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Medical Schools Embrace Alternative Medicine

Patients' desire for alternative therapies is driving changes in medical education.

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Now that nearly 40 percent of American adults swear by some form of complementary and alternative medicine, or CAM—from nutrition and mental relaxation to acupuncture, magnet therapy, and foreign healing systems like traditional Chinese medicine and Indian ayurveda—a growing number of medical schools, too, are supplementing medication with meditation.

Interest in teaching alternative approaches "has exploded, especially this last year," says Laurie Hofmann, executive director of the Institute for Functional Medicine, which is based in Gig Harbor, Wash. The nonprofit institute educates healthcare professionals to look for underlying systemic imbalances as a cause of illness rather than focus on treating symptoms and, when possible, to correct with lifestyle changes and mind-body techniques.

The Consortium of Academic Health Centers for Integrative Medicine, which encourages the spread of CAM education, was founded in 2000 after an initiative by eight academic medical centers; it now boasts 46 medical school members.

[Learn how medical schools are shifting focus to primary care.]

Traditional study of drugs and surgery, of course, still dwarfs class discussion of alternative medicine. Still, students want to add complementary methods to their black bags because they "know their future patients are going to be using them," says Shelly Adler, director of integrative medicine education at the University of California–San Francisco School of Medicine, which has a long history of teaching the topic.

"I could already see the limitations of Western medicine, especially when treating recurrent pain or other chronic conditions. I thought other healing traditions could fill in some gaps," says Carson Brown, a first year resident at San Mateo Medical Center in California. Spurred in part by the relief that acupuncture had offered her for hip pain induced by a sports injury, she took a two-week elective offered to fourth-year UCSF students last year that covered topics from acupuncture to mind-body medicine to herbs.

A similar elective was launched last spring at the Loma Linda University School of Medicine in California; the school is planning a second, more in-depth elective on functional medicine for chronic conditions. Such an approach to managing—even reversing—diabetes, for example, emphasizes exercise and a plant-based diet rich in whole foods, with medication as a last resort.

The schools insist that they approach the subject with an eye toward the evidence, advocating only methods that have withstood scientific scrutiny even as they examine any methods patients frequently use. But critics charge that this is not always the case. A 2009 review in the journal Academic Medicine of a handful of course curricula found a bias "in favor of CAM," noting recommendations of acupuncture for conditions like asthma where there is "no credible evidence" and instances of ignoring research—for example, studies associating chiropractic neck manipulation with stroke.

At the University of Arizona, where bestselling CAM guru Andrew Weil is a member of the faculty, a curriculum overhaul five years ago expanded the discussion beyond the scope of an elective or two. Based on the growing body of research supporting some holistic remedies, especially nutrition, and of smaller-scale studies on other treatments with limited risks, such as journaling to help rheumatoid arthritis, "it made sense to integrate these ideas into a variety of courses," says Victoria Maizes, executive director of the Arizona Center for Integrative Medicine at the medical school.

As before, fourth-year students have the option of a four-week elective on the topic. All students, in classes across the curriculum, now gain an understanding of the role of nutrition and recognized alternative remedies in healing and prevention and of the body's innate ability to heal itself. Faculty members who have gone through the center's full-fledged, two-year fellowship in integrative medicine often give students a window on how they may eventually incorporate CAM.