Over the past two decades alternative therapies have played an increasingly prominent role in the American health care system.
From groceries stores to pharmacies, homeopathic treatments and over the counter herbal remedies have crowded the isles that where once devoted to analgesics, sore throat lozenges and multivitamins. Even medical schools are embracing this rise by developing a curriculum to understand alternative forms of healing.
To better appreciate these changes one should first understand the history of medicine in the U.S.. As in all forms of development, medicine is also subject to politics and the socio-economic needs of the people.
The period from 1890s to the1920’s was a progressive era for physicians. It was during this time that physicians successfully established institutionalized and therapeutic control over the growth of medicine. In other words MD’s were able to sway most Americans to their cause of healthcare. This dominance in the political and social arena was effective in the establishment of a state sponsored monopoly of health care in the US. Lacking in both institutional power and scientific legitimacy, non-orthodox therapies retreated to marginal use. Keep in mind that alternative therapies had thousand of years of experiential knowledge in specific cultures. Due to this lacking in scientific data, the development and support of medical school and the advent of the pharmaceutical companies, the political and social context took over. This new developed medical model was embraced by the physicians claim as the expert. Skepticism and outright disdain of different voices forced the repression of alternative practices.
As the medical model became the voice of Americans, so did the need for the administrative scope of practice. There were questions and concerns whether Doctors would be able to maintain their professional autonomy against the inclusion of the corporate cost of running and managing medical practices, hospitals and medical schools, still this therapeutic authority of the physicians remained unchallenged until the end of the 1920s. During this period, the advent of the pharmaceutical companies began to take hold of the American health care model and with that the adoption in the medical schools of the use and practice of pharmaceuticals as protocols for symptoms displayed by patients. The growth of health care demanded administrative oversight and insurances to assure proper care and payment of services. More and more medicine of the sole practitioner was taken over by its bureaucracy. Some surely remember the physicians making home visits and office hours around patient needs and emergencies. Oftentimes the family physician was an intrical part of the family, delivering children, caring for their illnesses, became friend and social worker to the communities they served. The family physician became the specialist, the independent doctor could no longer maintain private practice and eventually came under corporate authority therefore the practice of medicine became a business.
Fast forward to the 20th century, the most powerful symbol of recent coming of age was the establishment of the office of alternative medicine (OAM) within the National Institute of Health. There were two senators responsible for the growth of this office, Senator Tom Harkin and Senator Orrin Hatch, a liberal from Iowa and a conservative from Utah.
Senator Harkin was a fervent believer in bee pollen for immunity and credits acupuncture in assisting with his terminally ill brother with comfort measures. Senator Hatch was a strong supporter of chiropractors and dietary supplements. These two Senators in 1994 pushed through legislation in congress called the Dietary Supplement Health and Education Act. This act not only allowed the use of dietary supplements, it protected supplements from the food and drug administration allowing freedom by consumers the use of supplementation. In 1998 both senators upgraded OAM to CAM, The National Center for Complimentary and Alternative Medicine.
CAM is one of the fastest growing fields in health care today and is more widely used than ever before. This widespread use has impacted practitioners, researchers and policy makers and the growing need to better understand the market from a personal and public health prospective.
This recent increase in interest and growth of CAM can be attributed to technological issues, economic and cultural issues as well as social trends. Also fueled by the rising dissatisfaction with traditional health care and delivery and the cost of medicine in the US. The once skeptical thought and disdain held by the American consumer is now replaced with empowerment, personal savings accounts and the internet enabling greater access to alternative medicine.
Some Americans feel the use of both CAM and traditional medicine enhance each other, filling in the gaps with treatment of chronic pain and other conditions that conventional medical practices are not always successful at achieving results. CAM is also particularly helpful in terminal conditions to enhance quality from the significant side effects of powerful drugs used for cancer. Other Americans are just turning to CAM because they feel the current healthcare system is failing them for many reasons. Some of these reasons are access to health insurance, cost prohibitive prescriptions, impersonal and dismissive physicians, a heavy reliance on drugs, misdiagnosis and conflicting views regarding the maintenance of wellness.
This empowered approach to wellness is a focused and more holistic method at achieving wellness, moving away from disease management. So, moving away from technology and focusing on the natural healing abilities of the body, encourages the user to invoke his or her personal value system.
Despite its fast growth, there are still low levels of understanding regarding complementary and alternative medicine. As evidence based research continues to grow this aspect will also be incorporated into routine physical care.
The emphasis with CAM therapies is always the natural healing ability of the body with focus on treating the whole person. Prevention is always the primary goal, treatments are always highly individualized, focusing on root cause rather than symptoms, and designed to support the natural healing process of the body.
There are whole medical systems that originated much earlier than conventional western medicine. They are based on philosophy and lifestyle. Some have been developed in western cultures such as homeopathy and naturopathy while others come from non-western cultures. Ayurvedic medicine is a medical system practiced in India and it focuses on practices of yoga, meditation, massage diets and herbs. Ancient medicines include Chinese medicine consisting of acupuncture, qigong, herbal medicine exercise and food therapy.
There are mind/body interventions focusing on psychotherapy, guided imagery, mediation, prayer, mental healing, hypnosis, dance, music and art therapy.
Biologically based treatments to include the use of herbs, minerals, hormones, specialized diets and dietary supplements.
Manipulative and body based treatments could include chiropractic care osteopathic care, massage therapy, pressure points therapy, polarity and cranio-sacral therapy.
Now the shift to integrative care which is an evolutionary measure arises from the CAM therapies, combining mainstream medical western therapies.
As we look back on our history of healthcare in this country we can understand the shifts and needs that are directed by the consumers of the U.S. One thing seems perfectly clear and that is the self centered patient approach to wellness is paramount. With the downside effects of prescription drugs, the high cost of medical care, the unavailability of affordable insurance, more and more Americans are seeking to empower themselves through life style changes and whole body systems that require personal participation according to their value systems.
These trends indicate that both the American public and those within the field of healthcare are carefully moving in the directions of an integrative medicine system that will support both CAM therapies and conventional medical care.
Western medicine excels in crisis intervention, given the use of technology, surgery and pharmaceutical intervention. Cam therapies are much more adept at treating chronic conditions as well as preventative maintenance. These two systems of care if utilized properly can provide the best possible world for the patient and is extremely cost affective. Imagine a world where quality supersedes profit and the maintenance of health is no longer a commodity held by the wealthy but a necessity for all Americans to ensure a valued successful life.