Medical students take lessons from the Far East

When June Tester was growing up in California, her Chinese mother often used Oriental medicine to treat her and her brother for colds and sore throats. When her brother got cancer, her mother helped ease his discomfort with a daily herbal tea treatment.

Tester went to medical school, but, still feeling the Eastern pull, she went to China to study traditional Chinese medicine for a month. There, Eastern and Western practitioners coexisted in the same hospital, consulting with and referring patients to the other. “It was unlike anything I had ever seen,” Tester said. “It was amazing to see that kind of mutual respect.”

That kind of communication between Western-trained doctors and alternative healers appears to be gaining ground in the United States. Patient interest in alternative medicine continues to grow, with about 62 percent of American patients seeking some type of alternative treatment, according to a survey on the Web site of the National Institutes of Health's National Center for Complementary and Alternative Medicine.

As more patients ask about unconventional treatment, more medical students want to be exposed to non-Western health care options. And while many scientists do worry about the safety and efficacy of alternative medicine--which encompasses a wide range of treatments ranging from megavitamins to acupuncture to prayer--the medical establishment now acknowledges that all doctors need to at least be able to talk about the options.

To encourage sound curriculum development, the center has awarded grants to 15 schools over the last seven years to develop standards for weaving alternative healing education into the medical curriculum. Nearing the program’s end, the grant recipients will meet this June at NIH headquarters in Bethesda, Md., to make recommendations on a nationwide standard.

The University of California, San Francisco, one of the grant recipients, has been incorporating information about nontraditional methods into required courses. In the first year, for example, students break into groups where they are presented with scenarios where patients ask them about alternative options for treatment. Dr. Ellen Hughes, the school’s curriculum director, thinks it's important for students to learn about alternative medicine because so many patients will be using it.

“Independent of your confidence level, your patients are interested,” Hughes tells students.

A handful of schools are going further, requiring courses on complementary and alternative medicine. At Howard University’s medical school, second-year students take an alternative medicine course with Dr. Adnan Eldadah, who has studied traditional and nontraditional treatments his entire career. “I’m old country and new country,” he said.

Eldadah’s course encourages students to think of alternative ways to treat common ailments like hypertension and chronic pain. He also teaches his students how to recognize cases where there may be cheaper and safer ways to treat patients than with pills or surgery. “The other courses the students take here end,” Eldadah said. “But this course extends beyond medical school for the rest of their lives.”

More Americans are also earning degrees in alternative medicine. The Pacific College of Oriental Medicine in San Diego has seen a large increase in the number of applicants over the last five years. Stacy Gomes, Pacific College’s dean of students, said the school opened campuses in Chicago and New York to meet the increased demand.

Like Tester, most students drawn to non-Western medicine often have had personal experience with it. When leg cramps crippled Greg Sperber, his martial arts instructor suggested he take an herbal concoction of Chinese rock sugar and corn silk. The leg cramps disappeared.

Sperber, then 19, had planned to follow in his grandfather's footsteps to become a doctor, but his first experience with Chinese medicine changed him. "It was at that point that I decided I didn't want to be a doctor,” Sperber said. "I wanted to be a healer."

Sperber did end up attending medical school, but he is now studying for his doctorate at Pacific College and will open his own acupuncture practice this spring.

Holistic medicine still raises questions among scientists because so much of the alternative forms of treatment either can't be or haven't yet been tested using Western evidence-based experiments. Lyla Hernandez, who led a study on complementary and alternative medicine, known as CAM, says that because the term "alternative" covers such a broad range of treatment, it's difficult for many to agree on what to accept and what not to accept. There are, for instance, some very conclusive randomized acupuncture trials showing that the treatment reduces pain.

"There are extremes of belief of effectiveness," Hernandez said. "For some individuals, no other evidence than hearsay or their own experience is necessary to determine that CAM therapy is effective. For others, no evidence of any quality or quantity is sufficient."

Since most medical schools are now offering some type of coursework in complementary and alternative medicine, Hernandez says it is safe to assume that medical school faculty members now belive that students should at least be able to talk with their patients about it.

The ideal, then, for Hughes and many others in the field of complementary and alternative medicine, is to encourage communication and respect between Western-trained doctors and alternative healers, like what Tester witnessed in China. That way, health care practitioners will understand when it's appropriate to prescribe certain types of care.

As Sperber said of his own field's limitations: "I always tell people that if I get into a car accident, don't call my acupuncturist."

E-mail: cew2111@columbia.edu