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Meet Your Health Care Team of the Future

By Kathryn Arnold

Medical doctors don't always have the answers to Americans' health problems. Traditionally, conventional medical practitioners don't focus on prevention in treating their patients. Complementary practitioners such as Oriental medicine doctors and naturopathic physicians do, however, and their wellness-oriented therapies may hold the key to the future of medicine.

Imagine waking up in the year 2020 with a sore throat. Feverish, you crawl out of bed, stumble over to your home computer and type in your symptoms: sharp pains upon swallowing, slight fever. Your computer asks you a series of questions, then responds, "It sounds like you have viral pharyngitis. Gargle licorice root tea and take extra vitamin C." Or the computer might tell you, "Your symptoms indicate a more severe condition. See your family doctor."

    Sound far-fetched? Actually, this future scenario is closer to becoming reality than national health care plan. In California, Arizona, New Mexico, Colorado and Utah, subscribers to American Western Life (AWL) Insurance Company's Wellness Plan can call a 24-hour, toll-free hotline for health consultations. AWL's Wellness Plan is the nation's first fully insured health care plan integrating alternative medical practices such as acupuncture, biofeedback and massage as part of its coverage. The Wellness Plan phone line is staffed by naturopathic doctors who answer health questions, offer self-care information, recommend research material and provide referrals to specialists. Because consultations take place over the phone rather than in a doctor's office, the clients save time off from work or away from home.

    Marcel Hernandez, N.D., director of AWL's Wellness Plan, explains the company's philosophy: "We've gotten accustomed to going to the doctor for every little sniffle, and we've gotten used to abrogating personal responsibility for managing our own health. Here at AWL we say, `You need to take some responsibility. We'll give you information over the phone on managing your health conditions, we'll send you educational handouts, we'll tell you where to go for more information, and we'll support you in every way we can.' This approach saves on doctors' visits and empowers people take responsibility for their own health."

    Taking responsibility for their own well being is an emerging concern among Americans. Fed up with expensive, risky and ineffective conventional medicine, Americans have begun to take control of their health by choosing complementary therapists. During 1990, we made more visits to alternative therapists than to primary care physicians, according to a study in the New England Journal of Medicine (1993, vol. 328, no. 4).

    "Americans are increasingly aware of the limits of allopathic [conventional] medicine," explains Kenneth Pelletier, M.D., author of Sound Mind, Sound Body (Simon & Schuster) and associate professor of medicine, Stanford University School of Medicine. "There's growing awareness that we're reaching the end of our ability to treat some conditions. Certainly in the area of cancer there hasn't been substantial progress in treating a number of specific cancers, and people are disillusioned and afraid. Until recently people didn't know what ayurveda or homeopathy or acupuncture were. Now they have more knowledge about these other methods."

    Knowledge is empowering, says AWL's Hernandez. "Patients are no longer satisfied with the `doctor as God' relationship. They want to participate in their healing," he says.

    The same New England Journal of Medicine study that found Americans were switching to alternative medicine also reported that 72 percent of patients seeing both conventional and alternative practitioners within the same timeframe didn't tell their medical doctors about their alternative treatments. "Patients often don't tell their physicians because they're afraid their medical doctors will disapprove," says Andrew Weil, M.D., author of Health and Healing and Natural Health, Natural Medicine (Houghton Mifflin). "Patients fear their physicians will make them feel stupid for using methods they think are ridiculous."

    The attitude of conventional medicine toward alternative medicine is shifting, however, with economic pressure and public demand driving the change. The New England Journal of Medicine article was a wakeup call for physicians and insurers. With $17 billion of health care going to alternative therapies annually, doctors and hospitals are suffering economically. To recapture the market share they've lost, providers are rushing to learn about alternative therapies and integrate them into their practices. Patients can now go to the University of Maryland Medical Center to receive acupuncture or to Stanford University Medical Center to get alternative interventions for heart disease. At Chicago's Grant Hospital holistic services are offered along with conventional therapies, and at San Diego's Sharp Hospital mind-body medicine is integral to the healing process.

    Weil, who teaches natural healing at the University of Arizona College of Medicine, believes, "There's a greater openness to alternative medicine than there ever has been, and it's forced by economic factors. Conventional medicine is in economic trouble so the market is shifting in the direction of alternative medicine. Patients aren't getting it from medical doctors, so they go elsewhere."

    Hernandez agrees with Weil's assessment: "Last November, Dr. Jonathan Wright and Dr. Alan Gaby, head of the American Holistic Medical Association, gave a seminar on orthomolecular medicine [vitamin therapy] in San Francisco. Two hundred doctors were expected; 400 showed up. So there's a thirst among conventional physicians for knowledge. Their patients are demanding it."

    Furthermore, says Joseph Pizzorno, N.D., president of Bastyr University and co-author of Encyclopedia of Natural Medicine (Prima), "Many physicians realize they've come to the limits of technologically oriented disease intervention, and those limits aren't only scientific, they're financial. We can't afford the conventional medical system any more. We need a new healing paradigm, which promotes health rather than treats disease."

A Cure for the Health Care Crisis?

Pizzomo estimates that 80 percent of illness is better treated with alternative methods. Alternative medicine encompasses a variety of therapies including traditional Chinese medicine, acupuncture, ayurveda, homeopathy, chiropractic, massage therapy, naturopathy and vitamin therapy—to name a few.

    The main difference between alternative medicine and standard or allopathic medicine is that alternative therapies are based on an underlying belief in the ability of the body to heal itself. Alternative medicine uses natural substances such as herbs and nonsurgical therapies such as massage and acupuncture to boost the body's healing functions. Allopathic medicine, on the other hand, combats disease by using substances such as pharmaceutical drugs and invasive techniques such as surgery. The allopathic approach typically takes over a function of the body when that function is no longer adequate, whereas the aim of alternative medicine is to make that function work better.

    "Most orthodox therapies are based on the concept that the doctor diagnoses a disease then treats it and makes sure the symptoms are relieved," Pizzorno explains. "While natural health physicians also diagnose disease, they're more interested in understanding what's going wrong with the body's own healing systems and helping the patient understand what needs to be done to re-establish normal healing system function."

    "The body has the innate power to heal itself, and the best thing we can do is support and develop the body's own mechanism for self-healing," Hernandez reiterates. "In the long run, this helps build the immune system and helps the body fight infection on its own rather than depending on external sources for that kind of superficial healing."

    Conventional medicine is great at treating trauma and emergencies, Hernandez admits, but it's a failure at handling recurrent and chronic conditions. He cites the standard approach to treating otitis media, inner ear infection. "Despite a recent article in the New England Journal of Medicine which stated antibiotics are effective in less than 25 percent of otitis media cases, standard practice for treating ear infections continues to be administering antibiotics," says Hernandez. "I see children with chronic ear infections who have taken successively stronger doses of antibiotics to the point where the microbes are resistant and the antibiotics don't work. In naturopathy, when a child comes in with otitis media, we ask, `What's the cause of these ear infections? What are the predispositions to the condition?' Then we take a history and try to determine the cause. We also use natural therapies that boost the immune system, which in turn helps clear the infection and prevent it from recurring. If necessary, we use vitamins and antibacterial herbs that work by different mechanisms than synthetic antibiotics. So, the approach is quite different. We don't just say, `You've got an ear infection, take antibiotics.' We ask, `What's the cause?"'

    There are some conditions such as autoimmune disease which, once they get established, are self-generating and more difficult for alternative medicine to treat, says Pizzorno. "Virtually every disease condition is treatable by natural medicine because natural medicine helps the body work better. However, that doesn't mean that every disease can be cured by natural medicine because some diseases go beyond the ability of the body to heal itself. For example, rheumatoid arthritis, if treated early in the disease process before there's too much tissue damage, is pretty easy to treat with natural medicine. But when people have had it for 30 years and their joints are seriously disfigured, then by that point it's a self-perpetuating disease. Even though you can still treat the causes, it's too late. You now have to take control of the body's own functions and treat the disease."

    Weil believes standard medicine helps only 30 out of every 100 people: "For the other 70, I think it's worth looking at what alternative medicine can do for them." In the future, Weil envisions the establishment of triage committees of well-trained doctors to sort out who should use allopathic medicine and who should use alternative medicine.

    Pizzorno has a slightly different vision: "To me the ideal medical system is one where the family doctor is a doctor of natural medicine who can make a standard diagnosis but focuses on how to help people be well. Then medical doctors become the specialists, and they're the ones you call on when the body no longer has the ability to heal itself."

    Not until we restore health as the objective of health care will we find a cure for our health care crisis, says Pelletier. "Right now the objective is treating disease. We call it a health care system, but it's really a disease management industry. If we start to ask what creates health for individuals and populations in terms of lifestyle practices, diet, environment, health policy and access to services, then we start to get very different answers. Those answers I think will help us create a true health care system for the first time."

Reprinted with permission from the March 1995 issue of Delicious! Magazine, a publication of New Hope Communications, Boulder, CO.