Medical Information - FOR PATIENTS
Center for Colon and Rectal Surgery
Ten Things Your Alternative Healer Won't Tell You
By Michael Kaplan in Smart Money - April, 1999
"I'm not a doctor,
but I play one in my office."
AMERICANS SPENT some $29 billion out-of-pocket on traditional medicine in 1997. That same year, they paid an estimated $27 billion to $34 billion for such treatments as massage, acupuncture and reflexology. The herbal elixir business is booming. Physicians are endorsing meditation. Even some insurers are covering naturopaths and yoga instructors.
When used as an adjunct to conventional medicine, alternative health care has its benefits, but too many patients view healers as highly trained medical profes-sionals. Take Dr. William Brown, who's based in Sedona, Ariz. He converses confidently about the bloodstream, capillary cells and the immune system. He also claims to be able to "accelerate the lymph stream and raise the immune system" through massage, which most physicians believe is scientifically implausible. It's easy to imagine that Brown is an M.D. But he's not. He's an N.D., a doctor of naturopathy. (He also holds doctoral degrees in nutrition science and religious counseling.)
"We have reflexologists who tell you that what they do" - curing ills through foot massage - "is better than medicine," says David Thornton, a supervising investigator with the Medical Board of California. "And then there are the iridologists who look into your eyes and can supposedly pinpoint what's wrong with you and prescribe vitamins, minerals and herbs to bring your body into 'alignment.' In most cases, these people may start out believing in what they do, but eventually it becomes more a matter of making money."
Thornton acknowledges that most of these practices can be done in legal, non-fraudulent ways. "It crosses the line when these people start telling you that you have certain physical or mental problems that they have diagnosed," he says. "At that point it becomes the practice of medicine. They have impressive-looking diplomas on their walls; they'll tell you that chemotherapy is killing you and that they cannot continue seeing you unless you stop the chemo. What they're [really] trying to do is get repeat business."
"Just because I'm an M.D. doesn't mean I'm not a flake."
ALTERNATIVE HEALTH guru Andrew Weil, a Harvard-trained physician, has written that "improper breathing is a common cause of ill health." Like him, many M.D.s have embraced various forms of alternative health care, but some, like their patients, go overboard. "I know a doctor who was an ordinary G.P.," says John Renner, M.D., a family practitioner in Independence, Mo., and the chief medical officer for HealthScout.com. "He had a good bedside manner and was always recommending simple solutions to people, suggesting hot and cold compresses for sinus problems and the like, which can help. But then he got excited about yeast syndrome, where you tell your patients that they're allergic to yeast and that's the cause of everything from fatigue to respiratory illnesses."
How can you be sure that your doctor isn't using alternative remedies to the exclusion of more effective, mainstream treatments? "Pick a physician with hospital privileges, because it means that other doctors have evaluated and accepted him," Renner says. "Be careful of doctors who know everything about everything and have treatments that nobody else - including the AMA - knows about."
"Take my miracle medicine
with a grain of salt."
UNLIKE FOOD and Drug Administration-approved medications, which have been clinically tested, many alternative treatments are verified solely by anecdotal evidence. "There's no reason why alternative therapies cannot go through the same rigorous tests that all other medicines do," insists Larry Dossey, M.D., executive editor of the journal Alternative Therapies in Health and Medicine.
Stanislaw Burzynski, M.D., of Houston, is lauded in radical cancer-therapy circles as a visionary for his medication - antineoplastons - which he initially extracted from human urine and then used in treatment, claiming it can "turn off the genes that cause cancer growth." Yet Burzynski was unable to agree with the National Cancer Institute on how his drug should be tested. The FDA charged him with a 75-count indictment that ranged from insurance fraud to contempt of court. (He was acquitted of all charges in 1997.)
When a former patient, who wrote about Burzynski pseudonymously in Health magazine last October, called his office to see if charges of his not cooperat-ing were true, "I was shunned… for asking questions that leaned toward 'the other side,"' she wrote. Burzynski's spokesman, Dean Mouscher, replies, "There've been a lot of changes since she was there. Today, every patient is treated either on an FDA trial, or pursuant to a special exception approved by the FDA." An FDA spokesman responds that Burzynski's current "trials can provide evidence of [healing] activity in a variety of tumor types. But these studies are preliminary and could not be viewed as definitive."
"Don't take this stuff if you're on real medication."
IN 1997 more than 83 million Americans sought alternative health care treatment. Yet less than 40 percent told their physicians that they were fiddling with mugworth or valerian. Most problematic, 15 million people took conventional drugs and herbal remedies simultaneously. "Why would you want to tell your doctor something that he will chew you out about?" says Larry Dossey.
Whatever the case, secretly taking medication increases one's risk of experiencing unhealthy interactions between pharmaceutical drugs and herbs that might be sold without warnings about complications or overuse.
Compounding the problem is the fact that bottles of herbal medication are not required to be labeled with ingredients - or even to be consistent in their potencies. "There are cross reactions that could happen between St. John's wort and Prozac," says Dr. Wallace Sampson, a clinical professor at Stanford University. Among the few things that Sampson and alternative enthusiast Julian Whitaker, M.D., agree on is the danger of mixing drugs with herbs and the need to keep doctors informed about what you are ingesting. "If the patient were mine," adds Whitaker, "I'd be sure to get him off the Prozac."
"I steer you to remedies
that I happen to sell."
IMAGINE YOUR CPA trying to peddle you mutual funds. It would make you wonder about his intentions, just as you should when an alternative healer encour-ages you to purchase herbal medication directly from him. According to Dr. Steven Barrett, founder of the Quackwatch Web site, "The products are typically sold at markups of 50 to 100 percent."
Worse than the chance of being ripped off is being steered away from the most effective treatment. As M.D.s Charles Rogers and Richard Lange recently wrote in the bulletin of the Medical Society of the State of New York, "a window of opportunity for survival may be lost" if patients pass up recognized treatments for "media-hyped" herbs.
ONE OF THE first things that doctors-to-be are taught is that 80 percent of the ailments that induce people to visit physicians require no treatment at all. Sporadic headaches, stomach pain, joint inflammation - such things normally go away on their own. Because of this, doctors tend to spend less time with patients who really don't require treatment.
That's why hypochondriacs like alternative healers, who often get most of their information from patient interviews rather than from blood work and head-to-toe physicals. In fact, they'll frequently devote hours to discussing the minutiae of a patient's life. "I went to a homeopath who focused on my dreams for 15 minutes," marvels Larry Dossey. "He spent two hours speaking with me. I left there feeling like a million dollars, even though nothing was done to me physically."
Conventional doctors insist that a friendly bedside manner should not be confused with bona fide health care. "For chronic sufferers - of pains that may be real or [psychosomatic] - this is very rewarding," admits Dr. William Jarvis, a professor in the School of Medicine at California's Loma Linda University. "They validate illnesses, imagined and real, that cannot be pinpointed. And when it comes to treatment, these guys have a never-say-die attitude. They will constantly be fishing for positive results." Good for a patient's psyche, perhaps, but terrible for his wallet.
"My weight-loss regimen could kill you."
DO THOSE HERBAL teas and capsules sold at health-food stores and on the Internet work? All too often, no. Most that do have a real effect contain an ingredient called ephedrine, or ephedra, which can spike your blood pressure, leave you feeling like a speed freak and even cause a heart attack. "Over 100 people have died from [ephedra]," says Dr. Steven Heymsfield, deputy director of the Obesity Research Center in New York's St. Luke's-Roosevelt Hospital. "It's very similar to methamphetamine."
Or it can drive you crazy. Take Karen Ruiz, a San Clemente, Calif., woman who had been taking ephedra laced with caffeine to stimulate weight loss and increase her energy. "After the first day I felt really peppy and had a sense of well-being," she recounts. "It was advertised as 'all natural,' so it seemed healthy. But then, [within six days] I went from being high to being manic. I thought I was God's wife and that my son was Jesus Christ. I started hearing voices. I wound up in a psych ward, and it took me two and a half months to realize that what [I imagined] wasn't real."
As for the more benign weight-loss herbs, Heymsfield says they won't hurt you, but they won't help you either: "Nothing herbal has been proven.... People buy these things thinking they won't have to do the hard work, which is diet and exercise.
"Most of my patients
AFTER SUZANNE HENIG, a former professor at San Diego State University, was diagnosed with cancer and had her diseased thyroid removed, she became understandably panicked. "The first feeling I had was terror," she says. "You suspend your disbelief and look for a magic bul-let." Henig pinned her hopes on a treatment that reportedly involved making a vaccine out of her own blood - and, she says now, it ultimately had no effect in treating her illness. "Nobody gets cured of cancer with herbs and alternative medicine," says Henig. "But there are no witnesses left. They go to their graves believing that they have been cured."
Desperate people often exhaust their life savings on fraudulent treatments. Shark cartilage, herbal vitamins and laetrile (an extract of apricot pits) all get touted as miraculous cancer cures. Dr. Saul Green, a biochemist formerly at New York's Memorial Sloan-Kettering Cancer Center, acknowledges that you'll hear about people getting better with quack cures, but warns, "These people have temporary remissions, which happen all the time without the treatments. Sometimes it's because they have previously had standard therapies. Sometimes it's because of the nature of the disease itself."
"Your crowns let me live like a prince."
LIKE CHIROPRACTORS, who build up their own importance by Insisting that bum backs cause countless other maladies, some dentists believe that the mouth is the center of the body. They diagnose imperfect bites as the cause of everything from headaches to menstrual cramps to facial pain. Treatment typically involves filing down teeth and crowning them. Dr. John Dodes, a Woodhaven, N.Y., dentist and the author of Healthy Teeth (St. Martin's Press, 1999), estimates that he's seen at least 500 people who've gone through this costly, painful and extreme treatment. One patient of his, a gynecologist, had the procedure done twice on all 28 of his teeth, at a cost of $700 to $1,000 per tooth each time. When he came to Dodes, his bite was still messed up, and his headaches, for which this treatment was prescribed, persisted.
Then there's the alarming belief among some dentists that silver or mercury fillings cause, as Dodes puts it, "every disease known to man." He insists that this belief is rooted in money rather than science. "With better tooth care and fluoridation, people have fewer cavities."
less is usually less."
IS HOMEOPATHY the greatest under-utilized resource in medicine, or sheer quackery? Based on the belief that the healing process will be expedited by ingesting a highly diluted concoction of substances that triggers a patient's symptoms, homeopathy is widely practiced in Europe, though John Renner voices the general view of mainstream medicine when he insists it's "unscientific and based on an outrageous theory." Adds John Dodes, "It's as if you went to the ocean, threw an aspirin in, then came back a month later and drank the ocean water to cure a headache."
Woodson Merrell, M.D., the executive director of Beth Israel Hospital's Center for Health and Healing in New York and an assistant clinical professor of medicine at Columbia University, defends homeopathy, but he disdains doctors who use it as anything other than "early intervention for benign problems that you are making go away faster. Doctors should not use it for serious acute problems or to treat underlying diseases."
Yet many hard-core boosters believe that by diluting the medicine to an infinitesimal degree, its effectiveness multiplies dramatically. It's a theory that dismays Renner. "If a doctor really believes in homeopathy - that the more you dilute something the stronger it gets - that's pretty serious," he says. "It means he doesn't understand chemistry and is buying into things based on the intangibles. That would worry me about the individual's scientific capabilities." Despite all this, sales of homeopathic medicine are growing at a rate of 20 percent a year.
Published in SMART MONEY - APRIL 1999
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