| Background
Everyone agrees that our healthcare system is in a state of
crisis. Increasing health care costs threaten the economic vitality
of our businesses and limit the choices of patients. This trend
is likely to continue as the baby-boomer cohort ages. Complementary
and alternative medicine (CAM) therapies need rigorous evaluation
with well-designed scientific research to assess their safety,
efficacy, and cost-effectiveness to separate those that are
useful from those that are not. Ancillary legal and ethical
implications of CAM therapies also need to be examined. CAM,
in partnership with the conventional healthcare community can
become part of the solution. Consumers, patients and their providers
deserve reliable clinical information in these areas of medicine.
Medical therapies are increasingly being chosen by healthcare
providers, patients, and insurers based on (1) clinical outcomes
(including safety), (2) cost-effectiveness, and (3) patient
satisfaction. Those who can adapt to this environment and provide
medical services meeting these criteria stand the best chance
to succeed.
Networks of insurers,
hospitals and healthcare providers using an integrative approach
to health care delivery incorporating CAM are beginning to form.
The success of these networks will be dependent on the ability
of a variety of licensed healthcare providers to work together
in a managed care environment and meet the criteria outlined
above. Primary care groups integrating CAM on both the primary
care and the specialty level of health care delivery will facilitate
this transition to an integrative approach with CAM therapies
integrated with conventional medicine.
Patient satisfaction is
likely to be higher in networks using an integrative approach
since it is clear that the demand for complementary and alternative
medical therapies has historically been consumer driven. Outcomes
data measuring effectiveness, cost, and patient satisfaction
will create an evidence profile that will facilitate the development
of evidence based practice guidelines. This will form the foundation
for communication among different groups of providers. When
linked with other historical and ongoing research efforts worldwide
this will create the rational basis for the process of integration.
The growth of conventional
healthcare in this century has largely been rooted in the promises
of pharmaceutical advancements (particularly antibiotics), medical
diagnostics, and evolving surgical techniques. The promise of
modern conventional medicine to cure disease quickly and without
side effects has proved to be elusive. Many patients and practitioners
have chosen to investigate CAM when conventional interventions
are ineffective or accompanied by unacceptable side effects.
The growing demand for CAM has motivated a growing number of
medical practitioners in this country to integrate CAM into
their practices. Medical programs integrating CAM with conventional
medicine are increasingly popular. For example, Dean Ornish,
MD, has developed a successful cardiac rehabilitation program
incorporating group therapy, yoga, meditation, and dietary modification
which has gained international recognition.
Alternative therapies
have caught the attention of insurers as patients report positive
outcomes and practitioners claim an overall lower cost of care.
The demand for alternative therapies in the US has increased
and progress toward reducing the barriers between conventional
and alternative health care continues. With accurate coding
on non-physican licensed healthcare providers on the horizon
with the ABC codes from Alternative Link actuarial data will
not be far behind.
The Integrative Medicine
Institute (IMI) is collaborating in practice based research
linking health care providers, the insurance industry (particularly
those using ABC codes), and the research community. The results
of the research is being disseminated in the peer reviewed medical
literature and at medical conferences.
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[About Dr.
Riley]
d
Contact:
Integrative Medicine Institute, 6 Amigos Lane, Santa Fe NM 87508
TELEPHONE:
505 983-0546 • FAX 984-9938 • E-mail:
dsriley at integrativemed.org
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