Old-guard medicine getting a face-lift

Jill Eisner lay still as an acupuncturist pushed thin needles into her face and feet, with soft music playing in the background. In another room, an herbologist studied his antidote for severe acne: a concoction of 12 ingredients, including dandelion roots, tangerine peel and dried raspberries. A few doors down, Linda Lee, dressed in a white lab coat, used the tools of conventional medicine to treat a patient for digestive problems.

The Johns Hopkins Integrative Medicine and Digestive Center, which opened Sept. 2, is the latest indication that alternative medicine is making its mark in mainstream health-care settings.

"We conventional doctors need to acknowledge that some of our therapies don't always work," said Lee, a gastroenterologist with 20 years of experience. In addition to Lee, the center has 12 specialists, including acupuncturists, nutritionists, massage therapists and a psychotherapist who uses hypnosis and touch therapy.

After spending four years together in private practice near Baltimore, Lee and her colleagues realized they needed more space, so they approached Hopkins. Housing the center under the umbrella of a prestigious institution will raise public awareness about complementary and alternative medicine, Eisner said.

"The Hopkins name is important" to patients, she said. "People will be much more receptive to it."

For Hopkins, the center is a way to capitalize on a burgeoning patient base, Lee said.

The center's link with Hopkins is part of a trend toward integrating CAM with conventional medicine. In a survey of 1,400 hospitals, 27 percent offered some sort of alternative or complementary treatment, according to a 2006 American Hospital Association study, up from 8 percent in 1998.

Last fall, Hopkins -- a bastion of mainstream medicine -- joined the Consortium of Academic Health Centers for Integrative Medicine. This group of 41 medical centers has pledged to invest in CAM research and to introduce integrative models of clinical care.

Investment in research is key to any true alliance between the two schools of care. Conventional practitioners often decry the subjective nature of many CAM treatments, which have not proved their worth through the controlled, randomized trials that are considered the gold standard of medical research.

"The kind of medical school training we get, we're taught to reject many other types of training," Lee said.

Efforts are under way to remedy the lack of solid research, according to Richard Nahin, a senior adviser to the director of the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health.

The NIH will invest about $300 million in CAM research this year, up from about $50 million nine years ago. In addition, private organizations such as the Osher and Samueli foundations have injected funds into CAM research.

Acupuncture, now widely used as a means of controlling pain, was said to be lacking evidence of effectiveness as recently as the late 1990s, when the NIH called for more research, stating "overall, results were hard to interpret because of problems with the size and design of the studies." Today, "a number of large, pivotal clinical trials have either been completed or are nearing completion," Nahin said, "and more are in the planning stages."

An NIH study of 380 advanced cancer patients at 15 U.S. hospices published in an issue of Annals of Internal Medicine this month finds that massage therapy may have immediate though short-term effects on pain and mood among patients with advanced cancer.