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In 1990, Hadassah became the first institution inIsraelto open a complementary clinic to answer the needs of the population for new health services. The clinic covers both traditional and complementary medicine, offering patient a unique way to approach their needs and providing optimal treatment by drawing from the best of both conventional and complementary medicine.

The clinic operates within the framework of theMedicalCenter, enabling close contact between staff and patients and access to laboratory and imaging facilities.

More than 1000 patients use the clinic services monthly - among them, a third are new patients - and enjoy benefits.

The clinic team includes qualified doctors and therapists in a wide variety of disciplines in both conventional and non-conventional medicine, specially trained in the integrative approach to both sickness and health promotion.

 

After complete medical evaluation and diagnosis, the patient is sent to any or several treatment programs that may include:

► Complementary modalities administered by physicians (MD/DO): Acupuncture; Homeopathy; Auriculotherapy; Mesotherapy; Osteopathy

►  Wide range of body and mind techniques and physical education: Reflexology; Shiatsu; Tui-na; Qi-gong; Bach flowers

► Nutritional consultations: promoting healthy eating habits; use of herbs; vitamins

 

Each patient is re-evaluated after a number of treatments. At that time, decisions are made about the continuation of the treatments and possible modifications.

The complementary clinic works in cooperation with several units in the hospital, for example at the unit of Oncology, assisting with alleviating the side effects of chemotherapy, pain reduction, stress control and improvement of quality of life and offering additional or alternate replacements for pain killers. Additional integrative connections with other departments in the hospital are planned in the future.

 

The importance of this integrative approaches presented in the following essay:

A HEALTHY ALTERNATIVE by Wendy Elliman

In what is probably the highest-tech ofIsrael's hi-tech medical centers, complementary medicine clinics are opening in department after department.

Alongside MRI scans, IVF, organ transplantation and chemotherapy, physicians at theHadassahUniversityMedicalCenterinJerusalemare providing acupuncture, biofeedback, osteopathy, homeopathy, auricular therapy, craniosacral therapy, relexology, naturopathy, tai-chi, aromatherapy, phytotherapy, Alexander and mesotherapy.

Oncology was the trail-blazer. "Most of our patients look for other options at some point during their long and difficult treatment," says Prof. Tamar Peretz, head of Hadassah's Sharett Institute of Oncology. "Some seek help in fighting their illness or in coping with therapy; others want alternatives to conventional treatment.  Not only are these patients entitled to every viable treatment option, but homeopathy and reflexology are known to markedly diminish side effects of chemotherapy in many patients."

With the approval of Hadassah's central administration, the oncologists asked Hadassah's Complementary Medicine Unit physicians to open a clinic within the Department some two years ago.

"Today, about half of all oncology patients come to our clinic for help in offsetting side-effects of treatment," says Dr. Martine Toledano, MD, head of Complementary Medicine at Hadassah.

"And they do it knowing they have the full support of their oncologists."

The invitation inside the hospital walls proffered by Oncology marked the end of 'stepchild' status for the Hadassah's Complementary Medicine Unit.  Created in 1989 to dispense 'all treatments and therapies not included under conventional medicine,' it has functioned ever since from the downtownStrausCenter.

To the surprise of most conventional physicians, however, it rapidly proved itself and was soon handling over a 1,000 patient-visits a month.  Not only this, it was achieving impressive results: banishing the migraines of a teenager, so frequent and severe she'd scarcely functioned; enabling a woman to conquer the fear and anxiety which continued to cripple her months after mastectomy; diminishing back pain in a young man which had debilitated him for a full two years after a road accident; enabling a successful pregnancy in an eager couple who'd failed to conceive.

"People with problems like these will understandably do or pay almost anything for hope or relief," says Toledano.  "If conventional medicine hasn't helped them, many will look to comprehensive medicine."

While comprehensive medicine is often effective, she says, patients frequently conceal non-conventional treatments from their physicians, which can result in dangerous or even disastrous drug interactions.  Or a vulnerable patient may fall into the hands of one of the many charlatans who taint the field.  By inviting comprehensive medicine inside Hadassah, these dangers disappear.

The past two years have seen not only the tangible success of complementary medicine inside Oncology, but also recognition from both the World Health Organization and the US National Institutes of Health that complementary medicine is a valid health-care approach. Hadassah's doors thus opened wider, and six months ago the Unit was given a green light to open and run clinics in every discipline for which there's reliable evidence-based research that complementary medicine is effective.

"That took us into Gynecology, Neurology, Orthopedics and the Pain Clinic," says Toledano.   "But the list of disciplines is growing all the time."

Hadassah's administration specified 'evidence-based' research because, while complementary medicine's adherents know beyond all doubt that it works, no one knows exactly how.

"Complementary medicine is based on a different physics, chemistry and biology, and on a different patient/therapist relationship from conventional medicine, that means the protocols used in conventional medical research are unsuitable - and makes it hard to convince the skeptics.

The complementary physicians make no claims to a universal panacea.  "What's important is recognizing your limits," says Toledano.  "Sometimes, conventional therapy is the best way. A choking child needs an Emergency Room, for example.  A cancer patient needs chemotherapy."

But for large numbers of patients, complementary medicine does hold the answer. "At a first consultation, we give a patient a full conventional medical examination," says Toledano.  "We take a medical history, and review the X-rays, CT-scans or biochemical test results - and possibly request additional tests.  But we also do a less conventional study  with the help of the chinese or homeopathic questionnaire.

In complementary medicine, treatment for the same complaint varies with the patient.   "If a woman comes to me with an intractable headache that responds neither to Voltaren nor to pain-blocks, I have several choices," says Toledano.  "If this patient sits and weeps and tells me she can no longer bear her headache because she's already burdened by problems at work or at home, I may recommend biofeedback.  If her headaches began after a car accident or strenuous exercise, I'll recommend a mechanical response, such as osteopathy.  If she has painful menstruation in addition to her aching head, I'll think in terms of a polysystemic problem, and start her on acupuncture."

Or a child is brought in with Attention Deficit Syndrome.  "His parents are at their wits end," says Toledano, "but they're unwilling to put him on ritalin, which not only makes him dopey but is also addictive.  As with the woman and her headache, I don't have an automatic answer.  I need to know first if the child has a history of traumatic birth - in which case I'd start with osteopathy or craniosacral therapy.  If he lacks self-confidence, biofeedback may help him most.  If the problem is rooted in his psychological makeup, homeopathy would be my first approach.  Or if he's suffering a nutritional imbalance, I'd recommend nutritional therapy."

With minimal research funding, the Unit has had little opportunity to examine its results, but it points to a proud record.  "We've reduced back pain so radically that patients no longer require surgery.  Several women with unexplained infertility have become pregnant following acupuncture in our Unit.  These are exciting results and we'd like to investigate them in full."

Meanwhile, withIsrael's medical establishment slowing coming to see complementary practitioners as medical colleagues who offer additional treatment options, complementary medicine at Hadassah is moving in a direction that Toledano has long hoped for.

"It's clear from both the demand for complementary medicine and its successes that some additional form of treatment is needed," she says.  "Complementary medicine techniques add therapeutic tools to the doctor's arsenal, often giving patients very great benefit at very low risk. Today, most doctors recognize there are many ways to help a patient, and understand that complementary medicine approaches are among those ways.

"My dream," she says, "is to see a new approach to patient care - known, perhaps, as integrative medicine - which embraces both conventional and non-conventional therapies.

 

Dr. Martine Toledano, Director

Hadassah Optimal:  1-800-399-388

Fax: 02-5823515

E-Mail: toledano@hadassah.org.il

Location: Hadassah Ein-KeremHospital Commercial Center

Telephone for Appointment: 1-800-399-388