Alternative Medicine Essay Example
Alternative Medicine Essay Example

Alternative Medicine Essay Example

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  • Pages: 16 (4222 words)
  • Published: March 11, 2019
  • Type: Research Paper
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When it comes to including alternative medicine, the health care industry has various policies and standards. Sociologically speaking, unconventional or unorthodox therapies refer to medical practices that do not meet the recognized criteria of the medical community.

The New England Journal of Medicine (1993) provides a definition for unconventional therapies, stating that they encompass medical interventions not commonly taught in U.S. medical schools or readily available at U.S. hospitals. Such therapies include acupuncture, chiropractic treatments, and massage therapy.

Insurance companies, such as conventional carriers, preferred providers, or Health Maintenance Organizations (HMO), aim to generate profit by collecting premiums and reducing costs. Unfortunately, this frequently results in the exclusion of alternative treatments like chiropractic care from insurance policies. While this may lower premiums for customers, it also restricts their access to complementary therapies that might prevent or treat illnesses. Insurance companie


s prioritize implementing strict and limiting policies to maximize profitability.

Both patients and doctors in alternative therapies must demonstrate the effectiveness of unconventional treatments in alleviating and preventing illness. According to a 1991 study, spending on unconventional therapy and supplements, including diet pills and megavitamins, reached $10.3 billion. This amount was equal to out-of-pocket spending for hospital care ($12.8 billion) and nearly half of out-of-pocket spending for physicians' services ($23.5 billion) in the US that year (NEMJ, 1991). These figures indicate a growing dissatisfaction with the outcomes or side effects of surgery and drugs commonly used in modern medicine treatments.

As a result, patients are seeking alternatives like chiropractic treatment for chronic illness and pain relief. Despite some doctors expressing negative reactions towards chiropractors, studies have shown that their spinal manipulations effectively alleviate lower back pain.

Orthopedic surgeons historically have referre

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patients to chiropractors, with approximately 30 U.S. hospitals also employing chiropractors (Wallis,1991). A study conducted in 1997 found that around 42 percent of alternative therapies were used for treating existing illnesses, while the remaining 58 percent were employed for preventative measures and maintaining overall health and vitality (JAMA, 1998). It is important to note that there is a substantial demand for alternative therapy despite the limited insurance coverage available for these services (JAMA, 1998).

Coverages provided by carriers vary greatly. I contacted the Kern County Superintendent of Schools (KCSOS) Personnel Office to explore the health policies available to the office's nearly one thousand employees. Each employee has multiple options to choose from. The main hospitalization plan used by most employees is the Blue Cross Prudent Buyer Hospital Only plan.

As per State and Federal regulations, the office must offer approved HMOs to employees upon request. The office currently has a significant number of employees enrolled in Kaiser-Permanente and Health Net HMOs. The administrative agency responsible for these programs is the Self Insured Schools of California (SISC), a consortium consisting of numerous school districts in California focused on cost containment. Presently, SISC provides coverage for over 35,000 employees and their eligible dependents.

The office offers more than just medical coverage. They also provide life, vision, dental, prescription, and mental and nervous policies. The mental and nervous policy, known as a carve-out benefit, is available to all employees and their dependents. Previously, the basic Blue Cross medical plan only offered limited and specific mental and nervous benefits. Carve-out benefits cover treatments that are not covered by other policies. Many companies introduced more comprehensive and affordable plans that replaced the

medical plan component.

An additional benefit of the offered plans is the net premium savings. Pacificare, MCC, and BHA are three companies that provide comparable rates for plans that include a range of family and personal counseling services. These services focus more on preventive medicine rather than hospitalization. Employee unions have expressed favorable reception towards these plans because they contain costs and provide intervention value for their represented employees. For instance, employees with substance abuse issues can receive confidential assistance to address these problems and avoid job performance-related discipline. The basic medical plans provided by the KCSOS office also offer different levels of coverage for various alternative medicine options.The Blue Cross Prudent Hospital Only plan covers services provided by licensed doctors of medicine or osteopathy, or other licensed providers specified in this Plan Description, as long as they are practicing within the scope of their license and the services are eligible for benefits. These other providers include dentists, optometrists, dispensing opticians, podiatrists or chiropodists, psychologists, chiropractors, acupuncturists (only for acupuncture), certified registered nurse anesthetists, clinical social workers*, marriage, family and child counselors*, physical therapists*, speech pathologists*, audiologists*, occupational therapists*, and respiratory therapists*.

Please note that services provided by the providers indicated by asterisks (*) are covered only with a referral from a Physician, as defined in SISC III, 48. Health Net has partnered with American Specialty Health Plans (ASHP) to offer affordable chiropractic coverage through Chiro Net. With this program, you have the freedom to seek care from a participating chiropractor listed in the Chiro Net directory. While you are always welcome to consult your Primary Care Physician, a referral is not required to see a participating

chiropractor. The following are covered: Office visits at $10 per visit, with a limit of 30 visits per year. Additionally, there is a $50 annual allowance for chiropractic appliances such as supports, collars, pillows, heel lifts, ice packs, cushions, orthotics, rib belts, and home traction units.

The text below outlines the limitations and exclusions of Health Net coverage, including various items and services. It states that air conditioners, air purifiers, therapeutic mattresses, vitamins, minerals, nutritional supplements, durable medical equipment, and appliances or comfort items are not covered. Additionally, it mentions that conjunctive physical therapy unrelated to spinal, muscle or joint adjustment, diagnostic scanning (MRI, CAT scans or thermography), exams or treatment for non-neuromusculoskeletal disorders, hypotherapy, behavioral training, sleep therapy, weight programs, educational programs, nonmedical self-help or self-care, and self-help physical exercise training are also not covered. Lab tests, X-rays, adjustments, physical therapy or any services that are not classified as chiropractically necessary or experimental are not included in the coverage either. Furthermore, treatment for temporalmandibular joint syndrome (TMJ) and treatment or services that are not authorized by ASHP or delivered by an ASHP provider are excluded. The coverage guide provided by Health Net does not mention any coverage, limitation or exclusion of alternative medicine treatment modalities except for chiropractic treatment, which is supported in detail. Based on this information, one may infer that chiropractic is the only alternative treatment with a proven beneficial reputation in preventing illness and promoting wellness in the western world.The extremist's argument is that Health Net's lack of coverage for alternative medicine suggests that these treatments are not widely recognized or considered effective for treating illnesses. Additionally, Kaiser Permanente's coverage plan has

more exclusions and limitations on treatment coverage than Blue Cross and Health Net under the SISC administrative agency.

In contrast to Blue Cross and Health Net, Kaiser's coverage guide includes information about chiropractic services and services provided by a chiropractor in the exclusions section. However, Kaiser indicates in section j of this same section that they do not intend to cover any other alternative medicine treatments. They specify that experimental or investigational services, as well as procedures not commonly provided in the Service Area, will not be covered. According to Kaiser, experimental and investigational services are defined as any service or item that is not recognized as safe and effective according to generally accepted medical standards for treating the specific condition. This definition also encompasses services requiring approval from a governmental authority but have yet to receive it. This suggests that Kaiser classifies most forms of alternative medicine treatments (excluding chiropractic) as experimental treatments. It should be noted that assuming section j was intended to label alternative medicine as experimental would result in a misleading statement. Therefore, it can be inferred that Kaiser does not include alternative medicine treatments at all in their coverage plan.

According to Kaiser, alternative medicine is not a suitable form of treatment for illness, symptom relief, or improving health in patients. A survey conducted by The Journal of the American Medical Association revealed that the use of at least one out of sixteen alternative therapies increased from 33.8% in 1990 to 42.1% in 1997. Moreover, the likelihood of users visiting an alternative medicine practitioner rose from 36.3% to 46.3% in 1998. This suggests a nationwide trend where more and more Americans are

seeking alternatives to conventional medical treatments, focusing on preventive medicine, wellness, and alternative therapies.

Conventional or modern medicine, which is widely accepted by U.S. medical schools and insurance companies as beneficial for treating disease and illness with scientific evidence, was established in 1993. The National Institutes of Health appointed Dr. Joe Jacobs as the head of their newly created Office of Alternative Medicine in response to Congress's concern about the high cost of advanced medical treatments and the limited effectiveness of standard medicine for ailments like AIDS, cancer, arthritis, and back pain (Toufexis, 1993).

The cost of regular medical treatment has increased greatly. A basic outpatient arthroscopic cartilage repair now costs more than $5000 for a 30-minute procedure, while simple Magnetic Resonance Imaging (MRI) exceeds $1000 in price. However, a visit to a chiropractor is less than $40. The Journal of Occupational Medicine conducted a study comparing the expenses of treating back injuries using chiropractic and conventional medicine.

According to a report from 1991, the cost of care varied significantly between medical and chiropractic claims in a data set of 3062 claims.

The ongoing debate explores whether it is more effective to prioritize preventive medicine or treat diseases after they have already occurred.

As a response to this debate, an increasing number of individuals are prioritizing their health over seeking cures for their medical conditions.

A study published in the New England Journal of Medicine (nejm) in 1991 reveals that one-third of respondents who used unconventional therapy in 1990 did not use it for their primary medical conditions.

This suggests that unconventional therapy is commonly employed for non-serious medical conditions, health promotion, or disease prevention.

In 1990, patients with anxiety (45 percent), obesity

(41 percent), back problems (36 percent), depression (35 percent), or chronic pain (34 percent) had over a one in three chance of also using unconventional therapy when visiting a medical doctor.

The most frequently utilized unconventional therapies during that year were relaxation techniques, chiropractic treatment, and massage according to nejm in 1993.

The insurance companies are not acknowledging that in 1990, there were over 425 million visits to unconventional therapy providers, surpassing the estimated 388 million visits to primary care physicians. Americans also spent around 11.7 billion dollars on these services if charges for alternative therapy provider visits were fully paid (source: nejm, 1993).

There has been a rise in nutrition stores due to the demand for various vitamins and potions believed by many to be effective in preventing illness and improving overall health. Moreover, fitness centers and exercise facilities have emerged widely, some operating 24/7 and providing a wide range of equipment, technical support, and personal trainers to help individuals improve their well-being and appearance.

A study (source: nejm, 1991) reveals that society recognizes the benefits and effectiveness of unconventional therapies. On average, those seeking treatment from alternative medicine providers visited them about ten times within the previous twelve months.

The American Chiropractic Association (ACA) defines chiropractic as a treatment that focuses on the body's natural healing abilities, excluding drugs or surgery. It highlights the relationship between the spine, nervous system, and overall health. Additionally, Doctors of Chiropractic acknowledge the significance of working together with other healthcare professionals to ensure optimal patient care (ACA, 1998).

Chiropractic treatment offers advantages both in conventional medicine and as an alternative form of medicine. The scientific justification lies in the fact that almost every

nerve in the body passes through the spinal cord, making manipulation of the spine a valuable approach. Chiropractors assert that adjusting the vertebrae can relieve tension in nerves and muscles, ultimately aiding in the treatment of various ailments (Wallis, 1991). Although there were initial contradictions, further analysis and explanation will establish its validity.

According to a report by JAMA in 1998, visits to alternative therapy practitioners exceeded the projected number of visits to primary care physicians in the United States by approximately 243 million. Visits to chiropractors and massage therapists constituted almost half of all visits to alternative therapy practitioners. For instance, an on-the-job back strain could be treated in various ways. The simplest and seemingly cheapest option would be for the employee to rest in bed at home. However, this form of treatment may actually result in the employee being absent from work for a longer period. This would ultimately increase costs for the employer, including Workers Compensation premiums, expenses related to replacing the injured employee such as sick leave benefits, and the costs of hiring substitute employees.

The employee can choose between traditional treatment options, such as seeking treatment from an urgent care facility or a family physician. These treatments might involve X-rays, an MRI, or a CAT scan to aid in diagnosing the injury. If the injury is significant, surgery and physical therapy for rehabilitation may be necessary for recovery. However, if it is a minor injury, treatment could involve using cold packs, taking pain medication, and resting. Traditional physician treatment tends to be expensive, with a standard MRI costing at least one thousand dollars.

Receiving a referral to an Orthopedic Surgeon and

undergoing subsequent treatment, which may involve surgery, medication, and physical therapy, can be quite expensive, amounting to tens of thousands of dollars. Additionally, it often requires a lengthy period of time off work. After examining various medical plans, it was observed that they all offer comprehensive coverage for most types of treatment, although deductibles or co-payments may apply. However, it is worth noting that experimental treatments are usually not covered. As an alternative, acupuncture treatment could be considered. It is important to note that the acupuncturist may or may not have the necessary license to provide or order X-rays, MRIs, or CAT scans. In such cases, traditional acupuncture treatment may be prescribed. Generally, rest is advised alongside any form of treatment.

Generally, most health plans (with the exception of Kaiser-Permanente) cover the cost of acupuncture, subject to deductibles and co-payments. In my opinion, chiropractic is the fourth and most appropriate treatment. A chiropractor can order or provide X-ray examinations, as well as order MRIs or CAT scans if necessary. If there is structural damage like a ruptured disc or fracture, the chiropractor will refer the employee to an orthopedic physician. However, if the injury is due to a subluxation, the chiropractor will typically perform an adjustment to realign the spine, remove nerve interference, and alleviate pain and discomfort. The chiropractor may also prescribe rest, cold packs, and physical therapy in some cases.

The initial evaluation consists of the patients' history and assessment, X-rays, spinal adjustment, and recommendations for improving their lifestyle to promote a healthier life, such as nutrition, massage therapy, exercise, and rest. This initial examination typically costs a few hundred dollars but is partially covered

by Blue Cross and Health Net, with deductibles and co-payments applied.
Follow-up exams include spinal adjustments and advice on treatment and lifestyle-related queries. The cost of these exams is usually around fifty dollars per visit. Blue Cross covers the full amount after the deductible has been paid. Health Net requires a ten-dollar co-payment per visit, up to thirty visits per year. However, Kaiser does not provide any coverage for chiropractic care expenses.
According to an article in Kiplinger's Personal Finance Magazine, an initial visit to a chiropractor can cost between $40 and $80, plus the cost of x-rays. Follow-ups are typically around $40 to $60. Insurance laws in most states require insurers to reimburse for chiropractic treatment if they also reimburse for comparable treatment by medical doctors. Delaware, Maryland, New Mexico, and North Dakota have mandated coverage for chiropractic care.

There are no requirements in Oregon, Utah, or Vermont for insurance coverage. Self-insured plans are not subject to state-mandated benefit laws. Additionally, according to Don White from the Health Insurance Association of America, insurers are now more willing to cover alternative therapies recommended by a doctor after conventional methods have failed (Clark, 1993). Chiropractic, like other conventional medical treatments, also carries its own risks.

According to Ian Coulter, Ph.D., chiropractors perform the majority of spinal manipulations, with a rate of over 90 percent. It is important to note that "manipulation" is a general term for adjustment in the medical field. The risk of complications associated with cervical (neck) adjustments is 6.39 per 10 million adjustments, while the risk for lumbar (low back) adjustments is 1 in 100 million adjustments. In comparison, some common medical procedures and the

use of medications carry higher risks. For instance, the risk of complications with NSAIDS (such as aspirin, tylenol, ibuprofen, etc.) is 3.2 in 1,000, and cervical spine surgeries pose a risk of complications in 15.6 out of 1,000 cases. It should be noted that there has been significant media coverage surrounding the potential dangers of chiropractic care in recent years.

This article emphasizes the safety of Chiropractic procedures compared to other medical procedures. To understand the level of safety in Chiropractic, you can inquire about your Chiropractor's malpractice insurance cost. Contrasting that with the same inquiry to your medical doctor will reveal a surprising difference (Chiropractic America, 1999). These preceding procedures address injuries and their associated pain using distinct approaches.

When considering treatment options, one must take into account its personal impact on the individual and their recovery speed. If a treatment is less invasive, the recovery time will likely be faster. Additionally, pain management is a crucial factor to consider. Resting may be sufficient for certain cases, but for severe injuries, it may lead to negative long-term consequences.

Surgery typically results in significant pain and the need for pain medication, which can potentially lead to addiction. In contrast, acupuncture is minimally uncomfortable and may offer a long-term solution. Acupuncture is primarily used for pain management but can also address conditions like hypertension and gastrointestinal disorders. By placing needles on specific points of the body, impulses are believed to travel to the brain and affected organs. The cost of an initial acupuncture visit is around $225, while follow-ups cost approximately $75 and may include Chinese herbal medicines as part of the treatment (Clark, 1991). Nonetheless, chiropractic would be

my preferred choice for treatment due to its immediate relief capabilities.

Before performing a subluxation adjustment, the chiropractor utilizes X-rays to assess the effectiveness of this treatment. In the event of a structural injury, such as a disc issue or fracture, the chiropractor has the option to refer the patient to a physician. However, chiropractic treatment is generally non-invasive and comfortable. According to a report from the Rand Corporation, a renowned research organization in Santa Monica, California, a group consisting of top physicians, osteopaths, and chiropractors concluded that chiropractic manipulation is beneficial for individuals experiencing lower-back pain within two or three weeks of developing back problems, despite being generally healthy. It is estimated that around 75 percent of all Americans will experience low back pain at some point in their lives. Consequently, this condition incurs significant annual costs in the U.S.

The cost of treating the widespread ailment is estimated to be a significant 24 billion dollars, which is much higher than the costs for AIDS ($6 billion) and lung cancer ($4 billion). If spinal manipulation could alleviate even a small portion of this financial burden, skeptics would be compelled to either suppress their doubts or take action themselves (Purvis,1991).

In most cases, the use of drugs is discouraged in order to avoid drug reactions and dependencies arising from treatment. It is widely acknowledged in medical circles that many illnesses are caused by psychological factors. A growing number of doctors across the country are becoming more receptive to alternative approaches, particularly examining the interconnectedness of the body, mind, and lifestyle.

Andrew Weil, a Harvard-trained M.D. and author of The Natural Mind, practices holistic medicine in Tuscon (Wallis,1991) which acknowledges

that stress from various sources such as work and family can lead to numerous ailments. It is puzzling, therefore, that certain health organizations choose to disregard the beneficial elements of alternative medicine in any of its forms.

Despite recognizing the importance of the mental aspect in medicine, the medical community often overlooks certain treatment options that have been proven effective in promoting healing, regardless of their origin. This response can be seen as a territorial defense mechanism, as the medical community views these treatments as a potential threat to its own existence. Dr. Saper, a neurologist, supports this notion by confirming that reducing a patient's stress levels through relaxation techniques or building trust in their doctor can contribute to the healing process. Research indicates that stress can trigger the release of chemical messengers in the brain that suppress the immune system. Conversely, relaxation can revive the immune response (Wallis, 1991). However, there is an increasing trend towards embracing alternate forms of medical practices.

A telephone poll conducted by Yankelovich Clancy Shulman for TIME/CNN on October 23, 1991 surveyed 500 American adults regarding their use of alternative medicine. The findings showed that 31% sought medical help from chiropractors, 6% from acupuncturists, 5% from herbalists, 3% from homeopathic doctors, and 2% from faith healers. When asked if they would return to an alternative doctor, 84% answered yes, while only 10% said no (excluding the 6% who were unsure). Additionally, among those who had not tried alternative medicine, 62% expressed willingness to consider it if conventional medicine failed (Wallis, 1991). If a significant portion of illnesses are indeed psychological and individuals believe in the curative powers of these alternative treatments,

it is advisable for insurance companies to offer coverage for them.

In comparison to the cost of other forms of medical treatment, alternative medicines are more cost-effective, ultimately. By providing coverage for alternative medicine, society can improve their health, both physically and mentally, which will result in a decrease in illnesses and lower healthcare premiums. The focus on maintaining wellness is increasing among employers and HMOs. The use of at least one of the sixteen alternative therapies has increased from 33.8 percent in 1990 to 42.1 percent in 1997, showing that society is increasingly accepting alternative medicine. Alternative therapies are most commonly used for chronic conditions such as back problems, anxiety, depression, and headaches.

According to a study published in JAMA in November 1998, more than half of the visits for alternative medicine treatments were self-funded and not covered by health insurance. However, due to increasing demand from members, more insurance companies are starting to provide coverage. Therefore, individuals who believe in alternative medicine should make an effort to voice their demands. A study conducted in England revealed that chiropractic treatment for patients with low-back pain who are able to undergo manipulation offers significant, long-term benefits compared to standard hospital outpatient treatment. Furthermore, an extended follow-up of these patients showed that chiropractic patients continued to experience better outcomes than those treated with traditional medicine (Meade, 1431-7).

At three years, the results confirm that patients with low back pain who receive treatment from chiropractic or hospital therapists in their regular practice experience more benefits and long-term satisfaction when treated by chiropractic professionals compared to hospitals (Meade, 349-51). The importance of cost-containment is significant, especially for those who have to

personally pay for their medical treatments. As per the JAMA, the majority of individuals seeking alternative therapy practitioners in both 1990 (64.0%) and 1997 (58.3%) paid for all their expenses out-of-pocket. Nevertheless, it is evident that the trend of turning to alternative therapies is increasing.

The survey results should be considered with caution as the AMA has a vested interest in them. In 1990, one-third of respondents who used alternative therapy did not use it for any main medical condition. This suggests that a significant amount of alternative therapy was used for promoting health or preventing diseases. By 1997, 42% of all alternative therapies were exclusively used for treating existing illnesses, while the remaining 58% were used to prevent future illnesses or maintain overall health and vitality. The AMA seems to acknowledge that many individuals use alternative therapies not only for curing but also for preventing illnesses and improving their well-being.

The medical community acknowledges the significance of alternative medicine. According to an article in the Journal of the American Medical Association (JAMA, 1998), it would be unjust to exclude individuals without health insurance or with limited income from accessing beneficial alternative medical services or seeking professional advice on using or avoiding alternative therapies. The AMA recognizes the value of these services by referring to them as "useful alternative medical services."

In fact, according to the American Medical Association (AMA), an increasing number of US insurers and managed care organizations now provide alternative medicine programs and benefits. Additionally, a majority of US medical schools offer courses on alternative medicine. The Journal of the American Medical Association conducted a study in collaboration with the Stanford Center for Research in

Disease Prevention, which concluded that significant numbers of people in both the United States and abroad are involved with various forms of alternative medicine. However, the reasons for this usage are currently not well understood. The study tested three hypotheses to explain this phenomenon: (1) dissatisfaction with conventional treatment, (2) belief that alternative treatments offer more personal autonomy and control over health care decisions, and (3) perception that alternatives align better with patients' values, worldview, or beliefs regarding health and wellness.

Additional predictor variables investigated involved demographics and health status. The study's findings were intriguing. Most alternative medicine users, despite having higher education and indicating poorer health status, seemed to choose these alternative therapies not primarily due to dissatisfaction with conventional medicine but mostly because they align better with their own values, beliefs, and philosophies.

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