The Miami Herald, Inc.; Friday, July 11, 1997
Karen Rafinski; Herald Staff Writer

Many doctors don't like it. But more and more they're being urged to consider it in their mainstream practices -- by patients who use it against doctor's orders and now by their peers.

"We as a profession must address the challenge of discussing alternative therapies with our patients and put an end to the `don't ask, don't tell' approach," writes David W. Eisenberg, M.D., director of the Center for Alternative Medicine Research in a recent issue of the Annals of Internal Medicine.

Doctors should face up to what amounts to an "invisible mainstream" where 70 percent of patients who use alternative medicine don't tell their doctors, Eisenberg argues. Even the American Medical Association recently took a position urging physicians to inquire about the alternative therapies patients are using and educate themselves and their patients about their value and risks.

Local doctors say they're not sure how many of their patients are treating themselves with alternative therapies without telling them but that they do make an effort to find out.

Dr. R. Judith Ratzan, an oncologist with Mount Sinai's Cancer Center in Miami Beach, said she believes only a small portion of her patients are using alternative therapies. She tries to steer patients away from diets like macrobiotics that she fears deprives them of nutrients they need to fight off disease and from supplements that might affect the drugs she prescribes. Often she questions the value of alternative treatments. But when she can't offer more than emotional support or palliative care for a dying patient, she usually goes along with whatever alternative regimen they've chosen.

"Some people need to be in control of what happens in their life and alternative medicine offers them that," Ratzan said. "I don't ever take that away from them . . . Even if I don't think it's doing them much good objectively, if it makes them feel better, that's OK."

For years, many AIDS patients fell into that category. Conventional medicine could do little for them so they turned to a wide range of alternative treatments. And to the degree that route comforts patients in a desperate situation, Dr. Michael Sension thinks many therapies -- like massage or meditation -- help patients muster the spiritual and emotional strength to fight a deadly disease.

But now a new class of anti-HIV drugs called protease inhibitors are dramatically improving and lengthening lives. While some patients who had rejected conventional medicine are coming in for the new drugs, Sension finds himself struggling to persuade others to try conventional medicine now that it can really help them.

"I often have to spend a lot of time debunking myths and conspiracy theories," said Sension, who treats AIDS patients at the North Broward Hospital District's Urgent Care Center in Fort Lauderdale. "To the extent that alternative treatments would keep somebody away from something that can really help them, I have a problem."

Sension also worries about the money his patients of limited means are spending on therapies with no proven value.

"When somebody's spending $60 on root powder I can't help but think that money would buy a lot of fresh fruits and vegetables that might be of more benefit," Sension said.

On the other side, a handful of local doctors are embracing some alternative therapies in their practices.

Imperial Point Medical Center has set up an alternative medicine center that is gradually being accepted by doctors there, said Dr. Richard Ott, a plastic surgeon who was instrumental in pushing for the center. Ott is in the middle of a two-year study of biophysics he hopes will help him better understand alternative practices and has slowly incorporated a few of those ideas into his practice.

And Dr. David J. Blyweiss, a family practitioner, is setting up an alternative practice in Plantation that will incorporate conventional and alternative treatments. He became interested in alternative medicine when he realized his patients knew more about some of these therapies than he did. Self-taught on the merits of an assortment of alternative therapies, he waves a copy of a mainstream medical journal to point out studies vindicating what was once considered "alternative" like the value of selenium in preventing cancer.

Blyweiss is taking a decidedly unconventional approach by offering vitamin supplementation, aromatherapy, healing touch and even chelation, a controversial therapy designed to remove metals from the blood. "I got tired of just treating symptoms, which is what conventional medicine does well," Blyweiss said. "I wanted to treat the whole person. I think the way to do that is by blending the best of conventional medicine with the best of alternative therapies." .

cutlines KAREN RAFINSKI / Herald Staff CONVENTIONAL AND ALTERNATIVE: Dr. David J. Blyweiss is opening an alternative medicine practice in Plantation. health

CAPTION: photo: Dr. David J. Blyweiss (a)

970711
MH970706

Always watch for outdated information. This article first appeared in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1997. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .