Dr. Steven Amoils didn't set out to be at the
forefront of a movement to re-imagine how we look at medicine, at least
not at first. He was a competitive swimmer just trying to figure out why
one month after he could swim 1,500 meters fast enough to set a record
in his native South Africa, walking up one flight of stairs would set
his heart racing and wear him out.
When conventional medicine couldn't pinpoint the
problem, he sought help from an acupuncturist. That acupuncturist took
Amoils' pulse, paused, and then asked why Amoils was so tired. "I hadn't
mentioned anything about that yet," Amoils says. "He got that from my
pulse, a pulse diagnosis. I was very impressed."
Impressed enough to start a lifelong journey of
learning about alternative medicine and treatments, including two years
traveling the world to study practices of indigenous cultures that
eventually led to the 1999 founding of the Alliance Institute for
Integrative Medicine, which he co-directs with his wife, Dr. Sandi
Amoils.
Their Kenwood facility has grown from an offshoot of
the dissolved Health Alliance to one of 10 centers in the nationwide
network of the Bravewell Collaborative, a foundation created to advance
the cause of integrated medicine.
You'll find traditional courses of treatment at the
Alliance Institute — they'll write you a prescription or refer you to a
surgeon, if that's the proper course of action — but also massage
therapy, acupuncture, chiropractic, hypnotherapy and nutrition
counseling, among other options. "The concept is you're integrating the
best of conventional medicine with the best of alternative therapies,"
Amoils says.
Alternative therapies aren't a new phenomenon (nor
is the public's interest in them), from the pain-management benefits of
acupuncture, chiropractic and massage to the stress-reduction benefits
of yoga and tai chi.
Studies in 1993 and 1997 by Dr. David Eisenberg, who
would pioneer research and education in integrative medicine at Harvard
Medical School, found that patients' visits to providers of
complementary and alternative therapies exceeded all visits to
primary-care physicians, and that out-of-pocket costs for complementary
and alternative therapies outpaced those for all hospitalizations in
1997.
The more recent development is the concept of
integration, where traditional and complementary treatments are offered
in conjunction with one another. Whereas traditional medicine was often
practiced "in silos," Amoils says, some of those walls are beginning to
come down.
"In the old days, doctors wouldn't speak to
chiropractors and acupuncture was voodoo," Amoils says. "What happened
was the public started saying, 'we're using this. We want this. We need
this.'"
Sian Cotton, director of integrative medicine at UC
and UC Health, agrees that there's a populist element to the growth of
integrative medicine. "Across health care, it's one of the few things
truly driven by consumers," she says.
In May, UC Health formally launched the integrative
medicine program at its new 26,000 square-foot UC Health Women's Center
facility in West Chester. Open to both men and women, the complementary
and alternative medicine therapies available include acupuncture,
massage, mindfulness groups, reflexology, therapeutic yoga, Pilates, tai
chi, and medical qigong, a traditional Chinese medicine therapy.
Another integrative medicine facility at the Barrett
Cancer Center at UC Health's main campus is in the works for January,
Cotton says. Putting traditional and complementary therapies under one
roof helps reinforce the integrative aspect, she says.
Having the resources of UC Health behind it also
allows UC Health Integrative Medicine to expand into areas like
research. Two trials are already under way: one to examine the impact of
mindfulness training in children with bipolar disorder, the other to
study the effectiveness of breathing retraining in African-American
teens with asthma.
Cotton prefers the term "complementary" therapies to
"alternative" ones, and UC Health focuses on those with documentable
benefits. "I don't necessarily endorse things that are really out there,
and I think that makes more people open to listening," she says. "I
prefer to speak from an evidence-based standpoint. What we offer is the
best of conventional medicine with the best of evidence-based
complementary therapies."
If skepticism of those therapies has waned, some
hurdles remain for bringing integrative medicine further into the
mainstream. Across his research, Amoils found that not only did some
alternative therapies have questionable usefulness, but also that within
some generally accepted disciplines, such as acupuncture, efficacy
varied greatly by practitioner. "It's all over the map," he says.
Also, patients' eagerness to try complementary
therapies hasn't been matched by insurers' willingness to pay for them.
Compensation varies by treatment and insurance plan. The Alliance
Institute does not accept insurance and advises patients up front to
consult plan administrators to see which, if any, therapies for which
they might be reimbursed.
On the plus side, Cotton says more and more medical
schools, including UC, are introducing an integrative medicine component
into the curriculum. Amoils believes advances in integrative medicine
may hold the key to helping solve a health-care crisis in the United
States.
"We know that despite the amount of money being
spent on conventional medicine, the health of the average person in
America is getting worse. We're at a point where the next generation
will be the first where the life expectancy of the children is less than
the parents.
"Chronic diseases are the next great burden, with
the potential to bankrupt the country. This is where alternative
therapies have a potential great role to play. Looking at lifestyles, at
stress, at diets, they're potentially much less expensive than acute
care."
Cincinnati's somewhat conservative reputation might
make it, to some, an unlikely bastion of therapies rooted in other
cultures. Where Amoils once doubted that himself, he says 10 straight
years of more than 20,000 patient visits to the Alliance Institute has
persuaded him otherwise.
"One of the things that helped us is that we came
out of the conservative system ourselves," Amoils says. "We're doctors
first; we know many conventional physicians. They know we're not going
to forego medicine in the process. But we can make almost any other part
of medicine do better."
For more information: Alliance Institute for
Integrative Medicine: myhealingpartner.com. UC Health Integrative
Medicine: uchealth.com/integrativemedicine.
