Workers' compensation insurers are starting to pay for meditation classes for injured workers.

That's a milestone worth noting, because work comp is a pretty conservative system and the last place you'd expect to find anything outside the box of conventional medicine. In most cases, a claims adjuster has to review and approve anything unorthodox before it's authorized for payment. When work comp payers are paying for alternative therapies, something important is happening in the healthcare system.

There are no statistics, and the numbers are probably small, but alternative therapies are beginning to be accepted, according to presenters at a recent meeting of the New Mexico Workers' Compensation Association.

"Mind-body is the future of medicine," said Dr. David Lyman, a 20-year occupational medicine physician. "The acute care models no longer meet our needs." For workers who don't recover with conventional treatment, he employs an interdisciplinary approach that includes mental techniques such as biofeedback.

David Lang, a massage and neuromuscular therapist and a former member of the New Mexico Massage Therapy Licensing Board, said New Mexico is a leading state in the development of integrative medicine. Lang works at the University of New Mexico's integrative medicine clinic, known as the Center for Life, which he said is ranked as one of the top 25 integrative medicine centers nationally. He said there are competent therapists in 22 of New Mexico's 33 counties who can help injury patients with a variety of techniques, such as neuro-muscular re-education, and physicians are learning how to take advantage of their services.

As defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine "combines mainstream medical therapies and complementary and alternative medicine therapies for which there is some high-quality scientific evidence of safety and effectiveness."

There is plenty of evidence for the benefits of meditation. Michelle Duval runs several medically sponsored mindfulness meditation programs for patients. She said most people who go through an eight-week meditation class say their condition is improved. Research at major universities is supporting this observation, she said. Even pain is reduced, because the patient learns to interpret the physical sensation of pain differently. Mindfulness enables the injured person to participate in his own healing.

Finding non-drug ways to help injured workers cope with pain has become increasingly important in light of New Mexico's struggle with overuse of addictive opiate pain medicines.

"Insurance companies will have to start covering these programs because they have to start saving money," Lyman said.

Integrative medicine remains limited, however, by what modalities and techniques are supported by evidence. That depends entirely on what is being studied, which in turn is determined by who bankrolls the studies. That's still heavily weighted in favor of conventional methods that somebody stands to profit from.

And there's a continuing concern that the studies Ð about the effects of pharmaceuticals or complex surgical procedures Ð are not nearly long-term enough to give a true picture of complications and side effects.

At a hearing I attended once, a number of severely disabled individuals testified about the crippling effects of a particular method of back surgery. These former workers would probably be disabled and in pain for life, and either their former employers, through workers' compensation, or all of us, through Social Security, would pay for their lifetime disability and medical costs.

Recently the news has reported on the severe side effects of metal-on-metal hip replacements. These are sharp reminders that the conventional healthcare system sometimes doesn't know what it's doing.

Any injury recovery technique with the fewest possible interventions to the integrity of the human body is worth study, experimentation and thorough data analysis. The doctor's first duty is still to do no harm.

Merilee Dannemann is an independent public policy professional in Albuquerque. Contact Merilee Dannemann through www.triplespacedagain.com.