Alternative medicine is rapidly gaining acceptance in this country. Last year, the New England Journal of Medicine revealed that appproximately 30 percent of Americans are using some form of alternative therapy. The National Institutes of Health have awarded $4,000,000 to research the efficacy of non-orthodox therapies and are currently in the process of establishing regional research centers to explore these therapies in clinical settings. Homeopathic pharmaceutical sales are growing tremendously. The State of Washington developed a pioneering model health care plan, slated to go into effect in June of 1995. This plan includes naturopathic doctors as primary care physicians and all licensed health care professionals (naturopathic physicians, midwives, acupuncturists and massage therapists) in the State universal coverage. Blue Cross of Washington and Alaska is now offering a pilot supplemental plan called Alternapath which covers a test group homeopaths, naturopaths and acupuncturists. Their intention is to analyze the data after six months and offer the plan on a more widespread basis.

This is an exciting moment which many of us have long awaited. As unconventional medicine becomes more widely available, many mainstream individuals, as well as longtime proponents of natural medicine, are turning to alternative practitioners. It can be quite puzzling how to comfortably straddle the two worlds.

How Do I Choose An Alternative Practioner?

This is a complex question, depending largely on the nature of your

problems, the scope of practice of your alternative practitioner, and your confidence in alternative medicine. A naturopathic or homeopathic physician can diagnose and treat illness, sees patients suffering from most conditions, and can perform appropriate diagnostic laboratory tests. Other alternative practitioners, though skilled in their particular therapies, may have much a more limited scope of practice. If you are seeking an alternative practitioner who can substitute for your "regular doctor", you will probably want to choose a homeopathic, naturopathic, or chiropractic physician. (The scope of practice of chiropractors varies widely from state to state.In some states, chiropractors are limited to adjusting the spine; in other states their practices are much more of a family practice.)

It is important to have one person who really knows and understands you to assit you in coordinating your overall health care plan. This is very different from getting all of your advice from a health food store employee. If you are healthy and want to self treat with herbs and vitamins, such advice may be sufficient. But if you have significant health problems, go to a practitioner who is more knowledgeable and experienced. You may also want to choose other complementary alternative practitioners such as licensed massage therapists.

It is important that you choose a practitioner who is aligned with your values and goals. If you are an ardent advocate of macrobiotics, it stands to reason that you might first seek the care of a macrobiotic nutritional counselor acupuncturist. If you believe that megavitamin therapy is the way to go, a naturopathic or holistic medical doctor might best fit the bill. If you are looking to address the central core of your problem with one single medicine that treats all of you, physically, mentally and emotionally, then homeopathy might be your cup of tea. You may live in an area where your choices of alternative practitioners are few or you may be fortunate enough, as we are, to live in the Bay area or Seattle where there are hundreds of qualified alternative practitioners.

One word of advice: be sure that your practitioner is adequately trained and experienced in the natural therapies that he or she practices. A series of weekend courses or a correspondence course is not adequate. Naturopaths and chiropractors must have attended four year medical schools. Homeopathic physicians, in addition to their license as an M.D., D.O., N.D., or D.C., need to have completed extensive advanced training in homeopathy.

When Can I Seek Out Alternative Care

and When Do I Need to See My Regular Doctor?

An alternative physician can serve, if you choose, as your primary health care provider. He or she can, if necessary, refer you to a specialist. Even if you need hospitalization, your practitioner can generally continue your alternative treatment along with your orthodox care. Our experience is that people who continue over the years with homeopathic treatment generally need far fewer medical interventions and drugs and need hos-pitalization much less often.

If you are under the ongoing care of a specialist, such as a cardiologist or endocrinologist, and need to continue your medication indefinitely, you will need to continue both types of care. In other cases, such as people taking antidepressants or antihypertensives, it may be possible, as you get better, to discontinue the prescription drugs. This is best discussed with the prescribing physician. In such a case, conventional doctors may be happy to see that you are improving and no longer need to take medications.

Will My Orthodox and Alternative Doctors Communicate with Each Other?

This depends on many factors including the degree of acceptance of alternative medicine in your community, the degree of open mindedness of your conventional doctors, and the practice styles of the two physicians. It is always a pleasant surprise when we receive a call from a conventional doctor who wants to know what we did with his or her patient that worked so well.

The Best of Both Worlds

There are many times when orthodox and alternative medicine can work hand in hand beautifully. We have seen this to be true literally hundreds of times when we have prescribed a pre- and post surgery protocol consisting of nutritional supplements and homeopathy. Our patients, without exception, have healed quickly without complications of surgery and their doctors have often been amazed by their incredibly rapid recovery. We await the day when orthodox and natural medicine can be truly complementary and when natural medicine is no longer just an alternative.

Drs. Judyth Reichenberg-Ullman and Robert Ullman are naturopathic and homeopathic physicians and cofounders of the Northwest Center for Homeopathic Medicine in Edmonds, WA. They are coauthors of The Patient's Guide to Homeopathic Medicine and Beyond Ritalin: Homeopathic Treatment of ADD and Other Behavioral and Learning Problems. They can be reached at (206) 774-5599.