Side A

……..produce voltage and currents hundreds of times greater than what the brain produces within the mouth and there's a lot of biomechanical aspects to dentistry that effects a persons over all health, but unfortunately dentistry by itself doesn't do it either, and so we are at a dilemma because they are looking for us in many cases to solve the problems that they can't address. And the problem I see is that this is shedding a, a kind of a negative light on a lot of the alternative medicine field, just as the snake oil syndrome happened in the 1800's, snake oil in the orient is and snakes in general are used as a therapeutic treatments, yet you take something that's very very good and when its prostituted by people who misuse or abuse or try and use it out of it's perspective it then gets a very bad reputation that will stick with it forever, and that is the position that a lot of the alternative now face themselves with, because unfortunately alternative when they are integrated with many modalities of therapy, not just one by themselves, but when you look at the entire body as a unit, and try and treat everything in its own perspective, they are very effective when used with other things that support them then we have a great effect, unfortunately when they are yet just used out of their element, misused if you will, then they're not going to work and it will bring the whole field down. The sad reality is unfortunately, right now that's how a lot of practitioners are practicing alternatives because of the way the regulatory agencies have made them go under ground. Their living in an atmosphere of fear as are normal physician are living in fear because they do not want to reach out and look at other alternatives or look the entire field the whole philosophy of medicine I think has to change to accept all the alternatives. Medicine and doctors and practitioners, such as myself or such as yourselves, we don't really cure the body we don't fix anything all we do is help take burdens off the body, so the body can function on its own, because if we don't leave the body that is in a self-functioning, self-regulatory, self-maintain state, it will eventually die, even if we take a temporary burden off, if our 00000000 of therapies are such that hurt the bodies own ability to withstand the insults of treatment then that body will not survive, just temporarily. So I think what we need is unbiased research, unbiased education that is going to help put everything in perspective and then unbiased public information and practitioner information systems that will provide a very good integrative unified approach for this field, hopefully by doing that we won't ruin the field.

Thank you

Thank you very much. The last person to speak on this panel is Ricki Pollycobe.

Thank you very much.

It's a pleasure to be here, I come from basically about as linear western scientific discipline background, I think as one can find, growing up in the bay area. I'm a graduate of UCFS. The UCSF OB/GYN program, and I also have participated prior to medical school in immunology research with breast cancer at UC Berkeley's clinical research labs. My perspectives after 20 years of practicing medicine in the beautiful bay area, as an OB/GYN now just GYN menopause breast cancer, and I do a lot of alternative therapeutic integration in my private practice is that of a very mindful and appreciative physician for the passive change which, you know is kind of slow on a human scale, on the other hand it's kind of slow since I was a medical student. I happen to read a little bit about homeopathy as an undergraduate, and I was a little disappointed when I finished my studies at UCFS, the few times I'd asked professors questions about homeopathy it was like that's flaky, so you know it's a wonderful thing, I teach at UC, and I see an integration of educational opportunities for medical students, but as a clinical researcher and I'm principal investigator on a Tibetan medicine study that is collaborative with UCFS, I see how difficult it is to innovate first of all these studies are grossly under funded, we're excited they are funded at all, but of course to bring this kind of alternative care, which is a supplementary program for standard western care, it is very difficult to bring it to women of color and minorities and low income groups, because their access is limited for a variety of reasons, that are difficult for regular western care. I have prepared some written comment which I already gave your staff, so I won't go into detail regarding the research, but I have some suggestions in terms of funding and to be sure that we are more inclusive as we fund studies so that we do not just collect information as to how other alternative complementary modalities affect upper middle class white women. The access to delivery and reimbursement for complementary and alternative medical practices and interventions is something that I feel very passionate about and I have written some comments but I just wanted to say, that I think it needs to be spoken as much as I love my colleagues I also see the turf battle element and ah I think that's significant, I think we need to pay attention to that, I think that doctors need to be healed as well, and I think that is a large part of our problem with the MD sector in health care today, it's a pretty bruised and limping group of colleagues. And lastly I wanted to make some comments about the delivery of reliable and useful information, because I do think that it takes an enormous effort , first of all to read outside of your field, and second of all to read in a way that's meaningful that actually will influence your practice and I think to be a critical thinker and subscribe to journals from the alternative and complementary literature is very frustrating, because the kinds of studies that are done, twelve patients in a homeopathically trial, this is something that is not statistical significant data. The reason I am passionate about providing an integrative practice to my patients is for the same reason that Jennifer spoke about her experience personally and her friend, which is that and I also appreciate Dr. Hanson's comments that a its everything together that boys up, supports and nurtures the individual, and our systems is not geared to take the time, it is a money issue, but also it has to do with being open because your personally not threatened, I do feel optimistic that if we can provide information to the more standard centers groups of doctors they will be much more comfortable to be embracing alternative and complementary modalities of healing. The point made by the previous panel about some of the medical/legal aspects just in the, you know the brief time I have been here and in private practice for 20 years, there have been a number of physicians who have been disciplined for questionable practice, just for putting electrical stimuli through their patience body. Its very scary, so I want to encourage the committee to ah particularly focus on information dissemination, my wish list is internet access to journals with the complete articles, CD ROMS, audio tapes, fax networks, and also you know if we can distribute bombquats and Medicare bulletin updates we can distribute them to include thoughtful reviews, and I think that to have sort of expert panels that are integrated to themselves, let the struggles occur distant from us and come to us in a way that our government provides. Thank you

Thank you very much, thank you all.

Dean do you want to begin?

….but .I don't have any questions, thank you.

Effie…

Effie Poy Yew Chow:

…Really great points have been brought out here. For example well Evelyn, hi Evelyn. That You talk about real research or innovative research and that is something that the commission has been thinking about, for example do we have a proper research protocol etc, and I think as these points that I put out, I really ask for each of you to put in more details about what you mean about these comments, because that is really important, I think we need research, but we need a different type of research and just like ah, ah, Jennifer, Jennifer saying, that you sense that a lot of the talk has been trying to squeezing CM CAM into a medical model, that's been one of our passion too, take a look at it and not to just you know band-aid it, and sort of still keep it, the medical model, and these things just floating around, we're really looking at recreating something, a system that is based on health and wellness, creating an optimism, not pessimism, and not money oriented and human oriented and I'd like to get more, and if you can help us by writing more of these things in, as Jim said the staff is real busy and you are part of our staff. And then, ah I'm sorry, Richard has some ah, your comment about fighting or you know like a jealous of one another. Its fine to say hey I'm a great, you know something I'm a great practitioner too, but I don't belittle other people, and there needs to be a lot of education for these people because it is an existing from fear, I think, and we need to face that aspect, and that is something that we are dealing it by itself, in developing organizations that are to foster the interrelationships and integration of all of this. So in this panel a lot of really important factors have been brought out that I would love to get some more information. I know Poly -you know your aspect on research is innovative too, and so please I want more written information from you people. Thank you.

I think one of the points was brought out is that and I'm going to turn it just a little bit to look at it slightly differently is that we don't have enough information, in many ways we have too much and in the information age we are barraged by information, the issue is the quality of the information and whether it communicates accurately and appropriately to different audiences that need different and are looking for different types of information and also have different levels of understandings, and in many cases different values. Data is not information, so, whether its in a medical journal or whether its in a magazine and so the question of how to provide information that is both useful, addresses particular audiences and is valid and incorporates good critical stands or perspectives on it, is a major questions, in fact is one of the four tasks that the commission has specifically asked to make recommendations on, so if anyone has any suggestions as to how to go about doing that, I am familiar with kind of standard evidence based approaches where by they provide best clinical evidence and guidelines and things like that and that's important, and I think that forms a good basis for things but it not enough, it's doesn't necessarily provide what other types of groups need or provide it in a way the public can interpret it, and I think those are issues that we'd like to have some suggestions on how to go about doing.

Thank you, when your comments, and Ricky your comments made me think that one of the things that when it came time to address information issues we need to talk about a balance or benefits of either public presentation of the information and the way its being presented privately now, because there are a number of companies on the internet that are presenting some of the information, so I think we need to really sort of to expand and deepen that discussion so I appreciate your bringing that up.

Thank you all very much. We are going to now take a 15 minute break, and then after the break there will be about another hour and a quarter and then we will conclude.

15 min. BREAK - Background music

……patience, some of you I know have been here all day, and I appreciated having you and thank you for being willing to wait until the end of the day. So lets begin with Roy Upton.

Roy Upton -

First I want to say thank you to the commission for inviting me here today to present on behalf of the American Herbal Skill and the American Herbal Pharmacopoeia-

Bring the mick a little closer - OK

First off regarding reimbursement of CAM interventions, you have to differentiate between CAM practitioners as well as herbal medicines specifically which is our interest or my interest, minimally reimbursement programs should be established for all approved CAM practitioners, just as a starting basis line, which specific interventions are going to be reimbursed you're gonna have to go to those particular practitioners to determine which interventions have merit for reimbursements, most importantly the approval of reimbursement of non-approved CAM therapies that's going to be the topic of future investigations, you are not going to have any answers for non-approved CAM interventions right now. Most importantly or more prevalent is the reimbursement or discussions of reimbursement of dietary supplements and herbal medicines, whether it be as supplements or directly as medicines. In one case you are going to look at reimbursements for specific botanicals for a specific indications, this is actually for a relatively easy task, because there is already a lot of authoritative sources that identify the specific indications for the specific botanicals and the characterization for those botanicals for safe and effective medicine or individual indication, so that would be relatively easy. There have been a few works like this in the natural pathetic community as well as in other countries, in which they have approved of specific indications for herbs. Second though is a reimbursement of custom blended preparations, predominant by nature pathetic physicians, arrogated practitioners, and traditional Chinese practitioners who literally compound in their clinics and in some cases they are going to dispense directly rather than prescribing out, that is going to require a whole different set of rules, guidelines, with regards to which types of formulas, custom formulas, are going to be reimbursed. On the traditional systems of Innovative and Chinese medicine this is very well established, as far as what indications for which classical formulas. Most importantly, maybe is something you have to look at is Regulatory Approval Process for botanicals. As you know right now, there is no mechanism for which herbal medicine can be approved for the treatment of disease, yes we can use them for dietary supplement even among the traditional Chinese medical community, in the state of California they can only be dispensed as herbal supplement not as herbal medicine. That's a big difference, so its going to be very difficult to change the rules and regulations regarding approval of herbs, I don't think it is undoable, most of the world live with the system that is based on traditional medicines, which lies somewhere between dietary supplements and pharmaceutical approved medicines. Now we try to push this through during the Dietary Supplement Health & Education Act debates and there was significant amount of political support on both sides of the isle, democrats and republicans and Trade As organizations as well as consumer advocacy groups for the development of the traditional medicines category and again this does exist in most other countries. Lastly you have to look at the reimbursement of botanicals being contingent upon adherence of quality control guidelines for the manufacturers of those botanicals. You can't just expect to go and get any valerian product off the shelf and it be equivalent in safety and efficacy, as one that adheres to very specific quality control guidelines, again these guidelines have been established in other countries and in international, national pharmacies appears and authoritative compendia. On the education side, you ask specifically about education of CAM practitioners, well each of the representative herbal organizations mostly represented by Naturopaths, Acupuntioners, Western Herbalist, and Innovative practitioners, they are already in the process of developing educational standards, or already have well developed standards of education, so has to be determined by the specific CAM practice in of in itself. We also recommend that the commission convene a focus group of these different representatives organizations in order to determine what the core competencies require in western medical sciences should be regardless of the CAM affiliation. Lastly and of primary importance to us is access. That's access, the ability of the public as well as practitioners to obtain herbal medicines and/or to dispense herbal medicine. We really look at herbal medicine as being the medicine of the people, which has and always will be and always should be, we oppose, strongly oppose any efforts by any professional, organization or economic interest to claim exclusive right to either the dispensing or the obtaining of herbal medicines, we believe that its every right, from every mother, every father, every grandmother, always has been able to dispense these as their families health care and this is especially true for traditional cultures, most of whom we don't see represented here. We're happy to work with the commission on these things and appreciate the time of making these comments.

Thank you very much. James Underdown

James Underdown-

My name is James Underdown, I am the executive director for the center of the Inquiry West, in Los Angeles, I represent between 10 and 20 thousand readers of the Western Inquirer Newsletter in southern California and the over 100 thousand readers of Skeptical Inquirer and Free Inquiry Magazines. I noticed that a this has been rather one sided all day today, out of the forty-four speakers, as I am the 44th speaker today I am the only prescheduled one who is here advocating spending less money and less energy on the general idea of alternative medicine. Ah….and I was not like many of the people here invited to this, I just found it out through other means. Ah there is great concern among our readers, concerning two basic issues the first issue is that tens of millions of dollars being spent on the office of alternative medicine in based on the false belief that over 40% of all Americans are using alternative methods of treatment. Two studies that appeared in the Journal of American Medicine in which influenced the large increase in funding for alternative medicine were both done by Dr. David Eisenburg and financed by the Fetzer Institute. A group which sponsors and promotes mind bodied programs and various alternative methods. In my opinion, Fetzer sponsoring such a study is a kin to Firestone sponsoring a study on tire safety. Eisenburgs studies are flawed and are greatly over estimated the use of alternative medicine in this country, they have influenced the press, the public, and money spent on this commission and on the office spent on alternative medicine. Dr. Timothy Gorsky, professor of gynecology of the University of North Texas State, reported on errors in studies in 1999. I will not go into the details about the errors and miscalculations of the Eisenburg studies, but Gorsky did in his paper, and the paper is available and has been peer review. Dr. Pete Parlov, professor of psychology at University of California Davis reported similar areas in Eisenburgs similar errors in Eisenburgs study. A third report published in JAMA by Bidross and R. Rosenhag of Yale also confirmed Grosky's criticism. The point is that it is incorrect to assume that 30 to 40% of the people surveyed had used alternative methods to treat their illnesses. Dross and Rosenheg surveys show that the figure was 10% or fewer, spending tens of millions of dollars to study and promote alternative medicines is simply not warranted for such a small percentage of use. That is the first point. The second great concern of our thousands of readers is that many alternative treatments have been thoroughly discredited by scientifically conducted peer reviewed investigation. It is a huge waste of time and money to discuss the integration and training of practitioners of treatment methods proven to have no demonstrated efficacy. We are concerned that there is little government regulation a gigantic industry based on little more than anecdotal evidence and the placebo effect. On the day he appointed this commission, President Clinton said, speaking of alternative medicine " there is no doubt that these therapies should be held to the same standard to scientific rigor as more traditional health care interventions". The 60 thousand member federation of American societies for experimental biology agrees and requested in a letter that the federal funding be redirected to standard and more promising basic and clinical research rather than to repeating studies already done on implausible methods. There have been reams of research already published on a wide range of alternative treatment from therapeutic touch to homeopathy. Most findings seriously question the efficacy of treatment and the credibility of calamities. I urge this commission to consider setting up a dialogue with the kinds of doctors and scientists who have brought humanity away from the primitive and unscientific treatments so many alternative medicines are based on. Set up a dialogue with experts who can truly evaluate medical claims and sift the fantasy from the science. If a treatment works, let it stand up to the same scrutiny we demand of our surgeons, our drugs and our researchers, no claim of efficacy should get a free pass, simply because we fail to ask the right question. Lets test and regulate these claims for all our safety. Thank you very much.

Thank you. Marc Halpern

I want to thank you all for being here, and giving us all the opportunity to have a voice in the future policy that takes place in our country. I recognize the enormity of task that you have before you and I hope that the comments that I'll make, at least in someway will make to help your job a little easier. I'd like to begin by addressing some of the comments that you had requested in the written literature that you had provided. To begin with -what can be done to expand research environment so that practices and interventions that lie outside the sciences are, conventional science are adequately and appropriately addressed. Basically I believe that funding should be made available to support research conducted by experts in each individual field, these experts are capable of understanding how to design research so that it addresses the complete approach of the discipline and not its individual components. Several people have made this comment throughout the course of the day, that the tendency in research is to tear apart an individual science, take a look at a small piece of it outside the whole, I believe that only an expert in that given field will be able to understand the paradigm from which that therapy comes from. Set up a research design to address that particular paradigm. How can we more efficiently integrate CAM and conventional research communities? Integration in important, the conventional research community often possesses the more skilled researcher than greater funding, so they're responsible for most of the research that is published, however, conventional research is generally lack the understanding of the CAM disciplines beyond the allopathic approach of isolated out of treatment or of therapy, testing it to a particular measurable parameter. CAM research is likely to be more complex and its design is going to have to be based on a whole picture and not on an individual component. How can access the safe and effect CAM practices and interventions be improved? Access can be improved by requiring an insurance companies to cover CAM practices, safety can be improved by working with individual disciplines via their national and state associations to establish proper testing of practitioners, accreditation's of schools and standards of practice. I want to emphasize that it is very important for any agency that has created through the Federal Government to work with the individual associations that a regulate the profession, individual profession and not to impose a set of unified standards on a particular discipline. How can uniform standards of education, training licensing and certification be applied to all CAM practitioners? Again uniform standards should not be created, rather the Federal Government should work with the individual, national and state associations to establish guidelines for each profession. Each discipline when it meets a basic standard, such as the formation of national and state associations, school accreditation's councils and practice guidelines should then be supported by the federal government in its quest to establish an individual license for that profession. Uniformity does not take into consideration the individual histories complexities, and scopes of practice of different disciplines. Some of the practices right now lumped under CAM, have a wide a scope of practice as mainstream medicine does today, these are usually the indigenous medical systems, whether it's the native American traditions, the Innovative tradition, which I represent or the Acupuncture or the Chinese medical community. These scopes of practice are far more extensive than other scopes that may have a more limited application. What training should be required of all health care providers to assure safe and effective CAM practices? For this question if you mean already licensed health care practitioners then, those practitioners should receive an overview of the individual discipline in their education, including a review of the research into that discipline. However, licensed, currently licensed health care providers, medical doctors particularly should not be administrating or administering CAM practices and interventions, unless certified to do so the regulatory administrations, established by that discipline. And finally to answer the most useful answer for you, what role should the federal government have? I believe a federal web site could be created as an informational center on CAM practiced with brief descriptions of each practice. Input would be required from each additional discipline, national and state associations for each discipline must be intimately involved, links to each association could be provided and the web sites would be able to, would need to be approved, the web site entries would need to be approved by a panel of CAM providers representing each discipline and appointed individual approved profession. I just wanted to mention that I am here representing California Association of Ayurveda Medicine and the California College of Ayurveda Thank you very much.

Thank you. Carla Wilson please.

Carla Wilson - Thank you, I'd like to thank the commission for their presence today, and allowing us all to share some really important and deep thoughts on the practice of complementary and alternative therapies. I am in my 28th year of practice of traditional Chinese medicine and I also represent a professional organization acupuncture know as the National Organization on Acupunctural Medicine. On a day to day basis, I also serve as director for Quan-Yin Art Center, which is a 16 year old non-profit complementary health care clinic and its in a public health setting located in the center of San Francisco, this clinic started out in response to the AIDS epidemic 16 years ago, and as a result of having a specialty in chronic disease, has evolved into addressing many other conditions. The thing I'd like to address today, I believe is to perhaps review some of the works that is currently going on in addressing public health and some of the things that take place at Quan-Yin , and just to sort of shed a little bit of light on some of the numbers that accumulate over a year. At Quan-Yin Healing Art Center we see a lot of people who are low income, 80% of the people that we serve are low income, and often times its been thought that CAM therapies are primarily enjoy by people of upper or middle class, and I can tell you that in the practice of Chinese medicines there have been those of us who have been very committed to taking CAM therapies into setting where people traditionally would not have access to them. So some of the programs that currently serve peoples, and I'll give you a little bit of insight into that is on a weekly basis, we serve approximately 50 women and provide child care on sight, so that low income women can come and have treatment for HIV, substance abuse and Hepatitis, we do that on a shoe-string. We work with urban health study, which is research that goes on with HCV and intravenous drugs users in the city. We do that on a shoe-string charging $5.00 a person, so that people can come and have acupuncture and work with their addictions. We work with a number of welfare programs, so that people who are coming off of welfare can start to change their lives, address a number of issues that may have currently stood in the way from being able to stay in treatment programs, specifically substance abuse and also untreated medical issues. Help Welfare serves approx. 100 patients in a week. We have a drop-in detox clinic that happens at $5.00 a person that is used by more than 100 people a month, we have a senior citizens program and that is not covered by Medicare, which means that senior citizens are served at whatever cost they can come in and afford, we are addressing arthritis, chronic pain, and situations where seniors are looking for new ways to treat conditions that might other wise be addressed through medications. We also have a trans-gendered help clinic, the majority of trans-gendered patients in San Francisco are not covered by insurance and so its either at a very low cost and sometimes its for free. Cancer support clinic, many people who are seeking support services when they are working with cancer are very taxed financially, often times their insurance will not cover treatment, but nonetheless, we have a low cost clinic so that people can have support during their treatment time. We also have a stroke and brain injury clinic, again most of the time it's not covered by insurance coverage and so people pay a low fee for that, and we also have an after prison project, for people with HIV and HCV who are transitioning from prison to living in San Francisco. Approximately 600,000 people plus a year get treated for these of programs alone as well as another almost 2000 that are particularly covered by the San Francisco Department of Health AIDS office. So my goal is just o have that on record that lots and lots of poor people and people who are under insured are getting services, its done because it need to happen, and so my request of you as a commission would be to focus on a couple of things, one would be to add your support to the legislature that's currently unfolding around including coverage for patients with Medicare, that would be senior citizens and people who are disabled, as well as to perhaps works towards developing an advisory council that could work specifically to find to develop those in roads within public health so then complementary medicine can find its way and continue to address people who are most in need of health care. Thank you for your time today. I appreciate it.

Thank you very much. I think what we'll do is ah, have questions for this group of 4 so that we don't stretch our memories too much or spread or selves too thin. Go ahead Effie, would you like to begin?

No questions.

Yes I have a couple of questions.

I want to address the issue that James Underdown brought up, because I think,, as you pointed out, you are one of the few individuals that has called for less funding, in these areas everybody else has called for gee we need more money, need more money, need more money, and I think that is an important issue to address, the importance and the issue of the prevalence that is used to justify often spending more money is really one of definition and if you think, a little trick that we frequently play in the federal government, that if congress, the folks up on capital hill ask us well what are you spending on this and the first thing we want to know well do you want a big number or do you want a small number and we want to define that , and that is one of the unfair, I think disadvantages of this hoge poge of practices that are all thrown together is that you can get at bigger number or a small number, and so one of the things that I hope we can get some assistance is with more decisive defining of what we mean by CAM, I mean is it exercise which is available in lots of cardiac rehab programs, is it you know psychotherapy and behavioral medicine, which are a large part accepted in medicine and I think this is a problem because you can get a big number or a small number and if you are using it to leverage your particular interest, obviously that is something that requires a particular addressing. Go ahead.

Yes I think the definition is a pretty loose, we have seen a huge variety here today, so I don't envy your task, to narrow this down some way and start addressing some of these individuals. I am not here to say that all these medicines are bad, or all these treatments are bad, all I am saying is lets use the type of science and methodology that has gotten us from the enlightenment to here to wintle this down a little bit, because we could be spending billions of dollars testing every single one of these treatments.

I think it would be useful if we could come up with a non-negative definition. We currently have one that is not available in here and that does keep it kind of loose. The other issue that I think would be kind of useful in this is run through a theme of a number of methods is we need scientific evidence and I think that is absolutely correct, we do need scientific evidence and we do need to use standard methods for getting that accepted, quality methods to make sure we get valid information. The ah, one of the ah, issues, and I'd like again, your input. To what weight should we put on the issues of plausibility as opposed to lets say clinical evidence, some things are looked at clinically and looked at plausible and some things are plausible and are accepted without being looked at very much clinically and part of evidence based medicine is about trying to look at them clinically. You have a sense of what kind of what kind of balance you think should be seen in those areas.

I think some of , I think a lot of it is on the books already, I mean we know the power, and a lot of people I alternative medicine know the power of the placebo affect, how much you want to trade on that is one question. Much has been written about a lot of these medicines already, there are certain areas like homeopathy for instance that is - defies the laws of physics, the ideas that homeopathy are based on are not consistent with scientifically agreed upon principals, so I would put much less weight, much less research effort in something that on the surface of it has little chance of succeeding, now I'd like to add one more thing. I realize that some of these herbs and some of these medicines we get a lot of our scientific based medicines from herbs, roots and plants and things, they're may very well be plenty of things out there that we'll find has scientific value, in that case as far as I am concerned, it becomes a part of scientific medicine but lets test it and prove it and make sure it's not hurting people and find out the mechanism by which it working and not attribute it to something like the chi or meridians that nobody seems to be able to find.

OK

So plausibility in some areas where it is very impassible you would give it larger weight than in others in clinical areas, yeah. Is there, I'm trying to think of an example but is there been an area where something has been proven not to work, clearly proven not to work, not that it has been understudied, I'm not talking about that, that 's most things actually.

Well you know its tough, because a two things contaminate the whole process, the placebo effect partially contaminates the process and also the effect that people are using lots of these medicines in conjunction with scientific medicines. So you are not real sure what is actually causing the cure, and some things like in the case of our good friend Edgar Casey, diseases just took 6 months, or a year or 5 years to cure themselves and sometimes its just the body doing it by itself, so some of these things we need to look at, but if a common cold is going to go away in two in a half weeks anyway, and the herbs cure it in two and a half weeks, lets move on to the next medicine.

So I think then hopefully in our research discussions will address some of these issues. I did want to ask one other item on herbal medicine. Both on the product and the regulation. As I understand it, there are a number of practitioners that are certified to deliver herbal care within the context of particular medical system like the oriental medicine for example. But there is no herbal certification in this country for herbal therapy similar to what there is in England for example, is that correct.

Not for western herbalist at this time, for Chinese herbalist yes, through NCCA and through the state laws that govern the practice of traditional Chinese medicine , as a of Fall of 2001 the American Herbalist Guild in conjunction with another organization the American Botanical Medicine Academy will be having their first examination which will lead to bullet certification and botanical medicine that'll be open to medical doctors, pharmacist and herbalist….

So there is a process in development for western herbal certification and these kinds of things. I would be very interested in any recommendations you sat through all, many of the supplement types hearings and I'd be very interested to know how should herbals be treated that are used to treat diseases? I mean, do they fall into a drug category and should be made sure to hold those kind of standards, or do they know should we keep them as dietary supplements, is there some specific things that you think that the federal government could do to properly regulate these in your field?

We had an official proposal that was submitted to congress at the time of the Duchee hearings that was suggesting development of the traditional medicines category of therapeutic goods.

Where? I'm sorry where would that be developed?

In the United States. But it is already in development and in action in most other countries. Virtually every other country on the face of the earth regulates their herbal medicines as medicines, but differently than pharmaceuticals medications because the long history of use of those botanicals of those countries like the UK, Belgium, France, Germany, all have a traditional medicines category.

Was the recommendation be that this be placed within the FDA or something like that ?

At the time there was a small, a very small a voice contingency that wanted this to take of the a dietary supplement classification, but because of the just the share momentum of industry that they were all moving toward, this dietary supplement classification, it didn't really take on, but there were a number of people that organizations that supported this, including people like CSPI and Henry Waxman, and very, very strong opponents of the Dushee classification, they were very much in favor as well as Senator Hatch and all the proponents of Duchee were very much supportive of this traditional medicine category FDA also expressed strong support for traditional medicines category because that would give them the mechanism to call these things drugs and regulate them as drugs, which is the way they want to do them.

I for myself would be very interested to see these recommendations and to see some of the certification and guidelines that you all are coming up with for Western….

We can provide that, I would if I could Dr. Jonas just real quick to answer your question what hasn't been proven, and what we tend to have lost track of here, there is a tremendous amount in conventional medical practices has not been proven or have been proven to be ineffective and often times held to a higher standard and without acknowledging the fact that what is at 50 to 60 percent of medical interventions have not been proven safe and effective by the scientific method, so I really feel that is an important part of this discussion right here.

I'd like to make………

BEGINNING OF TAPE

XI - WCH - (Side B)

….industry that they were all moving toward this dietary supplement classification, it didn't really take but there were a number of people that organizations that support of this including people like CSPI and Henry Waxman, which were very, very strong opponents of the Duchee classification , they were very much in favor, as well Senator Hatch and all the proponents of Duchee were very much supportive of this traditional medicines category, FDA also expressed strong support for a traditional medicines category because that would give them the mechanism to call these things drugs and regulate them as drugs which is the way they want to do it.

I, just, I for myself, would be very interested to see those recommendations and also and see some of the certification guidelines that you all are coming up with for western medicine.

We can provide that, I would if I could Dr. Jonas real quick just also answer your question, you asked what hasn't been proven, and what we tend to have lost track of here is a tremendous amount in conventional medical practices that has not been proven or have been proven to be ineffective and often times held to a higher standard and without acknowledging the fact what is it 50 -60% of medical interventions have not been proven safe and effective by the scientific method, so I really feel that is an important part of this discussion right here.

I'd like to make just a couple of comments, one I'd one and second would win so that we would very much appreciate whatever guidelines your coming up with for certification of herbalist. So I think its very important and we can bring that into our thinking as well. Ah a couple of other things that I wanted to address, one is a, we very much welcome your input Mr. Underdown, and we will make sure in the future this is our first meeting and I think our publicity altogether was imperfect although we did I am glad 51 of you signed up come and speak here, so we will let you know and you now have the schedule of all meeting, and we welcome speakers who present a variety of points of view about complementary and alternative medicine.

Do I understand correctly that when you read in Washington that you will be hand picking certain people to come in and ……

That is right, and we already; we are expecting to invite Dr. Samson in particular, I believe that you work with him, to come and talk about some of his concerns, to come and talk about his concerns in terms of scientific, specifically for the research panel. So it'll either be for this research panel or for second research panel that we have in Washington, and to have him come and express his and yours and your organizations reservations about research. We're interested in looking at everybody concerns about how the research is being done, how it should best be done and we are also interested in for example if you are talking about homeopathy and you might mention this to Dr. Samson, we're interested in your evaluation of those, I think some 150 controlled studies that have been done, placebo controlled studies, and why you make the kind of statement that you do about think why they don't hold. The process is meant to be a fault full scientific process and we welcome anyone who wants to engage in that dialogue. The other point I wanted to make about the Eisenburg study, and I think Wayne covered some of these issues is that the study, although I understand some reasons for expecting that certain practices perhaps should not be included as alternative, the study interestingly cuts both ways, I think in some ways it's a gross underestimate of the use of some of the practices, and I think it speaks a little bit of what Carla Wilson is talking about. The study is basically about a phone survey of English speaking people, and that eliminates large numbers of people who, for whom what we call complementary or alternative is in fact primary care. People who come from other cultures, people who don't phones, people who are migrant workers in this country, and that was noted actually, Eisenburg did note that in this second iteration of the study, and I'm concerned about that not so much because I'm concerned about the statistics, I think that's ah. But I'm concerned about reaching that population and ah it's a population with which I've worked for 30 year now, and I'm very interested in any of your suggestions about ways and any of your suggestions, about ways to bring those people who are not ordinarily included in kind of the public discourse on science, to bring them into this process, to bring in their concerns about the kind of care they are getting, the kind of care they would like to get. Ah so I welcome suggestions now, and I also I welcome suggestions in writing and I also welcome all efforts and we were talking about this again at the break to bring those people into the discussions, and the commission has both in Washington and around the country. I just wonder if you wanted to respond, Effie as well. Carla did you want to say something.

I wanted to just respond to that a little bit in that often times its an excess ability issue. I mean there are large groups of people of other cultures who certainly would be taking part in CAM therapies if they knew that they were available. You know and perhaps the commission could look into how to go into the different cultures of this country and seek out that input, and perhaps that could be done in public health base settings from a public health perspective. I think that there is, would be an eagerness of response, and a whole new start of information that would come forward that could be helpful.

Yeah, Thank you. This is related to what you were saying in that looking at different cultures and how they relate to the medicine here and how they relate to the research and the research studies. I wanted to comment for the indigenous medical systems of different countries that I think would be very important for this commission, to review the research that has been done in those countries that has been done on those people from those countries as well. I know in the innovative field that, universities, large universities such as Bernards Hindi University, and Gushurat Ayurat University have enormous volumes of research that have been done over a 100 year period of time and much of it on the herbal side of Innovative medicine, but also on the broader picture related to Innovative medicine. So I'd like to encourage you to work in conjunction with these other organizations in other countries as you form your policies.

If you would be helpful to us in bringing that research to our attention that would be a great assistance.

I'd be very happy to work with you, on that project, I just returned from a visit to those universities and was reviewing a lot of the research.

Great. Thank you. Effie.

I just have a, hi, hello.hi

I just have a comment that this very discussion brings to mind the very heavy responsibility I think, we as members of the commission have, I think every one of us have this commitment to look at the pros and the cons and we appreciate the pros and cons presentation and ah, Mr. Underdown , your comments, your concerns about good research I think that has been really underscored by many of their people, but I think we're looking, we are looking for ways, and we certainly would appreciate your help as Jim said, and as though, and I just wanted apprise the people, because coming into town hall meetings, and not knowing where we are coming from sometimes well is this another group that's just kind of there you know. We really want to make some changes in the health care system, to really be more effective and more cost effective and more creative and innovative, whatever that means, but certainly more effective for the people than it is now.

Thank you very much we appreciate the input and look forward to continuing to work with you.

Perfecto Munoz is in the hall and we'd like for you to come up to the table now. Thank you.

We don't want you to be lonely, so why don't you come over here.

So this will be the final panel of the day. First will be Howard Moffet.

I am so glad I could be here today, can you hear me. Speaking of physics thank you, I suspect that the theory of relativity defied the laws of physics. Of course that was in the last century, and I think even though the law, even though, even though relatively, relativity, excuse me has not been entirely proven yet, I think, I hope we'll continue to accept it as a plausible theory. I would like to bring us to public health. What is the role or the place of CAM in public health? I got involved in public health I think in '92 I started going to meetings of the American public Health association and was involved in founding the alternative and complementary practices SPIG. Special interest group, at APHA, I think that was in '94 or '95 and in fact Dr. Persourno let me know about this meeting and asked me to come, I was glad that I could be here. I know its very unscientific but I'd like to share and anecdote. When I was getting interested in public health and looking at schools of public health, I had a conversation with a faculty member of E.C. Berkley who was on the admissions or had been on the admissions committee and he just asked me frankly what was does acupuncture have to do with public health. I would have referred him to Dr. Jonas, I said well NIH has an office of alternative medicine now perhaps Berkeley would like to prepare people to enter the policy field in this area, and he thought that was a great answer, but then he told me he was no longer on the admissions committees, so that didn't help. I was in fact rejected by Berkley, twice, fortunately Harvard took me and I had a great experience and I thank Berkeley everyday for that. So what is the place of CAM in public health, I think there is some areas that come out to the fore. I think of palliative care for cancer or AIDS patients, treatment of addictions, we continue to see a some interesting research in that area, and in the area of stroke rehabilitation which is the area that I am working in now. I think we always are seeing the references that current updated listings of which medical schools are offering a survey course in CAM, I'd like to see that list of schools of public health, what schools of public health are taking any interest in this. I would be very interested to know if any schools of public health are taking any interest in this. The only on that I am aware of is at Boston University and regrettably the late Alan Meyer was the man who had a lot of interest in this area. Alan passed away in May; he was also one of the program co-chairs of our group at APHA. So without Alan, it be you, I really don't know anybody at any school of public health interested in this area, unless we really do take the broadest perspective and we have people who are interested in the social aspects of disease and you know, the importance of social support structures and so forth, in helping people. I want to add that I feel that Chinese medicine has a good connection to public health and the correlative thinking which is so central to TCM philosophy and practice is to me an allergist to an epidemiological approach which is really looking at the strengths of association between events and not simple at mechanisms of causation. So I think to me there is a beautiful congruence between TCM thought and an epidemiologist. So my request to this commission what things to look at, is to look at the role of CAM in public health and particularly looking at the schools of public health. Thank you.

Thank you very much. Len Saputo.

I want to thank you for putting this whole event on, because I think there is a real pandemic of disease, the cost of disease has become unaffordable and the safety has become a big issue as well. And so it's a time when we should all be bonding together, finding ways to work together as a team. So the whole idea of a unified approach to health care is really appealing to me and I think that is what we should strive to do. I want to personally thank you for writing the book A Manifestive for New Medicine, because it was something that really opened my mind, and I could see why President Clinton selected you to do this particular job, because you uniquely suited to do it. The idea of prevention, wellness, nutrition, natural therapies, finding meaningful purpose in life is exactly what you talk about, its exactly what we need and we all need to try to find that. We're too busy trying to treat diseases instead of human beings and that's where the technologies gets us all screwed up, in what we are trying to do. We are trying to throw dollars and technology at health care problems that we should be solving using the primary care approaches that you write about. What I am asking you to do in this presentation is to find a way to fund the grass roots organizations that are coming up with novel ways to look at how to solve our health care problem, we need some models, we need funding for new models. I became inspired after 20 years of being an internist, that there had to be a better way to practice medicine, when my wife got sick and I didn't know how to solve it, and over the course of a couple years learning alternative approach was marvelous, and as it turns out, today she is a healthy person taking no medications or as at one time she was on large doses of steroids. I've developed a foundation called the Health Medicine Forum, it's a 501 C3 educational foundation, and our goal has been to define what health medicine is, and we've come up with 4 principals that would be integrative, holistic, person centered and preventive when possible. We've devised a clinical model where we bring different clinicians of different disciplines to the same table at the same time with our patients, so we'll bring acupuncturist and homeopaths and psychologist and MD's and shamans and whatever other kind of disciplines there is that our patient wants and we meet with those patients with the health guide prior to our meeting so we can decide who should be included, and we'll meet for a couple of hours. A couple of things happen. First we exchange a lot of information, and that usually happens about the first 45 minutes and incidentally we've done about 75 of these panels and no practitioner has yet been paid, nor yet requested it, nor has it been something that we thought is appropriate to do because we are doing a study. So during the first part of this we exchange a lot of information, but the most important thing that happens is the connection between the group, we're getting back to Texas village to raise a child that takes a community to heal an individual, we'll take all the disciplines that are possible and we'll bring them together for this period of time, and we've seen some transformations in our patients that are mind boggling. What we need is funding to be able to do a study, because all we can do is report our opinion of having done 75 of these panels, we think we got some outstanding results, a lot of people have been inspired, but we haven't got the proof that we that need, because that is what you require, that's what the whole scientific community requires, and yet at the same time, I'd like to point out that we talk about evidence based medicine, western based medicine is not so evidence based, I mean this has been studied by the office of technology assessment, by the British Medical Journal and by UCSF and they've all come up with a number that says 15% is what we are evidence based. And when they look at the literature that is published, they come up with the number of 1% of the articles and our peer reviewed literature are articles that are evidenced based articles, so what are we sitting in this arrogant position, demanding that all the other disciplines are going to be required to have a 100% or something that is a lot more rigorous that what we do. So what I would like to see you do is find ways to help organizations like ours that are self funded that have not been able to find any kind of support from the outside that amounts to much, so we find ourselves handcuffed, unable to do the studies that we'd like to do, so thank you hearing me.

Thank you very much. Burton Goldberg.

I ah have a magazine called Alternative Medicine with a 100, 000 readers, I have a web site alternativemedicine.com with 10,000 pages, 20,000 physicians, so you can find the yellow page and about 238,000 monthly visitors to the site and I am intoned with between 75 and 150 e-mails a day that we answer. So I am intoned with the public, I know what the public wants, and I have my finger on the pulse of what's going on alternative medicine and I've studied it now for 25 years. I am in favor of reducing the amount we spend for research, because the research is in the field, all you have to do is go out and talk to the doctors who are treating stroke victims with hyper-barrack oxygen, with intravenous feeding, with keylation therapy. Cancer, I know of a clinic in Tijuana where cancer is melting using Dendredic cells, using Cyderkines, I've seen it, I was there this week. So go to these clinics, talk to them, because alternative medicine is a casual phrase for 50 different therapies, 60 different therapies, and not one of them alone can be used. You have to detox, you have to use homeopathy, and herbs and dentistry is so important. My master, a Catholic priest by the name of Schidel, a German says that as much as 50% in the reverse of degenerate disease, particularly cancer is dental, and most physicians ignore it. The relationship between the meridian system and the nervous system, every tooth in our mouth and head is connected to an organ and system and is totally overwhelmed. As far as Wayne Jonas wanting time, he is right. Alternative medicine is not a wham bam thank you mame shot in the deiraire. Nurse practitioners have to be used, physicians assistance, naturopaths and the problem with naturopathic medicine is, you have the male school and then you have the 4 year school and they don't like each other and then the state of California you have constipation, they can't get the law through because the 4 year students don't want the 2 year students included. So this is something we must address. But we must change the paradigm of medicine, because conventional medicine if failing. The paradigm of research is totally corrupt with the double blind, one size shoe fits all, one size bra fits all, it doesn't work that way. You and I can be diagnosed with the identical cancer yet the causes are completely different. Mine can be 90% mental, I got a bad marriage, yours, toxins. And we have the research, they don't pay attention to the research. Israel, 1973, they define the relationship between female breast cancer and pesticides and herbicides. They do a 10 year study, but they reduce pesticides and herbicides and the feed of only two things, milk cows and cattle. At the end of 10 years '76 to'86 the female breast cancer rate plummets in Israel 34%, in women under 40 for all ages it drops 8%, while we in this country go up 8%. We know what causes cancer. I did a book on cancer, it has 33 categories of the causes of cancer. Conventional medicine pays no attention to it, so every one of these things have to be removed from the body, keylated, pulled out, massaged, fed, the immune system has to be fed. Many of our clinics are working on the level of micoplasm, this stuff is all available, all that you have to do is go into the field, most of us here can guide you to where to go, because just studying one herb or one system, which are all vital, mind, body, all vital, it is the amalgamation of these synergistically used and so this doctors system of having this panel is really what its about. We need generalist, and these generalist don't have to be doctors they have to understand, and they can become educated. The medical schools are teaching cursory alternative medicine, probably 60 to 70% are now giving courses because the students demand it, but the cursory, the acupuncture that's kind of accepted, but they are not telling the people that you don't have to have heart disease. Most people don't even understand what is the cause of heart disease and yet, the mainstream medicine head of the American Heart Association came up with a book, its infection, 85% is infection the herpes infection, the s?????virus, the commitea and so all these things are available, all's you have to go and oh and I want you to study food, our food supply is denuded. Farmers ??? that food doesn't have the richness, I want you to study the ecology because it's the poisons in our bodies that create this holocaust known as cancer. Almost everything is reversible using the system of alternative medicine. Chinese medicine has their system, Arvedict has their system but it is a system and not one thing alone and I thank you.

Thank you very much. Next is Karen Ehrlich.

Hello, I am a midwife, I would like to first say that I honor you on the panel for after this whole day being awake, alert and oriented. I barely am myself. As a midwife, I would first like to talk about the Flexner report that keeps getting tossed around here. Midwifery was one of the modes of care in our country that was quite suppressed because of the Flexner Report. The midwifery schools closed. And it was a part of a real effort on the part, a consorted effort written up in their medical journal in the part of them the western medical doctors trying to eliminate the midwife. We are still operating on that suppression, trying to reverse it, yet only about 6% of the births in this country are currently in the hands of midwives, and those countries that use midwives for 70 to 75% of their births, the infant and neonatal mortality rates are far, far lower than they are here. The United States has a shameful record tied for the last place among the industrialized countries of the world in neonatal mortality. I wrote a presentation I that I was going to give to you, it is on a pink page that I see that Effie Poy Yew Chow has in front of her right now, and I am not going to speak it, because as I sat here today listening to all of these talks, there were other things that came to my mind that I felt was important to say to you. We keep hearing people say that the practitioners that are involved in their health care systems must be involved in the regulation of their practitioners, of setting up the principals of practice and codes of ethics. Here in California the California Midwives are regulated by the Medical Board of California, there is not one midwife who sits on that board. We are completely regulated without representation, I don't think is necessarily true in most of the other states in the United States, but I can see this happening not only for midwives but for others who are considered alternative practitioners or complementary practitioners. It doesn't work very well for us to be regulated by people who have no training in our discipline, no understanding, true understanding in our discipline, no experience in our discipline and who mostly don't even want us to exist. In our case the medical board prosecuted midwives for 20 years and now they are indeed the fox watching the hen house as somebody else spoke earlier. So this is one thing that I think has to happen for any complementary medicine, is that the practitioners must be in charge. In talking about setting up principals of practice and codes of ethics the Midwives Alliance of North America close to 20 years ago really set about trying to set these processes up and these codes for ourselves and what we found was that the best way to do that was to first of all establish our values. Figure out what we value and our codes of ethics will follow from that, if we try to set up a code a ethics that does not meet our values, that does not work either. So this would be another place that I really would hope that complementary medicine can look at what we value, before we try to establish anything more artificial about, that are going to determine our scope of practice. In terms of midwifery itself, this is a mode that is generally really looking to try to be simple, when at all possible. Certainly those of us who work in out of hospital settings, have that opportunity to do it more, than those who either choose to or must work in hospitals in order to work in our profession. However, in trying to be simple what we have to realize, is that we imprison women in our culture today who give drugs to their babies' utero. We dare to keep our children off drugs and give them huge anti-drug training and yet pregnant women are offered medication like water. We are drugging our babies utero and we really don't know what that does to them. There is some evidence that things like opiates that are used in labor, can be a beginning of drug addiction for that child later in life. During this enormous increase in the amounts of drugs that have been used in labor we've had huge increases in ADD, ADHD and autism in our country, I believe partly because how we are dealing with labor. Our families are in trouble; children and parents are not well bonded in our culture. It could be partly because of how birth is being manhandled in conventional obstetrics. The mother is separated from her labor and the baby is then separated from her breast all too often. We are not clearly looking what is safe in this incredible primal event in life and I believe midwives are here to try to correct some of that. Thank you.

Thank you, Robert Leppo

Thank you very much, I also appreciate this panel, I should first say that I am neither an alternative health practitioner nor a physician nor a scientist nor journalist. I focus on selfishness and greed, I am a venture capitalist. Second anything the commission can do that increases the freedom of individuals to make their medical decisions I support. Third I prefer to see you do that, take actions that will increase the freedom of individuals to make their own medical decisions, I prefer to see you do that not by getting more government power, and or money to promote an alternative medical agenda, but rather to use your influence to reduce current government control and regulation and money in medicine. And then the final thing that I wanted to say is that based on the venture capital opportunities that I see and am investing in, in biotech, including alternative medicine, I agree that a revolution is coming and a large part is mediated by the Internet power to give the individual access to information. Again thank you very much.

Thank you. Questions of comments, Effie or Wayne.

I am interested in your comment, Robert about reducing the government control, are you talking about funding or are you talking about regulations or what, can elaborate on that?

In general I believe that when the government is involved in an activity the effectiveness of the people involved in that activity goes down because there are complications, they can't focus just on the research or just on whatever there also are so often political involvement's that they appropriately have to pay attention to. By contrast out in the private industry and the free market, one of the reasons that I find things can be more effective is because they can be more focused, they don't have that political agenda which is so often appropriately part of government, so that I think what I am mostly talking about.

Is competition part of the factor?

Yes, yes I think also that very often, and I know of some cases where a government agency or an effort that controlled in part by government you will tend to have an interest group built up as we have seen so often, that is then resistant to any new developments and I am not myself as I said a doctor, but I have seen evidence of this in medicine, different professions within the medical community that have government sponsorship to see that. So then my solution would be to by reducing the influencing of government across the board you can then open up that in a general sense. And since you bring it up I would give one example of where I thought this worked. In the 1986 tax bill where there were so many special interest, that were interested in maintaining their tax benefits, whether it was oil tax shelters or so and so forth, and they came in and influenced the senators that were involved in writing the legislation until it just caused gridlock and what happened in that case, there is a good book called the The Show Down At Gucci Gulsh, about this experience, was that finally all the senators came in and said lets just scrap all of the special interest and that worked, and I think the '86 tax bill was a good tax bill because there was a reduction all across the board in such government regulation as tax breaks for a number of industries.

A question to you reflects kind of my own interest in the fact that we don't have in CAM particularly, we don't have a lot of good business people involved in it, you know and so that we are all heart and no business, or few, and also, and therefore to progress there needs to be some management and business sense to it, and I think their need for government but as you say less, but if there are more influence on people like yourself on helping to develop the business sense of it, your venture capitalist.

Well as I said.

But if you could.

Well I am making investments in this area, both in biotech in general and alternative medicine, I see some interesting ideas, so that's part of why I see a revolution coming and I'd be happy to be available, I've left my card, I'd be happy helpful with you.

If you have some specific ideas, models or whatever, I'd be interested to receive from you. Thank you.

I guess I am going to ask a question. First of all let me say to Dr. Saputo, I really appreciated the four principals that you put out, I think that we need to understand complementary medicine in a positive light and understand what its underlying principals are. And how those principals are and how those principals might impact our current medial organizations and that may in fact result in the elimination of some of the types of practices that we put under the rubric of CAM, so there is a risk of that, I think is important. I had a question really for Mr. Goldberg, because I think represents sediment that actually we heard several times here, and that is that and I guess I want to get a clear message. Do you believe that double bind placebo control trials should not be done, I mean there is not circumstances in which they are necessary.

In holistic medicine there are moral and they're ineffective, because they don't work. The ??? doses for my me could 50 grams and for you could be 20. So it doesn't work, and so in double blind studies you are acquired to use one product and one product only but perhaps selenium would be 6 did the job. And one of the things that are very important is the ability to see early diagnoses with physics, this business of electro-durmo screening, the business dark field microscopy where you can see disease coming as much as 10 years down the line, with the competent physician, is no different than the stethoscope, and than you have thermo-imagine, because I don't know if you know it mammograms cause cancer, why do think they run out of the room, they're not running because they don't want to have they're photograph taken, they're running because it kills the cells. Ductal Carcinoma Citu is now up 238% from 1983, because of, 200% is because of annual mammograms or the thrust for annual mammograms. Thermo-imaging is much better, so early diagnoses plays an enormous role.

How would you suggest a huge collection of multiple practices with lots of different opinions from different doctors and different practitioners then be evaluated to determine what value they have.

Because they require….

Then how would you suggest they be evaluated?

Because it require different strokes for different folks. Lets take heart disease, lets take cancer, Lou Gerigh Disease, who in this community has treatments that work? I do, so we go out to Newport Beach, I do, we go out to Wichita Kansas, or we go wherever there are people, and I know these people, I eat live and sleep in the trenches everyday, and its there. But you do not know about it. It may be in Mexico, it may be in Germany, it may even be in Russia, and you go out and you look at it. Berkley Bidell is doing a thing like this and Berkeley is the one that started this whole thing and he ran away because the National Institute of Health had an attitude, " how dare you prove us wrong, we've been killing people all these year" so they tide your hands when they ran it.

So you suggest a field investigation approach, in other words you go out……

Major, major big time, and see the variations, because there is no cut and dry situations. I was in Mexico and I saw tumors melting, as a matter of fact they were going away too fast, most people of cancer die of toxemia they don't die of cancer.

May I follow up on that a little bit. I mean I assume that we will address this more in the research panels, so I don't want to belabor it too much, but I a number of field investigations actually myself, personally while I was at the NIH, and I saw tumor melt away, in one case it was attributed to one thing and in another it was attributed to something completely different, including thought therapy, with no medical intervention what so ever, and so I began to look into the literature a little bit to see what was reported where people attempt to collect data on these areas, and found out well, appeared to me that you could find almost any claim for almost any disease cured about 80% of the time, I call that the 80% role and I wrote a little article on that and it still left me in this dilemma of differentiating whether when the next person who walks through my door with cancer that was spread or that there was no conventional approach or that was not for some reason wanted or good, what would I do with that individual, should I send them over to the thought field practitioner or should I send them down to Mexico or should I suggest that they go over to Europe or should I suggest that they begin to take electro-magnetic waves to kill fungi, for example that was an underline cause. And I still found myself in a dilemma needing some data, that would tell me something more that everything works 80% of the time for everything, and I don't know how to solve this problem, and I think maybe perhaps this is one of the things for those that would like to do field investigations.

YOU know there are certain people that don't want to get well. The mind has to be approached, and so there is no set rule, and you are right, its confusing and that is why the holistic approach, the doctors treat the patients not the disease, because, as I said my cancer can be 90% mental and yours due to pesticides and herbicides and heavy metals and mercury and cadmium and lead. These succors are really pulling down on our society, that's why we have this holocaust called cancer, and we're poisoning ourselves, and that's why I suggest you pay attention to the ecology. It is major and you got everybody against you. You're gonna have to have steal you know what, the food supply is denuded the pesticides and herbicides on them, hormone in the animals and then estrogenic pesticides and herbicides that become estrogen dominant which with so many reason fiber-such diseases, endometriosis and all the cancer, we are a mess, we are chemical cocktails plus all kinds of pathogens that you can't believe. You've got to treat the individual, it is not easy, but you talk about stroke, there's doctors now with hyper-baric chambers who are feeding intravenously that have as much as 10 years of dragging a leg, the face distorted or unable to speak, many of the cells are dormant or sleeping, and they'll come alive with multiple therapies, I know its hard to believe, and there are many, many clinics, you just put out the word, and I strongly recommend you do that.

I think perhaps one of the, I still have not given up hope that it is possible to do, to investigate practices, complex multiple practices.

Its easy just look at the charts though, you can read the x-rays, you could see the charts, you could see the progress, you could see stage 4 and the guy survive, how does he survive, what did they do to survive, but each case is different.

So I couldn't use that for the next patient, perhaps one approach, Hi? Mentioned, is to bring in the epidemiological approach which really doesn't, is less concerned with cause and effect than it is with associations and looking at these kind of multiple types of outcomes and interventions, so I would encourage us to look toward some of the public health schools as helping to perhaps develop some of these observational types assessments.

Thank you, it's a great discussion, its so great to have you here.

Couple of really challenges that I would like to issue or request for help, you can look at it either way. One of the issues that we face and Karen Ehrlich your testimony brought this up, I Doris Hare and I did some work together 25 years ago looking at the literature on child birth. It was clear then and its clear now that midwifery gets better results than obstetrician/gynecologist in low risk deliveries, the literature seemed quite clear, the question was how to make the change in practice, how to make that on a social/political/economical level you talking, Robert Leppo about removing some of the rules, some of the regulations government regulations and that somehow some of these approaches will blossom, Burt Goldberg, you're talking looking at different therapies, doing field investigations and its obvious to you, its obvious to me and obvious to Berkeley, its hard to move government of private money in that direction, so I am asking you where there are different situations where things look like, they make sense, look like they make eminent sense, how do we change, what do we do to change the political process, the scientific process, the government process in those directions.

You have the bully pulpit, you now have something that we never had before and its vital. You must use the media that is paid for by the pharmaceutical industry. Whether its viagra that you are watching, that your nose will turn black and you hair will turn red and fall off all the side effects of their drugs, they will not report honestly on our work. The New York Times will not report honestly on alternative medicine you have the bully pulpit, and you gentlemen and ladies have authority to make a statement, let see if they'll publish it, so I think its really important, good opportunity……..

XII WHC 8-9-00

…….to come to these meetings.

Yeah, I'll do it on the web site if Steven sends me all the information, we'll do the editorial.

That'll be great. And, and other suggestions that any of you again come up with, where it is obvious, or painfully obvious that something should happen and especially with the data as pointing in that direction, how do we make that shift, how do we use what ever data there is to make that shift.

Yes.

In Washington state the insurance people finally realized that they were going to save money if they started having midwives and encouraging even out of hospitals and home births and free standing birth center home births. They actually wrote up leaflets that were given to every pregnant woman when she first entered care in whatever setting she began, where ever she got her pregnancy test, perhaps is where she was given this piece of paper and it said " you could have a home birth with a midwife". There is no compromise in safety, it will save all of us money, you will have personalized care, it's a single sheet of paper. I could imagine something like that being mandated or encouraged or pressured or bully woped ??? ……the out of hospital birth rate is rising in the state of Washington, with no compromise in outcomes. You could look into more of this in Seattle. I will be letting my colleagues in Seattle know to come to your meeting.

……Great, that'll be great. We'd really like to hear about that.

Yes. And I will ask that they bring those documents with them when they come so that you can see that, but if this could come with some kind of government pressure, some kind of bully pulpit saying this is crazy to be spending the kind of money we are spending for no improvement in anything, in fact if anything we are hurting things by having you hospitalized for your births, this is, people have to begin to hear it, it is not getting through to the public. It is a really slow process. People currently, they seem to think that the biggest fanciest hospitals and the sharpest needles is where they need to go. In Santa Cruz we have a new hospital absolutely gorgeous, it looks like a resort, and people say " I think I'm going to have my baby there!" And you start asking them why and its because it looks pretty. So they don't realize that this is fluff this is cosmetics, until we really get this information out, and its been really difficult to do.

I'd also just ask you and your colleagues, to think about how we can bring information about Mid-Wifery into the curricula, suffices to say that at Harvard Medical School I don't remember the word Mid-Wife having been breathed. How can we can bring that into the curricula for the various professional schools, I think that could be very helpful.

I cannot imagine any midwife in our country who would not be eager to come and speak at any of these training programs. I personally offered myself, and I know many many, many of my friends all over the country who would drop anything in order to do this.

I think that I am asking another question. I know that, I believe that, I understand that. I am asking another question. What strategies to create the invitation for you to come? You don't have to answer that now, but just to think about that and just when we meet again in Seattle with your colleagues, we'd love to have that kind of information.

Yes.

Well let me make two comments. One, many of my investments are involved in the Internet and as I mentioned the internet can be very useful in terms of improving the access of the individual to information and so I am happy to a off line or anywhere you want, you have my cards be of help to you with ideas or contacts about how the internet can be helpful to you. The second thing I would like to say is that I am more in inclined to go with more the carrot than the stick so maybe one possible thing you might do is as you are looking at various alternative therapies as you find some that, where you think the evidence is the best that there is a positive, a benefit, that you could use a bully pulpit to publicize that and to encourage people to try that and the counter that I have seen a lot in government is not just in government, but if people perceive that you are threatening them then you are going to get much more resistance, but if you are just talking about, here is a success, and the threat to other people now I may be naive here, but I think might be less that would be a though, but I am happy to be more helpful to you later.

Thank you. Lynn and then Burton again.

One of the problems we really face is that we are trying to solve a problem that we are not prepared to solve because the culture isn't ready for it. We can't go about changing the medical system in a really drastic way by going from a financially oriented system to one that service based until the culture sees it that way. And the culture isn't going to see it that way until the individual sees it that way. The individual isn't going to see it that way until he is taught that by his parents. And as long as we have these problems where the parents are both working. And kids are being taught be nannies and television sets, we are done. We are caught in a materialistic paradigm that is locking the door. So to point the finger at any particular aspect of the society, whether it be the medical piece or any other piece as long as we think in terms of me and my and mine we are dead in our tracks.

Thank you. Burton.

First of all the US population now using some form of alternative medicine according to the New England Medical Journal is 69%. That is vitamins and minerals and chiropractic and on and on and on. 69% and that is a pretty nice journal. The state of Washington demands that alternative medicine be paid for equally as conventional. Deverson ??? commissioner on insurance has gone up to the supreme court and is withheld . That will make the biggest difference. I got a hundred thousand dollar donation from a clinic in Mexico to do a foundation that will go state by state working that the insurance companies in every state, we may have to do signatures and petitions. Its going to be dirty work, but that is going to make a difference, because as I speak before an organization, people can't afford alternative medicine, they have to pay for it out of their pockets, so the insurance picture is big. And I just wanted to remind you all of what Niels Borr said, the physicist " Science advances funeral by funeral".

Ha ha ha…….. I suppose that is appropriate Although I always think of the last scene in Don Giovani goes to Hell. Six people come out and sing this wonderful joyous song together. So I feel we are advancing and hopefully moving in the right direction. Thank you all again and thank you everybody whose come, and all those who have left, and especially thank you to my fellow commissioners and to Effie who has put so much effort out here to make things happen, and to our staff. We look forward to seeing you again. Please get the word out, we want all of you, and all of your colleagues and friends to come and meet with us.

APPLAUSE!!

SINGING…..Oh no here comes the sun again, that means another day…………………