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QUALITY: Can a hospital CEO get us all to integrate (medicine, that is…)

This is pretty interesting. A fairly hard nosed hospital CEO, under it appears the tutelage of his new wife, gets into alternate and preventative medicine. 

Three years ago, Treuman Katz got some troubling news: At 60, he was on his way to becoming a diabetic. Katz, CEO of Children’s Hospital & Regional Medical Center at the time, could have relied on the region’s top specialists. Instead, the man who had spent nearly 40 years running two of the country’s pre-eminent hospitals reached out to a naturopathic doctor. He took herbal supplements, changed his diet, started yoga and hired a naturopathic trainer. Soon, his blood sugar dropped and he began to feel healthier than he had in years, he said.

Fair enough. But then he tries to integrate it with the care his institution delivers.

That opportunity came five years ago, when Katz and his medical staff
started to notice an intriguing trend: More than half of their patients
were using natural medicine but not telling their doctors. Therapies
ranged from herbal supplements to acupuncture.

So Katz organized a small group of physicians to visit Bastyr to
start connecting NDs — naturopathic doctors — and MDs, Molteni said.
Brown-bag lunches with Bastyr naturopaths followed. The hospital put
together a group to study how herbs could affect drugs. It hired two
anesthesiologists/acupuncturists and will work with Bastyr to bring on
a chiropractor, a naturopathic doctor and a traditional
Chinese-medicine practitioner within the next year or two.

I live in a city with more than 70 yoga studios and probably more than 300 acupuncturists, so there is something going on in the alternate care movement that deserves some level of integration with tradition western care. This might be one approach that makes sense.

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7 replies »

  1. Naturopathic medical training at accredited schools such as Bastyr is largely evidence-based, which I am going to assume would make it “scientific”, but still alternative, according to Deborah’s classification. Alternative medicine is far too broad of a term to say anything general about. There are very well-researched, “scientific” practices that simply have not been integrated into conventional medicine and there are very out-there practices as well. To lump them together out of ignorance or convenience makes little sense. Somehow the myth that there is no evidence favoring alternative medical practices such as acupuncture, nutritional supplements or herbs persists, but it is simply not true.

  2. “But on the other hand, non-allopathic practice starts from theories that are unscientific, and produces treatments that are not subjected to the kind of testing that will demonstrate their pathways and prove or disprove their efficacy.”
    Deborah,
    That is nonsense. First off there is no such thing
    as an unscientific theory. Theories are subjected
    to the scientific method, scienciness(sic) is not a
    inherent quality required to propose any theory.
    In fact your statement evidences one of the main
    problems with science lately, hubris and prejudgement. The notion that an idea must have a rational
    basis based on your previous understanding, or its
    not even worth testing. Many novel discoveries have
    wilted away in dusty journals because at the time
    a “plausible” mode of action couldnt be elucidated or
    as is quite common with “alternatives” no money could
    be found to fully flesh out the discovery as no
    patents could be had on the “natural” treatment and
    so no funding would be forthcoming.
    And that was if they were lucky. Usually the discovery
    is ignored, the person losses funding and some level
    of character assasination ensues.
    Take a look at this years Nobel Prize in Medicine for
    an example of what two researchers had to endure just
    to get a couple of their fellow scientits to look into
    a microscope and see what had been in front of them all
    along, but had been obstructed by their egos and unwillingness to give up long held “truth” that ulcers were
    caused by stress and a dominant mother figure, for gods sake. From start to finish 20 years wasted an a discovery
    that should have taken 2. 2 years to prove it 18 years to
    change other scientists minds it turns out. sheesh.
    As far as clinical trials and pathways for alternative
    treatments such as herbs or the o’so arcane um vitamins are you not familiar with Medline? True, stage 3 trials
    are few but many treatments taken in total of all
    smaller clinical trials and animal studies from around
    the world can at least allow a doctor to make a risk/reward value judgement if the conventional treatment
    performs poorly or whose own method of action (Prozac) is
    poorly understood or just plain wrong, yup that can happen in orthodox medicine re neurogenisis/prozac. My point is saying there is no proof for alternative treatments is ignorant, its simply not the case. And saying that they are unscientific is insulting to the
    couragous researchers brave enough to put their careers
    on the line to espouse novel ideas in unpopular or
    allready “decided” areas.
    Travis

  3. Matthew—I have to disagree that “everything” I said applies to allopathic medicine. Yes, individual allopathic physicians sometimes indulge in idiosyncratic and unscientific practices, but the general basis of allopathic medicine is science, while the general basis of alternative “medicine” is unscientific. Allopathic physicians have scientific theories and clinical evidence available to them to guide their treatment plans. Some do not wish to use it, which is unfortunate for them and their patients. But on the other hand, non-allopathic practice starts from theories that are unscientific, and produces treatments that are not subjected to the kind of testing that will demonstrate their pathways and prove or disprove their efficacy. The only way that alternative medicine will be able to earn legitimacy is through honest clinical trials—just like any other treatment.

  4. Deborah–you are right of course. But everything you are saying pertains to allopathic medicine too….and loyl readers will be able to recite by heart the proportion of times that American physicians that followed reccomended guidelines in the RAND study.

  5. Matthew,
    One doctor jumping on the “alternative” bandwagon does not legitimacy make. “Alternative” medicine is based on tradition and anecdote, as opposed to the systematic study of cause and effect. Anyone who utilizes it ought to be reminded that neither anecdote nor tradition is a scientific, i.e. rational, basis for action. There are scientific studies being done on alternative medicine (e.g. at UC Irvine). The results of systematic study of these therapies should be a better basis on which to decide whether they have ultimate value or whether, as many suspect, they are primarily useful as placebos.

  6. Some HMOs offer coverage, and many more offer discounts for what they call alternative and complementary care. I was at a conference last year where I found a vendor booth for American Specialty Health Insurance Company. I didn’t learn much about them, but it seemed like they worked like a disease maanagemeent company, but only for things like chiropractic, accupuncture, message therapy and naturopathic medicine. I think they had about 20,000 providers signed up nationwide. I am definitely intrigued by the fact that “insurance” is in the company’s name

  7. Matthew,
    Thanks for bringing this to our attention. I see patients everyday that are sick due to lifestyle and there is no one way to get them to change. Any avenue that is beneficial and causes no harm must be explored and activated and constantly reinforced. It is good that the medical field recognizes their obligation to include keeping people healthy. But, when up to your waist in alligators, it is sometime easy to forget that you came to drain the swamp.
    Marcus

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