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. Half a year later, she is doing fine and is busy with her advertising firm and her family.

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

At St. 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. A 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 a massage and biofeedback sessions at a new Center for Complementary Medicine.

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 treatments from harmful ones, 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 to new MRIs and operating room suites. And 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.

Another hurdle for hospitals is that the credentials of nontraditional practitioners - such as yoga teachers, massage therapists and herbalists - are tough to check. New Jersey, for example, licenses acupuncturists, but not massage therapists.

That makes it difficult for a hospital, whose reputation and liability are on the line.

　　From Healthy.net