Hospitals Open Alternative

Care Sections

NEW YORK (AP) - Beth Israel Medical Center, a large New York teaching hospital, this month opened a funky looking facility - complete with pastel-colored walls and a waiting room with fluffy couches and a redwood bench - where physicians work along side chiropractors and practitioners who specialize in homeopathy and clinical imagery.

At Cedars-Sinai Medical Center, one of the most prestigious hospitals in Los Angeles, cardiac patients are given the option of receiving acupuncture or massage therapy after coronary bypass surgery.

At the University of Pittsburgh Medical Center, known for its ground-breaking organ transplants, psychiatrists prescribe herbal medicines to help patients overcome depression.

Hospitals, the bastions of Western medicine and high-tech gadgetry, are increasingly using procedures such as aromatherapy and Tai Chi to try to attract patients by tapping into one of the hottest trends in health care.

Though the medical profession remains skeptical about the effectiveness of alternative therapies, hospital administrators say they can no longer escape the reality that millions of Americans routinely use them to complement - or even take the place of - traditional medicine.

About 83 million Americans are spending some $27 billion a year on alternative care, according to a recent study published in the Journal of the American Medical Association.

With these patients and dollars in mind, about 13 percent of U.S. hospitals provide alternative therapies, according to a survey of about 1,000 hospitals by the consulting firm Deloitte & Touche. The figure rises to 25 percent for inner city hospitals and 32 percent for hospitals with at least 500 beds.

A decade ago, it would have been almost unheard of for hospitals to offer such services, industry analysts say. That's changing fast.

``It would be silly for doctors and hospitals to ignore something that will be a large part of health care for years to come,'' said Dr. Matthew Fink, a neurologist who is president and chief executive of Beth Israel Medical Center.

But doctors and the practitioners of alternative care don't always mix well.

Many doctors still are suspicious of alternative therapies and consider chiropractors and acupuncturists to be quacks. And health insurers are reluctant to pay for most alternative procedures.

At the State University of New York at Stony Brook, a move to affiliate with a group of alternative care practitioners prompted a firestorm of criticism from faculty members before the program got off the ground.

Despite occasional setbacks, alternative care providers and medical practitioners are increasingly seeking to find common ground to help their businesses prosper.

That's what's happening at Beth Israel's Center for Health and Healing, located on the second floor of a nondescript office building in downtown Manhattan. The $5 million center, with 17 treatment rooms, has pastel-colored walls. The waiting room is light and airy with fluffy couches, and there's a bench made from recycled redwood in the reception area.

``We are providing a wide range of therapeutic options of remedies that have stood the test of time and/or scientific scrutiny, and preferably both,'' said Dr. Woodson Merrell, the center's executive director who is a physician and an acupuncturist. ``I see integrative medicine as the future of medicine.''

The center, opened in June, includes medical doctors, registered nurses, nurse practitioners, psychotherapists and practitioners of acupuncture, chiropractic procedures, mind-body therapy and massage therapy.

Beth Israel officials opened the center not only to tap into the growing interest among consumers for alternative care but also to conduct research to try to determine if these therapies - some practiced for thousands of years- really do work, Merrell said.

Merrell said some Beth Israel doctors were suspicious of the center, especially orthopedic surgeons who are leery of chiropractors. To win the specialists' support, the center has agreed that after a patient sees a chiropractor three times, the case must be reviewed by a physician.

``We tried to get both sides to come to the table to work together,'' Merrell said. ``It was like putting together disparate worlds.''

Experts say alternative care providers gain credibility by working with physicians and hospitals. And the doctors and medical institutions are viewed as cutting edge for facilitating alternative care.

Financial barriers remain, however, because there is limited insurance coverage for alternative procedures. Beth Israel's center so far has been unsuccessful in attracting an insurer for a pilot project to test whether alternative therapies can save money and provide good care, Merrell said.

Still, support among physicians is growing.

Dr. Gregory Fontana, a cardiothoracic surgeon at Cedars-Sinai, uses acupuncture to relieve the neck pain he develops from surgery.

Seeing first hand how the therapy works for him - and concerned that his own patients were not receiving effective treatment for pain - Fontana recently led a group of physicians to start a pilot program to test acupuncture, massage therapy and guided-imagery relaxation techniques on cardiac bypass patients. Early results on about 100 patients show that nearly all reported some relief from the services, he said.

``As my practice evolved, I saw the frustrations of my patients and came to the realization that Western medicine does not have all the answers,'' Fontana said.

Fontana's study is just one area at Cedars-Sinai where there is alternative care.

The hospital last year launched its Integrative Medicine group, which offers such services as acupuncture and meditation as well as physician services. Doctors are becoming involved because their patients are asking about such procedures, officials say.

``Doctors fear they will lose patients if they do not know how to talk to patients about alternative therapies,'' said Dr. Mary Hardy, the group's medical director who is an internist and specialist in herbal medicines.

Beyond New York and Los Angeles, hospitals in more conservative areas of the country also are introducing alternative care.

Central Iowa Health Systems last year opened the Center for Health and Well Being in West Des Moines, Iowa. The center, which treats allergies with Chinese herbs and back pain with acupuncture, hopes the hospital name and logo will attract patients who are hesitant to give these alternative services a try.

``We give patients more of a comfort level because they know we've checked out these practitioners,'' said Sheila Gregan, the center's director.


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