Wellness remedies can work best in tandem
By Emily Tice
Oct. 20, 2009 10:43 p.m.
When a team of Japanese researchers approached Edwin Cooper seven years ago about becoming the editor in chief of a new journal on complementary and alternative medicine, he had his doubts.
“Afterward, I thought it was the most idiotic thing I had done and (that) it would be the end of my career,” said Cooper, an immunologist at UCLA for 47 years.
He nevertheless persisted, and the journal, Evidence-based Complementary and Alternative Medicine, has become the most highly regarded source of peer-reviewed research publication on alternative medicine, he said.
Alternative medicine refers to anything used for a therapeutic purpose that does not fall under the umbrella of conventional medicine; and complementary medicine differs in that it is used in conjunction with conventional medicine, said Mary Hardy, medical director of the Simms/Mann UCLA Center for Integrative Oncology.
The journal applies the same standards of randomized double-blind controlled trials typical in other scientific journals.
Cooper said he sees alternative medicine as more personal than conventional medicine, and even the way he manages the journal emphasizes interpersonal contact. Many of the people on the editorial board have become close contacts.
Hardy, one of the friends he has made as a result of the journal, explained how alternative medicine suffers from issues of nomenclature, which reflects its tentative place in Western society.
“Initially, things were alternative. You were either in the alternative system or in the conventional system. Then it became complementary ““ there was still a dominant medical system, still the Western system, but now there were these other medicines,” she said.
She added that the line between alternative and conventional can become blurred, and, for example, a case can be made that exercise can fall within either category.
Hardy said that she prefers the term “integrative medicine,” removing the issue of ownership, which is second to treatment for the patient.
“I see my work as addressing the entire person, the largest piece of that person I can possibly encompass,” she said.
Hardy explained that there are several reasons for the predominance of current medical practices. Counseling for lifestyle changes takes time, and there is little reimbursement to the practitioner for that time.
She added that society has become “pharmaceuticalized.”
“People tend to think that if there’s a problem, there’s now a pill for it,” Hardy said.
The quest for the acceptance of alternative medicine faces additional hurdles from insurance companies. For the treatments that fall squarely within the realm of the alternative, such as acupuncture and hypnotherapy, insurance companies pay little and selectively, said Lonnie Zeltzer, director of the UCLA Pediatric Pain Program.
Alternative medicines can be effective against chronic pain, but patients are usually responsible for payment.
“This biased system of health care coverage pushes families to rely on drugs alone or to go to multiple specialists and getting many costly and invasive tests, looking for a cause for the pain,” Zeltzer said.
She added that people tend to think too much or too little of alternative medicine, either believing it has no therapeutic value or that it can be used to replace conventional medicine.
However, the greatest benefits are usually achieved by adopting a more interdisciplinary approach that utilizes both, she said.
Subhadra Evans, researcher in the UCLA Pediatric Pain Program, studies the effect of yoga on young adults with either irritable bowel syndrome or rheumatoid arthritis.
She specifically researches Iyengar yoga, a form of yoga suitable for those with chronic health conditions that limit movement.
“When we ran our studies on young people with rheumatoid arthritis, a lot of them were really happy that (the treatment) wasn’t another medication,” she said.
Her research, funded by the National Institute of Health, also took into account changes in the patients’ psychological variables, such as mood, sense of well-being and their feelings toward themselves and their condition.
Evans said that these variables are important to the management of chronic pain.
However, Zeltzer said that the positive effects of alternative medicine cannot be attributed solely to the placebo effect.
“The placebo effect is a charge labeled by skeptics. Any intervention has the potential to have a placebo effect. I think the literature has clearly begun to show that integrative medicine has a positive effect,” Zeltzer said.
Cooper said he realizes that there are some limitations to alternative medicines.
“If you broke your arm, I doubt you would be asked to drink a glass of herbs,” he said.
But its limitations do not hamper his enthusiasm for its many potentials.
“The clinician, Western or traditional, wants you to get well,” he said.
