Go to the list: Top Docs ’08

It is no exaggeration to describe Portland as a mecca of alternative medicine. The online phone book Dexknows.com includes listings for 779 chiropractors, 309 acupuncturists and 307 naturopathic physicians in the metro area—and that’s not counting the throng of massage therapists, aromatherapists, chelation specialists, hypnotists, homeopaths and crystal healers whose remedies clamor for attention from every telephone pole and bulletin board. This curative profusion has turned Portland into a veritable marketplace of healing, one that attracts both practitioners and patients from across the nation. We are, in fact, the only city in North America that is home to separate accredited schools for conventional medicine (OHSU), acupuncture and traditional Chinese medicine (Oregon College of Oriental Medicine), chiropractic medicine (Western States Chiropractic College) and naturopathic medicine (National College of Natural Medicine).

Few Portlanders, however, rely on alternative remedies alone—after all, who treats a fractured wrist with herbs? Instead, they mix and match, seeking out alternative therapies when conventional treatment seems ineffective. According to a federal survey conducted in 2002, approximately 72 million adults, or one out of every three Americans, made use of some form of alternative care in the previous year. Another study estimated that the public spent between $36 billion and $47 billion on alternative care in 1997.

From the patient’s point of view, integrating conventional and alternative care sounds like a straightforward, practical idea. If your back hurts, after all, why not take anti-inflammatory drugs and enjoy a weekly Swedish massage? From a medical doctor’s point of view, however, combining therapeutic disciplines is like trying to check a patient’s heartbeat with a kitchen spatula. Conventional medicine and alternative medicine have radically different philosophies. They have fundamental disagreements about elementary concepts such as organs, energy and the very nature of health. They speak different languages. They have their own journals, their own schools, their own systems of accreditation.

They also have vastly different origins. Acupuncture, for example, is based on traditional Chinese practice stretching back at least 3,000 years. Naturopathic medicine was developed by a 19th-century Bavarian priest who reportedly cured himself of tuberculosis by plunging into the ice-cold Danube River. Chiropractic medicine got its start in 1895, when a magnetic healer in Davenport, Iowa, restored a patient’s hearing by manipulating his spine.

‘I was discouraged at how often we’d hit a brick wall in conventional treatment.’

Notwithstanding their significant differences, all these alternative therapies enjoyed a surge of popularity in the 1960s and ’70s, a time when just about every traditional pillar of American society, including the medical establishment, was called into question. As conventional medicine became more complicated, more technological and more impersonal, Americans became increasingly intrigued by the simplicity and intimacy of alternative forms of medicine, which offer patients “a participatory experience of empowerment, authenticity and enlarged self-identity when illness threatens their sense of intactness and connection to the world,” as Harvard researchers David Eisenberg and Ted Kaptchuk wrote in a 1998 article for the journal Annals of Internal Medicine.

President Richard Nixon’s visit to China in 1972 spurred interest in the traditional therapies of that nation, especially given that a New York Times reporter in his entourage had undergone an emergency appendectomy there a year earlier and received acupuncture for postoperative pain. (The Chinese doctors did, however, rely on a conventional anesthetic during the surgery itself).

Initially, the public embrace of alternative therapies generated a predictable backlash from the medical establishment, as physicians harrumphed—loudly—that these fields represented a doubtful brew of superstition and charlatanry. “In the interest of fairness, you might also solicit testimonials for bee-venom therapy, fad diets and trips to Lourdes,” wrote Dr Lonnie B. Hanauer, chairman of the Medical & Scientific Committee of the New Jersey chapter of the Arthritis Foundation, in a 1974 New York Times article denouncing the “quackery” of acupuncture.
Ironically, though, the explosive growth of alternative medicine has produced a quiet but dramatic structural shift in conventional medicine. MDs who were once taught to scorn alternative therapies as little more than faith-healing are taking a second look. In some cases, this is because of personal experience; in some cases, because they have been persuaded by scientific literature; and in other cases, because they are simply fed up with what they perceive as the inadequacies of the tradition in which they trained.