WASHINGTON -- Congress has given the orthodox medical establishment $50 million to sort out the claims, mysteries and realities of "alternative medicine." That's the term for a melange of potions and treatments that includes massage and acupuncture, as well as shark's cartilage for cancer and St. John's Wort, a low-octane anti-depressant for sale without prescription.
Unfortunately, the congressional generosity is misbegotten since the money was entrusted to the National Institutes of Health, where the management rates alternative medicine as synonymous with quack medicine. With lesser sums previously imposed on it by Congress, $20 million last year, the guardians of medical orthodoxy at NIH have been pawing at alternative medicine since 1993, with little to show for their efforts.
In fact, squabbles still persist about the definition of alternative medicine, with some proponents preferring to call it "complementary medicine," while others have recently shown interest in calling it "integrative medicine," sometimes in combination with the other terms.
It's important to look at it, the proponents argue, since Americans by the scores of millions are gulping strange potions beyond the reach of the Food and Drug Administration and subjecting themselves to procedures foreign to Western medical practice.
According to a recent issue of the Journal of the American Medical Association that was devoted to alternative medicine, Americans made 629 million visits to "alternative medicine practitioners" in 1997, "thereby exceeding total visits to all U.S. primary care physicians." The alternative healers are said to have taken in $21.2 billion; $12.2 billion of that sum was out of pocket -- which probably signifies a mixture of confidence and desperation among their clients.
The expressed concern in the ranks of orthodox medicine is that reliance on the alternatives might delay or interfere with effective treatments for serious ailments. There's also worry about fraud in the grand snake-oil tradition and well-intentioned but harmful incompetence.
A mainstream scientist is quoted in the JAMA issue as saying, "Why don't we form a center at Harvard for the scientific study of astrology?" Various alternative camps respond that these concerns reflect the turf insecurities of organized medicine, now intensified by the income-cutting rigors of managed care.
