New Jersey hospitals embrace alternatives

Some hospitals take cautious first steps in nontraditional care

Response to public demand

July 21, 2002|By Lindy Washburn | Lindy Washburn,KNIGHT RIDDER/TRIBUNE

HACKENSACK, N.J. - When Sherran Rapp was wheeled into the operating room in August, she wasn't thinking about the 10 hours of cancer surgery about to begin. Instead, she pictured her two toddlers listening to stories at bedtime and imagined the joyous melody of a Puccini aria.

She had been trained by the hospital to focus on the positive instead of her fear.

Rapp is one of a growing number of patients who receive everything from massage to aromatherapy at their local hospitals. Before her double mastectomy, Rapp took a class on imagery and music, a technique doctors say can help reduce time spent in hospitals.

The 47-year-old Mendham, N.J., resident was so calm going into surgery that she even exchanged smiles with the surgeon before the anesthesia took effect. She left the hospital in four days and stopped pain medication in six. Now, she is doing fine and is busy with her advertising firm and family.

Hospitals cautious

With the caution of a stiff person trying yoga for the first time, hospitals are embracing some decidedly nontraditional approaches to healing. Alternative medicine is going mainstream.

At Saint Barnabas Health Care System, where Rapp underwent her operation, open-heart patients can receive a full-body massage before surgery, and foot reflexology treatments during recovery. An herbalist will mix teas to soothe nausea and nerves. Patients are encouraged to take a class about the power of imagery and are allowed to wear headphones during surgery, a practice doctors say reduces the need for pain medication.

At Pascack Valley Hospital in Westwood, N.J., acupuncturists treat the chronic pain of arthritis and migraines, and patients can get massages and biofeedback sessions at a new Center for Complementary Medicine.

A former nursing school at Englewood Hospital and Medical Center houses yoga classes for new and expectant mothers such as Rie Crawford. "It definitely helped with the delivery," said Crawford, 34, a first-time mother from West New York. She returned to the "graduate" class - for new mothers and babies - just a month after delivering her son.

At Passaic Beth Israel Hospital, Carmen Johnson, 81, joins her older sister and other seniors for weekly classes in tai chi. Hit by a car as she walked in Passaic six years ago, Johnson's fast pace and spirited repartee attest to the miraculousness of her recovery. "You have to get up off your rusty-dusty and move," she said, as she began the smooth, weight-shifting movements of the Chinese martial art to the music of Frank Sinatra.

Louis R. Ycre Jr., the president of Pascack Valley Hospital, says hospitals like his are responding to the public's demand for these services. "It's no longer right for the medical profession to ignore this," he said, noting the effectiveness of some of these approaches to pain relief.

Hospitals have a role to play in distinguishing beneficial from harmful treatments, he said. "Isn't it better to have them controlled and in the hospital?"

Getting into the business requires little investment. Massage tables and yoga mats are cheap compared with new MRIs and operating room suites. Even though no hospital in the state has made money from these ventures, the programs are a good way to attract patients for more traditional procedures.

Although the public seems eager for these offerings, reaction from physicians ranges from scorn to enthusiasm, mixed with a large dose of caution. Skeptics say much of what is called complementary medicine is old-fashioned comfort care, relabeled with fancy names and billed by the hour. Little so-called alternative treatment has passed the rigors of scientific research, they say.

"Quackery has been renamed," said Dr. Stephen Barrett, a retired Pennsylvania psychiatrist and founder of Quackwatch Inc. "What it boils down to is the [hospitals] offer a little massage, some exercise, maybe some Chinese exercise to give it some mystique, and market it as complementary and alternative medicine. All they are is relaxation techniques. They have the value of relaxation techniques, which is not very high."

Hospital executives find it less controversial to add an exercise class for the healthy to their community offerings, for example, than to win physician acceptance for a herbalist to prepare brews from a cupboard of botanical remedies.

Yet no hospital can ignore the growing popularity of these treatments. In 1997, Americans paid more out of pocket for such care - $12.2 billion - than they did for hospital stays. The number of visits to alternative medicine practitioners, such as chiropractors, massage therapists and acupuncturists, exceeded those to primary-care physicians, according to a seminal study by Daniel Eisenberg published in the Journal of the American Medical Association.

Women, people age 35 to 49, and those with higher incomes and education were most likely to seek complementary care - exactly the kind of people for whom hospitals compete.

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