In its short history, the NIH Office of Alternative Medicine has represented perhaps the best investment that the Congress, the Federal Government, and American taxpayers have ever made in the future health of the nation. I can say this from considerable first hand experience with the Office, and with a perspective of more than twenty years as a journalist reporting on the whole field of complementary alternative medicine.

My experience with the OAM dates to September 1992, when I was invited to the OAM's first formal working conference at Chantilly, VA. For the next year, I served on two of the OAM's initial program advisory panels, and made many trips back and forth to Bethesda for meetings with my fellow panel members as we attempted to identify the most important therapies and issues and helped to chart a clear course for the fledgling Office.

From those humble, underfunded, and understandably chaotic beginnings, which led to the publication of the OAM's first major work, Expanding Medical Horizons, the OAM has evolved into an increasingly visible, effective, and credible focal point for the public's enormous interest in complementary alternative medicine. (I have personally witnessed and documented this interest as it has grown now to a point where it can be safely said that considerably more than one-third of the adult population is actively using some form of alternative medicine. A significant additional number of Americans are clearly intrigued by the concept.)

The OAM has made great advances in identifying key alternative therapies and proponents, helped to educate clinicians in how to conduct quality research, funded a wide variety of well-designed studies, opened a clearinghouse for essential information about alternative therapies, and started to channel many of its resources to the Internet's World Wide Web in order to communicate with citizens around the country and people beyond our borders. It has helped to establish a seriousness about and bring stability to an entire field -- alternative medicine -- that often seemed to be lacking in discipline and even spinning out of control.

The facts about alternative medicine's popularity and public acceptance, borne out by a variety of studies and statistics (including the ever increasing annual dollar figure spent on natural products and therapies; the growing number of U.S. medical schools adding courses in alternative forms of healing; reports that a majority of people with AIDS are using alternative therapies; and the popularity of the OAM itself), suggest that the status quo in Washington D.C. has been sadly out of touch and deficient in being slow initially to create an OAM and, since 1992, in not providing the OAM with funding anywhere near a level commensurate with the public's curiosity about and utilization of alternative therapies.

Meanwhile, the cost issue is emerging as a wake-up call which is propelling credible alternative medicine faster and much farther into mainstream utilization than most people had anticipated. Already, many Americans cite the impressive cost effectiveness of complementary alternative medicine, along with its clinical effectiveness, as a reason for their embracing it -- in many cases even paying for alternative therapies out of their own pockets. The insurance industry, HMOs, and managed care companies like Oxford Health Plans, Inc. have added significant alternative therapy options, citing the interest and demand of their customers. Intruiging experiments, like the publicly funded Natural Medicine Clinic in Kent, WA, are beginning to demonstrate unequivocally the cost- as well as clinical-effectiveness of complementary alternative medicine while elected officials and policy makers around the country search for real solutions to the growing dilemma of out-of-control medical care expenditures.

Barely a day goes by without another report in the mainstream media about the limitations of conventional medicine and a promising, new alternative medical treatment. In the past week, we have heard about the herb St. John's Wort for depression; vitamin C to prevent cataracts; and "plant-based" diets that fight cancer. Many of these approaches will ultimately be integrated into mainstream medicine of the future. Assisting and even fast-tracking that important and health-promoting process should be the responsibility of the Federal Government as expressed through a major commitment of resources to the OAM.

Regarding mainstream medicine's limitations, another recent report deserves mention, because the problems with conventional medicine that it describes are the basis for much of the public's interest in safer alternatives. A national public opinion sampling by Louis Harris & Associates conducted on behalf of the National Patient Safety Foundation (NPSF), a nonprofit group affiliated with the American Medical Association, has determined that "A large percentage of respondents -- 42% -- report that they or a close friend or relative has experienced a medical mistake," according to Mary Woolley, an NPSF board member, speaking in New York City about the poll results on October 9, 1997. Woolley noted that "misdiagnosis was reported by 40% of those people, medication error by 28%, and an error during a medical procedure by 22%. In one third of cases, the medical mistake was reported to have had a permanent effect on the physical health of the patient." According to a Reuters story about the poll, "A recent University of Chicago study has revealed that over 3 million medical errors may occur each year affecting patients admitted to the nation's hospitals. The study calculated that the expense of these errors may reach $200 billion."

This kind of information, coming from an affiliate of the AMA no less, helps to place the leading complementary alternative therapies into a better perspective. The latter tend to be less expensive than conventional therapies, less toxic and harmful (the number of patient lawsuits and complaints against licensed naturopathic physicians in the U.S., for example, is virtually zero), often more clinically effective (in terms of their ability to identify and get to the root cause of many health problems), and therefore, overall, deserving of a rightful place in the American medical mainstream. This is clearly where most of the American public feels that complementary alternative therapies should be.

It was, of course, the Congress that in 1991 created the Office of Alternative Medicine within the NIH, an institution that historically has been adverse to both innovative and truly traditional medical options. This action by the Congress was an example of the political process, and of lay oversight of scientific and medical experts, at its bipartisan best. Five years now since the first meetings in Chantilly, VA that helped to give the OAM its early form, the Congress again has an opportunity to get out in front of an important issue -- or at least to match the public's interest that is already there -- by taking actions that will result in more autonomy, an increased budget, and a higher profile for the NIH Office of Alternative Medicine.

Wherever Americans gather and exchange information -- in supermarkets, on talk radio programs, in bookstores where titles on alternative medicine are among the biggest sellers -- complementary alternative medicine is "hot." It's time that the commitment of the Federal Government to the issue and to the OAM -- complementary alternative medicine's only home within the huge Federal biomedical bureaucracy -- better reflect that reality.

Peter Barry Chowka is a writer, journalist, editor, and lecturer, whose work in a variety of media over the past two decades has documented the limitations of conventional medicine and the promise of nontoxic traditional and innovative alternatives. He is the former National Affairs Editor of New Age Journal. Currently, he writes articles about health for a variety of publications. His site on the World Wide Web is <http://members.aol.com/realmedia>. He can be reached by e-mail at <pbc@usa.net>.