Georgetown's Alternative Course GU Medical School Will Integrate Non-Mainstream Treatments Into All Classes
By Judy Packer-Tursman Special to The Washington Post Tuesday, October 2, 2001; Page HE01 In a move that demonstrates the increasing reach of complementary and alternative treatments into mainstream medicine, Georgetown University's medical school has begun a broad overhaul of its curriculum to educate new doctors about the unconventional therapies that many patients already use. With the help of a $1.7 million federal grant from the National Institute of Health's National Center for Complementary and Alternative Medicine, Georgetown officials plan to integrate into their courses information about complementary and alternative medicine (CAM), a loosely defined field that includes acupuncture, hypnotherapy, meditation and herbal treatments, and many other types of care. Some of these therapies have been proven effective by credible scientific research, but many have not. "Every physician needs to know more about these approaches," says James Gordon, a longtime member of the Georgetown faculty who is also chairman of the White House Commission on Complementary and Alternative Medicine Policy. "It's got to happen for students, residents" and the current generation of doctors, he says. "Our duty is to separate the wheat from the chaff," says Aviad Haramati, a Georgetown physiology professor who is principal investigator on the grant. The wheat includes such treatments as the use of the dietary supplements glucosamine and chondroitin sulfate for osteoarthritis, which scientific evidence has shown is effective. The chaff includes the use of acupuncture to help break a smoking habit, which has not proven effective. Haramati says medical students also must be made aware of the "downright dangers" of using CAM in some cases, noting that the herb St. John's wort, which is often used to treat mild depression, may reduce the effectiveness of a drug used to prevent the rejection of transplanted organs. The American Association of Medical Colleges (AAMC) reports that more than 90 of 125 U.S. medical schools included at least some CAM in its elective courses in 1998-1999; 75 of them incorporated CAM into required coursework that academic year. But these data may be deceiving: Offering even a single CAM lecture would allow school to report it was on the CAM bandwagon. Georgetown's commitment to revising its curriculum, which is expected to take five years, is far more ambitious. "Georgetown will be the first medical school in the country where all incoming medical students will have . . . an intensive introduction to the science of mind-body medicine," says Gordon. The National Center for Complementary and Alternative Medicine (NCCAM) plans to accelerate the pace at which alternative medicine is incorporated into medical, dental, nursing and other health care training. NCCAM has committed $15 million over the next five years to support 10 education grants, including the one Georgetown won in July. "What we're in the process of creating is one world medicine, integrating the best of the humanistic tradition in medicine with the precision of biomedicine," says Gordon, the founder and director of the Center for Mind-Body Medicine. Georgetown's goal, which school officials concede has met with some skepticism from faculty members, is to weave rigorous scientific data on unconventional therapies seamlessly throughout its four years of education. While Gordon has been lecturing on relaxation, biofeedback, nutrition, guided imagery and meditation in elective courses at Georgetown for two decades, he is now also teaching about hypnotherapy for reducing stress and meditation for lowering blood pressure in a required course on endocrinology. Similarly, biofeedback is being incorporated into a course on physiology. Gary Kaplan, another instructor helping to oversee the grant, has begun lecturing on acupuncture in the required course on gross anatomy and discussing acupuncture for pain relief in a neuroscience course. If the Georgetown faculty includes critics of integrating CAM, which has long inspired suspicion and even scorn from the medical establishment, they have not drawn much attention. Until the new curriculum is defined, individual course directors can decide whether to bring a CAM perspective into their classes, Haramati says, but they have shown a "unanimous willingness" to do so. Stephen Ray Mitchell, the senior academic officer at the medical school, acknowledges that a long history of producing good clinicians "puts pressure on Georgetown not to change anything." But he says physicians entering practice these days must be equipped to deal with patients who are using alternatives. Tom Taylor, a second-year Georgetown student, praises the inclusion of CAM into his courses. He says there could be "incredible benefits" to adding what he describes as "non-nuts-and-bolts medicine" to the curriculum. "For me, I'm an older student, and I've already lived out in the real world," says Taylor, who is 39. "I've taken advantage of some alternatives" -- acupuncture, chiropractic manipulation, massage therapy, echinacea and garlic. "Some have worked for me, some have not."
