to a strong doctor-patient relationship, in this era of
managed care and the seven-minute office visit. If
the public cannot turn to the conventional medical
establishment, turn to their own physicians or
other health care providers for reliable information
and open discussion about alternative medicine,
then to whom? The conventional medical estab-
lishment has an obligation to protect the public
from harm without limiting access to potentially
beneficial alternative treatment options.
Clearly the public’s desire for and utilization of
alternative medicine are increasing. In 1997 there
were 629 million visits to alternative medicine
practitioners, a 20 percent increase from seven
years earlier, and more visits than to U.S. primary
care physicians during the same year. In the
United States, more than $27 billion is spent
annually on alternative medicine. The public has
the freedom of choice to pursue alternative treat-
ments. However, without reliable, credible sources
of information, it is challenging for the individual
to make informed health care decisions. Discussing
one’s use of alternative medicine with one’s health
care provider is an opportunity to share values,
explanatory models, lifestyle, health beliefs, and
goals for care, all of which not only are clinically
relevant but also contribute to strengthening the
health care provider–patient relationship.
Many conventional practitioners, medical cen-
ters, health care systems, and universities are
beginning to recognize the public’s desire for infor-
mation about and increased access to alternative
medicine. In 1998, after finishing my training, I
was fortunate enough to have the opportunity to
pursue my dream of a more integrated health care
system and was hired to develop a program in
alternative medicine for the Saint Barnabas Health
Care System in New Jersey. After much considera-
tion, we chose to call the clinical center the Siegler
Center for Integrative Medicine, as opposed to
Alternative or Complementary Medicine. More
than just a matter of semantics, unlike alternative,
integrativeimplies the combination of conventional
medicine or biomedicine with certain validated
alternative treatments through an evidence-based
approach.
Although the center is involved in research and
education to a limited degree, the primary focus is
on providing integrative medicine. Patients can
undergo a conventional medical evaluation as well
as see an acupuncturist, nutritionist, massage ther-
apist, clinical herbalist, or mind-body practitioner
(licensed clinical social worker or Ph.D. psycholo-
gist). The more I practice medicine in this setting,
the more I find myself returning to the principles I
found to be most effective in maintaining my own
health and quality of life. Namely I focus on trying
to help people find their path. That path always
tends to have physical, mental, and spiritual com-
ponents.
Of course at times a patient enters my office
with tennis elbow and is quickly referred for a trial
of acupuncture. However, it is more common that
I will see someone with low back pain who not
only gets a referral for acupuncture, but also is sent
to the nutritionist because of obesity and
unhealthy eating habits, to the Wellness Center to
address deconditioning and a sedentary lifestyle,
and to the mind-body practitioner to learn medita-
tion or guided visualization to address poorly man-
aged stress. I ask patients to ask themselves, “What
gives my life meaning? What gives my life pur-
pose?” Without taking this “holistic” approach, it is
difficult to find true health and wellness. The
answer for most people is not solely contained in a
bottle, whether that bottle contains a medication or
an herb.
I find practicing in this fashion to give me the
same sense of fulfillment that I had when I was
teaching martial arts. I also found myself longing
for a more academic environment, where I could
focus on teaching not only patients, but also health
care providers. I found myself eager to get involved
in the research that will provide the evidence-
based framework for integrative medicine to grow
upon. Therefore, in July 2002 I accepted the posi-
tion of executive director for the Center for the
Study of Alternative and Complementary Medicine
(CSACM) at the University of Medicine and Den-
tistry of New Jersey. CSACM is just one example of
a university-based center committed to research
and education in the area of alternative medicine.
The more centers like the Siegler Center and
CSACM open and are successful, the more the con-
ventional medical community is able to accept and
even embrace new ideas about how to care forForeword xi