3. My friends and family are skeptical about the merits of alternative medicine. How do I help them feel confident in my decision to use alternative medicine?

To many people, alternative medicine is still suspect. Some of this is warranted. Not all of what is labeled alternative medicine can be assumed to be good medicine. So the concern and skepticism of your friends and family is only natural. The problem is that most people who are skeptical of alternative medicine base their caution on outdated information, facts that are only partially true, or complete misconceptions. Of course, there are those who would never even consider that alternative medicine has merit, regardless of what the facts are. ("Don't confuse me with facts, my mind is made up!")

Let's look at the roots of the bias against alternative medicine: A great deal of this distrust can be traced directly to the beliefs and opinions of the conventional medical community. Since conventional medicine enjoyed an unquestioned confidence from the public for almost five decades, the public accepted the critical views about any treatments not part of conventional biomedicine. As a result, in time conventional medicine's beliefs became the public's beliefs.

According to the "Chantilly Report" to the NIH on alternative medicine, one conclusion the public reached regarding conventional medicine is that it is the "one true medical profession." This originated through the "long-standing belief held by many conventional medical practitioners that they should be the only one representative voice for the whole of medicine."14

Another result is the public now places an unrealistically high level of confidence in conventional medicine's high-tech diagnostic and therapeutic procedures. Many presume that if procedures are "high-tech," they must be very effective. However, evidence points to the opposite conclusion: High-tech is not always effective.

A case in point: A young woman checked into a major New York hospital to treat a tumor on her chest. The hospital had a new experimental group and was researching the effects of microwave hypothermia on cancer. The woman was one of the first participants in their research group. Unfortunately, the researchers didn't have adequate thermal control and miscalculated the amount of hypothermia they gave this young woman. Within moments they had burned a hole right through her sternum. She also had burns from her chin down her entire neck and halfway down her trunk. After she recovered, she exclaimed that with such high technology in a major hospital in a large city, she had been very optimistic that she would be cured. She realized, however, that she should have been less optimistic, asked more questions, and been more cautious.

In contrast, many alternative treatments are not "high-tech" and are actually seen as "low-tech." Consequently they are perceived to be ineffective when they actually are effective. For example, our neighbor's one-and-a-half-year-old son Alex had a very high fever a few weeks ago. His parents took him to a pediatrician (M.D.) for a diagnosis. When they asked about using herbs to treat his infection, his doctor's response was, "Herbs are for salads. He needs something more sophisticated to help him recover. Drugs." This doctor was convinced of this fact despite the tremendous body of scientific research that indicates that herbs could, in fact, help the boy recover. Based on the recommendations they received from a naturopathic physician about other infections that Alex had in the past, his parents decided to use herbs before trying drugs. Within twenty-four hours of administering the recommended herbs to Alex, his fever disappeared and he was markedly better.

The public has grown to prefer the "safety of the status quo," which, in the United States, is conventional doctors and their medicines. Because doctors routinely prescribe drugs such as antibiotics and sedatives, the public generally believes that they are the most effective treatments. However, several major magazines and national news programs have reported the hazardous side effects of these drugs. As a result, an increasing number of patients now voice their concerns about these drugs and ask about alternatives.

The most fervent critics of alternative medicine charge that alternative medical practitioners are "quacks." The NIH's "Chantilly Report" defends the alternative medical practitioner saying, "The term 'quack' generally means one who pretends to have medical knowledge but does not; that is, it implies the element of fraud. . . . [However] most alternative healers do possess some other sort of knowledge [than M.D.'s] that they and their clients believe is relevant to health."15

Another charge is that alternative medical practitioners prey on the gullible and uneducated. The "Chantilly Report" also refutes this, stating that, "Recent studies of cancer patients indicate that well-educated persons with higher incomes are more likely to use alternative treatments, primarily because they want to take charge of their health."16

When using alternative medicine, you will probably encounter skeptics with these or other misconceptions. When this happens, the best strategy is to present an "unbeliever" with real facts backed by respected sources. Generally this is a much more effective approach than sharing personal stories about miraculous cures. Irrefutable facts have a way of calming skeptics' doubts - and sometimes - of changing their minds. Here are some facts that will alleviate the concerns and doubts of the people in your life:

• Worldwide, only ten to thirty percent of people use conventional medicine, 70 to 90 percent use alternative medicine.17
  

• Approximately $22 million of U.S. government money has already been spent on alternative medical research since 1992 at the National Institutes of Health and Public Health Services.18
  

• The American Medical Association (AMA), in Resolution #514, "is encouraging its members to become better in-formed regarding alternative (complementary) medicine and to participate in appropriate studies of it."19
  

• Renowned hospitals, such as Columbia-Presbyterian Medical Center in New York, have created alternative medical clinics in their facilities.
  

• Almost one-third of American medical schools - among them Harvard, Yale, Johns Hopkins, and Georgetown Universities - now offer coursework in alternative methods. (See reference section for a complete list.)20
  

• Many alternative approaches have been scientifically proven to be less invasive, less dangerous, more effective, and more economical than conventional medicine.
  

• Mutual of Omaha says it saves about $6.50 for every dollar it spends covering nonstandard (read: alternative) treatments.21
  

• Seventy-four percent of the American population desire a more natural approach to health care.22
  

• Of the one out of three Americans who have used alternative _medicine, 84 percent said they would use it again.23
  

• Traditional Chinese medicine has been chosen by the World Health Organization for worldwide propagation to meet the health care needs of the twenty-first century.24
  

• The U.S. Government sponsors the use of acupuncture in drug rehabilitation programs.25
  

• There are five homeopathic hospitals in Great Britain run by the British National Service.26
  

• One out of three drugs prescribed in Germany is an herb.27
  

• One out of every ten Americans is under the care of a chiropractor.28
  

• In 1993, Americans spent an estimated $1.5 billion on herbal remedies - ten times more than was spent on over-the-counter sleeping pills from grocery stores and drugstores.29
  

• In 1991 Americans made more visits to unconventional health care providers (425 million) than to conventional doctors (388 million).30
  

• One out of three Americans were using unconventional medicine in that same year.31
  

• Americans spent almost $13.7 billion on unconventional care in that twelve-month period.32
  

• Seventy-five percent of that money was out of pocket.33
  

• Twelve percent of Fortune 500 companies offer alternative medicine as part of their health care compensation packages. That number is expected to increase to eighteen percent by the end of 1996.34

  Despite all the facts and statistics you can offer others, when you are sure that you want to try alternative medicine, the most important information that you can offer the people who care about you is:

• You have investigated your options.
  

• You are confident in your choice.
  

• You look forward to sharing your success stories with them.
  

4. If I suspect there is something wrong with me physically, should I go to a medical doctor (M.D./D.O.) or to an alternative practitioner?

Most health care professionals, be they alternative practitioners or medical doctors, recommend that you first go to a conventional medical doctor or to an osteopathic physician to get a diagnosis. D.O.'s and M.D.'s receive extensive training in diagnosing pathology (illnesses and diseases). If you visit an alternative medical practitioner who has not had the vast experience and training in diagnosing pathology that a conventional medical doctor or osteopathic doctor has, that person might miss a problem that could mean your very survival. Dr. Len Wisneski, corporate medical director for Marriott Corporation, says, "Many times a patient will come to me after they have been working with an acupuncturist. I have found problems that the acupuncturist missed. If we are looking at cancer, there is some precious time that has been lost, which we could have used to combat the malignancy."35

After you have had a thorough examination, a diagnosis, and a recommended treatment program from an M.D. or D.O. then look at alternative medicine for other treatment options that might be as effective and less invasive. Of course, if you are in a crisis situation where time is of the essence, you will need to determine if you have the luxury of time to find an alternative. In a critical situation, your first and foremost commitment is to stay alive. In that case, conventional medicine may be your best answer. If this is not the case, we encourage you to look at all your alternative options.

Also, we encourage you to find a conventional doctor who will work with you as a team player as you explore your alternatives. Dr. Joe Jacobs, former director of the Office of Alternative Medicine at the National Institutes of Health says, "Keep your medical doctor informed about any alternative therapies you are trying or want to try. If you feel he or she is biased against alternative medicine, find another medical doctor. But maintain a relationship with an M.D [or D.O]."36

Just because there are shortcomings in our conventional medical system, don't underestimate the tremendous skills, training, and value a medical doctor can bring to your health care. A conventional medical doctor or an osteopathic physician is an important part of your health care team. The biomedical system is usually your best source for getting a fast and accurate diagnosis. Always use conventional or osteopathic medicine first if you suspect you have a potentially life-threatening health problem.

5. There are so many different kinds of alternative medicine. How do I know that I'm choosing the right kind?

It can be overwhelming to realize just how many alternative techniques and treatments are available today. The answer is to learn how to find the appropriate alternative medical options for you in an easy, efficient manner. You will need to find the most effective treatments from around the world for your health condition. You will need to learn how to "live well" while living with your health condition, thus enhancing your quality of life. By doing Step One: Learn your Options, you will gain the information and knowledge you need to make informed and wise decisions about which alternative treatment is right for you.

6. I've heard there are some charlatans in alternative medicine. How do I know who is well trained and competent and who is not?

In conventional medicine, there are both good and bad practitioners. The same is true for alternative medicine. For this reason, it is important to educate yourself. The below steps One through Five are designed to give you the tools you need to get the right information about any modality of alternative medicine so that you are not swayed by blind faith, by faulty information, or "a good line." Also, it is important that you learn what is considered competent training for the five licensed general health care providers of alternative medicine: the M.D. as an alternative medical practitioner, the Chinese medical practitioner, the chiropractor, the osteopath, and the naturopathic physician. This will help you discriminate effectively in choosing any of these alternative practitioners. You, as well as every health consumer, have both the right and the responsibility to make educated decisions about who should treat you and how. you should acquire the tools you need to determine how well the alternative health care provider is trained, if he or she is fairly priced, and if he or she is able to give you the health results you seek.

7. Is alternative medicine safe?

This is another question that does not have a simple answer. In this country, "safe" means a treatment method has been endorsed by the Food and Drug Administration (FDA). Most of the treatments that are labeled as alternative medicine have not yet received this endorsement, and it's possible they never will.

In the "Chantilly Report" on alternative medicine, it states that "the current Federal mechanisms of regulating medical research do not favor the evaluation of many forms of alternative treatment. Because the costs of developing, evaluating, and marketing new drugs are so prohibitive, pharmaceutical companies are not likely to invest time and effort in therapies, such as nutritional or behavioral approaches, that cannot be patented and are therefore unlikely to offer the opportunity to recover their investment and provide a return to stockholders. This means that many alternative therapies are likely to be casualties of the formal research process."37

This information indicates that health care consumers need to look beyond the recommendations of the FDA when making health care decisions - especially when one considers that other countries have regulatory systems, similar in function to the FDA, that have competently evaluated the effectiveness of many alternative therapies.

Europe, for example, takes note of substances that have a long history of effective use and approves them under "the doctrine of reasonable certainty." This rule parallels the World Health Organization's (WHO) Guidelines for the Assessment of Herbal Medicines, which states that a substance's historical use is a valid way to document safety and efficacy in the absence of scientific evidence to the contrary.

European and the WHO assessments of alternative remedies are available to you. You will need to personally decide whether or not the World Health Organization and Europe's standards of safety are adequate for you.

While you ponder the issue, consider the following: In comparison with the rest of the world, the United States ranks fifteenth in life expectancy - behind Japan, Iceland, Sweden, Switzerland, Hong Kong, the Netherlands, Norway, Canada, Spain, Australia, France, Cyprus, Greece, and Italy. Further, the United States is ranked number one among the industrialized nations of the world in infant mortality, death of children under the age of five, AIDS, cancer among men, incidences of breast cancer, and malpractice lawsuits.38

You can reasonably assume that licensed alternative providers use treatments and techniques that are safe when used correctly. If you have a question about a particular treatment or remedy recommended by an alternative health care practitioner, ask both that practitioner and other experts to provide you with as much information as necessary to determine if you can personally have confidence in the recommended treatment.

8. Will my insurance cover alternative medicine?

The answer to this question depends on the state you live in and your insurance company.

For example, many states now have a law that requires all health insurance policies to cover licensed chiropractic doctors. So, if you are in one of those states, you are legally entitled to receive chiropractic care and be reimbursed by your health insurance according to the terms of your policy. Your treatment must be defined as "medically necessary" and, at most insurance companies, conventional medical doctors decide if a licensed chiropractic doctor should be treating you or not. In the language of the trade, the conventional doctor is the "gatekeeper" who decides which procedures warrant reimbursement.

What does this mean? Because many M.D.'s do not appreciate the viability and effectiveness of the chiropractic paradigm, the process of determining "medical necessity" is usually biased against many chiropractic medical claims.

Conventional doctors decide that such treatment is not "medically necessary" in many cases. There are even documented cases of insurance companies stating that they will pay for expensive pain-relieving drugs or surgery from an orthopedic surgeon rather than pay for a much less expensive series of chiropractic adjustments to treat the same problem. Some insurance companies have made this choice even though competent research has shown the chiropractic approach to be an effective treatment for the same condition.

Still, there is hope, as ever-increasing numbers of insurance companies are taking a serious look at the importance of covering alternative medical treatments in their health policies. Mutual of Omaha now covers chiropractic, Prudential pays for acupuncture, and Blue Cross of Washington and Alaska offers a plan entitled "AlternaPath," which covers licensed naturopathic doctors. Also, a growing number of hospitals and HMOs are including alternative medical services in the treatments provided for their patient-customers.

Prevention magazine's New Choices in Natural Healing says the most comprehensive insurance plan covering alternative medicine today is American Western Life Insurance Company of Foster City, California. Ayurveda, homeopathy, nutritional counseling, massage, and physical therapy are all covered in their Wellness plan. The company includes a full-time Wellness Line with naturopathic doctors "on call" for their customers.

The Wellness plan costs 20 percent less than their traditional plans, because, says Wolf Klain, president of American Life, "We believe very strongly that if people do take care of themselves, if they take preventative measures, it's only going to save us all a lot of money in the long run."39

We suggest contacting your health insurance representative to get the facts on possible reimbursement for alternative medical treatments. If it turns out that your plan is "biased" against reimbursement for alternative medical treatments, we encourage you to shop around and find a plan that is better suited for your health needs.

Insurance plans covering alternative medicine are growing at a surprising speed. One successful HMO, Oxford Health Plans, is over one million members strong in the New York Metropolitan area. They surprised the industry by heavily committing themselves to covering preventive medicine using alternative medical techniques. Although their alternative medical plan is still in development, other HMOs are watching to see if this commitment will eventually turn into profits for Oxford. If so, we can only anticipate that more HMOs will follow in Oxford's footsteps.40

Also, if you live in Washington state, you are in luck. Washington now requires that all health insurance companies cover all licensed and certified alternative practitioners. Although Washington is the only state in the union to pass such a law, it is possible that other states will follow suit.41

9. Will alternative medicine work for me?

No system of medicine can guarantee success for every condition. Each system of medicine has certain health conditions for which it is best suited and some health conditions for which it would be the treatment of last choice. This is true for conventional medicine as well as alternative medicine.

An example is Chinese medicine, which has a long and respected history of treating conditions of infertility and impotence in less drastic and more natural ways than conventional medicine. Many couples who were unable to conceive have become happy parents after receiving a series of treatments of Chinese herbs and acupuncture for their condition.

The key to success with alternative medicine is to make sure you have all the accurate information you need from around the world about treating your health conditions. It can also get you information on how to "live well" while living with your health condition, thus embracing life. By doing Step One as outlined here you can be assured of finding the right alternative medical treatment for your health care needs if one exists. Becoming familiar with good research from throughout the world on your alternative medical choices increases your chances of getting the results you want.

10. Is there a way for me to responsibly seek out good alternative medical care for myself and my family?

The five steps described in the upcoming chapters is the best answer to this question. By participating in Steps One to Five, you can responsibly and wisely choose good alternative medical care for yourself and your family. Whether you are just beginning your exploration of alternative medicine or you have been using alternative medicine for some time, following these five steps will allow you to make good decisions about any modality of medicine. And incidentally, in most cases, by following the five steps, you can save time and money, too.

The Five Steps are:

Step One: Learn Your Options - Add to your M.D.'s recommendations by researching the latest resources to get all your treatment options.

Step Two: Get Good Referrals - Find referrals through various sources and verify that these referrals have the capability to really help you.

Step Three: Screen the Candidates - Make use of an alternative practitioner's staff to get reliable information about the provider and how they work.

Step Four: Interview the Provider - Ask the provider all the pertinent questions to know if you can confidently work with this professional.

Step Five: Form a Partnership - Maximize your healing potential by developing an active alliance with your alternative health care provider.

Each of these steps - when used together, they form a process that will lead you through the maze of alternative medicine to the results you desire.

For all of us, our relationship to our own health is an ever-changing process. Health care needs alter as we mature and grow and live life. 

For instance, if you are in a health emergency, diagnosed with a life-threatening or debilitating disease, your motivation for gathering all the relevant information and finding just the right health care provider will be significant. You will want to be thorough in both gathering and evaluating information because you won't want to miss anything important - like the key to your relief and/or remission.

In a serious health care crisis, doing each detail of all five steps will serve you well because each step is designed to be as complete as possible. Each step is presented so that you see "both sides of the coin" - so that you don't miss any important details, thus compromising your ability to get the health results you really need.

On the other hand, if you have a minor health care complaint, such as a digestive problem that is at the very worst annoying, you probably won't need to complete all of the recommendations in each of the five steps. You might not have the motivation, the need, or the time to check every information resource regarding digestion, gather a full list of referrals, and ask every pertinent question of the staff and the provider.

However, if a friend had great success with relieving her digestive complaints through an N.D., and you would like to try this provider but really don't know much about naturopathic doctors, this will be helpful to you. The chapter on naturopathic doctors will familiarize you with the naturopathic philosophy of medicine, typical treatments used by N.D.'s, what happens on a first visit, and N.D. associations and professional groups. After skimming through Steps One through Five you might get some ideas about how to partner with this provider. Perhaps you'd like to check that the N.D. graduated from an accredited college. Verification that this provider is qualified, along with other details you learn about N.D.'s, will help you feel more comfortable on your initial office visit, as well as assist you in making the most of your time with this health care professional.

Do what you need to do to get the health care results you want.

Notes

1. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), 183.
2. "Mapping Medicines Movements," Vegetarian Times, October 1994, 78; William Collinge. The American Holistic Health Association Complete Guide to Alternative Medicine (Warner Books, 1996), 42–43.
3. Mark Kastner and Hugh Burroughs. Alternative Healing: The Com- plete A to Z Guide to Over 160 Alternative Therapies (Halcyon Pub- lishing, 1993), 3.
4. Bill Gottlieb. New Choices in Natural Healing (Rodale Press, Inc., 1995), 4.
5. Complementary and Alternative Medicine at the NIH, Volume III, Number 1, 3.
6. American Demographics, July 1993, 16.
7. Complementary and Alternative Medicine at the NIH, Volume III, Number 1, 1.
8. Burton Goldberg. Alternative Medicine: The Definitive Guide (Future Medicine Publishing, 1993), 15.
9. Norman Cousins. Personal interview, January 1990.
10. James F. Fries, M.D. and Donald M. Vickery, M.D. Take Care of Yourself (Addison-Wesley Co., 1989), 116.
11. Adriane Fugh-Berman, M.D. "The Case for 'Natural' Medicine," The Nation, September 6/13, 1993, 242.v
12. Burton Goldberg. Alternative Medicine: The Definitive Guide (Future Medicine Publishing, 1993), 5.
13. Bill Gottlieb. New Choices in Natural Healing (Rodale Press, Inc., 1995), 3.
14. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), liv.
15. Ibid, xiv.
16. Ibid, xiv.
17. Ibid, xv.
18. Ibid, 2.
19. AMA Resolution #514, "Alternative (Complementary) Medicine," Reference Committee E, 10–11.
20. Fact Sheet #1, "Alternative Medical Courses Taught at U.S. Medical Schools," The Richard and Hinda Rosenthal Center for Alternative/Complementary Medicine. 21. "Unconventional Claims," Vegetarian Times, October 1995, 27.
22. Deirdre O'Conner, N.D. The Naturopathic Model of Primary Care Natural Medicine. Presentation at "Integrating Managed Care & Alternative Medicine," San Francisco, CA, December 1,1995.
23. David Eisenberg, M.D. "Unconventional Medicine in the United States," New England Journal of Medicine, January 28, 1993, 246. 24. Burton Goldberg. Alternative Medicine: The Definitive Guide (Future Medicine Publishing, 1993), 450. 25. William Collinge. The American Holistic Health Association Complete Guide to Alternative Medicine (Warner Books, 1996), 40.
26. Martha Ullman at the National Center for Homeopathy.
Personal communication, July, 1996.
27. Donald J. Brown, N.D. The Use of Herbal Medicine in a Clinical Setting. Presentation at "Integrating Managed Care & Alternative Medicine," San Francisco, CA, December 1995.
28. B. Hayes. U.S. "Survey of Insurers." Government study, HEW as reported by The American Chiropractic Association, Arlington, VA, November 1995.
29. Bill Gottlieb. New Choices in Natural Healing (Rodale Press, Inc, 1995), 3.
30. David Eisenberg, M.D. "Unconventional Medicine in the United States," New England Journal of Medicine, January 28, 1993, 246.
31. Ibid.
32. Ibid.
33. Ibid.
34. John Weeks. "Charting the Mainstream: A Review of Trends in the Dominant Medical System," Townsend Letter, PortTownsend, Washington, February/March 1996, 38 39.
35. Len Wisneski, M.D. Personal interview, September 1989.
36. Joe Jacobs, M.D. Personal interview, November 1995.
37. NIH. Alternative Medicine: Expanding Medical Horizons (U.S. Government Printing Office, 1993), xiii.
38. Andrew L. Shapiro. We're Number One (Vintage Books, 1992), 4,16, 22, 25, 27, 28.
39. Bill Gottlieb. New Choices in Natural Healing (Rodale Press, Inc, 1995), 7.
40. Hassan S. Rafaat, M.D. Integrating Alternative Medicine into the Mainstream: the Answer to an Ailing Health Care System. Presentation at "Integrating Managed Care & Alternative Medicine," San Francisco, CA, December 1995.
41. Washington State, House Bill 1046, 1995.

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