Will Integrative Medicine be
the Future of Healthcare?
Part III in a series (The Solution)
(Gem State Patriot) – Our approach to a healthy society is upside down: Those who are involved in healthcare have built an entire trillion dollar industry around it. As a nation, we do not try to keep our citizens healthy by any means. What we do is continue to allow corporations to use untested chemicals in household products, produce food that is genetically modified and sprayed with pesticides while promoting new expensive drugs that only address the symptoms of our illness.
They do all this while spending millions of dollars on advertising telling the public that all of these things are good for them. The real problem is that we are the lemmings that listen to this barrage of ads constantly coming from every media source we use on a daily basis. Corporations all do this for a profit motive, not from the perspective that any of these products are good for us. When you think about it, who has all of the money and power? The corporations of course. Do you really think they want to make less money? If not then nothing will change till we change it ourselves by being informed individuals and start saying “NO” to their unhealthy products.
Just suppose that we turned this around: and the only way corporations could make lots of money is if they produced products that would benefit our health and wellness? In other words, if it’s not healthy we charge them an unhealthy tax of say 15% of their profits payable to a health care fund. Surely that would end commerce and industry as we currently know it today. It would also put a stop the endless commercials that tell us what products are best for us even though they are bad.
So what is the answer? Health and wellness are about choices. If we eat products that make us fat and in turn cause our bodies to create spikes in our insulin, we will wind up with diabetes and need medical care. However, if we eat properly and exercise regularly to keep our bodies lean and healthy, chances are we will live a much healthier life and not need much in the way of medical care. So since our health depends on the choices we make, shouldn’t we be penalized for making bad choices by having to pay more for health insurance premiums if we smoke, are obese or are heavy drinkers? Why should those that keep themselves healthy and seldom avail themselves of healthcare services have to subsidize those who do not take care of themselves?
One of the most serious health problems we have in the world today is obesity. Whether you believe it or not, 72% of deaths are from non-communicable diseases. It is obesity and bad diets that are causing the many high-risk factors for coronary artery disease the leading cause of death everywhere along with cancer, stroke and Alzheimer’s. People may be living longer but many have serious illnesses in their end years. There are also over one billion worldwide who are suffering from mental health disorders or substance abuse that are not getting proper care.
Chronic pain not caused by cancer is among the most prevalent and debilitating medical conditions: but also among the most controversial and complex to manage. The urgency of patients’ needs, the demonstrated effectiveness of opioid analgesics for the management of acute pain, and the limited therapeutic alternatives for chronic pain have combined to produce an overreliance on opioid medications in the United States, with associated alarming increases in diversion, overdose, and addiction. More than 30% of Americans have some form of acute or chronic pain.(1,2) Among older adults, the prevalence of chronic pain is more than 40%. (2) Given the prevalence of chronic pain and its often disabling effects, it is not surprising that opioid analgesics are now the most commonly prescribed class of medications in the United States. (3) In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers.(4,5) Of these prescriptions, 65% were for short-term therapy (<3 weeks), (6) but 3 to 4% of the adult population (9.6 million to 11.5 million persons) were prescribed longer-term opioid therapy. (7) Although opioid analgesics rapidly relieve many types of acute pain and improve function, the benefits of opioids when prescribed for chronic pain are much more questionable. (8)
Big Pharma is killing us with drugs like Opioids which have terrible addictive effects: This epidemic has become a high priority public health crisis and statistics from the Surgeon General of the United States indicate that up to 2 million Americans are currently addicted to or dependent on prescription opioids. (9) Millions more are at risk of developing a dependency— in 2014, as many as 10 million people reported using opioids for nonmedical reasons. (10) The economic toll of the epidemic is tremendous, costing the U.S. economy an estimated $78.5 billion annually. (11) Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Of the 20.5 million Americans 12 or older that had a substance use disorder in 2015, 2 million had a substance use disorder involving prescription pain relievers (12) The first governmental account of nationwide drug deaths shows roughly 64,000 people died from drug overdoses in 2016. (13)
So what is the solution now that we can see that the Root Causes come from our everyday routines: If you had a primary care physician who saw you regularly they would be able to tell you to stop using all those house cleaning products with toxic chemicals and switch to those that are non-toxic? They would tell you to stop eating Genetically Modified Food and start buying and eating those products that are organic. They would ask you to start an exercise program three times a week and walk 10,000 steps a day. All of these things would make you healthier but you don’t have a primary physician to see or call on a regular basis because you would have to pay him each time you visit or call for advice. In some cases, it takes three months just to get an appointment with your physician.
What if you had a physician that you paid a monthly fee to for your care? This way you can call him whenever you need him or visit when you’re sick without worrying about a co-pay. This physician would also get to know you and be able to help you to recognize health problems before they become serious. All these things seem to be positive but we don’t have a system like that. Why don’t we have a system like this? Good question because if I remember when I was growing up that was the system? There is no money to be made in this type of a system with today’s onerous rules and regulations and unfortunately, our current healthcare system is based on the profit motive. We also don’t have enough primary care physicians to go around to everyone and in-fact we have a physician shortage which is estimated to hit 90 thousand by 2025 (14)
Suppose we had true freedom of choice in healthcare: we could actually choose our physician whether they were your general Allopathic physician or one who practiced Naturopathic Medicine or even a Chiropractor? What if we could decide to use Opioid drugs or a non-pharmaceutical therapy for depression or stress? What if we had the choice of going to an acupuncturist for knee pain instead of having to go through knee replacement? What if we could go to a chiropractor for back pain instead of considering surgery? This would truly be a healthcare system that could include all choices that were science-based and approved. The name of this system is Integrative Medicine. The only thing keeping us from having the freedom of choice is the third party payers known as the health insurance companies. This is where the change must start if we are to reduce costs and improve results.
What is Integrative Medicine: Integrative health and medicine reaffirm the importance of the patient and practitioner relationship, focusing on the whole person, informed by evidence and makes use of all appropriate therapeutic approaches, health professionals, and professions to achieve optimal health and healing goals. (Simply put, integrative health and medicine offer the best practices for optimal health and healing.) Scientifically validated integrative practices include: Acupuncture, Chiropractic care, Hypnosis, Massage, Meditation, Music therapy, Stress Reduction, Tai chi, and Yoga.
What are the principles of Integrative Medicine: Integrative medicine is healing-oriented medicine taking into account the whole person (body, mind, and spirit) and includes all aspects of a patient’s lifestyle. Emphasis is placed on a therapeutic relationship and uses all appropriate therapies, both conventional and alternative.
Integrative Medicine is the future of our healthcare system: This is because the old model is not only broken but obsolete and you never fix things by fighting the existing reality so it is best to build a new model with the emphasis on health and wellness first. Patients must be educated in how to keep themselves well through the proper use of nutritional and physical components that affect their wellbeing both physically and mentally. This can easily be done with the help of a primary care physician either allopathic or naturopathic. The old model would attack the symptoms but not get to the root of the real problem integrative medicine focuses on the whole person instead of just treating symptoms.
A Transition may be in progress: On September 18th the National Association of Attorneys General signed a letter to the President and CEO of America’s Health Insurance Plans Marilyn Tavenner, asking the AHIP to take proactive steps to encourage their members to review their payment and coverage policies and revise them, as necessary and appropriate, to encourage healthcare providers to prioritize non-opioid pain management options over opioid prescriptions for treatment of chronic, non-cancer pain. This will open the door for practitioners of alternative and complementary medicine to engage in an integrative process of using alternative medicine techniques to reduce and relieve chronic pain without opioids. It will also push both ends of the medical spectrum allopathic and naturopathic into working together for the first time to produce an integrative healthcare system. The Attorney Generals letter can be read in its entirety here.
The AMA takes a turn towards Integrative pain care: In an article published by the Huffington Post December 17, 2016, the headlines read AMA, Other Leading Medical Organizations Urge Insurance for Non-Pharma/Integrative Pain Care. Among those echoing the AMA in calling for this reform of insurance practices are the American Society of Anesthesiologists (ASA), American Pain Society (APS), Medical Board of California (MBC), American College of Physicians (ACP), American Academy of Pain Management (AAPM, now AIPM), and Trust for America’s Health (TFAH). You can read the full article from the Huffington Post here. This is a game changer and would fit right in with our scenario that we must move to the use of Integrative Medicine if we are to fix our healthcare system. Another significant article was published in the Journal of Alternative and Complementary which you can read here.
Integrative Medicine can provide solutions to our current dilemma of high costs and bad outcomes: Integrative medicine is a recognized strategy to plug the holes in the current health delivery system while lowering medical costs for chronic disease. It flips the system on its head and puts the patient at the center, addressing not only the symptoms but the root cause of their problems. It will also allow hundreds of professional practitioners in our state to supplant the shortage of doctors with the use of Naturopaths, Chiropractors and other integrative practitioners.
How would this system provide better outcomes at lower cost: We know from survey after survey that when patients have a choice of how to treat an illness they will almost always choose the least invasive way to a resolution of their problem. For instance, if you have a back problem and your choice is to either have surgery or to work with a qualified Chiropractor to fix the problem which would be the least invasive and inexpensive way. The costs are from 40 to 50% lower and outcomes are better in just about every survey. In all of the studies I have read there are very few that do not show cost efficiency and better outcomes by using these integrative practices. In many cases today you will find major corporations using integrative practices for their employee’s health and wellness programs and they are becoming more popular by the day.
We need to change the way we deliver healthcare in the U.S.: It is simple to see that what we have in the U.S. is not healthcare but sick care where our system is reactive, not proactive in helping prevent those problems before they occur. Our healthcare professionals need to spend less time waiting for symptoms of disease to appear, as opposed to spending more time on disease prevention, avoiding these serious diseases in the first place.
The problems with Western Medicine: our current approach to medicine is reductionist by nature focusing on the physical and objective basis of disease. It has been successful in treating one side of the spectrum but has almost completely forgotten about the maintenance of health and wellness which have been completely inadequate and causes patients to turn to integrative medicine providers.
Chronic disease is the cause of 70% of all deaths according to the CDC: (15) It costs over $1.5 trillion a year to care for these diseases which is about 75% of all medical expenses while we spend only a fraction of our budget on the prevention of sickness and health promotion in spite of the fact that evidence supports the fact that prevention can reduce the costs of chronic disease.
Acceptance of Integrative Therapies: Unfortunately many alternative therapies are not understood by the allopathic community and therefore there is resistance to anything but traditional biomedical treatments. While some of these therapies are not understood or misunderstood by the scientific community these therapies continue to grow in popularity and continue to show their value in just about every study I have read. Think back to when doctors never washed their hands before treating new patients until they learned about contamination and the necessity for sterility.
Who practices integrative medicine: A practitioner of integrative medicine could be a Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or a Doctor of Naturopathic Medicine (ND), or even a nurse practitioner who emphasizes a whole person approach and patient-centered care and utilizes both conventional medicine and nonconventional medicine to optimize the patient’s health and healing process.
What tools are used in Integrative Medicine: They can choose to use pharmaceutical or surgery based interventions which are carefully weighed in the context of other therapeutic choices, including alternative therapies. They will prioritize what they feel are necessary interventions according to their level of benefit and risk along with potential toxicity and cost. They also consider the wishes of the patient with the objective to work on finding the depth of the problem or disease that may or may not be present. More time will be spent in identifying lifestyle interventions that can lead to disease prevention or reducing the rate of progression of an established condition.
It’s time we changed the way we do business with health insurers and medical providers in Idaho: It’s time for the hospitals to become more transparent in the cost of procedures with a published list on the internet. St. Al’s already publishes a list but not St. Luke’s they are the least transparent of the facilities in our state. We need more insurers in the State who are willing to write policies with integrative options and we need to get rid of this idea of in-network doctors who will only work for certain providers. The real question is who will be brave enough to make the changes necessary to bring down the costs of insurance and institute true health freedom for the people?
Idaho healthcare insurers are expected to raise premium rates: between 38 and 50% with one indicating it will raise rates 81%. The average family will not be able to afford to get sick even if they are carrying insurance. Choice is the key to lower cost better healthcare and more doctors would be available with the option of integrative medicine.
It’s time to change the system from sick care to real healthcare. Call Idaho’s Attorney General and tell him you want to see insurers in Idaho cover integrative care in their policies.
208-334-2400 — Lawrence Wasden Attorney General.
- Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education and research. Washington, DC: National Academies Press, 2011.
- Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: results of an Internet-based survey. J Pain 2010;11:1230-1239 CrossRef | Web of Science | Medline
- Centers for Disease Control and Prevention. FastStats. Therapeutic drug use. 2014 (http://www.cdc.gov/nchs/fastats/drug-use-therapeutic.htm).
- Levy B, Paulozzi L, Mack KA, Jones CM. Trends in opioid analgesic-prescribing rates by specialty, U.S., 2007-2012. Am J Prev Med 2015;49:409-413
CrossRef | Web of Science | Medline
- National Institute on Drug Abuse. The latest prescription trends for controlled prescription drugs. 2015 (http://www.drugabuse.gov/news-events/meetings-events/2015/09/latest-prescription-trends-controlled-prescription-drugs).
- Volkow ND, McLellan TA, Cotto JH, Karithanom M, Weiss SR. Characteristics of opioid prescriptions in 2009. JAMA 2011;305:1299-1301
CrossRef | Web of Science | Medline
- Boudreau D, Von Korff M, Rutter CM, et al. Trends in long-term opioid therapy for chronic non-cancer pain. Pharmacoepidemiol Drug Saf 2009;18:1166-1175
CrossRef | Web of Science | Medline
- Chou R, Deyo R, Devine B, Hansen R, Sullivan S, Jarvik J. The effectiveness and risks of long-term opioid treatment of chronic pain: Evidence Report/Technology Assessment. Rockville, MD: Agency for Healthcare Research and Quality, 2014. No. 218 (AHRQ publication no. 14-E005-EF).
- Surgeon General of the United States, Opioids, https://www.surgeongeneral.gov/priorities/opioids/index.html (last updated June 1, 2017); Nora Volkow, M.D., America’s Addiction to Opioids: Heroin and Prescription Drug Abuse, National Institute on Drug Abuse (May 14, 2014), https://www.drugabuse.gov/about-nida/legislative- activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-abuse.
- See Surgeon General, supra 1 (citing National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration, 2014).
- Healthday News, Opioid Epidemic Costs U.S. $78.5 Billion Annually: CDC (Sept. 21, 2016), http://www.health.com/healthday/opioid-epidemic-costs-us-785-billion-annually-cdc.
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