considering creating a new center to house the work, and a new Ph.D. program to train young researchers in the field.

Complementary and alternative medicine -- sometimes called integrative or holistic medicine -- encompasses a broad range of therapies that have one thing in common: They're not a part of medicine as it's traditionally been taught and practiced in the United States.

The category includes chiropractic treatment, herbal and nutritional supplements, acupuncture and more exotic therapies such as those that claim to heal by manipulating energy fields. They are a set of therapies that have long been kept at arms-length, and even dismissed, by doctors oriented toward scientifically proven treatments.

But in the last 12 months, about $25.7 million worth of grants for CAM research has been awarded to Wake Forest Baptist researchers, according to the medical center's Office of Research.

National trend

A report released earlier this year by the Institute of Medicine, an influential national nonprofit that makes recommendations about health care and medical research, calls for more scientific evaluation of CAM.

"The main thrust of that report was to emphasize the need to study all of these (therapies) to document the effectiveness of all of them so that people can be accurately informed about what works and what doesn't and also the risk," said Dr. Stuart Bondurant, executive dean of the medical school at Georgetown University and the chairman of the committee that wrote the report. "Some of the other interventions, whether they have risk or not is just unknown."

Bondurant, a Winston-Salem native and dean of the UNC-Chapel Hill School of Medicine for 16 years, said that most Americans -- almost 75 percent according to a 2004 government report -- have used CAM therapies at some point.

Federal funding for research on CAM therapies has increased more than 60-fold in the last 14 years, from $2 million in 1992 to $123.1 million in fiscal 2005.

Even if science discovers that many alternative therapies don't work, health care professionals still need to know about them if their patients are using them -- because so many are.

In fact, educating health care practitioners about non-Western health care techniques is one of the goals of researchers at Wake Forest Baptist.

Thomas Arcury, an anthropologist who's worked in Wake Forest Baptist's Department of Family and Community Medicine for six years, has helped put together a network of alternative-medicine practitioners in the area -- acupuncturists, massage therapists, healing-touch practitioners and others -- to work with Wake Forest Baptist faculty members.

The idea is to get the two groups of practitioners, who sometimes may be treating the same patients, to talk to each other, establishing communication and trust.

"These are all people who are very concerned about patients," Arcury said.

He also interviews people, especially minority groups and people who live in rural areas, on how they care for themselves, how they get information on health care and what they believe about it.

Such research, he said, can be valuable for doctors who may not, for instance, realize that a patient has been using the folk remedy of a couple of drops of kerosene on a sugar cube to treat a cold.

"If we're trying to improve health care and trying to improve how people take better care of their health, we have to understand how they decide to use this health stuff," Arcury said. "If we want to do health education, if we want to do patient education, we need to know what models people carry around in their head."

Controversial still

Nonetheless, Arcury said the increasing attention to complementary and alternative medicine has sparked debate inside the medical center.

"This is an area of some controversy," he said. "There's many different sides to this."

But those differences, he added, are ultimately good.

"It's not that people are in knock-down, drag-out (fights)," he said. "I think it's healthy for there to be discussion."

About three months ago, Wake Forest Baptist's top research administrator, Associate Dean for Research Sally Shumaker, formed a committee to begin to catalogue the medical center's CAM work and to encourage more collaboration between researchers.

Besides Shumaker, other notable members of the committee include:

a.. Dr. Kathi Kemper, a pediatrician who specializes in holistic medicine and who was the founder and chairwoman of the just-created American Academy of Pediatrics' Provisional Section for Complementary, Holistic and Integrative Medicine.

b.. Floyd H. "Ski" Chilton, who runs a government-funded $7.5 million research center that combines the efforts of Wake Forest Baptist and Harvard University researchers to study whether certain substances in plants might be used to combat atherosclerosis (the build up of fatty deposits in blood vessels) and asthma.

c.. Gordon A. Melson, dean of Wake Forest University's Graduate School of Arts and Sciences, who was brought in as part of the discussions on creating a new Ph.D. program.

"We could be a top-ranked school in this area," Kemper said.

No decisions yet

In fact, Kemper, Shumaker and Chilton all believe that Wake Forest Baptist could distinguish itself among academic medical centers nationally by having a center focused on complementary and alternative medicine.

Kemper herself has been a force in promoting CAM work. She put together an alliance of people from the state's medical schools -- Wake Forest Baptist, Duke University Medical Center, UNC Health Care and East Carolina University's Brody School of Medicine -- to discuss common concerns.

Despite the activity at Wake Forest Baptist, there are still plenty of questions that remain about its CAM efforts. For instance, it's not clear yet how much it would cost to start up a center for complementary and alternative medicine that would be similar to the research centers the school already has in fields such as cancer, epilepsy and aging.

Also unclear is where funding for an additional research center, or a new Ph.D. program, would come from.

Shumaker said planning has just started on both those ideas and that formal proposals haven't been drafted yet. The final decisions would rest in the hands of senior university and medical center administrators and, for the Ph.D. program, the university faculty.

Launching a center or a Ph.D. program could take as long as a year, she said.

© 2005 Business Journal of the Greater Triad Area

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