It is impossible to get an appointment with Dublin GP Dr Elizabeth Ogden. People who call are politely told that she is planning for her retirement and has stopped taking new patients.
That retirement is not for seven years but such is the demand that Dr Ogden, who is a homeopathic doctor, has had to call a halt somewhere. If you want to consult with the Co Meath herbalist/ healer Sean Boylan you are told that he is not taking any appointments until the new year. Even try making an appointment with your local aromatherapist and you'll probably find you have to wait at least a week.
Just small indications of the phenomenal growth in complementary medicine in Ireland. As conventional medicine is pushing back the barriers of science with high-tech treatment options, there is a remarkable renaissance in the world of complementary and alternative medicine. Some figures indicate that seven out of 10 people in the Western world use complementary medicine (CM) in some form. BUPA's decision to include CM in its healthcare plans has proven a major marketing coup.
Nobody seems to know how many CM practitioners there are in Ireland, except that the number has grown hugely in recent years and the growth is set to continue. In the US almost as much money is spent by people going for complementary consultations as for orthodox.
The array of treatments available is bewildering. Walk into any health-food shop and you will find a stand filled with leaflets offering a range of treatment options from the better-known acupuncture, homeopathy and chiropractic to rolfing, hair analysis, cranio-sacral therapy and the metamorphic technique.
Advocates include those who have tried all the conventional medical approaches and turned in desperation to CM, but increasingly there are those who make it the first port of call. Members of the medical establishment are becoming marginally less sceptical and where they used to advise complete avoidance, they now tell people to approach with caution. But they are still seeking proof that these treatments work. In the majority of cases this is absent. Indeed many alternative therapies claim therapeutic benefits due to "energies" as yet undefined by science.
But its popularity, the huge bank of anecdotal evidence - stories of people being cured by healers after being written off by conventional medics, or simply getting relief from a chronic condition that has made their life a misery for years - has forced those involved in conventional medicine to take these therapies more seriously. Many are more ready to subscribe to the "holistic" approach. Increasingly doctors are training in complementary therapies so they can offer the benefits of both.
Why is complementary medicine so popular? As the public hears more about the resistance to antibiotics, the growing incidence of allergies, and stress-related conditions, they are looking for a more "natural approach". And as orthodox physicians become immersed in science, without time to devote to their patients, it seems that the "person-centred" approach given by traditional folk medicine is what is increasingly called for. In a fast moving, stressful world, a CM practitioner's rooms can be an oasis of calm where a sympathetic ear is given, common-sense advice dispensed and a treatment carried out.
The whole notion of self-care, one of the cornerstones of complementary medicine, is coming into its own. People are taking more responsibility for their own health and looking "within" for the resources to cure themselves. The mind is seen as a very powerful tool, and the power of the placebo effect is not to be ignored.
But, as a recently published Encyclopedia Of Complementary Medicine points out, the same questions that are asked of conventional treatments must also now be applied to complementary treatments. The benefits claimed must be closely analysed.
Prof Edzard Ernst, professor of complementary medicine at the University of Exeter, is concerned that enthusiasm for alternative medicine may lead to its acceptance within mainstream medicine without evidence from trials that it is effective. "The evidence is not there yet for many therapies. I do support complementary medicine but integration should be after evaluation and not the other way around," says Prof Ernst.
As his department studies the different forms of CM and their efficacy it is also attempting to examine the "placebo" effect. Studies conducted so far have shown that acupuncture works for low back pain and nausea and they have shown that a number of herbal remedies work. "St John's Wort works without doubt for depression. However this does not mean that all herbs are safe, we are trying to find out what is and what is not." Garlic is also good for a healthy heart, in particular lowering cholesterol and blood pressure.
Worrying results which have emerged in their investigations involve spinal manipulation and osteopathy and chiropracty. "There have been incidences of stroke followed by death following upper spinal manipulation. The number of cases in the literature are very low but we want to know more and are carrying out investigations. The literature on acupuncture also shows some dramatic cases of injury to inner organs and death or infection with hepatitis C or HIV. But we need to know for sure how often this occurs. The profession of healing is the largest of all complementary therapists and we feel we also need to look at that."
The ideal scenario, says Prof Ernst, is that patients try therapies that have the potential to help, but continue consulting their conventional doctor. "People should be disturbed by anybody from the complementary therapy world who promises quick cures. It can be damn dangerous."
Jan de Vries has been practising complementary medicine for almost four decades and has written 27 books on various aspects of it. "People are getting more aware of the side-effects of drugs and want to be closer to nature and treat themselves more naturally," he says, explaining the growth in the area. "The evidence that it works is not only strong but is backed up by scientific evidence. I see people from all over the world with problems such as arthritis, bronchitis, back problems," says Mr de Vries who recently gave a lecture in Dublin which was attended by more than 800 people.
He has seen a change of attitude from the medical establishment in recent times. "Ideally it should be a marriage between both conventional and complementary medicine to help human suffering. Why should one side act against the other? A lot of doctors are more lenient about it now. In the early days they were against it because there was so much quackery. There still is, in fact, quite a lot of it about. I have been quite astounded about where people go and the money that they spend," adds Mr de Vries, who lives in Scotland and has a monthly practice in Belfast.
Dr Cormac McNamara is a past president of the Irish Medical Organisation. While he questions the efficacy of complementary medicine he believes that it has benefits even if only for the "placebo effect" of making people think they feel better.
"Doctors are more open to it now. Before we had evidence-based, high-tech medicine, this approach was very much to the fore. But now, there is so much complex, scientific information which doctors have to cope with that precludes them from being able to spend time with a patient.
There is certainly a place for some form of treatment, provided they can at least demonstrate that the therapy does no harm. Classic examples are people with arthritis or migraine - with symptoms that are persistent or recurring and for which, in general, there is no cure. If you visit an alternative practitioner and he empathises with you and gives you various potions and rubs, there may be some benefit, you cannot exclude that possibility."
Simply going to a new therapist can keep hope alive, he says. "But there is little objective evidence that the underlying disease process in any of these chronic conditions has been affected." He warns against people deciding to stop taking necessary, and in some cases life-saving, medication without seeking advice from their doctor.
Irene Stein, the queen of Royal Jelly, who has brought out a new book on the development of the next generation of natural health foods, Health For Life, suggests that a little more should be taken on faith.
"If we go far back in history, there was a time when scurvy (vitamin C deficiency) plagued seamen. Then, in 1747, James Lind, a surgeon's mate on HMS Salisbury carried out an experiment to try and find an effective cure. He took a dozen sailors, all suffering from scurvy to a similar extent and divided them into six pairs. The first pair was given cider, the second dilute sulphuric acid, the third vinegar and the fourth sea water, the fifth a herbal preparation and the sixth citrus fruit. Of course, the sixth pair were up and about in no time and put to work looking after the others. At that time nobody knew about vitamins and it took 50 years before the British admiralty decided to issue each sailor with a daily ration of lemon juice. This decision eradicated scurvy at a stroke, but many men suffered during those 50 years of deliberation.
"I think you will realise the moral of this story. Doctors recommend the natural remedies for constipation and cold symptoms because they know how they work. The admiralty prevaricated for half a century because, although they could see that citrus fruits were a prevention against scurvy, they did not know how they worked."
Ways of bringing complementary health care into the National Health Service in Britain are currently being examined and already in some areas treatments such as aromatherapy and reflexology are being used. However there are no such plans by the Department of Health here to bring complementary health in from the cold. (More tomorrow)