Alternative Medicine 101

 By Ron Hunninghake, M.D.

Editor’s Note: This is taken from a Grand Rounds presentation at Via Christi Regional Medical Center.

I want to open with a quote from an article by David Eisenberg, M.D., et al., in the November 11, 1998 issue of The Journal of the American Medical Association:

Alternative medical therapies, functionally defined as interventions neither taught widely in medical schools nor generally available in U.S. hospitals, have attracted increased national attention from the media, the medical community, governmental agencies, and the public.

A 1990 national survey of alternative medicine prevalence, costs, and patterns of use demonstrated that alternative medicine has a substantial presence in the U.S. healthcare system. Data from a survey in 1994 and public opinion poll in 1997 confirmed the extensive use of alternative medical therapies in the United States.  Eisenberg went on to point out that alternative medicine usage is:
• Not confined to any narrow segment of society
• More common in women
• Less common with African Americans
• Most reported in ages 35 to 49
• More common in college educated people
• More common in people with an income over $50,000

• Predominantly in the western states

Alternative practitioners usually see their patients for an office visit, treatment is often nutrients, and they pay for the services out-of-pocket.  Insurance usually does not payor pays very little. In 1997, these patients spent $27 billion on these unreimbursed treatments.

••• 60% of the U. S. medical schools now offer courses in alternative medicine.

These patients also use standard physicians. Both the 1990 and 1997 surveys found that 96% of those patients who used alternative physicians also saw a conventional medical doctor in the prior twelve months.

These patients , though, often don’t tell their standard doctor about the alternative physician visits or therapies because they fear ridicule and criticism from their doctor.

Even though change comes very slowly, the seeds of change are here today. For instance, 60% of the U.S. medical schools now offer courses in alternative medicine. Many hospitals offer complementary medicine services and programs. More health insurers are covering alternative therapy.

Change is also coming in the federal regulatory system. “In ten years, the Office of Alternative Medicine will be a thriving organizational entity working closely with other National Institutes of Health components and federal agencies, academic centers, private organizations, and the public to facilitate quality research that integrates complementary and alternative medicine and conventional healing approaches,” said Wayne Jonas, M.D., former head of the Office of Alternative Medicine.

So, what is the force driving this growth in alternative medicine? It is patient demand Medicine-is becoming more and more patient driven. As we enter into the information age, this explosion of information has turned into consumer demands:
• My RIGHT to TRY!
• My RIGHT to BUY!

It is the do-it-yourself mentality that grows out of dissatisfaction with the services available to them. Patients are demanding results.

Patients feel that there must be something more than just the “absence of disease.” They believe that optimal health is achievable, that personal responsibility is the cornerstone of optimal health and that education and awareness are necessary to make progress toward this goal. The patients are wanting and taking more control of what happens to their bodies.

The core values of alternative medicine embrace all of these beliefs. Alternative medicine practitioners:
• Use natural remedies over artificial drugs
• Get to the root causes over treating symptoms

• Treat the person over attacking the disease
• Prevent illness over treatment after the fact
• Promote optimal health over mere absence of disease

Alternative medicine has come full circle. The alternative paradigm represents the re-emergence of the form of medicine developed by Hippocrates, the father of medicine-this is the empirical approach. By itself, this form of medicine is limited. But, in the context of modern medicine, it fills a void.

There will always be a need for acute care medicine. That is what conventional medicine does very well. But the void filled by alternative medicine deals with chronically ill patients. This alternative medicine does very well.

So, some people may ask, where does alternative medicine go from here? One answer may be that in 1978, the wellness movement in medicine was considered “fringy.” Twenty years later,
the wellness concept is mainstream and institutionalized.

Eisenberg’s two articles in The Journal of the American Medical Association tell us a lot about the future medicine. He found that:

• Alternative medicine can no longer be ignored
• There is a need to implement clinical and basic science research
• A relevant educational curriculum is needed in our schools
• There is a need to set credentialing and referral guidelines
• Quality control of dietary supplements needs to be improved
• Post-marketing surveillance of drug-supplement interactions needs to be established
• Both sides need to shift out of the “Us-Them” mindset

The patient is the customer and the patients are voting for alternative medicine with an increasing amount of dollars daily because they believe and have experienced an improvement in their journey to optimal health.

Wayne Jonas, M.D. says, “Alternative medicine is here to stay. It is no longer an option to ignore it or treat it as something outside the normal processes of science and medicine.

“The challenge is to move forward carefully, using both reason and wisdom, as we attempt to separate the pearls from the mud.”