Dr. Eisenberg, director of the Center for Alternative Medicine Research at Harvard Medical School in Boston, Massachusetts, gained notoriety as one of the principal authors of a 1993 paper on unconventional medicine that brought a great deal of interest and scrutiny to the field of alternative therapies.1
Dr. Eisenberg's visit to Dallas was sponsored by the recently chartered Alternative Medicine Research Foundation of Texas. The two evening presentations were held at the University of Texas Southwestern Medical Center and Southern Methodist University (SMU). The agenda for both nights consisted of Dr. Eisenberg's presentation of the results from his 1993 study, showing the prevalence of usage for alternative medicine by the American public. For many of us, the results are well known.
- In 1990, an estimated 60 million Americans used alternative medical therapies at an estimated cost of $13.7 billion.
- The number of visits to providers of alternative medicine (425 million) exceeded the number of visits to all U.S. primary care physicians (388 million).
- More than 70% of patients who acknowledged using alternative therapy never mentioned it to their medical physician.
In beginning his talk, Dr. Eisenberg asked for a show of hands from the group of 700-800 doctors and clinicians with the question, "How many of you, or a close friend or family member, have used chiropractic or acupuncture in the last year?" About 80 percent of the audience raised their hands.
Dr. Eisenberg then discussed his recent paper, "Advising Patients Who Seek Alternative Medical Therapies."2 He shown the audience an outline of the program instituted by the Harvard Medical School in which medical students are given the opportunity to take an elective course covering alternative medical therapies. This type of program is now being offered in more than 30 of the 150 U.S. medical schools, and Dr. Eisenberg expects more schools to offer similar programs within the next few years.
Dr. Eisenberg's presentation was followed by a panel discussion, then a question and answer period with the audience. The panel was comprised of prominent MDs that had used alternative medicine, or had been exposed to it in their practice. One of the doctors related the relief of his wife's migraine headaches through the use of acupuncture. He stated that 20 years ago, a friend had helped his wife by sticking hat pins into her, much to his own surprise and disbelief! This event led him to begin using needles on his own patients for pain control. Following this, he began experimenting with electro-acupuncture, an easier and faster method than the traditional Eastern practice.
During the question and answer period, the majority of interest was centered around homeopathy, nutrition, exercise and chelation therapy. Ken Cooper, MD (the developer of aerobics) was in the audience and spoke briefly in response to questions concerning high blood pressure, diet and exercise.
The opportunity of having Dr. Eisenberg speak at both UT-Southwestern and SMU (along with local TV and radio station coverage) was yet another step in advancing and "legitimizing" alternative or integrative medicine for both practitioners and the general public. News of the Harvard Medical School program teaching medical students about alternative medicine was well received and deemed a responsible and proactive step in patient care. Dr. Eisenberg's hope of continuing this program as part of the curriculum in other medical schools has been called visionary.
As chiropractors and the leading practitioners of alternative medicine, we should follow the development of such programs and opportunities closely. We have an obligation to our patients and ourselves to ensure that the best interests of our field are safeguarded.
An important concern that was left unanswered was whether these ideas and programs will result in the referral of patients to licensed practitioners of alternative medicine, or whether MDs will merely attempt to provide these services themselves. For instance, what if the previously mentioned MD, whose wife had been helped by hat pins, had instead been helped by a cervical manipulation. Would that MD now be adjusting his patients to get rid of their migraines?
References
- Eisenberg DM, Kessler RC, Foster C, et al. Unconventional medicine in the United States -- prevalence, costs and patterns of use. New England Journal of Medicine 1993;328:246-252.
- Eisenberg DM. Advising patients who seek alternative medical therapies. Annals of Internal Medicine 1997;121:61-69.
Nicholas Chamberlain, DC
Dallas, Texas