In a recent EXPLORE! feature, Unhealthy Options, we examined the controversy over what is known as alternative medicine--treatments such as chiropractic manipulation, acupuncture, homeopathy, megavitamins, herbal therapy and others. A rush of studies to determine if these treatments are indeed effective or merely hype has produced mixed results--some work, some of the time--and yet that hasn't dampened their popularity.

Although many in the traditional medical community continue to debunk these treatments, the public clearly doesn't agree. Instead most have embraced alternative medicine as part of their personal health care regimen. A study in the Journal of the American Medical Association indicated that Americans now visit alternative care providers nearly twice as often as traditional physicians, and the numbers are growing. In 1997, Americans spent an astounding $27 billion on visits to alternative practitioners, an increase of 45 percent over 1990. Sales of megavitamins alone rose from $0.9 billion in 1990 to $3.3 billion in 1997. And most of that money was not reimbursed by medical plans.

So why, we asked readers, is the public turning away from the family doctor to dabble in the untested (officially, at least)? The flood of responses we received came from those who swear by various alternatives and from skeptics, physicians and patients, from around the world.

The responses are intriguing. The answer, it seems, it that people are alienated from an increasingly impersonal health care system. Traditional medicine is seen as expensive, impersonal and, in the end, not all that effective at promoting health, but rather at treating illness. On the other hand, alternative therapists are viewed as attentive, responsive and willing to give the patient a role in the treatment and its outcome.

The common thread is that we are seeking long-term health, not quick-fix cures; prevention, not pills; and, most of all, care. And we are willing to chance the outcome and pay the cost from our own pockets. Even the best bedside manner is no substitute for none, and so the old adage stands: "An apple a day keeps the doctor away."

Here is a selection of the letters:

Health care is a misnomer. We go to physicians for care of an illness, not for health. Therefore health care consumers are on their own to manage their health the best way they can. They have to maneuver through a system that is bewildering and confusing. In addition, insurance policies do not cover preventative care.

There are several factors that deter people from using a physician for health care. The high cost of a visit, the difficulty of getting an appointment and the time spent waiting for that appointment are reason enough to seek alternative therapies.

Health care consumers must have some medical knowledge to steer clear of the pitfalls and unscrupulous individuals that would take advantage of them. Finally, consumers have to sift through the claims of miracle cures and ultimately experiment on their bodies with compounds that have not been tested or standardized for dosage. It is only a matter of time before an over-the-counter "herb" is found to be harmful instead of helpful.

The problem is the health care system. The methods of health care that have flourished are not necessarily the best, but the most profitable. This mindset won't change until we shift the emphasis of illness care to health, and value preventative medicine. Then some of these alternative therapies, which are actually preventative measures, will be included in our health care system..

LAURA CRALLE
Midland, Texas

There are two reasons why Americans are turning to "alternative" methods. The first regards the price of healthcare. Many people don't have the money or the healthcare plan to pay for expensive methods, so they turn to cheaper alternatives. The second reason is the fear many have of going to doctor's offices. Because of that fear, they want to try less painful remedies. I am not saying that alternative methods are effective or not, but until they are proven ineffective, many will try them.