It was a case of art imitating life. Still desperately wanting a baby after a series of failed infertility treatments, the character Charlotte York on HBO’s Sex and the City bumped into a friend during lunch one day. Believing that the friend was unable to get pregnant, Charlotte was shocked to see her expecting a baby and asked how it was possible. The friend raved about Dr. Mao, an acupuncturist who had helped hundreds of women overcome infertility with the traditional Chinese treatment and herbal therapies. And while the fictitious story line ultimately took a humorous approach to the subject matter, the scenario was actually steeped in reality.
Women undergoing in-vitro fertilization can increase their chances of becoming pregnant by nearly 65 percent if they also receive acupuncture.
—British Medical Journal
In fact, a recent report published in the British Medical Journal revealed that women undergoing in-vitro fertilization can increase their chances of becoming pregnant by nearly 65 percent if they also receive acupuncture. It’s this type of scientific evidence that has brought a compelling topic to the forefront in the healthcare dialogue—the pervasiveness and effectiveness of complementary and alternative medicine (CAM).
According to a survey conducted in 2007 by the National Institute of Health’s National Center for Complementary and Alternative Medicine (NCCAM), the government’s lead agency for scientific research on CAM, Americans spent $33.9 billion out of pocket on CAM treatments during the previous 12-month period, which accounted for approximately 1.5 percent of total healthcare expenditures and 11.2 percent of out-of-pocket costs for the year. In addition, more than 38 percent of adults and 12 percent of children use some form of CAM as part of their healthcare regimen.
“People are increasingly aware of the limitations of conventional medicine, including the side effects of medication. They also like to play an active role in maintaining their own health,” explains Zhaoming Chen, M.D., Ph.D., M.S., C.F.P., F.A.A.I.M., chair of the American Association of Integrative Medicine (AAIM). “The human body is the most sophisticated being, and it needs comprehensive care. Integrative medicine can truly serve the best interests of patients.”
According to NCCAM, paying for CAM is a frequently discussed topic. Most patients end up paying for CAM treatments out of pocket, as insurance companies are still wary about covering some of the unproven therapies. And when insurance companies do cover CAM, the coverage “varies by state and is often limited.” However, some therapies have made the list, such as chiropractic care, acupuncture, massage therapy, biofeedback and naturopathy. As patient interest in CAM options grows, insurance companies and managed-care organizations are evaluating if and how they will cover these medical alternatives. Talk to a representative from your insurance carrier to learn more about what your plan covers.
Understanding the terms
Hold on a second, you’re thinking. Are we talking about complementary medicine, alternative medicine or integrative medicine? It’s easy to get confused, especially since the terms are often used interchangeably. However, there is a difference, and it’s important to recognize it.
The Mayo Clinic defines complementary medicine as treatments that are used in addition to conventional therapies prescribed by a doctor; alternative medicine encompasses treatments that are used instead of conventional methods. For example, Chen notes, using acupuncture to treat pain and nausea associated with chemotherapy would be complementary medicine, while using herbal medicine alone to treat a chronic disease would exemplify alternative medicine. Integrative medicine actually takes complementary medicine to the next level. NCCAM experts describe it as combining “treatments from conventional medicine and CAM for which there is evidence of safety and effectiveness,” such as using both statin medication and fish oil to reduce cholesterol levels, Chen adds. “Integrative medicine is a personalized medicine—the medicine of the 21st century,” he says. “It provides optimal medical care based on an individual’s medical condition only, blending the pros of both medical systems with few or no cons.”
Of course, before you can choose the right CAM option, you need to know what is available to you. The experts from NCCAM state, “According to the 2007 National Health Interview Survey, the top 10 most common CAM therapies among U.S. adults are natural products, deep breathing, meditation, chiropractic and osteopathic manipulation, massage, yoga, diet-based therapies, progressive relaxation, guided imagery and homeopathic treatment.” Additional practitioner-based therapies include acupuncture, Ayurvedic medicine, biofeedback, chelation therapy, naturopathy, reflexology and Reiki, among other treatments. See the sidebar CAM at a Glance for definitions of popular complementary and alternative therapies.
Awaiting a verdict
Whether or not CAM works is debated daily, as advocates extol the benefits of its therapies and skeptics look for unequivocal proof. Fortunately, research in this area has surged in recent years. “NCCAM research efforts inform the integrative-healthcare movement, as CAM modalities are increasingly used in conjunction with conventional care,” the experts at NCCAM observe. “However, as with all areas of medical research, building a solid evidence base takes time. We learn from each study, whether positive or negative. Each study contributes to building that evidence base for integrative medicine and informs and shapes future research.”
For instance, a clinical trial conducted by Memorial Sloan-Kettering Cancer Center indicated that cancer patients who received massage therapy were able to reduce symptoms like pain, fatigue, stress and anxiety, nausea and depression by approximately 50 percent. Additionally, the results of a 2009 study published in the Archives of Internal Medicine showed that an 8-week course of acupuncture significantly improved patients’ symptoms of chronic low-back pain. Chen also points to other research that has supported CAM in terms of pain management, stress reduction and improving sleep quality. At least a portion of these positive results may be attributed to the fact that many CAM therapies focus on the mind-body connection, which can be powerful in terms of healing. “An individual’s mind, including thinking pattern, experiences and mood, can affect the function of the body for good or bad,” Chen says. “We now realize that health is harmony physically, mentally and spiritually.”
While research is still ongoing, integrative medicine has made great strides in the conventional-healthcare setting. “More and more physicians are recommending and even offering the integrative approach to help patients,” Chen says. The experts at NCCAM add, “NCCAM research influences patient care as CAM practices are integrated into clinical-practice guidelines. For example, the American College of Physicians and the American Pain Society include CAM treatments in their guidelines as options for treating low-back pain.”
Some physicians are even learning how to administer CAM therapies themselves. Case in point, as Chen reveals, there are now several approved programs offering acupuncture training for conventional-medicine physicians who want to become licensed acupuncturists.
In the end, the NCCAM asserts that it’s important to talk with your doctor about any treatments you wish to try to ensure safe and coordinated care. Furthermore, Chen maintains that conventional medicine will always have its merits, so you should not reject standard medical care. “Western medicine has made wonderful scientific breakthroughs that have allowed us to diagnose and treat acute diseases with pharmaceuticals and advanced surgical skills,” he concludes. “But there are two distinct medical systems developed from different cultures, wisdoms and philosophies in different parts of the world. Many CAM therapies have a history of thousands of years, with billions of people having practiced them. This is the biggest clinical trial ever—billions of people can’t be wrong for thousands of years.
CAM AT A GLANCE
While you’re probably familiar with terms like chiropractic and massage, the names of other CAM therapies might be new to you. Refer to the following list to learn more about some of the most popular treatments available.
- Acupuncture: One of the oldest healing practices in the world, this traditional Chinese medicine aims to restore and maintain health through the stimulation of specific points on the body by penetrating the skin with thin, solid, metallic needles.
- Ayurvedic medicine: Originating in India, this is one of the oldest medical systems in the world and comprises a variety of techniques, including the use of herbs, massage and specialized diets.
- Biofeedback: A therapy that involves learning to control involuntary body responses such as heart rate, brain activity, or blood pressure, this non-medical treatment uses special equipment to monitor bodily processes.
- Chelation therapy: This is an investigational therapy using a man-made amino acid called EDTA, which is added to the blood through a vein. An international research study is now testing whether this therapy is safe and effective for treating heart disease.
- Naturopathy: A whole medical system that is rooted in healthcare approaches that were popular in Europe in the 19th century, this therapy places an emphasis on supporting health rather than combating disease and promotes the use of natural substances instead of pharmaceuticals and surgery.
- Reiki: A Japanese healing practice in which practitioners place their hands lightly on or just above the person receiving treatment, Reiki’s goal is to facilitate the patient’s own healing response.
—National Center for Complementary and Alternative Medicine
TIPS FROM ATLANTA EXPERTS
We asked some local experts why it is important to explore complements and alternatives to traditional Western medicine today, and here’s what they had to say:
The practice of medicine is both a science and an art, and there is much to be learned from the respect and study of alternative approaches to health. No country has a monopoly on medicine, and each group brings its own unique perspective. Western medicine, for example, tends to focus on science and ignores or minimizes spirituality. Examination of alternative medicine may offer patients therapy that complements traditional Western approaches.
—J.K. Champion M.D., Videoscopic Institute of Atlanta
Nobody cares about your health and well being more than you. Unlike Western medicine, where your level of care is often dictated by insurance companies and politics, alternative medicine empowers you to control the direction of your health. There is a time and place for each discipline, including traditional Western medicine; the key is to seek out a team of health professionals who recognize that many traditional and nontraditional disciplines complement one another, and who are willing to work together for one common goal your health.
—Cheryl A. Luther D.C., M.S., C.C.E.P., C.S.C.S., P.E.S., Sport and Spine Performance Institute
We are fortunate to have traditional Western medicine at our fingertips. However, incorporating alternative-healthcare modalities into our lifestyle can not only optimize our well being, but possibly greatly reduce our use of costly medications, procedures and surgeries. Our bodies contain their own “pharmacies” within to heal themselves. Complementary medicine encourages the body to produce what substances it needs to provide healing and protect us from disease.
—Sandi Stephens, Tuscan Sun Massage and Wellness Center
Like the rest of our lives, Western medicine has evolved with technology. Doctors can do things with medicines, treatments and surgeries that were thought impossible not too many years ago. However, very few of these new breakthroughs have come without dangerous potential side effects. Just read the long list of possible reactions found on most prescription and over-the-counter medications and you will wonder if the cure is worth the risk. Natural medicine, on the other hand, has been around for thousands of years. Like modern medicine, it has benefited from breakthroughs in technology. Our understanding of the body and how it works is far more advanced than in recent years, and with that understanding comes even better application of natural/alternative treatments to help cure and prevent illness.
—Natalie Flurry, The Detox Diva
Many treatments which we recognize today as mainstream medicine were once defined as alternative. On the other hand, many scam treatments have fallen by the medical wayside. What separates the two is the scientific method. Unsupported claims, testimonials and wishful thinking are not a substitute for scientific proof, but contempt prior to investigation arrests progress altogether.
—James Fugedy, M.D., Atlanta Pain Doctors
In today’s world, you have to be your own doctor. By that I mean you have to research your symptoms, talk to experts, visit specialists, then choose whose advice seems to make the most sense. I tell patients that whenever they have a health problem, they should explore Eastern, Western and alternative specialties. Research and investigate. Listen to testimonials. The more information, the better.
—Dr. Ronald Tucker, Brookhaven Chiropractic
It is important to explore complementary/alternative medicines, as they take a broader, more holistic approach in their application in determining the root cause of the pain/disease and balance the body through a variety of means, including dietary adjustments, mind-body development, energy medicine, etc. Traditional Western medicine may treat the site of pain, but not necessarily treat the problem since pain often can be referred to other areas of the body.
—Kyle Holloman, Concourse Athletic Club
Everything old is now new again in the field of nutritional medicine. Traditional medicine has not kept up with the change, as evidenced by the rapid rise in degenerative diseases. As the new emerges, we find answers for degenerative diseases that has eluded traditional medicine. Drug therapy provides nothing but a Band-Aid. Whole-food nutrition actually feeds and nourishes the body so it can heal and regenerate itself.
—Chris Greene, D.O., Dr. Chris’ Natural Remedies
Many so-called alternative approaches emphasize preventative care. For instance, life coaching encourages the client to confront his or her life choices while educating the person on the likely outcomes of such. Furthermore, the coach assists the client to design a strategic plan of action, which, when implemented, will ward off potential harm and, even more importantly, bring well being and an experience of wholeness to the client.
—Farra Allen, MA Psych, Director LifeWorks School of Coaching