Patients are thinking outside the Rx.
(Dec. 1, 2008)  When it comes to herbal supplements and alternative medicines, the federal government has a new motto: “Ask and tell.” Recognizing the growing popularity of these therapies, the National Institutes of Health has launched a campaign to encourage doctors and health care workers to ask patients about nontraditional medicines they may be taking and encourage patients to “‘fess up.”

“Patients should talk to their doctors about it, but doctors are very judgmental about alternative medicines and that makes the patient fearful of talking,” said Dr. Henry Pohl, vice dean for academic administration at Albany Medical College, who is trying to expose medical students to alternative care.

Americans spend more than $40 billion annually on alternative and complementary medications, according to the NIH. Herbal supplements, vitamins, chiropractic care and meditation are among the most popular therapies, although prayer is at the top of the list.

While two-thirds of Americans older than age 50 use alternative medicine, most of them keep it to themselves, according to a survey conducted by NIH’s Center for Complementary and Alternative Medicine and the AARP. The survey found that patients didn’t tell their doctors about the alternative medicines they were using because the doctor never asked, they didn’t know they should or they were embarrassed.

Alyssa Cotler, a public health adviser with the NIH, helped design the national “Time to Talk” campaign. The government created tool kits that give doctors advice on asking patients about it and the kits are dispensed at medical meetings. Government officials are concerned about potential interactions between drugs that doctors prescribe and natural supplements a patient may be taking.

Instructors at Albany Med and Albany College of Pharmacy and Health Sciences are trying to train the next generation of doctors and pharmacists to be open-minded.

“Our students need to know about alternative and complementary therapy,” Pohl said. “The most important thing that we do is we tell medical students they should respect the patient’s desire to have an alternative medium.”

Medical students get a taste of alternative therapies in several classes and learn how to ask patients about nontraditional medicines in their clinical skills class. But Albany Med takes a hands-on approach, too. Students from a local massage therapy program give the medical students massages in exchange for anatomy lessons.

“My idea is if they use something like massage therapy, this may help them see it’s beneficial to their patients,” Pohl said.

The pharmacy college will soon require students to complete a one-credit class on alternative medicine to graduate. The class of 2012 will be the first affected by the curriculum change.

“As health care professionals, you really need to deal with it,” said Dudley Moon, a biology professor at the Albany College of Pharmacy. “The idea is to give the pharmacy students broad exposure to what we would call alternative medicine, though in other parts of the world they would be called routine.”

Moon organized a conference at the college in June that brought together scientists, medical professionals and makers of alternative medicines with the goal of cultivating and spreading scientific information about nontraditional medicines.

The school offers students several electives to teach them the science and evidence, or lack of evidence, of alternative therapies.

“We are not aiming to convert them to anything,” Moon said. “But, rather, open their perspectives.”

By CATHLEEN F. CROWLEY, Staff writer