Alternative Care Edges Into Medical Mainstream : Health: Hospital conglomerate offers Indian folk treatments. The results interest U.S. government, insurance industry.
The regimen is very Californian: Hot oil massages. Aroma therapy. A special diet tailored to the season and your particular dosha (body type). Doses of yoga, meditation and other mental exercises to cleanse the mind.
Sounds right at home in Southern California, fertile territory for every alternative medical treatment from acupuncture to Zen.
But the spin here is that the 6,000-year-old form of Indian folk medicine called ayurveda is now available at the Sharp Institute for Human Potential and Mind-Body Medicine, an offshoot of the Sharp HealthCare medical conglomerate, a charter member of the medical Establishment. Sharp operates a string of good, gray hospitals where Marcus Welby would feel right at home.
Dr. Welby’s world is changing. Alternative medicine, once relegated to free clinics and storefront practitioners, is slowly gaining acceptance within the mainstream.
A widely quoted study in the New England Journal of Medicine suggests that a third of Americans spend $14 billion a year on alternative medical methods. Eighty percent of those continue to see their regular doctors, a strategy that fits with how the Sharp institute sees ayurveda blending with conventional treatment.
Through aggressive marketing and adroit deal-making, the not-for-profit Sharp chain--which includes six hospitals, 18 clinics and five affiliated medical groups--has come to dominate the hospital market in affluent and conservative San Diego County.
Sharp executives are determined that Sharp will be a major player in the alternative medicine market.
And to lead the charge, Sharp has teamed up with New Age superstar Dr. Deepak Chopra, the nation’s best known pitchman for the notion that thinking healthy is the first step toward being healthy and that toxic emotions are as deadly as carcinogens.
The federal government, which holds the purse strings for medical research, is watching for signs of success at the Sharp Institute. So too is the insurance industry, which has shown flickers of interest in paying for alternative care.
Dr. James S. Gordon, a clinical professor of psychiatry and family medicine at Georgetown University and an adviser to the federal government on alternative medicine, said the creation of the Sharp Institute is an important development in the movement to incorporate alternative methods into current medical practices.
Sharp Chief Executive Officer Peter Ellsworth thinks the mind-body devotees just might be on to something important that could reduce the American dependence on surgery and drugs. In other words, more massages and meditation just might mean fewer bypass operations and prescriptions for blood pressure pills.
Ellsworth is bullish on mind-body but careful not to make claims about its effectiveness that cannot be substantiated. He feels that Sharp, with its large patient base, is the perfect place to assess the mind-body theories.
“There is something there,” Ellsworth said, “but we don’t know what.”
He makes two points quickly: One, that mind-body therapies supplement conventional treatment, they do not replace it. And two, that mind-body may offer a solution to the nation’s runaway medical costs.
“If this country does not address lifestyle abuse, we are going to keep running out of money regardless of how we change the system,” Ellsworth said.
Dr. David Simon, the board-certified neurologist and meditation master who serves as the institute’s medical director, is convinced that ayurveda, or something like it, is the future.
“People want their physicians to be more than just technicians of illness,” he said. “They want them to be educators about health.”
Simon, who was chief of staff for two years at Sharp-Cabrillo Hospital, became interested in meditation in medical school: “I realized that conventional Western medicine often lacks human values.”
To spread the gospel of ayurveda, Chopra and Simon keep an ambitious lecture schedule that includes seminars for health professionals and lectures for prospective patients.
Chopra’s books and tapes extolling ayurveda (from the Sanskrit words for health and life) are perennial bestsellers. His credentials and celebrity have brought him invitations to chat with Oprah, Donahue and Geraldo, and to lecture at Harvard Medical School and hospitals throughout the world.
“We’re very close to a critical mass in mainstream medicine and mainstream America of people who are interested in consciousness,” Chopra said. “The medical profession and the intellectuals are always behind the times.”
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For the first time, the federal government is funding research into the effectiveness of alternative medicine, particularly in the areas of stress, chronic pain and life-threatening illnesses.
Nudged by a senator intrigued by bee pollen treatments for allergy sufferers, the National Institutes of Health in 1992 opened an Office of Alternative Medicine. The research budget for 1994 is a modest $3.5 million. Thirty researchers and institutions--including Sharp’s mind-body institute--were selected from among 452 applicants for grants of up to $30,000 each.
Included for funding were projects testing acupuncture, hypnosis to relieve pain and heal bones, massage therapy for surgical patients, dance movement for cystic fibrosis, macrobiotic treatments for cancer, biofeedback for diabetes, yoga for heroin addiction, tai chi for balance disorders and massage therapy for AIDS babies.
The NIH definition of alternative medicine is any method that is not taught in medical schools, not covered by insurance, and not considered to have sufficient documentation in the United States to prove its safety and effectiveness.
The NIH grant will allow the Sharp Institute to study two groups of patients: one that follows Western practices of diet and exercise, one that is dedicated to ayurveda. After a year the two groups will be compared on the basis of blood pressure, cholesterol, weight and stress.
Along with Sharp, other researchers and hospitals are exploring the heretofore off-limits world of alternative medicine:
* Columbia University’s College of Physicians and Surgeons has begun evaluating scientific and anecdotal evidence about the effectiveness of alternative medicine.
* The Chicago Holistic Center announced a cooperative agreement with a community hospital in Chicago whereby doctors can consult with alternative practitioners.
* Stanford University medical school professor Dr. David Spiegel, in his book, “Living Beyond Limits: New Hope and Help for Facing Life-Threatening Illness,” described his studies of women with breast cancer that found that women with strong support groups live longer than those without. In one of Spiegel’s studies, group therapy and hypnosis helped reduce the pain of women with advanced breast cancer.
Other studies cited by Spiegel, a professor of psychiatry and behavioral sciences, have shown that depression can suppress the immune system and that prolactin, a stress hormone, might be a cause of prostate and breast cancer. Spiegel notes a “small but growing body of evidence” that psychological and social factors can help fight illness.
Spiegel wrote, “It is not simply that mind can triumph over matter, but that mind matters.”
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In San Diego, an introductory session for mind-body treatment can begin with a two-hour evaluation by an ayurvedic practitioner for about $250. Half a dozen practitioners are aligned with the Sharp institute and take referrals.
Aroma therapy consists of sniffing your favorite fruits, flowers, resins and barks. Music and sound therapy provides melodious chords to reach your inner being.
Incidentals such as massage oils and Chopra’s books and tapes are extra. A panchaka , or purification treatment, goes for $825 for three days, $1,125 for five.
For those who want to know more before committing their bodies and checkbooks, the institute is developing a series of eight two-hour lectures, “From Prevention to Renewal. The 8-Step Guide to Physical, Mental and Spiritual Well-Being,” to be held at Sharp.
For patients seeking the deluxe treatment, a one-week stay at the swank Inn L’Auberge in Del Mar (the institute offices are just down the block) goes for $3,250.
In the next year, Simon foresees holding seminars for doctors in specialties such as oncology, cardiology, gastroenterology and obstetrics.
Half of the patients who have contacted the institute in the past year in search of mind-body treatments, Simon said, are probably looking for a spa-like rejuvenation. The other half have chronic medical problems, including AIDS.
Kathryn Duckworth, 52, of Lakeside decided to try the Sharp Institute when conventional methods had failed her. She had seen Chopra on “The Phil Donahue Show.”
She had been diagnosed several years before as having fibromyalgia, an exceedingly painful muscular disease of mysterious origins that predominantly strikes women between 30 and 50.
At the institute, Duckworth was diagnosed as a vata , one of the three basic constitutional types, or doshas . The typical vata is lean, restless and prone to insomnia.
A vata should eat rice and wheat but stay away from corn, rye and oats. A vata is advised to eat cooked vegetables, not raw, and to favor avocados, bananas and berries over apples and pears, according to a handbook given to patients.
Duckworth was sent home with a daily regimen tailored to vatas and three months later she returned for three two-hour tuneups called panchakarma.
“These things have made it possible for me to have a life again,” said Duckworth. For the first time in years she is virtually pain-free.
An articulate and cautious woman, Duckworth probably would have been leery of a mind-body clinic if it smacked of flakiness or experimentation. But she lost all reluctance when she found that the institute is affiliated with Sharp. She is undisturbed that there is almost no Western scientific evidence to support the techniques of Chopra.
“I don’t care,” Duckworth said. “I’m living proof. It works for me. Western medicine wasn’t working.”
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Chopra and Sharp have come under strong, if narrowly based, criticism from within the medical profession. Two devoted quackery hunters have put Chopra near the top of their lists.
“I think he’s nothing but a promoter of Chopra,” said William Jarvis, a professor of public health at Loma Linda University and president of the National Council Against Health Fraud. “As far as ayurvedic medicine is concerned, all Chopra is doing is promoting prescientific nonsense in the name of medicine.”
Jarvis is no less displeased with Sharp and Ellsworth, the chief executive officer.
“I don’t understand the thinking of a hospital administrator who uses pseudo-science as a marketing tactic for good medicine,” he said. “I think that’s irresponsible.”
Stephen Barrett, a retired physician from Allentown, Pa., and author of “The Health Robbers: A Close Look at Quackery in America,” devotes a chapter to Chopra and ayurvedic medicine in an upcoming book. He takes particular aim at the notion that all people can be classified as vata , pitta or kapha and treated accordingly. “It’s absurd,” Jarvis said.
Chopra and editors at the Journal of the American Medical Assn. engaged in a public and nasty dispute that began in 1991 when Chopra and two other Indian-born doctors published an article in JAMA that discussed ayurvedic medicine in glowing terms.
JAMA later printed a lengthy clarification saying that if the editors had known of the trio’s supposed financial stake in selling ayurvedic products, they would not have published the article.
Months later a JAMA editor published a lengthy, exhaustively documented article that, in effect, accused the trio of doing nothing more than peddling warmed-over transcendental meditation with no scientific basis. Chopra was a devotee of TM guru Maharishi Mahesh Yogi until the two split in the early 1990s.
Chopra struck back at JAMA with a lawsuit and accused it of reacting like an intolerant religion trying to stamp out heresy. The suit has since been dismissed, but Chopra remains furious at JAMA, and there is no indication that JAMA has softened its view of Chopra.
Like everybody else in organized medicine, Simon and Ellsworth were aware of Chopra’s dispute with JAMA before they recruited him for Sharp.
“He definitely pushes the envelope,” Simon said.
