Unconventional Medicine in a Conventional Setting
Complementary and Alternative Medicine, referred to in the US as “CAM,” is a group of diverse medical and healthcare systems, practices, and products that have historically fallen outside customary approaches within Western medicine.
The most commonly recognized CAM practices in the U.S. are acupuncture, massage, vitamins, supplements and herbal remedies, homeopathy, hypnotherapy, guided imagery, and a wide variety of energy-healing techniques. Conventional medicine is medicine and surgery practiced by holders of an M.D. degree or a D.O. degree (a U.S.-trained doctor of osteopathic medicine) and by allied health professionals, such as physical therapists, psychologists, and registered nurses.
Practitioners of American conventional medicine were jolted to attention in 1993, however, with Dr. David Eisenberg’s landmark study in the New England Journal of Medicine, “Unconventional Medicine in the United States – Prevalence, Costs, and Patterns of Use.” Through phone surveys, Eisenberg had interviewed 1,539 adults in 1990 to inquire about their use of the most common CAM therapies. The results were startling.
Nearly 34 percent of the respondents used at least one unconventional treatment, and 72 percent did not relay the information to their doctor. Extrapolated to the entire U.S. population, Americans made an estimated 425 million visits for unconventional therapies in 1990, exceeding trips to all U.S. primary care physicians by more than 37 million visits.
Expenditures for these practices totaled approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out-of-pocket. This figure was comparable to the $12.8 billion spent out-of-pocket that year for all U.S. hospitalizations. The discovery was a wakeup call for Western healthcare systems.
Eisenberg’s 1998 follow-up survey, published in The Journal of the American Medical Association (JAMA), was even more remarkable. Demand for CAM therapies had increased, and 42 percent of U.S. adults were using unconventional therapies, paying 629 million visits to alternative practitioners. “We estimate that between $27 billion and $34 billion was spent out-of-pocket for complementary and alternative medicine,” said Eisenberg.
And the rise of alternative medicine has not been isolated to the U.S. By 2001, CAM was reported to be the second biggest growth industry in Europe. In December 2004, The European Federation of Complementary and Alternative Medicine (EFCAM ) was formed to bring together organizations, patients, CAM practitioners, researchers, and the conventional medical community to plan political actions that would gain recognition for unconventional therapies throughout Europe.
An Emerging Place for CAM
A difference in research standards between native traditions such as acupuncture and herbal medicine and conventional medicine is the primary reason Western-trained physicians have mistrusted CAM modalities.
Mostly pharmaceutically based Western medicine is built on reproducible experiments and statistical analysis, whereas CAM treatments are built on a different system of diagnosis and therapies that are individualized to the patient.
This is very different from “one-size-fits-all” healthcare. For example, asthma is treated with a standard set of medications in Western medicine, but with CAM, asthma can be effectively addressed in a multiplicity of ways, uniquely designed for the patient.
Over the years the language of CAM has changed. “Alternative medicine,” which implies an “either/or” approach such as using juicing and saunas to treat cancer instead of surgery, radiation, or chemotherapy, has given way to “complementary medicine.” This suggests that a CAM therapy can be used in conjunction with a conventional treatment.
To CAM practitioners, however, “complementary medicine” is unsatisfactory because it implies that non-invasive therapies are optional and secondary in importance. During the past decade the description of the important interplay between CAM and conventional medicine has evolved to the point that “integrative medicine” now rightfully explains that the best results include a combination of conventional methodologies and effective CAM therapies.
While few schools in the U.S. offer training and certification in CAM therapies, an educational program for physicians is offered through the Institute for Functional Medicine in Gig Harbor, Washington. A new model of healthcare, “Functional medicine” is personalized medicine. Doctors trained in Functional medicine seek primary prevention and underlying causes.
Complex, chronic diseases can be improved by intervening at multiple levels to restore health. Rather than promoting a new or separate body of knowledge, Functional medicine is grounded in scientific principles and medical school basics, including research across all disciplines.
Functional medicine physicians actively incorporate CAM therapies into their treatment protocols. The approach has been shown to repair dysfunctional physiology by restoring anatomic, biochemical, and energetic relationships. It is a transformative model that promises to become the new standard of care in medicine.
CAM in a Hospital Setting
Consumer demand for CAM is driven by a desire for treatment options and therapies beyond what conventional medicine has to offer. It represents the need for a different approach to getting well – one with a greater emphasis on healing the whole person.
For many, CAM is sought out when orthodoxy has failed. In a study of 251 cancer patients in Korea who were incorporating CAM therapies into their programs, many did so because CAM made them “feel hopeful,” a powerful statement of how patients feel toward conventional care.
But first-line CAM intervention is becoming more prevalent. The expense and worrisome side effects of conventional treatments and the desire for options beyond drugs are driving the inclusion of CAM into the hospital setting.
Integrating CAM practices into a hospital setting has a unique set of challenges, however. Administrators may at first view CAM as an untapped revenue source because consumer demand is high. But because there are few international standards for credentialing practitioners – and because training varies extensively throughout the world – institutions and insurance providers have legitimate concerns about how to evaluate a practitioner’s training and abilities.
Many hospitals include community health and “whole person” health in their mission statements, making CAM services seem a natural fit. In 2007, a 44-question survey was sent to 6,347 U.S. hospitals, with 748 responding (12 percent) and 37 of those stating that they offered CAM services.
The key reasons hospitals gave for including CAM services were patient demand (84 percent), clinical effectiveness (67 percent), and consistency with organizational mission (57 percent). The greatest challenges they faced were budgetary constraints and physician resistance. What kept them going was patient satisfaction, reported to be 86 percent.
In the U.S., some of the most elite medical centers, including the Mayo Clinic, Duke University Medical Center, Stanford Medical Center, and the University of California-San Francisco (UCSF), now offer acupuncture, massage, and other CAM services.
All 18 hospitals recently named by U.S. News as “America’s Best Hospitals” provide some type of CAM services. Fifteen of the 18 also belong to the three-year-old Consortium of Academic Health Centers for Integrative Medicine, a group of 36 U.S. teaching hospitals pushing to blend CAM with traditional care. Major hospitals around the world that are contemplating the addition of alternative practices should know they are not alone.
Where CAM is not “CAM”
While Western-trained physicians struggle to understand functional medicine, many practices considered to be “alternative” in the West have been the prevailing modes of care elsewhere for centuries. In Korea, for example, much of the population regularly uses herbal medicine, and acupuncture and hospital-based acupuncture have been available for years.
Hilot, the indigenous Filipino healing art, dates back to around the 5th century. And in 1997 Manila passed a law promoting alternative medicine, but so far no privately owned hospital offers the practice, and only a handful of state-run hospitals employ acupuncturists and hilots.
The hilots are, however, legally allowed to work in areas where registered midwives, doctors, or nurses are not present, and the practice is gaining ground. It is a matter of time before this native practice is part of existing hospital systems.
K.L.E.S. Hospital & Medical Research Center, in Belgaum City, India, has a department of Holistic Medicine that incorporates the traditional Indian medicine system into its full range of modern medical care. Services include Ayurveda, yoga, naturopathy, homeopathy, and guided meditation.
An Example of Fully Integrated Hospital Care
While adding massage and acupuncture to the in-patient setting is a significant step toward an inclusive approach, a hospital in Rosarito, Baja California, Mexico, has gone further and represents a stellar example of a hospital that offers fully integrated medical care.
Sanoviv Medical Institute opened in 1999, fulfilling the vision of its founder, Myron Wentz, PhD – also the founder of a global network marketing supplement company, USANA Health Sciences. The 47-bed hospital, situated on a cliff over the Pacific Ocean, has the look and feel of a 5-star resort.
All rooms are private, with an ocean view and a balcony, and most rooms offer a private area for a companion. Sanoviv has a medical spa, serves organic food, and offers a wide array of educational, fitness, cooking, and meditation classes for all guests and their companions.
Sanoviv’s mission is twofold. Prevention programs identify and correct unrecognized nutritional deficiencies and overall inflammation. Moreover, by combining conventional technologies and treatments with the holistic principles of oxygenation, hydration, alkalization, and good nutrition, Sanoviv’s medical programs are designed to assist in the healing of all types of chronic degenerative disease.
Personalized medicine at Sanoviv starts the moment guests arrive at San Diego International Airport, where a private van awaits to transport them safely and comfortably across the border. (All program participants are referred to as “guests” instead of “patients,” reducing the anxiety many feel when arriving at a foreign hospital.) The 40-minute scenic drive along the coast is a relaxing beginning to their hospital experience.
On arrival, guests are escorted to their rooms and given organic cotton clothing to wear throughout their stay. Each is assigned to a healthcare team that includes a medical doctor, dentist, psychologist, nutritionist and, for most guests, a chiropractor.
Beyond their medical training, the doctors have completed an intensive 18-month certification program in Functional medicine and nutrition. In addition, all medical professionals are fluent in English and Spanish.
Medical treatments at the hospital include use of a wide variety of advanced energy equipment, such as Vega technologies and the acuscope, which can identify imbalances in acupuncture meridians, the body’s often overlooked energy systems.
Highly trained technicians administer these therapies in an area of the hospital referred to as the “quiet room,” a peaceful location for relaxed, meditative healing that overlooks the ocean. Next to the quiet room is a lovely, full-service spa. Therapies are individually prescribed by the physicians as part of each person’s integrative medical program.
Whether a person is healthy and wants to remain that way or is seeking relief from chronic disease, Sanoviv’s medical programs are tailored to the guest’s specific needs and goals. The cornerstone program, Complete Diagnostic (CDP), is a one-week evaluation using conventional and functional medicine tests for a full health assessment.
Tools such as the WatchPAT™, to screen for obstructive sleep apnea, and the EndoPAT™, to non-invasively screen for endothelial inflammation, are part of the unique assessment.
Several programs are available for prevention. For those seeking to reduce stress and improve health, a one- or two-week detoxification program called Rejuvenation is the perfect healthy escape. In addition to therapeutic spa treatments, guests receive intravenous nutrients, colon hydrotherapy sessions, and full assessments from their Healthcare Team.
To encourage couples to safeguard their health, women can choose the Breast Health and Wellness Program, a one-week program that includes state-of-the-art breast thermography, while their male companions participate in the Prostate Health and Wellness Program.
Guests interested in getting in shape can choose between a two- or three-week fitness and weight loss program called Lighten Up. Designed for groups of up to eight, Lighten Up is managed by a team of nutritionists, fitness experts, and psychologists who conduct monthly aftercare calls to ensure success.
When the Lighten Up program is not an option for weight loss, Sanoviv offers a five-day Lap Band Program that includes psychology, fitness, and nutrition before the surgery to prepare the candidate and to ensure the best possible results.
Specialized programs are available to address specific health conditions. The six-week Cardiovascular Program – three weeks at Sanoviv and three at home – is designed to lower blood pressure and reduce risk factors associated with heart disease. The program includes the use of ozone, intravenous nutrients, detoxifying spa treatments, and a heavy metal toxicity evaluation.
To address neurodegenerative disease, Neuro Repair eliminates heavy metal toxicities through the use of glutathione, hyperbaric oxygen, and ozone. For all other medical conditions and degenerative disease, Detoxification, a two- to three-week intensive program, is the key to getting well.
Oncotherapy is a four-week cancer treatment protocol. It combines state-of-the-art hyperthermia with metronomic dosing of chemotherapeutic agents with nutrition, detoxifying spa treatments, and other progressive CAM therapies.
Sanoviv also has an active research department. Through associations with the Universidad Autonoma de Guadalajara and the Mexican Health Department, Sanoviv has research protocols to track outcomes.
All medical programs at Sanoviv include an extensive list of services and consultations competitively priced and packaged to include room and board and few additional costs. Nearly 70 percent of U.S. guests have a large portion of their stay reimbursed by their medical insurance.
The Future of Healthcare
As the global economy struggles to find its balance, people around the world who are looking to improve their health will be searching for safe, effective, value-driven holistic treatments. Using alternative therapies in the hospital setting and understanding how to get people well through the use of functional medicine will be the next wave of health and healing.
Examples of CAM practices:
Whole Medical Systems:
homeopathy; naturopathy; acupuncture; hilot healing; traditional Chinese medicine; Ayurveda; anthroposophic medicine.
Mind-Body Medicine: meditation:
prayer; biofeedback; therapies that use creative outlets such as art, music, or dance.
Biologically Based Practices: herbs; foods; vitamins:
Manipulative and Body-Based Practices:
massage:shiatsu; reflexology; Feldenkrais therapy; yoga; manual manipulation such as chiropractic, osteopathic, and craniosacral therapy.
Two types: 1) Biofield therapies – Qigong, reiki, tai chi, therapeutic touch. 2) Bioelectromagnetic-based therapies – pulsed fields, magnets, alternating-current or direct-current fields.
By 2001, CAM was reported to be the second biggest growth industry in Europe.
CAM treatments are built on a different system of diagnosis and therapies, individualized to the patient.
All 18 hospitals recently named by U.S. News as “America’s Best Hospitals” provide some type of CAM services.
Dr. Sherri J. Tenpenny is the Executive Director of Sanoviv Medical Institute in Rosarita, Baja California, Mexico. She is also the president and founder of OsteoMed II, a clinic established in 1996 in Cleveland, Ohio, that has provided integrative medical care to patients from 38 states and 9 countries. Dr. Tenpenny is on the Advisory Board for the Medical Tourism Association and can be reached at Sherri.Tenpenny@sanoviv.com. For more information about Sanoviv, go to www.Sanoviv.com or call 801-954-7600.