21st CENTURY HEALTH CARE
"The division between conventional and traditional medicine is as artificial as the division between science and nature. They can be woven together in a fashion that meets our physical, emotional, and spiritual needs. This is the foundation about which integrative medicine is built."
- Tieraona Low Dog, M.D.
Most causes of illness are related to personal and cultural health behaviors
75% of US health care costs are spent on chronic, largely preventable diseases
95 cents of every dollar was spent to treat disease after it had already occurred
The human mind and body have essential capacities for self-repair
that can be supported by our life choices and appropriate therapies
CONTEMPORARY MEDICAL PRACTICE
INTEGRATIVE MEDICINE PRACTICE
- Disease oriented
- Find it, fix it
- Biomedical interventions
- Individual left to enact
- Professionals control care
- Health oriented
- Identify risk and minimize it
- Whole person approaches
- Lifelong planning
- Support in implementation
- Patient is the source of control
TRENDS TOWARD THE NEW
OF 21st CENTURY HEALTH CARE
Academic Support for Integrative Medicine
Government Support for Integrative Medicine
The National Center for Complementary and Alternative Medicine (NCCAM) provides five classifications of Complementary and Alternative Medicine:
Mind Body Therapies,
Alternative Medical Systems,
Biologically Based Therapies,
Manipulative and Body Based Therapies, and
Some have a strong historical, clinical or experimental evidence base for efficacy, and others may not.
Check out the "NIH Classifications" page I created under 21st Century medicine for additional information on the specific therapies and systems that come under these five NIH classifications that I learned about while I was going through the Integrative Health Coach Professional Training at Duke University Integrative Medicine Center.
Public Policy Support for Integrative Medicine
The Institute of Medicine (IOM) is professionally recognized for its leadership in public policy excellence. The Institute of Medicine is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice on modern health care to decision makers and the public. Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863.
In 2001 the Institute of Medicine issued IOM rules for the 21st century health care system recommending the following rules of practice to shift from our current system to an improved system:
RULES OF PRACTICE
- Care based on visits
- Professional autonomy drives variability
- The professionals control the patient's care
- Care based on continuous healing relationships
- Care is customized according to patient needs and values
- The patient is the source of control
In 2005 the IOM made the recommendation that:
The same principles and standards of evidence of treatment effectiveness apply to all treatments, whether currently labeled as conventional medicine or CAM
Health profession schools should incorporate sufficient information about CAM into the standard curriculum at the under graduate, graduate and post graduate levels to enable licensed professionals to competently advise their patients about CAM
Integrative medicine fulfills the new 21st Century IOM Rules of Best Practice through:
Healing approach, patient-centered approach
Engages the mind, spirit, and community as well as the body
Partnership with patient in process
Is committed to the practice of best medicine, whether its origins are conventional or alternative
Integrative medicine offers the possibility for:
- Decreased harm of interventions
- Treatment of conditions where conventional medicine fails
- Decreased cost
- Improved outcomes
Public Support for Integrative Medicine
The people themselves are leading the emerging health care paradigm and the return to whole life health care with their dollars and choices in how they invest personally in their own health. Conventional medicine has no idea of the scope of complementary and alternative medicine (CAM) numbers and dollars.
A 1997 survey of the public showed these trends in health care:
40% used unconventional therapy
The public made 629 million visits to complementary and alternative practitioners - as compared to 385 million visits to their primary care physicians, if they had a primary care provider
The public spent $27 billion out of pocket for complementary and alternative health care
60% of the public did not inform their physicians that they were choosing and using complementary and alternative health services
80% of the people used their chosen complementary and alternative services in conjunction with conventional medicine - not instead of it
A National Health Interview Survey in 2007 of over 23,000 adults and over 9000 children showed that:
- Adult use of complementary and alternative medicine (CAM) increased from 36% in 2002 to 38.3% in 2007
- 12% of children were using complementary and alternative medicine
- The most common category of complementary and alternative medicine was the use of natural products such as fish oil, echinecea, glucosamine, flax
- The biggest increases in CAM between 2002 and 2007 were in breath work, meditation, massage and yoga
The majority of people use CAM as a complement to conventional medicine, not as an alternative
Dissatisfaction with conventional medicine was NOT predictive of the use of CAM.
The people are choosing
complementary and alternative medicine
because it is more congruent with their own values, beliefs, and philosophical orientations
toward health and life
A BROADER VIEW -
PAST, PRESENT, AND FUTURE
The history of our current
disease-focused medical care system:
It is helpful to step back and see the broader picture of our current health care beliefs and paradigm. The practice of contemporary allopathic medicine as we know it today is relatively new, emerging in the late 1800s and early 1900s. According to a course in the history of medicine offered as an elective at Harvard Medical School, just over one hundred years ago, people became physicians primarily by apprenticing with their community barber who was the person in the community who treated gun shot wounds and other health crises. If an aspiring doctor's family was wealthy enough there were a few medical schools on the East Coast of the United States and in Europe but going to medical school was not the common or required route to medical education and becoming a medical doctor. Medical School was six to twelve months in length from start to graduation as a physician. Medical education was very different than it is now - just one hundred years ago.
This Harvard Medical School course in the history of medicine teaches that during the Great Depression in the United States in the 1930s the American Medical Association organized politically to create economic advantage for their profession and discredited other health care professions, especially those offered by women practitioners such as midwifery and herbal healing. This led to the current, inaccurate public view of many consumers and medical doctors that the medical doctor and their practice is superior to other health care professions and that other healing professions are not based on the same degree of science as the contemporary medical system. This misinformation has led to distrust in the public eye of other health care professions and practices.
When you realize how recent the practice of contemporary (also referred to as "allopathic") medicine is, you may appreciate how incredibly far the medical profession has come in just over one hundred years and how it came to its current economic and marketing dominance of the health care field.
Rapid progress in the health care field continues at an ever increasing pace in the 21st century and natural healing is once again returning to its historical place as part of a full health care paradigm for the people. Prevention and whole health are once again becoming the foundation of health rather than seeing health care as just disease treatment.
As we work together in partnership to maximum the opportunities for health care for everyone, there will be many amazing and wonderful advances made in health care in the 21st century.
Regenerative Medicine is one of the most exciting and life transforming medical fields of the future.
All the advances in modern medicine however, will mean little if people do not assume full responsibility for their own health and the quality of their lives. The Duke Wheel of Health truly does show the highest promise of 21st century medicine with YOU at the center of your own life making positive, life affirming choices to have your body, mind, heart and spirit support your greatest life experience.
Imagine the future we can have when all health care professions work together to create and offer the best evidence-based health care system we have ever had - with each person in charge of and at the center of their own health care choices and system!