After rejecting alternative medicine, CHOP gives acupuncture a shot

Children's Hospital of Philadelphia will offer acupuncture to all of its patients beginning in July, joining a growing number of pediatric medical centers providing alternative therapies.

The hospital plans to add other unconventional options, including therapeutic massage and aromatherapy, in the next year, said Maria R. Mascarenhas, medical director of the new Integrative Health Program.

"Our patients and families have been asking for it and seeking these therapies outside of CHOP," said Mascarenhas. "It's important for us to offer those services by providers who are up to CHOP's standards."

Providing alternatives in-house also makes it possible for doctors to know exactly what extra treatments their patients are receiving, Mascarenhas said.

Acupuncture will be used to augment conventional treatments for pain and nausea. And with rates of opioid addiction and overdose fatalities at record levels nationally, Mascarenhas said the hospital was seeking to reduce the use of strong narcotics.

In the past, alternative options were not welcome at Children's Hospital. The institution removed most dietary supplements from its list of approved medications in 2013 because it could not guarantee their safety and effectiveness.

Paul Offit, chief of infectious diseases, said the hospital's stance on supplements would remain unchanged.

Though anecdotes abound, complementary and alternative treatments - a broad category that includes supplements, homeopathy, and chiropractic - generally lack enough scientific evidence to prove effectiveness. Most health insurance policies don't cover them.

But they are widely accepted by the public. Americans spent $30.2 billion out of pocket on alternative treatments in 2012, according to a report released last week by the National Center for Health Statistics. About $1.9 billion of that is spent on children.

Offit is an outspoken critic of alternative treatments and author of the 2014 book Do You Believe in Magic?: Vitamins, Supplements, and All Things Natural: A Look Behind the Curtain.

He described alternative treatments as "placebo medicine" in an interview but acknowledged that they were worth studying.

"It's a good thing to open our eyes to alternative ways to relieve pain, stress and depression that are not pharmacological," Offit said. "You can learn to release your own endorphins."

There is evidence that acupuncture works - specifically for pain. A 2012 analysis of dozens of randomized controlled trials concluded it effectively relieves some types of chronic pain.

"We don't fully understand how it works," said Mascarenhas, "but it's therapy that lets the body naturally reduce pain and improve functioning."

Children will have to be old enough to understand what the acupuncturist is doing.

"You need a cooperative patient," Mascarenhas said. "You don't want them moving during the therapy session."

Seattle Children's Hospital, which began offering acupuncture in early 2014, is providing guidance as Children's Hospital of Philadelphia develops its Integrative Health Program.

"We're taking the time to build this the right way," said Kevin Gross, administrative director of the program here.

Acupuncture, as traditionally practiced in China, is based on the belief that the human body is controlled by a vital force called Qi. Illness is believed to be generated by a disturbance in Qi (pronounced "chee") that flows along defined pathways. Practitioners insert extremely thin needles into a patient's skin at specific locations to redirect and rebalance the flow.

"We know that there's a strong history going back to ancient China," said Gross. "When it comes to Qi, we try to avoid that and focus on the preliminary research. We also acknowledge that it still needs to be studied more."

samwood@phillynews.com

215-854-2796 @samwoodiii