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.