Doctors Embrace Integrative Medicine

GREENWICH, Conn. - There's not a lot of hustle and bustle typical of a doctor's office at the River Street building in Cos Cob, home for the last two years to Greenwich Hospital's Center for Integrative Medicine.

There's little noise at all, save for the water trickling delicately down in a small glass waterfall, light music playing soothingly over speakers and the nurses and other staff speaking in hushed tones as a tai chi class takes place in the large classroom and a patient undergoes acupuncture therapy in one of the treatment areas.

The environment is what first struck Dr. Robert Stark, who practices cardiology and internal medicine in town, when he visited after it opened in 2007.

"The whole environment is stress free," Stark said. "Everything about it has been calculated to be relaxing."

Stark, who has been practicing for more than 30 years, said though he likes to think he looks at his patients in a holistic way, he has referred some to the center for help managing chronic pain and musculoskeletal complaints, or for general counseling, which is the main goal of integrative medicine.

"I have always believed that the mind and spirit do have some influence on our health and on our bodily functions," Stark said.

While doctors in Greenwich and elsewhere have become accepting of and even advocates for the alternative therapies like acupuncture and massage that the center offers, they aren't necessarily as familiar with the herbal supplements and natural remedies that are a big part of what it does.

As the word "holistic" implies, the center looks at people as whole, in multiple ways, said Dr. Henri Roca, the center's medical director.

"We're looking not only at specific diseases and disease processes, we're looking at the imbalanced processes of the body that link specific diseases together," Roca said.

The center has become more popular since opening, and saw 118 percent growth between May 2008 and May 2009.

"This type of medicine's been around for many years," said Donna Gaudioso-Zeale, director of the hospital's Center for Healthy Living. "We in the northeast are one of the last explored frontiers."

Dr. Frederick Nahm, a neurologist, trained in California several years ago, and was exposed to alternative therapies that were already common there.

Nahm said he has seen patients with back pain with no mechanical explanation for it. That's where alternative therapies can be helpful.

"A lot of times they would see pain specialists," Nahm said. "It's a huge expansion of options for a lot of people who maybe we don't find the answer in the typical medical lore."

There are still doctors who are skeptical, however.

Dr. Alfred Padilla, an endocrinologist in town for more than 25 years, is an outspoken critic about the use of alternative medicine at the hospital. He says there are few real studies on supplements and other alternative therapies, and that they have the potential to harm people by masking the symptoms of more serious diseases, interfering with regular medications or causing patients to avoid proven treatments.

Supplement manufacturers do not have to get approval from the U.S. Food and Drug Administration before selling their products, and the agency doesn't have a lot of oversight on safety.

"Nothing is subject to proof unless it's also subject to disproof," Padilla said. "If you're dealing with human beings and human life, you have to show that it works."

Roca says the natural substances the center offers have been used for hundred of years, and that while the studies on pharmaceuticals tend to be larger, they haven't been used for as long a period of time.

"There's a tremendous amount of science in the world of natural medicine," Roca said.

Donna DiFabio travels about an hour to Cos Cob from Carmel, N.Y., to see Roca for help with chronic fatigue and acid reflux. After undergoing several tests last year, she takes a regimen of supplements, including protein and fish oil.

DiFabio, 42, who wasn't new to alternative medicine and had acupuncture elsewhere before coming to the center, said some of the general doctors she's seen are accepting of the natural remedies, and some are not.

"The general doctors don't seem to look that deep," DiFabio said.

Some patients say they chose to go the alternative route because traditional medicine wasn't relieving their symptoms, or because they don't want to have to see several doctors to address multiple problems.

New Canaan resident Gale Stafford started seeing Dr. Roca to address fibromyalgia, a disorder that causes chronic muscle pain, along with diabetes and a pinched nerve that affects her right hip and knee.

"Instead of seeing three, four separate doctors we're kind of dealing with my issues as an entirety and me as an entirety," said Stafford, 57. "As a result, I'm getting better sooner and I'm getting better in ways I haven't gotten well before."

One drawback is that many insurance companies don't cover all of the services at the center. An hour massage, for