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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 (see "The Five Areas of
Alternative Medicine"); 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.
What's Driving the Demand?
Consumers, particularly those between 30 and 55, are powering the growth of
alternative medicine. According to
Eisenberg's 1997 testimony before the U.S.
Senate, one out of every two boomers uses non-conventional therapies. What
boomers seem to favor is the safe, noninvasive nature of
alternative treatments. Furthermore, many
alternative remedies hold the promise of slowing
of the aging process.
Mainstream (cont.)
Another motivation is the increasing cost of health care—without an increase
in the quality of the care, says Dr. Roger Jahnke, doctor of acupuncture and
traditional Chinese medicine,
chairperson of both the Qigong Department at the
Santa Barbara (Calif.) College of Oriental
Medicine and the National
Qigong
Association, and author of "The Healer Within." A third driver, says Edelberg,
is that conventional doctors are coming around to accepting
alternative therapies: "More papers are appearing on
alternative medicine
in conventional medicine journals;
there's a National Institutes of Health division on it; and
they themselves are experiencing it. We regularly have doctors coming into our
clinic for chiropractic or acupuncture or sending their patients
over...Cardiologists are taking antioxidants and vitamins, and psychiatrists
are beginning to realize that St. John's wort actually works.
Choosing Safe and Effective
Alternative Therapies
Edelberg says attitudes toward
alternative medicine
still vary
greatly by
region, but that chiropractic is relatively common as is acupuncture. Usually,
the more studies that have confirmed the efficacy of a particular therapy, the
greater its acceptance. For instance a number of controlled studies have proven
the effectiveness of acupuncture for treating a variety of conditions, from
osteoarthritis to migraine headaches. Other studies have shown positive results
in pain management and drug addiction—two areas where conventional
medicine is limited. But as with anything else, it pays to be a careful consumer when it
comes to alternative medicine. According to
the Food and Drug Administration,
the Centers for Disease Control and Prevention, harmful
alternative treatments
include DMSO, laetrile, snake venom, coffee enemas, ozone generators, and
ephedra (also known as ma huang). Studies have also shown some remedies to be
harmless—but not necessarily effective. These include dong quai and wild yam.
The latest research on using garlic to reduce blood pressure indicates theeffect only lasts several months.
Insurance coverage still iffy
Though popular with the masses,
alternative medicine
has yet to be
embraced by
health insurers. In his 1987 testimony to the U.S. Senate, Dr. David Eisenberg
described a patient who defined it as "therapies I have had to pay for out of
pocket." That statement still sums up how often
alternative medicine
users are
reimbursed by their insurance companies.
It goes round and round," says Jahnke. "As an acupuncturist back in the '80s,
probably 60 percent of my charges were reimbursed by insurance companies. But
by the end of the '80s it was down again...And now there are what they call
discount networks that are being contracted by insurance companies to provide,
not reimbursed services, but discounted services." Dr. Vasant Lad is director
of the Ayurveda Institute in Albuquerque, NM. Although he says Ayurvedic
services are as popular as "hot cakes," insurance companies do not reimburse
for them. John Weeks is editor and publisher of the newsletter, The Integrator
for the Business of
Alternative Medicine.
He says, "From a consumer
perspective, despite the increased interest, most payments are cash out of
pocket." He added that there's been a trend over the past three years toward
discounted access, in which the consumer pays a reduced rate and has the
reassurance that the provider has met the insurance company's criteria. The
modalities most often covered are chiropractic, massage, acupuncture and
naturopathy.
Power to the patient
The real news about the growth of
alternative medicine
in the West is a
shifting of responsibility from the doctor to the patient, says Jahnke. He says
the key is "the revelation that 'Oh, you mean I can do something? And I
can do it at home for free?'...The real breakthrough that's happening in health
care right now is that we're realizing the client, the customer, the patient can
also do something. "In fact, if you do something in a timely way, you might not
need to be a patient."
By
Wynne Brown
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