WHEN a medical crisis hits, people want to know that someone smart in a white coat can prescribe Prozac to boost their mood, perform heart surgery to open their clogged arteries, or administer chemotherapy, radiation or surgery to cure them of cancer.
But growing numbers of Americans are also eager to experiment with alternative therapies. They take herbs to boost their immunity, meditate to calm frayed nerves and seek acupuncture to combat nausea and pain. Two 1998 studies reported that 42% of Americans use alternative medical therapies to treat their conditions -- and that, in 1997, Americans made an estimated 629 million office visits to complementary therapy providers. A 2002 government survey found that 36% of adults use some form of complementary and alternative medicine, and if megavitamin therapy and prayers for health are included in the list, the number rises to 62%.
A natural tension has long existed between these two kinds of medicine. Western medical practitioners have been wary of the sometimes wacky-sounding, often-untested therapies in alternative medicine's toolkit. Alternative medicine practitioners have typically operated outside the conventional system, with consumers paying out of pocket.
But over the last 10 years this wall has started, partially, to erode. Aided by federal funds, an increasing number of alternative therapies have been put to Western-style clinical tests, separating ones that seem beneficial, such as acupuncture for relief of pain, meditation to reduce hypertension, or ginger to relieve nausea -- from the chaff that appears ineffective. And conventional practitioners have come to appreciate the effect of the mind on chronic pain, heart disease, autoimmune conditions, anxiety and depression -- even the progress of disease.
About a decade ago, doctors began to be trained in what health guru Dr. Andrew Weil dubbed "integrative medicine," a new kind of doctoring that combines Western medicine with the best, most evidence-based alternative therapies.
Creating such centers -- and making them cost-effective -- has proved challenging.
Yet today there are an array of such clinics in Southern California. And the interest is growing. A 2003 survey by the American Hospital Assn. reported that 16% of hospitals, including medical facilities at Harvard and Duke, featured integrated medicine centers -- double the number available in 1998.
Here is a look at three successful centers, each -- in different ways -- blending Western medicine with folk traditions and practices from the East.
**
BILL COLEMAN SCRIPPS CENTER
'I was stressed'
Through classes like music, cooking and yoga, the tony La Jolla clinic teaches its heart patients to reflect on, and revise, their everyday lives.
BY the time Bill Coleman arrived at the Scripps Center for Integrative Medicine in mid-2005, he'd been through the wars. His first heart attack struck in 1998, and doctors put three stents in his heart. Two years later, they put in two more.
Then in 2005, a stress test showed he had a blockage in one of the main blood vessels to the heart -- the left anterior descending artery, also known as the "widow maker." He awoke after an emergency surgery with a total of seven stents in his heart.
Getting the stents was effective and easy -- too easy in some ways.
"It is such a quick fix. It gives you a false sense of security," said Coleman, 61, who runs an electrical contracting company in Loma Linda. "I didn't take care of myself. I didn't make any lifestyle changes."
His cardiologist at Scripps Clinic -- the mainstream medical facility that the integrative medicine facility is attached to -- told him he was heading in the wrong direction and asked him to consider the integrative center's Healing Hearts program, designed to stop the progression of heart disease.
More Americans die of heart disease each year than any other illness. Western medical care excels at acute care and trauma: Stenting and bypass surgery are routine procedures. But once the crisis is over, alternative medicine can offer a prescription for prevention and lifestyle change. Many alternative practitioners deal with the more nebulous -- but still, for heart disease, vitally important -- areas of emotion, spirituality and stress reduction, and are generally more eager to focus on low-tech interventions such as anti-inflammatory, low-glycemic index diets.
The Scripps program started after cardiologist Dr. Mimi Guarneri was approached by Dr. Dean Ornish, the celebrity doctor known for showing that coronary disease could be reversed without surgery using a low-fat diet, exercise, yoga, meditation and support groups. Scripps became part of Ornish's Multicenter Lifestyle Heart Trial, and Guarneri's clinic grew out of that experience. Scripps Center for Integrative Medicine opened in 1999.
