Though the scientific basis for non-traditional therapies is unproven, consumers have found these alternatives to be increasingly attractive.

Eisenberg's studies revealed a marked increase in both dollars spent on and number of visits to non-traditional practitioners in the 1990s. The results, published in The Journal of the American Medical Association (JAMA) in 1998, showed that visits to non-traditional practitioners increased nearly 50% from 1990 to 1997. In both years, visits to non-traditional practitioners outnumbered visits to primary care medical doctors.

What MDs Need to Know

Even physicians who are skeptical of non-traditional therapies encounter patients who self-medicate with herbal treatments.

Eisenberg stressed the need for traditional medical doctors to be willing to talk with patients about the herbal or botanical substances they are taking. He cited, for example, evidence that the popular herbal supplement St. John's Wort seriously impaired the ability of Indinavir, an anti-viral drug used to treat AIDS, to function in the blood stream.

"One of the most important things about herbs is that they can interfere with medications people may be on," Rosenthal says.

Some physicians may refuse to treat patients if they discover the patient is using herbal medications in addition to traditional drugs. Patients may therefore hesitate to tell their doctors about such outside treatment.

" We need to make it easier and more comfortable for patients to talk to [physicians]," says Eisenberg. "The potential for drug-herb interaction is huge."

A New Medical Orthodoxy?

One of the featured speakers on the first morning of the conference was Ted J. Kaptchuk, an expert in traditional Chinese medicine. He sported a short salt-and-pepper beard, a black beret, and a short ponytail.

"In 1978, I was arrested for practicing medicine without a license," Kaptchuk says. "Now I'm an assistant professor at Harvard Medical School teaching the next generation of physicians."

Kaptchuk also studies the history of non-traditional medicine in the United States. There have always been conflicts between those who expose medical orthodoxy and proponents of other kinds of treatments. He spoke about the early 19th century when there was no medical licensing.

"The most important issue is power," he says. "The medical profession realizes that it is a cohabitant in the medical landscape."

According to David Reilly, a doctor at both the Glasgow Homeopathic Hospital and the Glasgow Royal Infirmary, the relationship of medical orthodoxy with non-traditional medicine typically goes through three stages.

First, there is hostility, then acceptance, and then "the third phase is to be crushed in a bear hug," Reilly says.

Some conference attendees expressed concern that association with traditional medicine would subsume, rather than integrate, non-traditional practices.

"The act of co-opting would alter the practice and individuality (of non-traditional medicine)," Eisenberg says. "That is part of our global health care challenge."