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The health care industry has a variety of policies and
standards regarding coverages for alternative medicine
modalities. From a sociological standpoint, unconventional,
alternative, or unorthodox therapies refer to medical practices
that are not in conformity with the standards of the medical
community. The New England Journal of Medicine defines
unconventional therapies, “as medical interventions not taught
widely at U.S. medical schools or generally available at U.S. hospitals. Examples include acupuncture, chiropractic, and
massage therapy”(1993). Coverages vary widely among conventional
carriers, preferred providers as well as the omnipresent Health
Maintenance Organizations (”HMO”). The primary emphasis and, for
that matter, the only reason for the existence of insurance
companies is a single word, profit. More specifically, premiums
less costs provide the all important profit margin, the life
blood of the insurance industry. By not providing coverage for
the billion dollar industry of alternative treatments, insurance
companies are keeping the cost of the premiums down but at the
same time not allowing their customers to use complementary
treatments such as chiropractic to prevent or cure illness. The
more rigid and restrictive the policy provisos, the more
assurance for the companies that they will maximize their bottom
lines. Therefore, patients of alternative therapies as well as
doctors must show that such unconventional treatment provides
relief and prevention of illness. “The total projected out-of-
pocket expenditure for unconventional therapy plus
supplements(such as diet pills and megavitamins)was 10.3 billion
dollars in 1990. This is comparable to the out-of-pocket
expenditure for all hospital care in the United States in
1990($12.8 billion), and it is nearly half the amount spent out
of pocket for all physicians’ services in the United States($23.5
billion)”(nemj,1991). From this one may infer that society has
become fed up with inadequate results or side effects associated
with surgery and drugs which accompany the treatment of modern
medicine. So, in an effort to cope with the inadequate treatment
patients are receiving from conventional medicine, they are
seeking alternatives such as chiropractic for chronic illness and
pain. “Although most doctors wince when you mention
chiropractors, some fairly rigorous studies have shown their
manipulations of the spine to be effective in relieving lower-
back pain. Orthopedic surgeons have even been known to refer
patients to chiropractors, and some 30 U.S. hospitals have
chiropractors on staff”(Wallis,1991).
Relevant Policies and/or Practices
“In 1997, 42 percent of all alternative therapies used were
exclusively attributed to treatment of existing illness, whereas
58 percent were used to prevent future illness from occurring or
to maintain health and vitality” (JAMA, 1998). “The magnitude of
demand for alternative therapy is noteworthy, in light of the
relatively low rates of insurance coverage for these services”
(JAMA, 1998). Coverages vary widely depending on the policies
provided by the carriers. In my research, I contacted the Kern
County Superintendent of Schools, (”KCSOS”), Personnel Office to
inquire into the health policies provided to the nearly one
thousand employees of the office. There are a variety of options
available to each employee. The basic hospitalization plan used
by the majority of employees is the Blue Cross Prudent Buyer
Hospital Only plan. As required by State and Federal law, the
office is also required to make available approved HMO’s if
employees request them. To that end, the office has a large
number of employees enrolled in Kaiser-Permanente and Health Net
HMO’s. The administrative agency that provides the programs is
the Self Insured Schools of California, (”SISC”), which is a
cost-containment consortium of hundreds of California school
districts. Currently, SISC provides coverage for more than
thirty-five thousand employees and their eligible dependents. In
addition to medical coverages, the office also provides life,
vision, dental, prescription and mental and nervous policies.
The mental and nervous policy that is provided for each employee
and dependents is described as a “carve-out” benefit. Prior to
this type of policy utilization, the basic Blue Cross medical
plan provided very specific and limited mental and nervous
benefits. Carve-out benefits provide coverages for treatments
that would not be covered otherwise. Several companies came
forward with plans that were more comprehensive and cost-
effective and replaced the medical plan component. An additional
benefit was that there was a net premium savings. Three
companies, Pacificare, MCC and BHA, offer plans at comparable
rates which provide a variety of family and personal counseling
services which are more along the lines of preventative medicine
rather than the hospitalization plans that were offered under the
basic hospitalization plan. Employee unions have been very
receptive to these plans due to the cost-containment provisions
as well as the intervention value for the employees that they
represent. For example, an employee with an alcohol or drug
addiction problem can get confidential assistance to assist in
the resolution of these problems and avoid being disciplined for
job performance problems.
The basic medical plans offered by the KCSOS office provide
various levels of coverage for several forms of alternative
medicine. The Blue Cross Prudent Hospital Only plan provides
coverage as follows: “A doctor of medicine (M.D.) or a doctor of
osteopathy (D.O.) who is licensed to practice medicine or
osteopathy where the care is provided, or one of the following
providers, but only when the provider is licensed to practice
where the care is provided, is rendering a service within the
scope of that license, is providing a service for which benefits
are specified in this Plan Description, and when benefits would
be payable if the services were provided by a Physician as
defined above: a dentist, optometrist, dispensing optician,
podiatrist of chiropodist, psychologist, chiropractor,
acupuncturist(but only for acupuncture and for no other
services), certified registered nurse anesthetist, clinical
social worker*, marriage, family and child counselor*, physical
therapist*, speech pathologist*, audiologist*, occupational
therapist*, respiratory therapist*. Note: Services by the
providers indicated by asterisks (*) are covered only by the
referral of a Physician as defined above”(SISC III, 48).
“Health Net has partnered with American Specialty Health
Plans (ASHP) to offer Chiro Net quality, affordable
chiropractic coverage. With this program, you’re free to
obtain this care by selecting a participating chiropractor
from the Chiro Net directory. Although you’re always welcome
to consult your Primary Care Physician, you won’t need a
referral to see a participating chiropractor.
What’s covered
Office visits
$10 per visit
30 visits per year
There is a $50 annual chiropractic appliance allowance
toward the purchase of chiropractically necessary items such as
supports, collars, pillows, heel lifts, ice packs, cushions,
orthotics, rib belts and home traction units.
What’s not covered
Limitations and exclusions
Air conditioners, air purifiers, therapeutic mattresses,
vitamins, minerals, nutritional supplements, durable medical
equipment, appliances or comfort items
Conjunctive physical therapy not associated with spinal,
muscle or joint adjustment
Diagnostic scanning, MRI, CAT scans or thermography
Exams or treatment of strictly non-neuromusculoskeletal
disorders
Hypotherapy, behavioral training, sleep therapy, weight
programs, educational programs, nonmedical self-help or
self-care, or any self-help physical exercise training
Lab tests, X-rays, adjustments, physical therapy or other
services not chiropractically necessary or classified as
experimental
Pre-employment physical or vocational rehabilitation arising
from employment or covered under any public liability
insurance
Treatment for temporalmandibular joint syndrome (TMJ)
Treatment or services not authorized by ASHP or delivered by
an ASHP provider
This is only a summary”(HealthNet, 7).
Nowhere in the Health Net coverage guide did it mention
coverage, limitation, or exclusion of the numerous treatment
modalities of alternative medicine except for chiropractic
treatment, which it supported in explicit detail. From this one
may conclude that chiropractic is the only alternative treatment
that has established a beneficial reputation in possibly
preventing illness and promoting wellness in the western world.
An extremist might say because Health Net does not include any
other forms of alternative medicine, that these modes of
treatment are not generally accepted by the medical community or
deemed effective or appropriate in treating illness.
Kaiser Permanente’s coverage plan has a significantly larger
number of exclusions and limitations regarding treatment coverage
compared to Blue Cross and Health Net within the SISC
administrative agency. The exclusions section of Kaiser’s
coverage guide states in section i, “Chiropractic services and
services of a chiropractor,” which is in contrast to both Blue
Cross and Health Net, each of which fully recognize and provide
coverage for chiropractic services. In section j of the exclusion
section it seems that Kaiser is attempting to eliminate coverage
of all other alternative medicine treatment by stating,
“Experimental or Investigational Services and those procedures
not generally and customarily provided to patients residing in
the Service Area.”(Kaiser, 13) Their definition of Experimental
and Investigational Services is, “any service or item that is not
recognized in accord with generally accepted medical standards as
being safe and effective for use in the treatment of the
condition in question, whether or not the service is authorized
by law for use in testing or other studies on human patients; or
any service requiring approval by any governmental authority
prior to use when such approval has not been granted prior to
provision of the service or item.” (Kaiser, 27) This seems to be
an attempt to classify all other forms of alternative medicine
treatments, with the possible exclusion of chiropractic, as
experimental forms of treatment. If this proves to be a
fallacious statement, by concluding that section j was an attempt
to deem that alternative medicine as an experimental service;
then one might conclude that Kaiser dismisses alternative
medicine treatment altogether by not including them in their
coverage plan at all. Either way Kaiser must view alternative
medicine as being inadequate or inappropriate treatment for
illness, providing relief of symptoms or improving their patients
degree of health.
Preventive medicine, wellness and alternative therapies are
fundamental components of a growing national trend. According to
a survey conducted by The Journal of the American Medical
Association, “…use of at least 1 of 16 alternative therapies
during the previous year increased from 33.8 percent in 1990 to
42.1 percent in 1997, and the probability of users visiting an
alternative medicine practitioner increased from 36.3 percent to
46.3 percent” (1998). More and more Americans are seeking options
other than conventional forms of medical treatment. Conventional
or modern medicine can be defined as treatment that is widely
accepted by U.S. medical schools and insurance companies as being
beneficial to the treatment of disease and illness with
scientific evidence. “In 1993, the National Institutes of Health
chose Dr. Joe Jacobs to head their new Office of Alternative
Medicine. The office was created last year under pressure from a
Congress alarmed by the soaring cost of high-tech healing and the
frustrating fact that so many ailments such as: AIDS, cancer,
arthritis, back pain, which have yet to yield to standard
medicine”(Toufexis,1993). The cost of standard medical care has
risen dramatically. For example, a simple arthroscopic cartilage
repair on an outpatient basis costs in excess of five thousand
dollars for a thirty minute procedure. A simple Magnetic
Resonance Imaging, (”MRI”), costs over a thousand dollars. In
contrast, a visit to a chiropractor costs less than forty
dollars. The Journal of Occupational Medicine performed a study
comparing costs of treating back injuries with chiropractic and
traditional medicine. Using identical diagnostic codes for 3062
claims, the report reached the following conclusion: “For the
total data set, cost for care was significantly more for medical
claims, and compensation costs were ten-fold less for
chiropractic claims.”(1991).
Major Position or Argument
Is it better to exercise preventive medicine rather than
focus on curing disease after the fact? In response, a growing
number of people have concluded that it is a quality of life
decision for them to opt for optimizing their health rather than
seeking cures. According to the study that represented the use of
unconventional therapy for the 10 most frequently reported
principal medical conditions, published in the New England
Journal of Medicine, “…a full third of the respondents who used
unconventional therapy in 1990 did not use it for any of their
principal medical conditions”(nejm,1991). From this fact we can
infer that a substantial amount of unconventional therapy is used
for non-serious medical conditions, health promotion, or disease
prevention. “The probability that an individual patient who saw a
medical doctor also used unconventional therapy in 1990 was
higher than one in three for patients with anxiety(45 percent),
obesity(41 percent), back problems(36 percent), depression(35
percent), or chronic pain(34 percent), relaxation techniques,
chiropractic, and massage were the unconventional therapies used
most often in 1990″ (nejm,1993). How can the insurance companies
ignore the fact that, “an 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(general family practitioners,
pediatricians, and specialists in internal medicine) combined.
Also, if one assumes that charges for visits to providers of
alternative therapy were paid in full, Americans spent
approximately 11.7 billion dollars for these services in
1990″(nejm,1993). Nutrition stores have multiplied in the past
few years due to the growing demand for a variety of vitamins and
potions regarded by many as a viable means to fend off disease
and to improve on one’s daily health. Additionally, fitness
centers and exercise facilities have sprung up on every street
corner. Some are open twenty-four hours per day and provide
numerous forms of equipment, technical assistance and even
personal trainers to assist dedicated individuals in improving
their general well-being and appearance. Society has become aware
of the benefits and effectiveness of unconventional therapies
shown by a study that those who sought treatment from providers
of alternative medicine has seen the provider an average of ten
times in the past twelve months(nejm,1991).
Body of Paper
The American Chiropractic Association defines chiropractic
as follows: “Chiropractic is a health care discipline which
emphasizes the inherent recuperative power of the body to heal
itself without drugs or surgery.” “The practice of Chiropractic
focuses on the relationship between structure, (primarily the
spine), and function, (as coordinated by the nervous system), and
how that relationship affects the preservation and restoration of
health. In addition, Doctors of Chiropractic recognize the value
and responsibility of working in cooperation with other health
care providers when in the best interest of the patient.” (ACA,
1998). There can be little doubt that chiropractic treatment is
valuable as both a standard medical treatment and as an
alternative form of medicine. There may very well be some
scientific justification in the manipulation of the spine because
almost every nerve in the body runs through the spinal cord.
Chiropractors maintain that they can treat illness by adjusting
the vertebra of the spinal column to relieve nerve and muscle
tension(Wallis,1991). This position may, at first, seem
contradictory but with further analysis and explanation, it will
become clear that it is a supportable premise. “The visits to
practitioners of alternative therapy in 1997 exceeded the
projected number of visits to all primary care physicians in the
United States by an estimated 243 million; visits to
chiropractors and massage therapists accounted for nearly half of
all visits to practitioners of alternative therapies” (JAMA,
1998).
As an example, a simple on-the-job back strain could be
treated in several ways. The simplest and seemingly least costly
treatment would be for the employee to go home and rest in bed.
However, this form of treatment may actually keep the employee
away from work for the longest period of time which would make
the cost factor to the employer higher in the long run due to
Worker’s Compensation premium costs and the costs associated with
replacing the injured employee such as sick leave benefits and
the costs of providing substitute employees.
The more traditional treatment would be for the employee to
seek treatment from an urgent care facility or from a family
physician. Treatment would generally require X-rays, an MRI or a
CAT scan to assist the physician in diagnosing the source of the
injury. Depending on the nature and severity of the injury,
surgery and rehabilitation through physical therapy may be
required to resolve the injury. Otherwise, in the case of a
minor injury, cold packs, pain medication and rest may be
appropriate treatment. Costs for traditional physician treatment
are generally very high. For example, a standard MRI will cost
at least a thousand dollars. Referral to an Orthopedic Surgeon
and subsequent treatment including possible surgery, medication
and subsequent physical therapy can cost tens of thousands of
dollars and extended periods of lost work time. All of the
medical plans that I examined provide full coverage, less
applicable deductibles or co-payments, for the cost of most forms
of treatment with the exception of those considered to be
experimental.
A third alternative may be acupuncture treatment. The
acupuncturist may or may not be licensed to provide or order X-
ray, MRI or CAT scans. If not, the treatment may be the
traditional acupuncture treatment. Rest is generally
recommended. Generally, the cost of acupuncture is covered,
subject to deductibles and co-payments, by most health plans with
the exception of Kaiser-Permanente.
The fourth and most appropriate treatment, in my opinion, is
chiropractic. A chiropractor has the ability to order or to
provide X-ray examinations as well as to order MRI’s or CAT scans
as necessary. In the event that structural damage such as a
ruptured disc or fracture exists, the chiropractor would refer
the employee to an orthopedic physician. However, if the injury
is due to a subluxation, the chiropractor would typically perform
an adjustment to the spine or other form of manipulative therapy
to realign the spine and remove nerve interference and to relieve
pain and discomfort. The chiropractor may also prescribe cold
packs, rest and, in some cases, physical therapy. The initial
examination, which include: the patient’s history and
assessment, X-rays, spinal adjustment, and recommendations for
improving of making changes in their lifestyle to promote a
healthier life (nutrition, massage therapy, exercise, rest,
etc.). The initial examination costs a few hundred dollars,
which is covered by Blue Cross and Health Net less the
deductibles and co-payments. Follow up exams include spinal
adjustments and recommendation or advice on questions pertaining
to the treatment and your lifestyle. The cost of these exams
usually cost around fifty dollars per visit, which Blue Cross
covers the full amount after the deductible has been paid; Health
Net requires a co-payment of ten dollars per visit up to thirty
visits per year, and Kaiser doesn’t cover any of the expenses of
chiropractic care. According to an article in Kiplinger’s
Personal Finance Magazine, “An initial visit to a chiropractor
could cost $40 to $80, plus the cost of x-rays; follow-ups are
around $40 to $60. Insurance laws in most states require insurers
to reimburse for treatment by chiropractors if they reimburse for
comparable treatment by M.D.’s, and coverage is mandated in
Delaware, Maryland, New Mexico and North Dakota. There is no
requirement in Oregon, Utah and Vermont. Self-insured plans are
exempt from the state-mandated-benefit laws. Also, according to
Don White of the Health Insurance Association of America,
insurers are “much more willing to pay than they used to be” when
alternative therapies are recommended by a doctor after
conventional methods fail”(Clark,1993).
Chiropractic is not without its own set of risks just as
other forms of traditional medicine. Ian Coulter, Ph.D.
identified those risks and facts as follows:
“chiropractors perform more than 90 percent of spinal
manipulations (manipulation is the generic, non specific
medical term for adjustment); the risk of complication with
cervical (neck) adjustments is 6.39 per 10 million
adjustments; the risk of complication with lumbar (low back)
adjustments is 1 in 100 million adjustments. The risk of
complication in some common medical procedures and
medications were not as good: the risk of complication with
the use of NSAIDS (aspirin, tylenol, ibuprofen, etc.) is 3.2
in 1,000; and the risk of complication in cervical spine
surgeries is 15.6 in 1,000. By way of commentary, there has
been a lot of news coverage concerning the dangers of
Chiropractic care over the past few years. This article
clearly points out that Chiropractic procedures are
significantly safer than many common medical procedures. For
the best reflection of how safe Chiropractic is, ask your
Chiropractor how much his/her malpractice insurance costs.
Then ask your medical doctor the same question. The
difference will surprise you.” (Chiropractic America, 1999).
The preceding procedures treat injuries and the pain
associated with the injury in widely differing manners. It is
also important to consider how each form of treatment personally
affects the individual. Obviously, the less invasive the
treatment, the quicker the recovery. Pain control is another
serious consideration. Simply resting may be adequate in some
instances but if a serious injury exists, the long term result
may be negative. Surgery generally generates substantial pain
which requires pain control medication which, in some instances,
can become addictive. In contrast, acupuncture causes very
little, if any, discomfort and may provide a long term solution.
“Acupuncture is most often used to treat pain, and is also used
for ailments such as hypertension and gastrointestinal disorders.
Needles placed on points on the body are said to transmit
impulses to the brain and then to the affected organ. An initial
visit might cost $225; follow-ups run about $75, including a
supply of Chinese herbal medicines, which are part of an
acupuncturist’s treatment”(Clark,1991). However, chiropractic
would be my first choice for treatment because of the immediate
nature of the relief this form of medicine provides. It provides
for safety in that prior to a subluxation adjustment, the
chiropractor would use X-rays to determine the efficacy of this
form of treatment. If a structural injury exists, such as a disc
problem or fracture, the chiropractor would be at liberty to
refer the patient to a physician. Otherwise, chiropractic is
neither invasive nor uncomfortable. In a report released in July
1991 by the Rand Corporation, a prestigious research organization
in Santa Monica, California,
“…a panel of leading physicians, osteopaths and
chiropractors found that chiropractic style manipulation was
helpful for a major category of patients with lower-back
pain: people who are generally healthy but who had developed
back trouble within the preceding two or three weeks. By
some estimates, 75 percent of all Americans will suffer from
low back aches and pains at some point in their lifetime.
The annual cost to U.S. society of treating the ubiquitous
ailment was recently tallied at a crippling 24 billion
dollars, compared with $6 billion for AIDS and $4 billion
for lung cancer. If spinal manipulation could ease even a
fraction of that financial burden, remaining skeptics might
be forced to stifle their misgivings or get cracking
themselves”(Purvis,1991).
In almost all cases, drugs are discouraged so that drug reactions
and addictions are never an issue as a result of treatment.
It is recognized in almost all medical circles that many
illnesses are generated by the mind. “A growing number of doctors
around the country have become more open to alternative
approaches, looking particularly at the way that body, mind and
life-style interact. Andrew Weil, a Harvard-trained M.D. and
author of The Natural Mind, practices this sort of holistic’
medicine in Tuscon”(Wallis,1991). Stress from many sources
including work and family is the cause of many maladies. That is
why it seems very curious that some health organizations ignore
the positive aspects of some or all forms of alternative
medicine. On one hand, the medical community recognizes the
mental side of medicine and then they summarily ignore forms of
treatment that people believe in and that result in healing
whether the source is medical or physical. It seems to be a
territorial response to what the medical community perceives to
be a threat to its existence. Dr. Saper, a neurologist,
“…confirms that lowering a patient’s stress level, with
relation techniques or simply encouraging trust in the doctor,
can be healing. Research suggests that stress triggers the
release of chemical messengers from the brain that suppress the
immune system; relaxation would therefore revive the immune
response”(Wallis,1991). However, the trend seems to be towards
acceptance of alternative medical practices. A telephone poll of
500 American adults was taken from TIME/CNN on October 23, 1991
by Yankelovich Clancy Shulman that contained three questions
about their use of alternative medicine. The results of the
survey were: 31 percent of the poll sought medical help from a
chiropractor, 6 percent sought help from an acupuncturist, 5
percent went to an herbalist, 3 percent visited a homeopathic
doctor, and 2 percent sought help from a faith healer. When those
who had sought medical help from alternative medicine providers
where asked if they would go back to an alternative doctor, 84
percent of them said yes, and only 10 percent answered no, with
the 6 percent of not sures’ being omitted. Among those who had
not sought help from a practitioner of alternative medicine, 62
percent said that they would consider seeking medical help from
an alternative doctor if conventional medicine failed to help
them(Wallis, 1991).
If a high percentage of illnesses are truly psychological
and if these people believe that these forms of alternative
medicine will cure them, then the insurance companies should
provide coverage for them. Ultimately this is cost effective
because in comparison to cost of other forms of medical
treatment, alternative medicines are much less expensive. By
providing coverage for alternative medicine, society should in
fact increase their health either physiologically and/or
psychologically, which will in turn decrease the number of
illnesses and health care premiums will decrease. Maintaining
wellness is a emerging focus of both employers and HMO’s. Use of
at least 1 of 16 alternative therapies during the previous year
increased from 33.8 percent in 1990 to 42.1 percent in 1997.
This shows that society is accepting alternative medicine on an
ever increasing basis. Alternative therapies were used most
frequently for chronic conditions, including back problems,
anxiety, depression and headaches. Also, more than half of these
visits were paid for out-of-pocket, that is health insurance
would not or did not pay for the cost of treatment (JAMA, 11/98).
Incidently, more and more insurance companies are providing
coverage due to member demand. Therefore members who believe in
treatment through alternative medicine should make a concerted
effort to make their demands heard. One study, conducted in
England, found that “for patients with low-back pain in whom
manipulation is not contraindicated, chiropractic almost
certainly confers worthwhile, long-term benefit in comparison to
standard hospital outpatient management.” An extended follow-up
of the same patients found that chiropractic patients continued
to fair better than their medically treated counterparts (Meade,
1431-7). “At three years the results confirm the findings of an
earlier report that when chiropractic or hospital therapists
treat patients with low back pain as they would in day to day
practice those treated by chiropractic derive more benefit and
long-term satisfaction than those treated by hospitals”(Meade,
349-51).
Cost-containment is of vital importance, especially to those
that must pay out-of-pocket for their medical treatments.
According to the JAMA: “The majority of people who saw
alternative therapy practitioners paid all the costs out-of-
pocket in both 1990 (64.0%) and 1997 (58.3%).” Even so, the
trend is apparent. More and more people are turning to
alternative therapies. It must be remembered that the AMA has a
vested interest in the results of such a trend and therefore
would be inclined to put the best “spin” on the survey. “In
1990, a full third of respondents who used alternative therapy
did not use it for any principal medical condition. From these
data, we inferred that a substantial amount of alternative
therapy was used for health promotion or disease prevention. In
1997, 42% of all alternative therapies used were exclusively
attributed to treatment of existing illness, whereas 58% were
used, at least in part, to prevent future illness from occurring
or to maintain health and vitality.” The AMA is apparently
recognizing the fact that many people use alternative therapies
not only to cure but to prevent illness and to improve health.
This is a revealing statement for the medical community to make.
The article goes on to say that: “As alternative medicine is
introduced by third-party payers as an attractive insurance
product, it would be unfair for individuals without health
insurance and those with less expendable income to be excluded
from useful alternative medical services or consultation (eg,
professional advice on use or avoidance of alternative
therapies).” (JAMA, 1998). The AMA is actually recognizing the
value of alternative medicine when it refers to them as:
“…useful alternative medical services….” In fact, the most
impressive statement made by the AMA was: “An increasing number
of US insurers and managed care organizations now offer
alternative medicine programs and benefits. The majority of US
medical schools now offer courses on alternative medicine.”
The Journal of the American Medical Association in a study
conducted by the Stanford Center for Research in Disease
Prevention concluded that: “Research both in the United States
and abroad suggests that significant numbers of people are
involved with various forms of alternative medicine. However,
the reasons for such use are, at present, poorly understood.”
The study went on to say: “Three hypotheses were tested. People
seek out these alternatives because (1) they are dissatisfied in
some way with conventional treatment; (2) they see alternative
treatments as offering more personal autonomy and control over
health care decisions; and (3) the alternatives are seen as more
compatible with the patient’s values, worldview, or beliefs
regarding the nature and meaning of health and wellness.
Additional predictor variables explored included demographics and
health status.” The conclusion of the study was quite
interesting. “Along with being more educated and reporting
poorer health status, the majority of alternative medicine users
appear to be doing so not so much as a result of being
dissatisfied with conventional medicine but largely because they
find these health care alternatives to be more congruent with
their own values, beliefs, and philosophical orientations toward
health and life.” (JAMA, 1998).
Chiropractic, as one of the alternative medicine options,
has proven to be a valuable and viable form of treatment for many
common ailments. It is a relatively painless method for
controlling pain as well as providing long-term relief from
specific symptoms. In support of this proposition: “…the
Agency for Health Care Policy and Research which is an arm of the
U.S. Department of Human Services, developed a clinical practice
guideline for acute low back pain: they looked at the quality and
quantity of research backing common treatments. In the final
guideline, the multidisciplinary panel found that for patients
with acute low back symptoms without radiculopathy (irritation of
the spinal nerve root), the scientific evidence suggests spinal
manipulation is effective in reducing pain and perhaps speeding
recovery within the first month of symptoms.’” (Health Ways,
1998).
Chiropractic is much less costly than traditional medication
and because of its non-invasive nature, recovery is generally
much quicker. Users of chiropractic find that this form of
treatment is more consistent with preventative health patterns
and practices. There is a very low occurrence of side effects and
risk involved compared to traditional medical treatment, which
includes oral medication and surgery. Chiropractic is supported
by a good deal of evidence as mentioned above. Supporters of
Chiropractic would be likely to promote that one should prevent
disease and illness through spinal adjustments, and resort to
drugs as a secondary option to regaining health, and surgery as a
last resort. Society has come to recognize the benefits that
alternative medicine provides. Insurance companies are slowly
coming to the realization of the efficacy and the health benefits
that alternative medicine has to offer. The only way to persuade
the insurance companies to provide coverage is for the users to
voice their opinions.