Recently named by President Clinton to chair the White House Commission on Complementary and Alternative Medicine Policy, James Gordon, M.D., is Clinical Professor of Psychiatry and Family Medicine at Georgetown University School of Medicine, Director of the Center for Mind-Body Medicine, and was the first Chairman of the Advisory Council of the National Institutes of Health (NIH) Office of Alternative Medicine (OAM). He is a member of the NIH Cancer Advisory Panel and was the Director of a Special Study of Alternative Services for the President's Commission on Mental Health. A graduate of Harvard College and Harvard Medical School, Dr. Gordon serves on the editorial boards of Alternative Therapies in Health and Medicine, The Journal of Alternative and Complementary Medicine, and Alternative and Complementary Therapies.
Gordon has written several books on holistic medicine, including the landmark Manifesto for a New Medicine (Addison Wesley, 1996), and developed at Georgetown one of the first medical school curricula on complementary and alternative medicine. He is, in short, a pioneer in the field.
Since 1998, Gordon's Center for Mind-Body Medicine has sponsored annual Comprehensive Cancer Care (CCC) conferences, bringing together the world's leading alternative and conventional cancer researchers and practitioners, policy makers, and patients in an unprecedented meeting of the minds, to explore the full range of cancer treatments and midwife the creation of a truly integrative approach to this most challenging illness. Now co-sponsored by the National Cancer Institute and the NIH's National Center for Complementary and Alternative Medicine (NCCAM), CCC is among the foremost models for breaking down barriers between conventional and alternative therapies. (Transcripts and summaries of the CCC conferences can be accessed at www.cmbm.org). Gordon's most recent book, Comprehensive Cancer Care (Perseus, 2000), co-authored with Sharon Curtin, draws on the presentations at CCC I and II as well as Gordon's work with cancer patients in his practice.
In this wide-ranging interview with Dr. Daniel Redwood, Dr. Gordon describes the goals of the White House Commission, the key areas it will address, and the commission's desire to elicit the broadest possible input from both the alternative health and conventional health communities. He also discusses the current status of CAM research for cancer and recent steps toward greater integration of CAM in medical education.
The Commission will release an interim report in July 2001 and a final report in March 2002. As part of their information gathering process, members of the Commission will hold a series of regional town hall meetings around the country. The first two are scheduled for San Francisco on September 8, 2000 and Seattle on October 30, 2000. Dr. Gordon expects one of the town meetings to be held in Washington, DC.
For further information:
White House Commission on Complementary and Alternative Medicine Policy
6701 Rockledge Drive
Bethesda, MD 20817
Center for Mind-Body Medicine
5225 Connecticut Avenue, N.W.
Washington, DC 20015
DANIEL REDWOOD: According to the law passed by Congress calling for the appointment of a White House Commission on Complementary and Alternative Medicine Policy, what is the commission's job?
JAMES GORDON: The commission's job is to take a look at a variety of different aspects of CAM [complementary and alternative medicine] and to try to understand the overall significance of CAM, and in particular, how we should enlarge or rethink four different areas: research, public information, training of health professionals, and delivery of services. The commission will make recommendations to the President through the Secretary of Health and Human Services, and also to Congress, about what kind of legislation is needed to make sure that whatever kinds of perspectives, practices, and approaches we think are important are included in health care for everybody.
REDWOOD: Over the years, there have been blue-ribbon government commissions on many topics whose recommendations were never implemented. Are you hopeful that your commission? recommendations will result in actual policy changes?
GORDON: I'm very hopeful. I see the work of the commission as sharpening our national perspective, not only on specific CAM therapies but on how health care and health education as a whole, and health care research, can be enriched and transformed by the perspective in CAM, by a holistic perspective, by an emphasis on healing partnerships between patients and health care practitioners, and by a focus on education and not just on treating.
I see this as an opportunity to present a worldview about health care, and then also to present very concrete proposals. The reason I'm very hopeful about it is because there is tremendous bipartisan support. Many commissions come up with recommendations, and I think the reason they get stalled is because there is a great deal of division about specific issues. On the issue of integrating CAM therapies, there is tremendous bipartisan support for the idea that those therapies that are useful, those approaches that make sense, should be part of health care. So I'm very optimistic about much of what we recommend coming into legislation, and at least a significant part of that legislation being passed.
There may be more difficulty, of course, about who is going to pay for whatever is being recommended. But my hope is that what we can do is not only show that some of these approaches are effective, but to encourage major experiments in integrating some of these approaches into health care so that we can see if, on a large scale, they're not only effective but also save money.
REDWOOD: What's a good example of work like this that's already been done?
GORDON: A good example of something that's already been done is Dean Ornish's work using an integrative approach to treat serious heart disease. [Ornish? program combines a very low-fat vegetarian diet, yoga, meditation, and sharing groups]. There's been a kind of progression of initially looking at this as a totally outrageous approach to heart disease, to the point at which, after having done some fairly large scale experiments using this approach [published in Journal of the American Medical Association and Lancet], it's now become a part of health care in many hospitals and is covered by many insurance companies. I'm hoping we can make recommendations that will move the whole field forward in that way. To say, here are some approaches that look very interesting, here are some data that suggest that they may be useful, so now let? see about doing a significant experiment or pilot program to see if this can make a difference to large numbers of people.
I would also expect the commission to recommend that certain kinds of education be included in the training of all health professionals. I obviously don't know at this point what the commission's recommendations are going to be, but I think it? reasonable to recommend that whatever we come up with should be mandated as part of the education of health professionals. I think that can have a significant effect.
For us, the final challenge is going to be to put all that into simple, direct language that can be part of legislation. I think we'll be able to come up with some very significant things. Just the fact that the National Center for Complementary and Alternative Medicine (NCCAM) has begun to put out requests for applications for education on integrative medicine has stimulated major medical institutions to apply for those grants and to be more willing to integrate CAM approaches into their curriculum. For example, if we have legislation that says part of the work of a particular government agency is to foster education in these approaches and here is an appropriation of x number of dollars to do that, then I think that? going to happen. The time is right. What's needed is guidance and financing.
REDWOOD: Does the commission's membership reflect the diversity of CAM practice in the United States? Aside from holistic MDs like yourself, Dean Ornish, and Wayne Jonas [Wayne Jonas, MD, is the former head of the NIH Office of Alternative Medicine], are there non-MD alternative providers represented?
GORDON: Yes. Some have been named already, and more members going to be appointed. There are a number of MDs who are integrative care practitioners, that? true, but there are several more members who are alternative practitioners. There will be a chiropractor and there are two people who practice Chinese medicine. The fact that there are physicians who are holistic practitioners along with various alternative practitioners is a wonderful bonus for the commission. Many commissions are asked to address a certain area, and may only have one or two, if any, practitioners in that area. Also, the role of the commission is not just to rely on our own expertise. Our work is to go and find those people in the alternative community who will come in and tell us what they think.
REDWOOD: How will you do that?
GORDON: There will be plenty of time, both in the regular commission meetings and in town hall meetings around the country where we will be soliciting input. We're having a town hall meeting in Seattle on October 30, and our major partner in that meeting is the naturopathic community. So whether or not there is a naturopath on the commission, there is going to be major input from the naturopaths. I think we'll see the same pattern all over the country. In some areas there will be input from curanderos and Native American healers. The effort is to make sure that all voices in the alternative community are heard.
REDWOOD: Are you also reaching out to the medical establishment?
GORDON: Absolutely. We've just been planning our first research meeting for October 5th and 6th. This will be the first of two meetings on research issues. As part of this, we're asking major medical centers what they are doing in this area and why they are doing it. And if they're not doing research on CAM therapies, why not? We're also going to be asking major government agencies. Our role is to bring in everybody who is already interested in this area, or who we think could or should be interested, and find out what they're doing. And if they're not doing much, or doing anything, to ask why not. Also, to ask them what would make it easier for them to do work in this area. These are the kinds of questions we would be asking the dean of a medical school which has not done anything in CAM, or the head of a hospital system which was not particularly interested in CAM therapies. So our goal is to find out what? going on and what's in the way of moving ahead.
REDWOOD: Why do you think you were chosen to chair the commission?
GORDON: I think it's partly because I was the first chair of the Advisory Council for the Office of Alternative Medicine (OAM) and, more generally, because a lot of my work has been bringing together people from different worlds and helping them have a dialogue about what kinds of approaches to health care we should be taking. Also, I suppose, because I am a physician who has used complementary and alternative therapies for over 30 years. I integrate a variety of different systems, both in my work with patients and in my public work?irst, when I was a researcher at the National Institute of Mental Health (NIMH), then working with the OAM, and creating other programs. One of these is our nonprofit, the Center for Mind-Body Medicine, that embodies what I hope is the best of the modern western scientific method and the most exciting, hopeful, and promising of the complementary and alternative therapies.
That's what our annual cancer conference is about as well, bringing those groups together. That may have influenced the White House. Also, I know Mrs. Clinton read my book, Manifesto for a New Medicine and the President at least looked at it. So I assume they have a sense of what I'm about, who I am, and what my perspective is. I also think?nd this is partly based on a conversation with Mrs. Clinton?hat it's the fact that I am concerned with making sure that people of all income levels and all ethnic groups are involved in this process and have full access to everything that rich folks have access to. That perspective was probably an important one to them as well. A lot of the work I've done for the past 35 years has been with people who don? have money and don't ordinarily have access to these approaches.