It now seems safe to say that alternative medicine is no longer on the fringe of health care.

A visit to your neighborhood drug store tells the story. There, you'll find shelves stacked with about as many brands and types of vitamins as over-the-counter cold remedies.

The trend reflects the fact that Americans spend more than $30 billion of their own money on complementary and alternative therapies each year, according to a 1997 study published in the Journal of the American Medical Association.

They also made 628 million visits to alternative health-care practitioners, 243 million more than visits to all primary-care physicians. Nearly half of those visits were to chiropractors and massage therapists.

Alternative Medicine Defined

Dr. David Eisenberg is the author of that landmark study and director of the Center for Alternative Medicine and Research and Education at Beth Israel Deaconess and assistant professor of medicine at Harvard Medical School, both in Boston.

His definition of alternative medicine is any form of therapy not taught widely in medical schools or generally available in hospitals. The term "integrative" or "complementary" medicine refers to the weaving together of alternative options and allopathic or conventional science-based medicine.

The list of alternative therapies changes frequently as more practices are proven safe and effective, but generally falls into five areas: traditional systems (Chinese, Ayurvedic), mind-body interventions, hands-on body work, biological-based therapies (vitamins, herbs) and energy therapies.

A key concept, according to Dr. David Edelberg, founder and former chairman of the integrated medicine clinic, WholeHealth in Chicago, is that most users of alternative medicine don't want to give up their conventional health care. "When we opened our center, we found people weren't giving up their family doctors, they simply wanted physician-supervised alternative medicine....They wanted a center that had two toolboxes," says Edelberg.