More med, nursing schools teaching alternative remedies

Future doctors and nurses are learning about acupuncture and herbs along with anatomy and physiology at a growing number of medical schools. It's another example of how alternative medicine has become mainstream. And it's often done with Uncle Sam's help.

The government has spent more than $22 million to help medical and nursing schools start teaching about alternative medicine -- lesson plans that some critics say are biased toward unproven remedies.

Additional tax money has been spent to recruit and train young doctors to do research in this field, launching some into careers as alternative medicine providers.

Doctors need to know about popular remedies so they can discuss them nonjudgmentally and give competent advice, the government says, and many universities and medical groups agree.

"Patients are using these things" whether doctors think they should or not, and safety is a big concern, said Dr. Victor Sierpina, an acupuncturist at the University of Texas Medical Branch in Galveston who heads a group of academics who favor such training.

But to critics, it's like teaching Harry Potter medicine. Students are being asked to close their eyes to science principles that guide the rest of their training in order to keep an open mind about pseudoscience, they say.

Teaching about alternative medicine implies acceptance of it and "potentially creates more gullibility and less critical, objective thinking," said Dr. Wallace Sampson, editor of the journal Scientific Review of Alternative Medicine. "This will be felt in many indirect ways," he said, including judgment errors, misguiding people with severe diseases, and lax standards and laws.

For Jackson physical therapist Justin Franke, these methods need to be proved through an unbiased report before they are taught.

"Patients trust health care professionals for good reason," he said in an e-mail interview. "A treatment that does not have an evidence base should be treated as experimental and clinically researched as soon as possible." Franke practices at Select Physical Therapy.

The real issue is not whether alternative medicine should be taught, but how, said Dr. Joseph Jacobs, former head of the federal Office of Alternative Medicine.

"The parallel here is creationism versus science," Jacobs said. "If the topic is taught objectively, to help students communicate with patients, it's a good idea. If it's being taught as part of an advocacy, for acceptance among physicians, I think that's a little bit bogus."

Sometimes the line is blurry.

Some schools have close ties to alternative medicine providers or advocates who shape information on the schools' websites or classes. Two examples:

* The University of Arizona's Center for Integrative Medicine has medical residency programs in hospitals around the country, partly sponsored by well-known advocate Dr. Andrew Weil, the center's founder. A private group that promotes such care, the Bravewell Collaborative, gives scholarships for dozens of the Arizona school's students to get hands-on training in integrative care clinics.

* The University of Minnesota offers medical students an elective course in alternative healing methods at a Hawaiian medical center founded by a philanthropist-advocate of such care, although students pay their own transportation and living expenses. In interviews with an Associated Press writer in 2007, several students raved about things they had tried firsthand, and said they returned more willing to recommend acupuncture, meditation, yoga, herbal remedies and other nontraditional care.

"Consumers are demanding it" and more research is needed to see what works, said Mary Jo Kreitzer, who directs the Minnesota school's alternative medicine curriculum. "Ultimately we need to align policy" so that insurers pay for these therapies, she said. "You could say that in that respect, we are advocates."

The field got a boost 10 years ago, with creation of the National Center for Complementary and Alternative Medicine. It made merging alternative and mainstream medicine "a central and overarching goal" and gave $22.5 million to 12 medical schools, two nursing schools and the American Medical Student Association to develop curriculum plans.

Kreitzer's and Sierpina's universities got grants, and both are active in the Consortium of Academic Health Centers for Integrative Medicine -- 42 centers involved in researching or advocating for complementary and alternative medicine, or CAM.

However, a review of some of those teaching plans by Drs. Donald Marcus and Laurence McCullough of Baylor College of Medicine in Houston concludes that they are "strongly biased in favor of CAM," cite poor-quality research, and were not updated after better studies revealed a therapy did not work. The review is in the September issue of the journal Academic Medicine.

Sierpina, the head of the medical school consortium, said the purpose of these lesson plans is not propaganda.

"We are not trying to make students CAM practitioners," but to train them to be "sensitive to where people come from, their folk medicine, their home remedies," he said.

Just as there are true believers who ignore evidence that something doesn't work, there are true doubters who are guilty of "arrogant thinking that we've got it all figured out," Sierpina said.

Dr. Mehmet Oz agreed. The Columbia University heart surgeon and frequent Oprah Winfrey guest, now with his own TV show, has long shown an open mind toward complementary and alternative medicine.

"Medicine is very provincial. We grow up thinking the way others have taught us to think. We are naturally biased. It is imperative that we look at what alternative cultures offer us, that we at least are fair in our skepticism of their impact." Otherwise, "we run a risk of locking out newcomers" with fresh ideas, he said.

Officials at several top schools say they teach respect for patient choices, but do not teach unproven remedies or theories.

"All medical treatments ought to be held to the same standard," whether a prescription drug, an herbal pill or a mode of care, said Dr. Philip Gruppuso, Brown University's associate dean for medical education.

Southeast Missourian features editor Chris Harris contributed to this report.