Complementary Medicine: Viable Models
McGrady, Elizabeth S., Frontiers of Health Services Management
SUMMARY * COMPLEMENTARY MEDICINE has had a quiet, consumer-based, grassroots evolution, generally spearheaded by individual champions. In this article, McGrady describes six models of complementary medicine and details specific practitioners who have implemented these models. Solo practitioners, physician-based practices, academic and research initiatives, wellness centers, provider networks, and hospital-based initiatives are discussed to display the diversity of options for complementary medicine. In addition, the author touches upon the legalities and credentialing of practitioners, as well as the financial considerations that health systems must face.
A MAN IN his fifties had tendonitis in his elbow that was so painful he could no longer play the weekly game of golf he so loved. The golf pro suggested he try acupuncture, which was successful in alleviating the pain, and he continued with his golf game. A friend of his, in her forties, suffered the same condition, also to the extent that golfing was painful. He shared his success with acupuncture with her. However, despite the testimony of her trusted friend and even though she couldn't articulate why, she wouldn't try acupuncture. Her course of treatment, prescribed by an orthopedic surgeon, included steroid injections, physical therapy including TENS, heat packs, and weight training. Several months of this treatment program has not relieved her pain, and she is now considering surgery.
As the above true story illustrates, some people embrace complementary medicine and others hesitate to even try non-traditional practices. While we marvel at the technological accomplishments of modern American allopathic medicine, we must still answer why the U.S. healthcare system ranks 37th among 191 nations even though it is the costliest, according to the World Health Organization (Modern Healthcare 2000). As the leaders in the provision of healthcare, hospitals and physicians hold the responsibility to examine their role in providing the best yet most cost beneficial means of improving the health status of our citizens. New ideas are emerging about practices complementary to conventional allopathic medicine, which may yield better results when integrated in a collaborative approach to health and wellness. The first step in this process is to assess what is currently happening in the community and determine viable models and relationships that match consumer readiness.
MAN AS MACHINE
The use of complementary medicine modalities by the public has been widely published. Of significant importance to conventional practitioners, including allopathic physicians and hospitals, is why patients are keeping it a secret. The answer is probably more telling about the practitioners than the patients. The simple answer is that conventional medicine has no room for any approach outside of the realm of allopathic medicine. In part, this is based in the Hippocratic oath in which the physician pledges to "do no harm"; many allopathic physicians are uncertain about the efficacy and safety of complementary medicine practices and practitioners. They were not taught about complementary medicine in their medical training and believe that complementary medical practices have not yet been proven by the clinical trial methodologies upon which modern Western medicine was founded.
Modern medicine as we know it evolved during the late nineteenth century and was influenced by rational laws such as Newtonian physics and Cartesian philosophy that postulated that the human body was like a clock and could be reduced to the sum of its mechanistic parts. As such, disease could be reduced to something biochemical or structural and therefore could be eradicated through pharmacological agents and surgery. This scientific framework is reductionistic and views illness to be the result of outside invaders and traumas best treated in a distant and detached manner. Although this approach can be effective for conditions with single causes, it is not always as successful for complex conditions such as chronic pain, arthritis, allergies, asthma, cancer, hypertension, depression, and digestive disorders (Cohen 1998). …