Complimentary care can lower health costs
Patients have more choices than ever

by Christopher Key

 

Technology has introduced amazing new forms of treatment to “Western” medicine. It has also contributed heavily to astronomical health care costs that preclude more and more people from taking advantage of such treatment. A growing number of patients are turning away from what is not very accurately described as “traditional” medicine. In fact, the prevailing medical paradigm in North America is just slightly over 100 years old.

Both the receivers and the providers of medical care are also rejecting the once unassailable idea that doctors are somehow omniscient when it comes to what the patient needs. Patient-centered care, where the medical layperson takes greater responsibility for his or her own care, is a prominent buzzword in health care circles today.

Preventive care is a supremely sensible concept, and yet we still smoke, eat unhealthy foods and exercise only with the TV remote. Western medicine has been focused for years on treating the sick rather than preventing the sickness. There are lots of other choices that are not only more effective and less invasive than “traditional” medicine, but are far less expensive, as well. That lower bottom line has even caught the attention of the health insurers who are now paying for a much wider variety of treatment than they did just a few years ago. And whatever you do, don’t call it alternative care.

“By calling it alternative care,” said naturopathic physician Dr. Dennis Littleton, “we are dichotomizing the different approaches. It is not an either/or situation. People can have both.”

Indeed, most complimentary care practitioners believe in working closely with other providers, but the favor is not always returned.

“In every other developed country in the world,” Littleton said, “people consult a naturopath first, then a specialist in medicine, then a technical specialist.”

From a purely technical standpoint, the training received by a naturopathic physician is very similar to that of an MD. The main difference is philosophical.

“We are preventive medical specialists,” said Littleton. “This is about lifestyle patterns, avoiding disease. It’s about living a robust quality of life rather than waiting for something to go wrong. It’s about healing versus medicine.”

According to Littleton, only the material aspects of illness are addressed by the conventional system. Not surprising given the materialistic nature of our society. Holistic practitioners, as the name suggests, treat the whole person.

“Preventive medicine has never gained acceptance,” Littleton said, “primarily for economic reasons. The health care industry can’t make as much money off it. Our values get transmitted from one generation to the next and it’s very difficult to accept a transition.”

Preventive care, according to Littleton, is always up for redefinition as opposed to more rigid models. He also points out that some oriental approaches date back thousands of years, which is why referring to western medicine as “traditional” rings a bit off-key.

“Oriental medicine,” Littleton said, “asks what took place before a disease takes material form, such as a tumor. What led to that problem?”

Our material bodies, Littleton explained, often get in the way of true healing.

“Our bodies like structure and predictability,” said Littleton. “They demand all our attention. Any change means death. We fear change and fear the learning curve that goes along with change.”

Changing the prevailing system will require patients to develop a sense of responsibility and accountability for their own health.

“For decades now, we have been surrendering control of our health to the medical establishment,” Littleton said. “That needs to change.”

Even a sizeable proportion of the “medical establishment” is coming to agree with that thesis.

“As the number of MD’s gets smaller in proportion to the population,” Littleton said, “standards will get lowered. The lines of people waiting for health care will get longer until they reach crisis proportions. Then, what will people do?”

In order to keep up, many practitioners have turned to ancillary personnel, such as physicians’ assistants.

“Some naturopaths will also be getting more recognition,” Littleton said. “People will eventually be forced to live differently.”

MDs, who receive at least four years of pharmacology, may be forced to rethink the chemical management approach to treatment. Littleton thinks this will happen gradually as they are forced to deal with the results of a drug oriented model. That will require reevaluating our whole belief system.

“Health care providers need to be neutral observers,” Littleton said, “and we can’t do that if our belief systems get in the way.”

The successful health care provider of the future, according to Littleton, must be able to draw on every available paradigm. They will be much more open-minded, he thinks, and be trained in communications skills. The patient will be at the center of any treatment plan and his or her ultimate authority will never be usurped. Integrated medical groups including many types of practitioners, will work together, recognizing that each has something unique to offer.

“Health care recipients should stop expecting MDs to practice like naturopaths,” Littleton said. “Let them do what they’re good at and let me do what I’m good at.”

Littleton himself has far more training than most MDs. He has a master’s in medical microbiology and worked for 12 years as a medical technologist. He has a four-year doctorate in naturopathy and a master’s level education in Chinese medicine and acupuncture.

“Do you know what I do for a living?” Littleton asked. “I listen.”

For years, the medical establishment tried to characterize chiropractors as quacks. Those days are gone, for the most part, and chiropractic is now widely accepted for a very simple reason. It works. That has been scientifically proved beyond a shadow of a doubt. Most medical insurance programs now pay for chiropractic care.

“We’re mainstream now,” said Dr. Jeffrey K. Sather. “For the past few years, there have been more visits to chiropractors than MDs. This happened even though, until recently, insurance wouldn’t pay for it and it came out of the patient’s pocket.”

Washington state L & I (Labor and Industries) statistics showed that chiropractors treated 54 percent more injured workers at 32 percent less cost per claim at a time when health care costs in general were skyrocketing.

According to the New England Journal of Medicine, over 80 percent of Americans will have spinal health problems in their lifetime. It’s the second largest cause of hospitalization in the US and medical experts estimate that 71 percent of those hospitalizations are inappropriate. More back pain sufferers now seek chiropractic care than any other treatment. Studies in Florida, California, Kansas and Washington show why: chiropractic cost was 50 percent less; recovery time was 367 percent faster; patient satisfaction was 300 percent greater.

“Chiropractic is no big mystery,” said Sather. “If you understand how the body works, if you understand anatomy and physiology (A & P), then the mystery goes away.”

Sather points out that the Latin root from which the word doctor comes is “docere,” to teach. He sees himself as a teacher first, then a health care provider.

“The pharmaceutical companies spend $30 million a day on advertising,” Sather said. “It’s no wonder we assume that drugs can take care of everything. We’ve spent six trillion on cancer research and the basic approach hasn’t changed: radiation, chemotherapy and surgery.”

Sather worked in construction before undergoing a mid-life change that led him to study chiropractic at Palmer West in California.

“I had a desire to help,” Sather said, “and I was intrigued by the idea that you could produce improvements in well being by adjusting the spine.”

Most chiropractic schools require some pre-medical studies. Their teaching focus is on anatomy and physiology, biochemistry, and physics. Sather says you can complete the 13 quarters of study in three years if you go full time and don’t take summer breaks. The last three quarters are spent in supervised hands-on situations in student clinics.

“We get more A & P than MDs do,” Sather said. “We learn how biomechanical processes affect the nervous system. If we improve the function of the nervous system, it allows the body to function properly. We don’t cure anything. We work with the patient to improve the function of the body, which, in turn, promotes healing.”

Most people live with some kind of pain, according to Sather, and it’s mostly unnecessary.

“Chiropractic started in the in the late 1800s,” Sather said, “and was widely accepted until MDs gained the upper hand with the advent of penicillin. They became more powerful as a group and tried to eliminate competition.”

Chiropractic was on the defensive until 1987 when a district court ruled in Wilks vs. the American Medical Association (AMA) that the AMA had conspired to destroy chiropractic and thereby violated antitrust laws. The ruling was upheld on appeal.

“It’s unfortunate that some MDs still choose not to work with us,” Sather said. “The patients are the ones paying the price and the public deserves better. We’ve tried to interact, but how many times can you stand getting slapped down? The old ways tend to linger here, but younger physicians are now leaning more toward the patient first approach. I don’t concern myself with the politics of the situation. My goal is to assist patients to the best of my ability.”

Judy Chiasson was doing social work for a small agency when she first went to a chiropractor to help restore muscle function after an ankle injury. She was impressed with the results, but friends were urging her to explore acupuncture.

“I am a very needle-phobic person,” Chiasson said, “but I had to check it out.”

She took an introductory class and found acupuncture to be totally different than what she expected.

“The needles are not like the ones on hypodermics,” Chiasson said. “They are hair-fine and flexible, so there is minimal discomfort. Some patients don’t feel anything at all. For some, there may be a tingling or a dull ache. The treatment is very relaxing. You get that ‘wet noodle’ sensation like after a massage.”

She not only went on to become a licensed acupuncturist, but followed it up with studies in herbal medicine. She graduated second in her class from the Seattle Institute of Oriental Medicine. That requires premed courses, then three years of full time work including a large proportion of clinic hours. Now, physicians are starting to refer patients to her for pain treatment. She specializes in pain issues and women’s health and is branching out into treating chemical dependency and withdrawal.

“You don’t have to believe in acupuncture for it to work,” Chiasson said. “Many people have tried other approaches before coming here. Sometimes it helps for me to walk people through the process.”

Often, her treatments help people, but she cautions that acupuncture is not a panacea.

“No single health profession can help everyone,” Chiasson said. “It’s good to have a variety of approaches available.”

Herbal medicine relies on a completely different diagnostic system.

“We don’t just treat a headache,” Chiasson said. “We break it down into many subcategories depending on what caused the headache. Chinese herbs are given in an elegantly crafted formula that might involve 8-14 substances, depending on the patient. What doesn’t work tells us as much as what did.”

Chiasson is quick to point out that people without training can easily misuse herbs. Ma huang (ephedrine) is a good example. Untrained people have been using it for increasing energy or weight loss. Chiasson says this is a dangerous misuse of the drug. It is valuable for short-term treatment of colds in combination with other herbs.

“It would be a tragedy to lose the use of Ma huang,” Chiasson said, “as a result of people misunderstanding how it should be used.”

Chiasson recently returned from China where she pursued advanced studies.

“In China, they use both eastern and western paradigms,” Chiasson said. “Tests developed by western medicine are often used to check treatments in the eastern tradition. There is enormously more acceptance of the ancient practices by physicians. They usually try acupuncture before more invasive procedures. Everybody works together.”

Ranan Rauch originally came to Bellingham to get her master’s in exercise physiology at Western Washington University. She has served as visiting faculty at WWU and taught at the Northwest Indian School. Rauch felt that something was missing in her training and that something turned out to be Chinese medicine.

She studied at the International College of Traditional Chinese Medicine where she learned acupuncture and herbology. While in China, she also became interested in a treatment method known as Qi Gong. Qi is pronounced “chee,” and refers to energy. It’s as ancient as other oriental paradigms and similar in some ways to Reiki.

Qi Gong teaches that there is a flow of energy throughout the body. When that flow is not blocked, you’re in good health. When you’re not in good health, a practitioner of Qi Gong can help restore the correct flow of energy. Rauch’s practice is called Rei-nan Taoist Healing Arts. Rei-nan was chosen because of the similarity to her name. It means “whisper of auspicious healing.”

“We are all becoming aware that the patient is responsible for his or her own health,” Rauch said. “Too much dependence on doctors doesn’t always lead to good health. I try to walk with you through the healing process rather than trying to do it for you. No one can heal without the patient’s help.”

She is a firm believer in the both/and approach rather than the either/or.

“I refer patients to MDs right away if that is what’s needed,” Rauch said, “and they often refer to me. I can help support radiation and chemotherapy.”

It hasn’t been easy to familiarize people with different approaches and complimentary practitioners sometimes have to be discreet in how they present themselves.

“The key lies in taking away pain instead of masking it,” Rauch said.

It seems quite possible that complimentary health practitioners may help take away more than just our bodily aches and pains. They also may be a vital part of the solution to an increasingly painful and dysfunctional health care system.