Disease — is it just a state of mind and bad energy?

The bigger story’s been missed. No one has put the pieces together. Two medical news stories this month may have appeared to be completely unrelated, but they had everything to do with each other. What they forewarn may be the most important message of all for the future of our healthcare.

New clinical guideline from the American Academy of Pediatrics

This month, the American Academy of Pediatrics issued a new Guidance for the Clinician in Rendering Pediatric Care on using alternative modalities. This professional society supported pediatricians complementing their medical practices and the advice they give with alternative modalities (called CAM, holistic or integrative), incorrectly claiming that CAM use is increasing and more than a third of adults have used alternative modalities.

CAM was described as caring for the whole patient and considering their biological, psychological, family and social needs — all of which has been part of medical assessments and nursing care plans as long as I can remember. The real “distinction between CAM and mainstream medicine,” said the AAP guideline, is that mainstream medicine includes practices that have undergone rigorous research. It reported that many alternative modalities have proven effective, lessening “the distinction between CAM and mainstream medicine,” and that clinicians have an ethical responsibility to know about evidence-based CAM, and be open and respectful of CAM use.

This is an example of a term no longer meaning what we think it does: ‘evidence-based’ no longer means sound and scientific evidence.

Readers who weren’t reading the AAP guideline closely might have come away believing that CAM had been soundly shown to be effective in clinical research. “More than 1400 randomized clinical trials and 47 systematic reviews of pediatric CAM [have been identified]. Formal evaluation has suggested that the quality of RCTs of CAM is as good as that of RCTs of conventional medicine,” it said — neglecting to report that the findings of those reviews have been notably negative.

The AAP guidance, published in its journal Pediatrics, presented the Kemper Model of Holistic Care and uncritically reviewed the efficacy and popularity of everything from biofield modalities “intended to affect energy fields,” to acupuncture, therapeutic touch (“healing is promoted when the body’s energies are in balance”), reiki, spiritual healing, healing massage, supplements, functional foods, magnets, and homeopathy (used by an estimated 3,000 clinicians in the U.S.) for babies and children.

Medscape offered an accompanying continuing medical education course, giving doctors and nurses credit for answering (incorrectly) just two questions — the most popular CAM used in children and how doctors should address the use of CAM in children.

How did we go from treatments that would once have been deemed patent medicines and been treated to careful scientific analyses of effectiveness and safety in medical literature — to these same practices being advocated by a professional medical society using innuendos and ad populum?

This isn’t a trivial concern, nor is it just about what is traditionally considered alternative modalities. We’ve increasingly been seeing unsound medical information being unquestionably accepted by healthcare professionals, and published in peer-reviewed journals, that neglects basic principles of research, fact checking, or statistics — surrounding everything from weight management, preventive health, lifestyle and anti-aging medicine, misuse of risk factors and epidemiology, and food as medicine dietary ideologies. What explains the growing departure of science and the scientific process from medicine? As major academic medical and nursing schools across the country adopt core CAM curriculums, are medical professionals who are trained to believe in alternative modalities losing the ability to recognize sound scientific research and evidence-based medicine?

In trying to better understand what is happening, this AAP guideline proved to be an invaluable resource.

A case study of medical curriculums

The lead author and founder of the Holistic and Integrative Medicine section at the American Academy of Pediatrics is Dr. Kathi J. Kemper, M.D., MPH, a professor of Pediatrics, Social Sciences and Health Policy at Wake Forest University School of Medicine in Winston-Salem, North Carolina. She also authored that recent continuing medical education course offered by Medscape on using CAM for headaches in young people. As the Caryl J. Guth Chair for Holistic and Integrative Medicine, she founded the Council on Bioenergetic Healing, the Council on Mind-Body Medicine, the Committee for Holistic and Integrative Medical Education, and the Herb and Dietary Supplement Task Force at Wake Forest.

Dr. Kemper was finalist for the Bravewell Leadership Award in Integrative Medicine in 2003 and 2005, and has been a NCCAM grant recipient since 2000 and is currently researching therapeutic touch. Since 1999, the National Center for Complementary and Alternative Medicine (NCCAM) has spent $983.135 million supporting alternative modalities – a 60-fold increase in tax-payer funding just since 1992. As we’ve seen, schools have also found NCCAM’s educational grants for incorporating CAM into their curriculums irresistible.

Dr. Kemper is the Director of the Program for Complementary and Integrative Medicine at Wake Forest University School of Medicine. This program coordinates and integrates CAM throughout the medical school curriculum and hospital departments. It is also part of the Consortium for Academic Health Centers for Integrative Medicine, funded by the Bravewell Collaborative. We’ve looked previously at the CAM curriculum being taught in medical schools per the Consortium’s core curriculum (and what passes for a final exam).

Wake Forest’s clinical services include employee wellness, therapeutic touch (as distinguished from human touch), hypnosis and guided imagery, acupuncture, reiki, massage, mindfulness; and the Pediatric Second Opinion Clinic, under Dr. Kemper’s direction, which offers supplements, nutrition and lifestyle advice, guided imagery and therapeutic touch for children.

In an interview in the NCCAM newsletter, Focus on CAM, she encouraged doctors to research CAM — not by going to original randomized controlled clinical trials and peer-reviewed journals — but said:

Read, ask patients, and ask colleagues about these therapies. Go to lunch with a chiropractor, acupuncturist, or massage therapist to find out more about what they do. Ask patients who go online for health information to bring in what they find. Be willing to ask others who know more about a therapy. Join the American Academy of Pediatrics' Provisional Section on Complementary, Holistic and Integrative Medicine. There are also other, similar groups elsewhere in the world… and an increasing number of medical schools and academic health centers in the Consortium of Academic Health Centers for Integrative Medicine.

For a better understanding of what medical students — our future doctors — are being taught, Dr. Kemper’s course material, “Mental Health Naturally,” at Wake Forest’s Program for Holistic & Integrative Medicine provides some helpful insights. The program’s stated mission is to promote understanding of ‘evidence-based’ mind-body therapies. The online course draft has grown since July and includes chapters on homeopathy and Bach flower remedies, human growth hormone (which might “prevent or treat memory problems and improve a sense of vitality”), environmental toxins, and acupuncture (“it does indeed work for a number of conditions”).

Dr. Kemper’s nutrition lessons, alone, could keep students busy for months researching the scientific literature. Among the prolific unsound food scares are: the dangers of salt, sweets, ‘processed’ foods, fast food, saturated fats, preservatives and nonorganic foods. Misinformation abounds: the need to drink lots of water because even mild dehydration leads to impaired cognitive function and school performance; antioxidants are vital for improving memory; HCFS damages the brain; animal and saturated fats should be avoided and aren’t needed at any level in the diet; and sugar and sweetened drinks cause ADHD, diabetes, kidney stones, obesity, “fatigue”, sugar ‘highs’, weak bones, Alzheimer’s disease and depression.

Chapter 26 on magnets and electricity available for public view is especially relevant to today’s discussion, as it is exemplifies the energy medicine being taught in many medical schools and academic hospitals. She writes:

The brain generates an electromagnetic field (EMF) that can be measured with an EEG, and its function can be affected by other EMFs. In fact, a great deal of the concern about the safety of high frequency power lines and the use of mobile telephones is related to the biological effects of the EMFs they generate. Furthermore, some people are much more sensitive to EMF and SMF than others; subtle fields that have little effect on most people can dramatically impact a few…

Pulsed EMFs are catching on as treatments to decrease inflammation and pain, promote wound healing, and turn genes off and on. Over the past 25 years, there has been an explosion in the use of EMFs and static magnetic fields to treat diverse diseases. Magnetic mattresses are available for low back pain and to promote sleep; magnetic belts and pads are sold to help with back, abdominal or pelvic pain. There are necklaces, bracelets, and wraps for the neck, head, shoulders, knees and ankles. Shoe inserts are available to help with painful feet in diabetics and back pain in people whose jobs involve a lot of walking...

A few studies have addressed the effects of EMF on other problems affecting the brain and nerves such as multiple sclerosis, spasticity, and migraine headaches…

Dr. Kemper goes on to teach that pulsed magnetic fields have “proven useful in promoting sleep in controlled studies” and that static magnetic fields (magnets in mattresses) also appear to work. The rest of the chapter discusses “bioelectromagnetic healing” and “electromagnetic medicine.” [Electromagnetic fields were covered here.] She says that thanks to pioneering work in holistic medicine, electromagnetic stimulation has benefited thousands of patients with depression, anxiety, alcoholism and other addictions, ADHD and sleep problems.

She recommends the book by Thomas Valone, Bioelectromagnetic Healing: A Rationale for its Use, published by the Integrity Research Institute. This is the book widely referred to as providing the science of energy medicine.

When beliefs in energy modalities are being taught to medical and nursing students as being evidence-based, valid or scientifically plausible, perhaps we shouldn’t be surprised that healthcare professionals may not recognize unsound modalities. Healthcare professionals were once encouraged to help educate and protect patients and families from fraudulent, unproven and potentially harmful remedies. Now, even when the most extreme, costly and dangerous alternative modalities make the news, as they have recently, sadly, most healthcare professionals and scientists have remained silent.

Bioelectromagnetic healing

Thomas Valone, Ph.D., is a physicist and engineer, with an impressive bio and membership in the most prestigious science and engineering organizations, including the American Association for the Advancement of Science. He is also the President of the Integrity Research Institute. Its Bioenergetics program promotes bioelectromagnetic healing, as well as his electromagnetic machine, the Premier Junior, which is said to energize the body using a wand to receive electrons which preliminary studies show will fight free radicals. “Many people use it everyday to increase their resistance and relieve pain.” IRI also endorses Valone’s white paper on electromagnetic fields in chronic fatigue syndrome, which claims that free radicals damage the immune system, deplete cellular energy, and lead to shortened lifespans.

Valone’s presentation at the Whole Person Healing Conference and Tesla Energy Science Conference, also published at Integrity Research Institute, explained how bioelectromagnetic healing ‘works.’ High voltage Tesla coils “deliver broadband, wide spectrum, nonthermal photons and electrons deep into biological tissue,” Valone wrote:

Electromedicine or electromagnetic healing are the terms applied to such developments in the ELF, RF, IR, visible or UV band…Tesla PEMF devices may represent the ideal, noninvasive therapy of the future, accompanied by a surprising lack of harmful side effects. A biophysical rationale for the benefits of BEM healing a wide variety of illnesses including cancer, proposes a correlation between a bioelectromagnetically restored transmembrane potential, and the electron transport across cell membranes by electroporation, with normal cell metabolism and immune system enhancement. The century-long historical record of these devices is also traced, revealing questionable behavior from the medical and public health institutions toward such remarkable innovations..

Dr. Gustave Kolischer announced: “Tesla’s high-frequency electrical currents are bringing about highly beneficial results in dealing with cancer, surpassing anything that could be accomplished with ordinary surgery.”

The free radical theory not only proliferates in alternative supplement and nutritional literature, but also in energy medicine. Valone said that aging and most diseases, including cancers, relate to free radicals. Manipulating the body’s energy fields using light, vibrational, electrical and magnetic energies is believed to have important antioxidant and detoxifying effects.

Energy medicine has a long history going back as far as 1890, he said, when electricity and vibrations were used in female patients who were routinely diagnosed with ‘hysteria.’ Nikola Tesla’s high voltage coil devices were the earliest energy machines, followed by the work of other scientists developing various energy devices claiming to treat cancers and restore the immune system to normal. These include George Lakhovsky’s radio frequency oscillator; Royal Raymond Rife’s high voltage gas tube device; Antoine Priore’s electromagnetic machine; and California physicist at Oakland University, Dr. Abraham Liboff’s device using alternating magnetic fields and electricity which he said would treat cancer in 100 days.

There are many bioelectromagnetic devices offering miraculous healing benefits and being marketed around the world today as part of the growing field of energy medicine. Examples, he said, include: the Tesla Coil, Lakhovsky MWO, the Rife Frequency Instrument, the Natural Energy Institute’s Electronic Wind Faser, the Azure Therapy Device, the Vibration Integration Biophotonic Energizing (VIBE) device (VIBE machine), the Tesla Photon Machine (NovaLite 3000), the Pappas Pulsed Magnetic Induction Device, and the Light Beam Generator.

These machines are primarily being sold to practitioners, mostly via the internet, who then offer treatments at holistic healing and wellness clinics. The Tesla Star was even sold on Amazon. The VIBE machine has been sold in more than 150 centers across the country and in at least two dozen countries, at a cost of $17,800 each, with a 10-minute treatment subsequently costing patients about $30.

The Tesla Photon Machine

The Tesla Photon Machine is endorsed by the Institute for Spiritual Development in Washington, DC, to the San Francisco Telsa Society. “The key to understanding health, healing and wholeness, is to recognize the age old truth that everything is vibrating,” says the ISD website.

The NovaLite’s Tesla Photon Machine is marketed for the “more scientifically minded.” The ISD quotes Valone abundantly in explaining what “raising cells vibrations mean biologically and scientifically.” These devices are said to “induce a flood of negatively charged electrons that penetrate the clothing and skin, terminating free radicals… inducing microamperes of intercellular current… increase ATP production levels in the cells… feed the healthful respiration portion of the Krebs cycle… optimize the Na-K pump in the cells’ membranes… increase the transmembrane potential of the cells … and recharge the biophoton energy vital for DNA-cellular activation.”

The healing properties of electromagnetic, vibrational energy devices are promoted around the world, using similar science-sounding gibberish and total bunk.

The VIBE Machine

The Australian distributor of the VIBE machine promises it “increases your inner connectivity to your DNA, giving it what it needs to balance itself.” This scientific breakthrough is claimed to help the body “reach its optimum vibrational energy level” and return the “cellular frequency amplitude back to its original healthy state.”

Its website quotes VIBE product literature, claims that our bodies are imbalanced by modern life with “toxic substances we eat, pollutions we breath, exposures to negative energetic environments, and how we process information in our thinking and feeling.” The VIBE machine not only detoxes the body, it says, it results in “amplification of your intent or thoughts that you hold while the machine is on.”

The VIBE machine is made by VIBE Technologies in an unassuming shop in Greeley, Colorado. It was invented and patented by Gene Koonce, a former electronics repairman. The company’s website [as accessed 12/18/208] describes the invention — now called the QuantumPulse — as based on proven technologies and pioneering scientific theories. It works on several different levels by using electromagnetic fields, the website says. “In this field, a high voltage is added along with ozone. The charge is placed at a negative voltage which is being transmitted to an antenna designed to twist the magnetic field. It is then routed through noble gases.” It all sounds quite scientific:

The QuantumPulse uses a multi-wave oscillator and spectrum tubes containing noble and other gases to create frequencies that fall between the infrared and ultraviolet spectrum range. It also uses a coil to create high voltage and a subtle electromagnetic field. This combination produces biophotonic light. The electromagnetic field is used as a carrier to transmit the frequencies in a radius of approximately 6-8 feet around the machine. The new tuning capacitor, that is patent-pending, sits on top of the machine and produces alpha waves. The QuantumPulse produces a 90° phase shift between electrical and electromagnetic fields. The base of the machine is constructed of materials which block electrical fields, but allow electromagnetic fields to flow.

Quantum mechanics is regarded by virtually every professional physicist as the most fundamental framework we have for understanding and describing nature, for the very practical reason that it works; it is “in the nature of things”. It is, in fact, an entity related to both energy and momentum of elementary particles and of photons.

According to the website, the VIBE machine can do whatever the customer wants it to do because it all depends on their state of mind and intent (defined as their conscious plan). “Therefore, whatever…your conscious plan is at the time will be what you ultimately experience. It could range from inner peace and profound enlightenment to merely a non-destructive energy. It’s for you to decide.”

Testimonials from users now make most health claims that convince people to seek these treatments, such as those on the Australian site:

I cannot speak highly enough of its ability to restore good health. For years I'd suffered from plantar fasciitis…[after] my very first VIBE treatment..there was no pain! It had completely disappeared…My ankles and other joints had become flexible all of a sudden, back pain had disappeared and for once, I felt like I could breathe with ease. I'd been plagued for years with shortness of breath, made worse by anxiety attacks. The attacks - brought on as a result of shyness - lessened a great deal and I began to feel far more comfortable in social situations. My thoughts seemed to become clearer and more logical, left/right co-ordination improved, senses of smell, taste and hearing improved and muscles lost their aches and tension. I continue to use the VIBE Machine for energy top-ups. I wind up feeling completely relaxed, with all minor aches and stresses eliminated like magic...

I could feel the energies moving through me in waves. I felt extremely energised with renewed ZEST for LIFE and that alone is worth a visit!"

I had a lump in my breast I had been addressing with various forms of healing for years with no result. After three VIBE sessions it is gone forever.

VIBE patient testimonials recently published at a chiropractic site are also typical of the health claims that consumers have been hearing for years. This testimony claims VIBE cured nerve pain described as multiple sclerosis, detoxed and healed her:

I was no longer sick after my VIBE treatments. I felt lighter and my energy felt cleaner. The quality of my sleep improved, as the ringing in my ears lessened. The migraine headaches disappeared… the improvement in my overall wellness and level of energy changed not only the way I felt on a physical level, but greatly enhanced my relationships, decision-making process, ability to manage stress, and level of confidence.

If these sound exactly like the testimonials in that nocebo-placebo experiment done on underprivileged minority teens incarcerated in a residential school, they are. Those youngsters had been told that they had been exposed to poisons in meat and dairy products and that was why they had aggressive and deviant behavior problems, and that invisible poisons in modern ‘processed foods’, sugars and fats had made them sick, fat, sluggish and dumb and would give them cancer, heart disease and dementia. When given an organic vegan diet, along with 3 quarts of filtered water a day, that they were told would purity their body of poisons and make them healthy, give them unlimited energy and strength, and make them feel alert and happy… they believed it did. [This curriculum is now being taught to children by lay people in hundreds of elementary schools across the country.]

There is a flourishing underground market in unproven energy healing devices, a Seattle Times investigation found. What makes these energy devices potentially dangerous is that they typically prey on people with real cancers and serious conditions who turn to them for healing, rather than receive sound medical care that could save their lives.

In December 2007, the Seattle Times reported on a couple who, from 2002 to 2005, had been treating patients with cancer, hepatitis and other diseases using the VIBE machine and a Rife radio-frequency device. An investigation by the State Department of Health and the U.S. Food and Drug Administration found the couple had brought in $807,950 in fees from patients, but at least one patient — a 32-year old man with testicular cancer whose doctor had recommended immediate surgery to save his life. Instead, the man spent thousands of dollars on energy treatments before dying in 2004.

Beginning in 2002, VIBE’s website, product literature and labels on the machines had claimed that the machine had successfully treated conditions like cancers, rheumatoid arthritis, goiter, leukemia, migraines, back pain, fibroid tumors, diabetes and insomnia. An internet infomercial for VIBE machines which aired last year on WBR Health Journal Television, hosted by General Norman Schwarzkopf, said it could help healthy people achieve optimal health. And in a radio spot, the inventor said that five terminal brain cancer patients had been cured.

The VIBE Technologies website now says only: “The QuantumPulse is not a medical device and is not intended to be used in a medical situation of any kind; therefore, it is not FDA cleared.” This came about — not because lots of medical professionals, professional societies, and major academic medical centers spoke out with sound information and issued warnings for the public, but — only after the FDA stepped in.

The FDA takes action to protect public health

The FDA made a rare move this past week and announced a Class I recall of two unapproved devices being sold as treatments for cancer to headaches. This is the highest level of FDA action. The FDA generally doesn’t have the authority to order a company to recall an unsafe product, but can only request a company voluntarily remove it from the market. Class 1 recalls are the exception. These are the most serious type of recall and involve situations in which there is a reasonable probability that use of a product will cause serious injury or death. These Class I recalls are rare and have been issued in the past for medical devices such as defective artificial heart valves, defibrillators, ventilators, pacemakers and infusion pumps.

According to the FDA announcement:

The FDA is concerned that based upon the original health claims made by the company, patients may forgo approved therapies, and that this could result in more severe illness or death. “These recalls underscore the importance of taking action against manufacturers who make false medical claims for their devices,” said Daniel G. Schultz, M.D., director of the FDA's Center for Devices and Radiological Health.

One of the products was Nebion, LLC’s HLX-8 magnetic resonance device that was marketed as treating cancers, carpel tunnel syndrome, migraines, premenstrual syndrome, rheumatoid arthritis, ruptured disks, shingles and sports injuries. “The firm has failed to provide the FDA with any evidence to support these claims,” said the FDA announcement. The FDA had first issued a Class 1 recall notice to the company on June 25, 2008.

The second product was the VIBE machine. The FDA had inspected the VIBE Technologies facility in November 2007 and found that the company had not obtained FDA market approval for its VIBE device, which was being claimed to treat cancer, infections and depression. “The FDA also cited the company for substantial deviations from the current Good Manufacturing Practice/Quality System regulation.”

After several contacts with the company over the intervening months, during which the company failed to give the FDA documentation of corrective actions, on April 11, 2008, the FDA issued a warning letter to the company. It said the company was in violation of the law by selling a device “intended for use in the diagnosis of disease or other conditions or in the cure, mitigation, treatment, or prevention of disease, or is intended to affect the structure or function of the body that had not been shown to be safe and effective.” The FDA said that failure to take prompt corrective action could result in regulatory action, including to seizure, injunction and/or civil money penalties.

It was shortly after this warning letter that the name of the VIBE machine was simply changed to QuantumPulse. The health claims were removed from the company’s website, but the testimonials of patients and the inventor continued, as did sales.

Finally on October 1, 2008, the FDA issued a Class 1 Recall of the VIBE machine, manufactured and distributed from November 16, 2002 through March 19, 2008. It stated: “This device has not been approved by FDA, lacks safety and effectiveness data, and is not manufactured under current good manufacturing practices.” The company sent a certified letter to each of its customers who had purchased the device, instructing them to stop using it — 840 letters were sent out, meaning at a sales price of $17,800, the company had generated about $15 million in sales.

According to the FDA recall notice, the letter also directed that a warning label be permanently placed on the machine stating that it is not a medical device and should not be used as one. An updated operation manual/users’ guide was to contain no medical conditions or treatment claims. Finally, a certification to be signed by the user and returned to the company acknowledging that they had:

● received the letter.

● attached the warning label on the device, and

● understand that the VIBE Machine does not affect the structure or function of the human or animal body.

Users were also requested to certify that they will:

● not promote the VIBE Machine as a medical device.

● remove any medical claims from their individual websites, and

● destroy any VIBE literature making medical claims.

● a warning that failure to sign and return the certification will result in the company refusing to service their machine.

Healthcare professionals and consumers were encouraged by the FDA to report adverse reactions or problems experienced with this product to the FDA’s MedWatch Adverse Event Reporting Program, as instructed here.

The Greeley, Colorado local news CBS-4 reported on October 8, 2008, that the Class 1 Recall had done nothing to deter patients from believing in the “amazing results” of the VIBE machine. Reporter Rick Sallinger found people continued to line up for treatments for their arthritis to cancer. The follow-up CBS-4 report last Friday noted that the FDA was already after the inventor for the QuantumPulse, too. It was heartbreaking to watch the elderly people, who were so desperate for relief from chronic pain and hope for cancer, they believed the VIBE treatments could help them. The VIBE Technologies waiting room was still full of seniors waiting for treatments….

And, meanwhile, the most prestigious medical schools have continued to teach the use of energy modalities and bioelectromagnetic devices, such as VIBE.

It’s bigger than losing scientifically-proven medicine

If you’re tempted to think this troubling story is about people in desperate circumstances being victimized and put in danger by predatory quack modalities but that all of that has nothing to do with you, you haven’t been paying attention to the news.

The movement to reform our healthcare system has been led by calls to move away from medical care to preventive health and ‘wellness’. Bravewell Collaborative has made the adoption of ‘integrative medicine’ a national agenda objective, and its members and stakeholder partners have been promoting beliefs that most chronic diseases of aging are caused by bad diets and lifestyles, and that alternative modalities should have a central, not complementary, role in healthcare.

It’s about wellness care, not disease care, said Dr. Ralph Synderman, M.D., of the Bravewell Collaborative program at Duke University, on an episode of the Charlie Rose Show (March 28, 2008). Christy Mack, President of the Bravewell Collaborative, said that integrative care is a philosophy of healing and prevention. We see prevention as behavior change and making lifestyle choices and being responsible for your wellness, she said, and integrating the mind-body connection with evidence-based alternative modalities. Bravewell Collaborative has funded and commissioned the private organization, the Institute of Medicine, to convene a summit on integrative medicine in February 2009, to identify priorities and move our nation’s healthcare system forward in a new direction.

As our country faces growing healthcare needs with an aging population, and medical care becomes increasingly expensive and technologically advanced, our lives may depend on what we choose to support, fund and demand in research, care, and medical and nursing schools. As our country faces a shortage of doctors and nurses, can clinicians trained to reject science provide the medical care that you may need to save your life?

Going back to the AAP Guideline, the authors reported that between 1994 and 2010, the number of CAM providers is expected to grow more than five times that of physicians.

© 2008 Sandy Szwarc