Medical schools are enriching the traditional medical curriculum with survey courses that provide an overview of the increasingly popular field of alternative medicine. Students attending medical schools such as Johns Hopkins School of Medicine can expect lectures on acupuncture, meditation, and herbal medicine beyond the traditional studies of sicknesses, labs on cadavers and bodily functions.

The new addition to the Johns Hopkins curriculum is a wide array of practices known as Complementary and Alternative Medicine, or CAM. Students appreciate the school's effort to bring awareness and understanding of the emerging practices.

"I think it is important, if for no other reason than some people will be using those therapies, whether we like it or not," said Anthony Graves, a Johns Hopkins medical school student. "It is necessary to understand exactly what a patient is doing" in order to treat that patient effectively.

Area medical schools also uphold the belief that doctors need to fully understand what the patient is going through in order to treat the illness effectively.

Since the probability of the patient use of the new practices is rising, medical schools have in recent years moved to add information on CAM to their required and elective coursework. Both the Johns Hopkins University School of Medicine and the University of Maryland School of Medicine now include at least some basic CAM lectures in their curricula.

The action is in response to a growing embrace of CAM both by health care consumers and by the medical establishment.

In 1992 Congress established the Office of Alternative Medicine (now called the National Center for Complementary and Alternative Medicine) at the National Institutes of Health. The American Medical Association charter likewise encourages members to "become better informed regarding alternative medicine and to participate in appropriate studies of it."

In the May 2000 issue of Consumer Reports, a poll showed that 35 percent of respondents had used alternative treatments during the past two years.

"Our patients are using [alternative medicine] and so we need to know what things work. We need to know what things are dangerous. And we need to be able to advise our patients, who are asking us about these things," said Adrian Dobs, a professor of medicine at Johns Hopkins.

Johns Hopkins school of Medicine's interest in CAM is dramatically escalating. Last year, Hopkins secured an $8 million grant from the National Institutes of Health. The money supports CAM research, as well as a monthly seminar on alternative therapies.

Professor Dobs pointed out that doctors would like to know if any alternative therapies might help in their healing work. At the same time, they want to be sure that uncontrolled herbs, such as vitamins are not interfering with their patients' mainstream treatments.

"We want physicians to know and understand what it is their patients are taking," Dobs said. "Some of these botanical products have some serious side effects, and so we want them to know about some of the unique issues and problems that face them when they care for patients who use these things."

CAM advocates say there is a sound business rationale for encouraging doctors-in-training to take an active interest in alternative therapies.

Mind-body therapies used to control pain and stress could eliminate 37 percent of visits to the doctor per year, according to the Health Education Alliance for Life and Longevity, an information resource center in Eureka, Calif.

With American health care spending expected to reach the $2.1 trillion mark by 2007, the center says, these mind-body therapies alone could save the country some $54 billion a year.

At the University of Maryland School of Medicine, students learn about CAM through 13 hours of required coursework, and clinicians utilize acupuncture, herbalism and meditation in conjunction with conventional therapies in the treatment of chronic conditions.

"Some of the therapies include techniques that have real value, for instance in treating chronic pain. Sometimes acupuncture or some of the [relaxation] techniques can be helpful," said Brian Berman, a professor of family medicine and director of the University of Maryland School of Medicine's complementary medicine program.

Berman said that with so many people using alternative therapies, physicians can and should bring their skills of scientific analysis to bear in order to ascertain the validity of these techniques. Moreover, the university is eager to promote the basic premise that underlies most of the various CAM therapies, the idea that people are more than just parts.

"We want them to be thinking more about treating the whole patient: Not just treating the back pain, but also treating the person with back pain. We want them to have a more holistic viewpoint, or at least to know about that approach," Berman said.

Experts in the field of CAM applaud the intentions of these programs, but say such efforts have not gone far enough.

"Surely in the last decade there has been an increased openness toward lectures, seminars and discussions, but I have not seen a lot of schools that have really put into their curricula a full course on complementary and alternative medicine," said William Haskell, a professor of medicine at Stanford University in California who has studied alternative medicine on behalf of the Office of Alternative Medicine at the National Institutes of Health.

In addition to wanting more formal coursework for medical students, Haskell said he also would like to see more CAM-related information provided to physicians who already are in practice.

"It would be very helpful for continuing medical education run by existing medical schools to try to ensure that information on CAM therapies is included as a part of their curriculum," he said, adding that to a small degree "that is starting to happen. The number of courses and workshops being offered by departments of continuing medical education is steadily increasing."

The medical schools?steady attempt to adapt to the alternative treatments of a growing proportion of the population is a great start for effective practice of a new generation of doctors.

　　From Healthy.net