MONDAY, Nov. 22 1999 -- Even though almost half of doctors think some alternative therapies such as herbal remedies and yoga work and would tell their patients to use them, less than one-third of them would ever even bring up the subject, a new survey finds. "I was surprised by some of the findings," reports Leigh Callahan, one of the authors of the study and associate director of the Thurston Arthritis Research Center at the University of North Carolina at Chapel Hill. "I was surprised that 84 percent of the physicians favor more funding for alternative therapies."
Mainstream medicine has traditionally scoffed at alternative therapies, but in recent years these treatments have been ever more popular with patients and, in some cases, with their insurance companies. Doctors have taken notice. A study presented at the recent American College of Rheumatology conference found that while 85 percent of the doctors the researchers surveyed believed that at least some alternative therapies worked, many of the doctors wouldn't tell their patients to use them.
Callahan and her colleagues randomly chose 2,146 U.S.-based physicians from readers of the Bulletin of Rheumatic Disease and asked them about 64 different types of alternative therapies. The therapies asked about ranged from taking omega-3 fatty acids and glucosamine sulfate to having massages, doing yoga, biofeedback, meditation, having acupuncture, going to a chiropractor, writing journals, believing in spirituality and more. They asked doctors to evaluate the whole range of therapies by choosing responses such as "would advise," "against it," "don't know," and so on.
Two-thirds of the responses came from primary-care doctors and most of the remaining responses were from rheumatologists. Forty-seven percent of these physicians believed some alternative therapies worked and would recommend them. Another 37 percent believe they work but do not recommend them. Twelve percent believe they don't work and 4 percent would tell their patients not to use alternative therapies.
Most of the doctors would talk about alternative therapies only if their patients brought the subject up first. Not even one-third of the doctors would bring up the subject themselves. Women physicians were more likely to discuss alternative therapies as were doctors in the 40-55 age group and rural doctors.
Jerome McAndrews, national spokesman for the American Chiropractic Association found the study encouraging. "We're pleased with this study because we're interested in bridge building and better communications [between alternative and mainstream medicine]."
Callahan advises, "I would recommend that doctors bring it up because I think a lot more of their patients are taking alternative therapies than they realize and patients should know that it looks like doctors are more willing to hear about these treatments than they realize." She explained that from other studies they had found that patients were somewhat fearful of bringing up the subject with their doctors, but emphasizes that it's important for doctors to know about everything you're taking.
McAndrews agrees that communication is critical and says, for example, that because certain herbs may have an influence on patients and how they react to anesthesia while they're in surgery, patients have to let their doctors know about all treatments they're using.
To find out what mainstream hospitals are doing in the alternative medicine field, take a look at University of Maryland School of Medicine, the New York Presbyterian Hospital department of complementary medicine and Thomas Jefferson University Hospital. Even the government has its National Center for Complementary and Alternative Medicine.