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US Alternative Medicine Report Spurs Controversy

Mon Mar 25, 2002

By Alicia Ault

WASHINGTON (Reuters Health) - The Department of Health and Human Services (HHS) on Monday released the final report of the White House Commission on Complementary and Alternative Medicine Policy without fanfare, simply posting the recommendations on the Commission's website.

Controversial from the start, the Commission took several hits during its two-year existence, including, as the final report was drafted, a public airing of dissatisfaction from two panelists. Joseph Fins, director of medical ethics at New York Presbyterian Hospital-Cornell and Tierona Low Dog, a New Mexico-based acupuncturist, wrote a separate statement, included in the report's appendix.

They said they the Commission did not "appropriately acknowledge the limitations of unproven and unvalidated CAM [Complementary and Alternative Medicine] interventions or adequately address minimization of risk."

They criticized the Commission for not setting research priorities, for appearing to endorse certain CAM techniques as effective preventives or therapeutics, for advocating improved access to techniques when many people can't get conventional medical care, and for being overly generic and vague.

The 20-member panel's recommendations are not binding, but Commission Chairman Jim Gordon, a psychiatrist and director of the Center for Mind-Body Medicine, thinks they will be scrutinized and acted on despite other pressing issues on the health care agenda.

"The reason the Commission was created is that a major portion of the American public is using these therapies and they want better information on them," Gordon told Reuters Health. "So if the public demands that this report be attended to, the report will be attended to." The Commission estimated that 158 million Americans spent $17 billion on dietary supplements alone in 2000.

The report urged more federal funding of basic research, and into training investigators and practitioners. And the panel called on the government to make sure that accurate information on CAM is available to the public. This could be done by creating a task force at HHS to coordinate information exchange within the government, said Gordon.

The group could help insurers and employers decide which CAM interventions should be covered. The panel said that insurers should consider covering techniques and therapies that have been shown to be safe and effective and to improve health or functioning.

In a nod to the criticism, the report introduction stated that "most CAM modalities have not yet been scientifically studied and found to be safe and effective."

However, Fins said he and Low Dog still felt they needed to register their differing opinions.

"Despite the last minute changes in the introduction, the body of the report did not reflect our concerns," Fins told Reuters Health.

Gordon said the report was balanced and fair, and was a launching point, not an endpoint. "This report is a ground plan, a map for ways to integrate complementary and alternative medicine approaches to health care into the system," Gordon told Reuters Health. "It lays out the next steps we need to take," he said.

HHS spokesman Bill Hall said he did not expect HHS to move any time soon.

"There's a lot that needs to be digested first before taking the next step of saying where we're going to go," Hall told Reuters Health, adding, "at this point, it's premature to say what the future holds."

Several Senate and House members have been supportive of complementary and alternative medical practices, and may hold hearings on the report said Gordon.

Among those: Sen. Tom Harkin (D-IA). A spokesman for Senator Harkin said he was exploring the schedule for an opening.

SOURCE: Department of Health and Human Services (HHS)

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