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.

DHRUV P
Chicago, Illinois


World War II showed the American public that science and technology can win wars and solve problems. That same wartime energy was directed at postwar consumerism, promising great wealth, luxury and fantastic solutions to health problems. Yet we have now had a generation grow up in the world of promises, and they all seem to have fallen flat on their faces.

Technological achievements are great, but they create massive unemployment, encourage greater income gaps and increase pollution many fold. Medical drug advances are astounding in their ability to work on the human body, yet new diseases appear every day; drug-resistant microbes abound; and fears of a technology-driven plague have arisen. Americans put a man on the Moon, but now can barely return to space. Doctors used to extol the virtues of cigarette smoking, yet now cancers associated with smoke and other pollutants abound.

Basically, the public has been promised everything and let down repeatedly. The scientific community is no longer trusted, due to the arrogance of the scientists just after the war (they KNEW they could solve the world's problems, with a little work) and the public's lack of understanding of how science is done (pursuing research into dead-ends, working towards unknown goals because principles are not yet understood.).

The return to holistic/alternative medicines is an attempt by many to rid themselves of the "deceivers," perhaps even to return to a simpler age. In part, they are right--drug companies drive research for profit and care little if the drug works (other than limiting law-suit level side effects) as promised. At the same time, snake-oil salesman abound and turn many a buck from the unsuspecting health consumer.

The solution is, of course, a return trust to the medical profession, as long as they operate with open-mindedness towards new therapies, and an acceptance by the public that unbiased studies do show some of the public's beloved alternative treatments are placebos at best, and deadly at worst.

I have no idea how that may be achieved, other than having the medical profession start serious clinical trials on a wide range of these alternative therapies. And this may have to be done with public funding, because anything funded by a pharmaceutical company is almost guaranteed to be suspect!

ARNOLD G. GILL
Nanaimo, British Columbia, Canada


Alternative therapies are better than conventional medicine for reaching a real improvement in health. The conventional therapies have failed to do that--even with the tremendous costs for prescriptions and laboratory analysis.

MARCO C. SALVADOR
Chicago, Ill.


After years of taking a lot of antibiotics (that cost a lot of money), I gave up on "official" medicine. The example you refer to in the article is an exception. So-called alternative medicine is cheaper, works and doesn't harm our health.

MARCO AURLIO DA SILVA
Belo Jardim, Brazil


It appears that the general public is turning to alternative medicine to find resolutions to issues that traditional medicine has failed to address--primarily preventive medicine. For too long the conventional medical wisdom promulgated in American medical schools was to address the alleviation of disease, not the prevention thereof.

With alternative medicine presenting a more balanced approach to both prevention and alleviation, it is intuitively appealing to many people. The medical community is now learning from the masses how to approach healthcare in a more balanced and rational manner. This is, of course, not to mention that there is big money in prevention.

JOHN COTE
Flushing, Michigan


More and more people are turning to alternative medicine because the established medical community--in concert with pharmaceutical and insurance companies--cares less about patient health and more about their own profitability. The problem is easily summed up by "Show me the money." In a word, greed.

It is a rare thing in my experience to find a doctor that is more concerned about my health than his own bank account. That causes me to lose confidence and trust in their motives and their abilities. Therefore, I look to other sources. What have I got to lose?

KEVAN S.
Minnesota


The debate is more than "my substance is better than yours." The efficacy of the therapeutic relationship comes into play as well. Some people seem to feel better as a result of the therapeutic relationships they have with non-medical practitioners.

The work of Leonard Syme [University of California, Berkeley] and Michael Marmot [University College London] indicates that poor health is often associated with low status. Perhaps it follows that therapeutic relationships that reduce stress and elevate status are sought out wherever they are available.

It shouldn't be too difficult to research the nature of successful therapeutic relationships, especially if stress reduction is one of the important features. If the nature of the therapeutic relationship is a factor, what are the key elements? Length of consultation? Genuine communication? Feeling cared for? I submit that research into the efficacy of therapeutic relationships is as least as important as research into the efficacy of drugs.

ADRIAN VERRINDER
Victoria, Australia


I live in Atlanta, Georgia, which, if I'm not mistaken, is home of the nation's--if not the world's--leading school for chiropractic therapy. A good friend of mine is a student there, and part of the graduation requirements is spending a certain number of hours in a clinic seeing a certain number of patients. So I thought I'd help her out a bit and be one of her patients, receiving treatment every other week or so.

I started going over a year ago and, let me tell you, regular adjustments are the best thing that has happened to me from a health standpoint. I would go into the school's clinic if I had a headache. Instead of having to buy expensive over-the-counter drugs, a quick adjustment and I'm on my way, sometimes with immediate results.

She's helped me relieve sinus congestion in a mere few hours, improved my posture, suggested certain workouts and stretches considering particular bone or joint ailments that she may be treating at the time, and, personally, it's the most relaxing part of my week.

Since my adjustments, I have felt the best I have ever felt physically. I don't get sick nearly as often as I used to, my joints and muscles feel terrific and I feel energized. Of course, as with anything, results will probably vary, and some people are extremely squeamish about getting their spine "cracked," as was I. But for me, at least, at my present state of wellbeing, it's been worth it and I highly recommend it.

CHRIS LUJAN
Atlanta, Georgia


First, do not call it "alternative" medicine. This name suggests a choice between two identical possibilities that will give the same outcome. On the other hand, the term "complementary" suggests a extra choice that can be used in addition to what is already available.

Unfortunately, the "pill for every ill" promise of recent years, makes people have very high expectations of modern medicine. When it fails them, they frantically search for something else that will help. Usually this option doesn't help either, especially if the disease is chronic or severe, but it gives them a sense of being in control of their own lives.

If people want to try out "complements" to modern medicine (itself rigorously tested for efficacy and safety), then worst case, it will probably only hurt their pockets. But don't expect it to be more than psychological help.

Herbal medicine is a partial exception, of course, because many drugs are the active ingredients of plants--willow (aspirin), foxgloves (digitalis) and yew (taxol); they are the foundation of modern pharmacology. However, I would rather take a purified, defined amount of these "herbs" without all of the other toxic ingredients that are present in crude whole extracts.

A visit to the site www.quackwatch.com is de rigueur for anyone thinking of parting with hard-earned money to try a complementary therapy.

JANET DAWSON
Bennwil, Switzerland


The article on alternative medicine was interesting in presenting both sides. One thing to remember is that Modern Medicine came from some of these age-old practices. Some have better results than modern medical treatments.

When I was a boy, my mother would make me an herbal tea out of the book Back to Eden. It would break a fever in about an hour and make me rest. I treat my self mostly naturally now. But I also get checked by a regular physician.

I firmly believe that both systems should be integrated. They both have a lot to offer each other. The minute you start to ignore possibilities is when you start to become extinct. There are always possibilities and potentials in alternate thinking.

TOD M. KELLY
Seattle, Washington


I am a member of the medical profession who practiced General Medicine, which we called general practice (1943-1983). I used all medical approaches available, as well as acupuncture and hypnotism in selected cases with very gratifying results, both for me and my patients. I also used herbal medications in selective cases, again with gratifying results.

Unfortunately there are many in our profession who feel that American Medicine is the best (and only) in the world and scoff at those who dare to venture outside the mainstream of medicine. I made four trips to the orient--mainly China to study acupuncture and herbal medicine--and I can appreciate why these methods have survived for thousands of years. I say that alternative medicine methods have a definite place in the armamentarium of the modern physician.

R. W. WESTFALL
Alamo, Texas


I believe people are turning back to traditional therapies, such as herbal medicine, homeopathy, Traditional Chinese Medicine (TCM) and many manipulative therapies, for a number of reasons. The medical doctor quite often these days appears to be a peddler of prescribed drugs from the drug companies. How often does one leave a doctors office without a prescription of one kind or another?

Of course these drugs can serve us when used in the correct way, but quite often it is just to free us of a possible discomfort of the body, which given time and rest would right itself. Very little advice is given on how to care for our bodies; it is quite often reactive treatment after the disease process is well underway. This then possibly leads to surgery.

Even though I have to pay upfront for my healthcare with alternative therapies, I generally walk away feeling empowered in my life, that I am in charge of my own wellness and that the practitioner is my support.

Doctors in Australia quite often call herbal medicine quackery, and argue that it can kill. Yes there can be that minimal danger. Yet if you look at the Australian Bureau of Statistics, 12,000 people died in 1997 in public hospitals for drug-related reasons. Fear tactics should not be what motivates us to look at healthcare, but rather the general well-being of the public. This calls for great introspection to see truly if openness of mind is a quality the medical profession can have. I hope so, because then we can have the benefits of all systems.

VICKI BOUCHER
Melbourne, Australia


Alternative therapies do work, if you follow certain guidelines. I was fortunate because I had the privilege to experience first hand the benefits of wellness. First you need to find a licensed professional experienced in alternative practices. I happened to hear of a medical doctor in the area that I lived. I was experiencing a number of ailments--aches and pains, poor digestion, lethargy, post surgical toxicity. I just wanted to have an alternative to mainstream medicine because I knew that it wasn't helping.

So at any rate I went through the exam. The whole experience was much different from the usual. Despite the normal setting of a waiting room and exam rooms, the atmosphere was less intimidating. I filled out forms with more in-depth questioning and was then led into the exam room to be given a complete physical. I never had a more complete physical in one setting.

Then I was led to another room where the doctor performed electroacupuncture, a non-invasive way to test for toxins and allergies. I received the results immediately, when the assistant then sat down to explain the whole thing to me. I went on a cleansing diet for 11 days to remove toxins and to prepare my body for the next, more fine-tuned testing. I lost some weight and felt somewhat improved. I returned for further testing after taking a series of homeopathic formulations, compounded at the clinic specifically for my allergies. Retesting is recommended once or twice a year depending on symptoms.

The doctor's patients swore by it. For many, it was their only hope. People that went to that little clinic in the middle of a small midwestern town came from near and far, and I know because several years after I went to that doctor, I ended up working for her for nearly six years. I learned so much. I met so many wonderful people, some of whom I keep in touch with to this day.

Many have passed on and I'll never forget their stories, hopes and prayers for health. It's never too late. Health is a gift from God and we have the power to choose how to live. Eat well, get oxygen, drink pure water and enjoy love and laughter. That's how to stay healthy.

NO NAME PROVIDED


Growing up in the poor country Vietnam, my family had no access to western medical doctors. If there were doctors in my town, I doubt my family could have afforded it. Therefore, I grew up relying only on Traditional Chinese Medicine (TCM). Not only did TCM help keep me and my family healthy, it cured lots of people who were critically ill. Among them were some patients that were sent home from hospitals to prepare for death, because there was nothing those hospitals could do.

It sounds unbelievable to those who have not seen it happen. It is even harder to accept when the Chinese try to explain their TCM theory in terms of Yin and Yang, things which we can't see or feel. I hope that some day research will prove that TCM really works. And in the meanwhile, I will continue to see TCM doctors whenever I get sick.

THANG BUI
Ocoee, Florida


Although alternative medicines should be scrutinized, they should be tried for oneself. I am a Physics undergraduate student at the University of Massachusetts, but I am also a second degree Usui-Gray Reiki Practitioner. I heal people by transferring energy from my hands to people's bodies.

From my own experience, I had gone to an allergist for five years to treat my allergies and asthma. After getting years of shots with little or no result, I gave up on it. My own medical doctor assured me that there was no possible way to cure allergies and asthma.

Yet for the past two and a half years, I have been practicing Tai-Chi and have noticed a significant improvement in my general health. This, added to my recent acquisition of Reiki skills, has enabled me to live through the past two winters with clear sinuses and almost no asthma attacks. This is compared to traditional medicine, which also offers treatments, but not cures or preventions to colds and flu (I got a mild flu last year one day after I got a flu shot).

People are going towards alternative medicine because doctors are capitalists first and healers second. In a word, they are too expensive. Traditional medicine has gotten too expensive for the average person. Pharmaceutical companies charge outrageous prices for medicine. In contrast, if one has the knowledge, he or she is free to pick herbs. And if one practices preventive medicine, they will not get sick. I am a vegetarian, I eat right, breath right (yes, there is a right way) and exercise regularly via Tai Chi and Kung Fu. Living a healthy life leads to healthy body.

SETH A. SILVERMAN
Dartmouth, Massachusetts


I believe the reason that people are going to alternative health care providers is threefold. The first reason is that it actually works. As a user of chiropractic care, I can vouch for its effectiveness. I know many others that have visited other "alternative" health care providers and feel the same. The second reason is that it is often less expensive than conventional health care.

The third, and to my mind the most important, reason is that when you go to an "alternative" health care provider, they BELIEVE you when you say you hurt. Conventional doctors are masters at making you think you are a hypochondriac. They don't believe you when you say you hurt or feel ill. If they say you may have a condition or injury, and you are impudent enough to look up information on the subject, they treat you as if you wish to be ill.

Conventional doctors want you to sit down, shut up and let them do all the thinking. This is especially true for female patients. My mother, who is chronically ill, went to doctors for many years until she found someone who would believe that she was really in pain. Because there were no visible symptoms, they refused to believe her. They would pat her on the head and send her on her way. (As an interesting side note, the doctor that finally believed her, ordered the tests and discovered her fibromyalgia was female.)

It is attitudes like this that make people loath going to a conventional doctor. This is why we are happy to embrace an alternative. I have found that they really want to take care of patients. They don't just want to collect an exorbitant fee.

L. TAGGART
Lanham, Maryland


For the lower-financial and independence-loving USA citizens, the cost of much of US medicine is destructive and alarming. A person can travel to a third world country and receive acceptable health care for the cost poorer US citizens can pay--one forth as much.

US medicine is for the wealthy US citizen and not the average world citizen. It is little wonder that many US citizens consider alternate health cares and health routes. We have "Cadillac medicine," when many citizens only need to find simple "Chevy medicine". The advance of alternative medicine should be a warning that things are not right.

DAVID L. MORT
Warsaw, Indiana


Certainly any endeavor that directly impinges upon our continued well-being should undergo periodic investigation. Alternative medicine is being widely embraced because patients find that it works. Not only do they feel better for the attention they receive, they are persuaded by the practitioner's manner that he/she is genuinely focused on their best interests: painless recovery from whatever ill-health is plaguing them. This is not always the case with the harried specialist.

In 50 years, perhaps, all of these distinctions will disappear. You will present yourself to any clinic of your choice, run your card through the reader and your entire history from anywhere in the world will be available for a team of varied medical practitioners to plan a schedule of treatments in consultation with you and/or your relatives. Those designated as immediate family will be contacted minutes after you enter the clinic. All clinics will be directly connected to larger facilities, to which the patient will be transferred if, and only when, it becomes absolutely necessary.

Herbalists, masseurs, acupuncturists, yogis, reflexologists and even shamans from diverse ethnic backgrounds will be as fundamental to healthcare as ear, nose and throat specialists, surgeons and craftsmen who make the most advanced prosthetics. Everyone will be geared to the single goal of the patient's comfort, cure and continued longevity. Whatever works is best.

VICTOR LUCAS
No address provided


The reason Americans are turning away from traditional medicine is because traditional medicine does not seem to work for them and alternative medicine does. Also, alternative medicine puts so much emphasis on wellbeing--something we materialistic Americans do not really have.

Whatever the case, extensive studies should be done to see which kinds of alternative medicine really works and which don't.

DAMMY OSOBA
Phoenix, Arizona


I began using alternative medicine when I was uninsured and working for a health food grocer. I was introduced to Chinese and western herbs, both of which proved effective. Later, after I got a job that did provide insurance, I found that my very busy doctor prescribed remedies that on several occasions were less effective--and much, much more expensive--than homeopathics. For instance, I had a long-term, severe rash. The hurried doctor ($10 copayment; one-week wait for an appointment) didn't know what caused it, but prescribed a steroid cream. My HMO didn't cover the medication (it was a "cosmetic" problem) and a small tube cost $75. It relieved, but did not cure, the rash.

When the tube ran out, my doctor renewed the prescription; I went to an herb store instead. There, the resident "herbalist" (free, walk-in) prescribed tea tree oil soap ($4) and some kind of anti-inflammatory ointment ($15). She also asked if I had changed my diet, household detergents or cosmetics in past months. I had changed my laundry soap; she recommended I change it back. The rash cleared up within two weeks.

The fact is, there are not enough regular doctors to handle the demand; the AMA restricts the number graduating every year. This, besides being immoral and, as my holistic practitioners might say, "bad karma," has pushed many of us into the arms of the numerous alternative doctors available. The effectiveness of their treatments keeps us coming back.

Don't get me wrong--I love having access to doctors and hospitals and would do anything to keep my insurance. But until doctors have the time, and patients have the money, to reach modern medicine's vast potential, I'll have to look for alternatives.