Friday, October 23, 2009

Using holistic medicine to help contain costs?

I was speaking yesterday with the ex-directory of the Osher Center, UCSF's complementary medical center. He is good friends with Andrew Weil (whom he calls "Andy") and other holistic practitioners, but he also trained at both Harvard and Stanford medical schools and was Associate Chief of Nephrology and Medical Director of the Artificial Kidney Center at the Santa Clara Valley Medical Center. (In other words, he's well-versed in both worlds and not easy to dismiss as a "quack") My question to him, and one I raise to you all now as well, is what role could a more holistic approach to health take in the US's attempts to lower costs? I wrote my thesis on Chile's adoption of both indigenous medicine and CAM (complementary and alternative medicine) in mainstream public clinics. By adopting both for very specific conditions, they were able to reach a larger population and save costs. The doctor I spoke with yesterday seemed frustrated, at least partly, by the "reductionism" of modern medicine, how it breaks down health into little tiny portions (looking at each disease and molecule individually) and ignoring interactions. (I'm simplifying for the sake a manageable-length blog post.) His comments, combined with what I'd found in Chile, made me wonder if the US might be able to benefit from incorporating more holistic views of health, and if alternative therapies might in some cases help in cutting back on those 40% of health problems attributable to lifestyle. I'm not talking about prescribing a homeopathic tincture for a heart attack, and I'm certainly not suggesting avoiding vaccines bc they're "not natural", but things like making sure people's nutrition and vitamin intake is balanced (e.g. Had I known two months ago that my Vitamin D levels were low, it's quite likely I would have avoided a stress fracture, saving 5 doctor visits, 9 Xrays, 4 physical therapy visits and over $1000) or making more of a medical point of helping people manage stress. It's quite possible, too, that natural and lower-cost methods could be used to equal or better effect than some high-cost drugs. Before you throw that idea out as quackery - my mom suffered worse-than-usual nauseau from two different chemo regimens. After working through every single anti-nausea prescription her doctor gave her with no result, she finally tried something a bit more natural (legal here but perhaps not NJ yet, so I'll leave it at that) with much better results and none of the awful side effects (except some coughing, which provided some good "laughter therapy").

I'm certainly not saying that we make a mass migration over to alternative/holistic medicine or that we start forcing doctors to incorporate it into their practice or anything radical, but I do wonder if there are aspects of complementary and holistic care that could provide lower-tech, cheaper ways to avoid and handle health problems. It would take research and strict controls to make sure it's done in a safe way, but I wonder if it's even possible or reasonable to bring the two different medical worlds (CAM and mainstream) closer together.

1 comment:

Amy said...

Very interesting thoughts, Andrea, and I agree that trying to bring the 2 worlds of CAM and mainstream medicine closer together could be a great idea.
In fact, your post made me remember a doctor who works at the Kaiser Richmond Medical Center a few days a week as an Acupuncturist. He deals with referrals, has his own panel of patients that come to see him, and has some really cool posters of key acupressure points up on his exam room walls :)
Also (and don't laugh too hard at my somewhat embarrassing tv-watching habits), but on Private Practice (the spin-off of Grey's Anatomy), there is 1 doctor out of just 5 or 6 who only practices alternative medicine techniques.
Anyway, what this tv example & my own observation at Kaiser made me realize is that even though not every medical facility has someone practicing alternative medicine from within, there are some that do, and it is possibly becoming more popular (has to be if it's on tv, right?). It would be interesting to evaluate whether this trend can spread to help with health care cost issues, or even just to give some patients alternatives to the mainstream ways of dealing with certain diagnoses and diseases.