At a public hospital in Minneapolis, a physician leads a half-dozen medical students in a discussion on spirituality and health. Posing a question that might have been unthinkable in this secular setting only a few years ago, a student asks, "Is it OK to pray with a patient?"
At a strip mall in Sedona, Ariz., a mecca of the New Age, an Illinois woman who underwent surgery and radiation therapy for a brain tumor visits a naturopath. The "healer" prescribes herbal tinctures, made in an adjacent shop reminiscent of a 19th-century apothecary, to ease her depression.
"My neurologist wasn't very helpful with that," the woman says of the disease's crushing emotional fallout.
At a retirement village in Laguna Hills, an osteopath tells a gathering of senior citizens about unapproved, and perhaps dangerous, treatments for heart disease, stroke and dementia. He jokes about appearing on a list of "quacks" assembled by a watchdog group.
"That's how we know you're good," says a woman in the audience. "If you've been to jail, you're even better!"
Here in all its promise and peril is America's expanding alternative medicine movement, a vast hodgepodge of treatments, practices and products embraced by young and old.
Once a counterculture phenomenon, alternative medicine is now an $18-billion industry edging into the mainstream, with California leading the rest of the nation. Although it is gaining fast in popularity, alternative medicine is still very much an experiment--one that huge numbers of Americans are conducting with themselves as the guinea pigs.
The movement is touching tens of millions of lives, reshaping the health care system, and pumping enormous sums into industries and professions whose considerable political clout belies any image of the humble neighborhood folk healer.
Despite its astonishing growth, alternative medicine remains riddled by uncertainty and controversy, polarized over even the most basic issue of what constitutes proof that a treatment actually works.
In contrast with standard medicine, government agencies provide relatively little oversight of many alternative practices. Lacking such safeguards, consumers have reasons for concern.
Testing conducted for The Times by an independent laboratory, for example, raises questions about the consistency and quality of some herbal supplements.
Surveying the scene last year, the American Medical Assn.'s Council on Scientific Affairs issued a bottom line that offers consumers small comfort: "There is little evidence to confirm the safety or efficacy of most alternative therapies."
The label "alternative medicine" covers a range of products and treatments, some derived from centuries-old spiritual and healing traditions of non-Western societies, others as new and high-tech as pressurized oxygen chambers. What all have in common is that they fall outside the list of "standard" therapies approved by government agencies and the medical authorities.
Even advocates acknowledge the deep uncertainty about the impact that alternative medicine is having. "Is this movement taking our health care system backward, or is this the health care system moving forward and maturing?" asks George DeVries, president of American Specialty Health Plans, a San Diego insurance provider covering alternative practices.
Questionable scientific evidence has not kept medical centers and insurance companies--formerly hostile to alternatives--from hopping aboard the trend. Alternative medical practices may provide health plans with a relatively low-cost feature that is attractive to consumers, many entrepreneurs hope. Six major health insurance firms in California decided this year, for example, to cover acupuncture and traditional Chinese medicine.
Cedars-Sinai Medical Center in Los Angeles opened its Integrative Medicine Program in May, after a year of internal debate and turmoil over the legitimacy of offering acupuncture, chiropractic, mind-body techniques and herbs. The Stanford University Medical Center opened a similar patient care program in April.
Californians, ever the experimenters, appear to be blazing the alternative path, according to a Los Angeles Times poll conducted this spring. Statewide, 35% of those polled said they had tried high-dose vitamins at some point in their lives; 32%, chiropractic; 11%, homeopathy; and 8%, acupuncture. Those figures are roughly twice as high as levels found in recent nationwide polls.
No alternative approach has grown more quickly than herbal supplements, from St. John's wort for mild depression to black cohosh for premenstrual syndrome.
Americans will spend some $3.65 billion on herbal remedies this year, a 100% increase since 1994. Advocates view the herbal boom as a long-overdue embrace of nature's kinder, gentler drugstore, since many effective pharmaceuticals have been derived from plants. But critics lament the fad as a return to the days of patent medicine, when all kinds of healing powers were ascribed willy-nilly to mysterious herbal blends.