While healthcare reformers have been aggressively debating issues of access and finance, a quiet revolution has begun across the country. Many Americans are no longer content to accept the confines of traditional medicine.
They are turning, in ever increasing numbers, to alternative providers of care: chiropractors, homeopaths, acupuncturists, hypnotists and other nontraditional practitioners. If physicians and hospitals fail to respond appropriately, the consequences of this movement may profoundly affect their long-term cultural authority.
One of the first researchers to document the rapid growth of nontraditional care was David Eisenberg, M.D., a Harvard professor. In an article published in the Jan. 28, 1993, edition of the New England Journal of Medicine, Dr. Eisenberg said, "An estimated 61 million Americans used at least one of the 16 unconventional therapies we studied, and approximately 22 million Americans saw providers of unconventional therapy for a principal medical condition."
Even more interesting is the conclusion that "the estimated number of ambulatory visits to providers of unconventional therapy in 1990 was 425 million. This number exceeds the estimated 388 million visits in 1990 to all primary-care physicians combined."
Dr. Eisenberg concludes that the out-of-pocket cost for this care is equivalent to nearly half of the total out-of-pocket expense associated with physician care in America.
Public acceptance.Not only are Americans increasingly seeking alternatives, but they appear to be satisfied with the results they are getting. A 1991 telephone survey of 500 Americans conducted by Time magazine revealed that 84% of respondents who had used a provider of alternative care would return for subsequent treatment. A more recent survey, conducted by Self magazine in the fall of 1993, produced corroborating evidence on high patient satisfaction with alternative medicine. When asked, "What do you think about alternative medicine?" 36% of the respondents said that they had "more faith in it than in conventional medicine."
While the majority of respondents surveyed said that, on a scale from one to five, their level of confidence in traditional medicine would rate a three, some 60% of respondents rated their confidence level in alternative medicine as four or higher. The vast majority of respondents believed that they, or someone they knew, had been cured via alternative therapy.
Many in traditional medicine have historically responded to the claims of alternative providers with a quick rebuke, warning of the distinctions between what they consider rational medicine and what they say is outright quackery. But such inflammatory rhetoric does little to reveal the cause for the growth of this phenomenon or to address its impact.
Numerous factors have led to the renaissance in alternative care. Perhaps first and foremost, however, is public disenchantment with allopathic medicine's perceived impotence in treating a host of maladies ranging from mundane lower-back pain to devastating diseases like AIDS.
The public is fickle, and although people recognize the medical miracles that exist thanks to science, many believe today's physicians should have the knowledge and power to heal all ills. When these high priests of science cannot divine the answer to a perplexing medical dilemma, the public loses faith. When these priests become increasingly divided into specialties, their authority is further diluted. And, as technology increasingly insulates this community from its patients, the sacred bond finally breaks.
Providing hope. Alternative medicine offers a great deal to sufferers. It holds out the promise of hope when traditional methods of therapy have failed. It often provides a higher level of patient involvement in the healing process. Plus, most alternative therapies are vastly less invasive, as Harvard-trained physician Andrew Weil, M.D., so clearly points out: "The American Medical Association loves to accuse chiropractors of causing strokes and paralyses by their method of spinal manipulation. The AMA's accusation is a classic case of people in glass houses throwing stones.
"Compared to such procedures as pneumoencephalography (imaging of the brain), angiography, and many other techniques used in every allopathic hospital today just for diagnosis, the treatment methods of chiropractic and other unorthodox systems are quite harmless."
Fortunately, not all hospitals or providers are locked into the narrow paradigm of traditional medicine. Chicago's Grant Hospital, a 479-bed facility owned by Columbia/HCA Healthcare Corp., recently established a collaborative program with the Chicago Holistic Center. The program is designed to expand the type of care available to Grant's patients while reducing costs through the minimization of inpatient care. Other hospitals, such as the University of Massachusetts Medical Center in Worcester, have long-established programs in mind/body science. It's time others follow their lead.
Alternative therapies are neither panacea nor placebo. Selective treatments may well complement existing allopathic therapeutic regimens. The provider's job is to stop thinking in terms of black and white or the ability to instantly demonstrate efficacy using the sacred covenants of science. It is the responsibility of providers to openly explore alternative methods that do not jeopardize the health status of their patients.
While it is hard to quantify the value of the human touch, few physicians would dispute this claim. There must a balancing point that exists between skepticism and open-mindedness, traditional methods and the alternatives.