CAM: The Hidden Healthcare Systems
Wednesday, April 25th, 2007Having just come from the 5th conference on Integrative Medicine, it is more obvious than ever that patients are taking their health into their own hands, like it or not. AARP and NIH have both published statistics that indicated (1) billions of out-pocket dollars are being spent on complementary or alternative therapies and (2) no one is talking. The part that indicates the gap between what patients do and what they tell their physicians is dangerous given the known conflicts between drugs and herbs, between over the counter meds and prescription drugs.
Hospitals that are setting new standards for exemplary care are intentionally venturing into the arena of CAM for all good reasons. The therapies in question, which includes everything from music therapy to therapeutic touch to massage to acupunture and more…these are effective, have low to no risk to patients, and bring back into a technologically based system the human and caring modalities that were the basis of medicine for hundreds of years. Furthermore, current practices are still not providing treatments that are 100% effective for everyone and therefore can benefit from complementary practices.
On this side of this conversation, it is clear to me that I use everything. I take seriously the advice of my hand-picked physician, I pay attention to other kinds of options that will keep me from overusing pharmaceuticals each of which has a long list of side effects, and I have integrated music, art, good diet, exercise, joy, laughter, and love into my life. Why is it that these same practices that make life worth living are not considered serious enough to be provided when life is threatened by illness? Florence Nightingale knew all along that what makes life good is ever more important to the confined patient who is already a victim of a malady over which they have little control. The best physician has a sense of humor, hugs patients, laughs with their staff, is open-minded enough to listen to their patients and give
information to prevent a patient from harming themselves.
In reality, CAM is not CAM but is good medicine, integrating all the modalities that may help their patients. Primary care will be redefined to include quality of living practices, not just taking aspirin and calling in the morning. It might even become clear that laughing …really a good belly laugh…is good respiratory exercise, that singing helps oxygenation, that being touched by someone who loves us is mandatory for each of us to thrive, and that food that is healthy tastes better than bare herbs and FDA approved pills.
This conference focused on the Optimal Health Environment which is, of course, where Dallas and I have placed our work for two decades. What is most encouraging is that the discussion has become so much broader, now including the built environment and, most critically, many other factors that in totality become the context in which one experiences either health or disease. The work of the Samueli Institute is bringing forward not only this broader definition of what the Optimal Healing Environment is, but is also funding the research needed to demand changes in our current allopathic system.
I will write more from the event as will Dallas…we are still putting together our thoughts from a most stimulating two days.
April 25th, 2007 at 11:41 am
The recent conference on Integrative Medicine (healthcare delivery that encompasses traditional and alternative practices) was exceptional in its positive and optimistic atmosphere according to several of the presenters more accustomed to presenting to disgruntled physicians. The optimism present at the conference was based on the celebration of the pioneering work presented by several leading hospital systems, in which complementary and alternative medicine (CAM) is available within the traditional hospital context.
Much discussion was centered around the failings of our healthcare system on the organizational level. Problems of overworked nurses, declining physician reimbursements, and accessibility for the approximately 46 million Americans without health insurance, are endemic to our current system. A realistic assessment of the political climate led to the prediction that healthcare reform will occur on a state-by-state basis rather than through some grand design ala the Clinton plan.
One interesting discussion concerned the need for more research in the field of CAM. The majority of research, funded to a large degree by the pharmaceutical industry, is tilted toward the testing and validation of a single element (drug, protocol, etc.) being used on a single population (demographic, diagnosis, etc.). This the research pathway used to bring new drugs into the market. It is much more difficult to design rigorous research that takes a broader view favored by practitioners of integrative medicine. The traditional allopathic approach is (forgive my gross oversimplification) to diagnose specific symptoms and prescribe specific treatment protocols resulting in the absence of disease. The integrative approach seeks to promote total health/wellness (a broader more vague concept) through the application of practices more geared to prevention and promotion of healthy lifestyles (again, a gross generalization). Both approaches deserve to be researched. And both approaches belong in our hospitals. The integrative approach is still the exception rather than the common accepted approach in most hospitals.
Finally, the point was made that everyone (another generality) working in healthcare must have within themselves the desire to be a “healer.” This healing impulse is a natural part of human nature. As a society, we need to support the creation of a healthcare system that supports the realization of the fullest potential of all the individuals working within it. The financial underpinnings of the healthcare system must encompass prevention and wellness promotion, as opposed to the current fee-for-service system that perpetuates the highest cost-per-capita in the world while delivering a level of healthcare that has been documented as being lower than many other countries in the developed world. This conference revealed desirable directions and trends for the future as well as highlighting some current model institutions led by outstanding role-models for leadership in this complex field.