Sunday, April 13, 2008

10 Big Problems We Must Overcome to Make Alternative Medicine the Major Healthcare System

(photo courtesy of feelgood_paradise at Flickr)

There is no doubt that alternative medicine is becoming a popular option among patients in the U.S. and Canada. We love it! We are choosing it in greater and greater numbers, even though we have to pay for many of these services out-of-pocket. Americans spend over $27 billion on out-of-pocket expenses on holistic healthcare each year. Fully one-third of us use some form of holistic services, and total visits to holistic providers exceed the number of visits to medical doctors each year.

But Western medicine is still considered the “major healthcare system” in Canada and the U.S. What will change this?

I've discovered that there are at least ten factors holding holistic healthcare back. In this article, I'll outline each factor, in the hopes that this will spur you, my readers, on to action to fix each of these ten issues.

#1 – Get Organized

Holistic healthcare, for all its popularity among clients, is extremely disorganized. In my city of Columbus, Ohio, we have various cliques of practitioners who isolate themselves from others and seem to consciously limit communication and interaction with other practitioners. I know this is true in many communities. Holistic healthcare must become a “profession.” It must have univeral standards, professional associations across modalities, and lots of professional networking. This is what makes Western medicine so powerful. They have a very organized and powerful professional association, in the American Medical Association (AMA) and they have strong links in to all levels of government and community. Holistic healthcare must do the same, although we must do it in our own way. We are an industry. We are professionals. We must act this way. We must get organized, professionally and politically.

#2 – Change the Laws

The laws in many U.S. states and Canadian provinces discourage use of holistic services. Here in Ohio, everyone from naturopaths to reflexologists to nutritionists are illegal, according to the letter of the law. It's antiquated, yes, but the licensure boards feel they must enforce these antiquated laws and they often do, shutting down legitimate practitioners who are helping their clients and not harming anyone, just because the law is wrong.

We've organized the Health Freedom Coalition of Ohio here in this state, and many other states have similar groups. Check the national Health Freedom Website for groups in your area. Join us in changing the laws to reflect the needs and wants of holistic healthcare patients and practitioners. As far as I know, no Health Freedom groups exist in Canada. However, international laws like those coming from Codex Alimentarius are threatening healthcare freedoms everywhere.

#3 - Reject the Gold Standard of Controlled Trials

Holistic healthcare is, by definition, holistic. Controlled trials, also called randomized, double-blind, placebo-controlled controlled trials, are meant to measure patients' reactions to drugs. In a vain attempt to “fit in,” many holistic healthcare advocates are submitting holistic practices to these controlled trials to provide “objective proof” to Western doctors that these practices work.

Using positive results from controlled trials is a reasonable short-term strategy to making holistic healthcare pallatable to Western doctors and their followers, but it will not work in the long term.

The reason it can't work for holistic practices goes back to the nature of holism. A holistic practitioner treats a patient as a “whole person – body, mind, spirit, environment.” These aspects of the person are inseparable. You can't reduce a person down to a single organ, a single disease, or a single symptom. And, unfortunately, reductionism is inherent in the nature of controlled trials. Each controlled trial attempts to eliminate all “outside causes” and reduce the study down to “the effect of one drug on one part of the person.” This is categorically impossible in a holistic perspective.

Holistically, energy fields exist. We must take a person's energetic profile into account with their physical body. We must understand the person's relationships in the family and society. We must know their history. We must understand their mental state.

No controlled study can eliminate all these factors. Controlled trials are not the way to test holistic healthcare modalities. We must come up with a better way of testing our modalities, which is every bit as scientific and rigorous as controlled trials, but does not have the downsides.

#4 - Patients Need Road Maps

Holistic practitioners must be able to provide each patient with a road map of treatment, given the patient's problems and circumstances. This is a marketing issue. If the practitioner asks the patient just to “play along” with the practitioner tries this and that, patients will not likely stick with the program, because there really isn't a “program” that they can see.

Practitioners need to give patients an understandable set of steps that practitioner and patient will take together that are likely (although not guaranteed) to solve the problem at hand. The roadmap will include the services the practitioner can provide, the services needed from other practitioners, and the activities the patient needs to accomplish.

#5 - We Need Truly Integrative Clinics

A true integrative clinic is not just a bunch of practitioners sharing the rent and referring patients.

True integration means that a patient sees themself as a patient of the clinic, not a patient of a particular practitioner. The patient expects that the clinic will provide him with the right services at the right time, and feels that he is supported and led through the maze of various modalities to the right ones for his situation, background, needs and beliefs.

This means that the clinic has what I call a “holistic patient manager,” who is independent of holistic modalities and who's sole purpose is to guide the patient through the process of getting healthier. The patient manager works with the patient to create a road map (see Point #4) and answers their questions and concerns throughout the process.

It also means that the practitioners working in the clinic have faith in the overall processes, and are constantly giving their input to improve it. It means that practitioners compare notes on each patient and strive to give consistent advice to the patients (NOTE: HIPAA compliance on patient record confidentiality will be necessary.)

#6 – Practitioners Must Serve Their Clients' Need Above All

I've noticed that many practitioners feel that the main reason they are practicing their particular modality is for the love of that modality. For instance, a massage therapist feels that the whole reason for her practice is that she can “do the work she loves.” While it is important to do what you love, the main reason for a holistic practitioner's business is to serve clients. When times get tough, and the practitioner needs to do things that they don't love (taking out the laundry, collecting money, etc.), this incorrect focus gets messy. A practitioner must remember, first and foremost, to focus on the needs of the clients, and then to focus on enjoyment of the work. If this is backwards in the mind of the practitioner, the business will not survive.

Here's a test to see if your business is client-focused or modality-focused. Look at your list of services. If the list is simply a list of modalities (massage $50/hour, reflexology $60/hour, nutrition counselling $70/hour, etc.) then you are modality-focused. If your list of services is a list of client problems (fatigue revitalization $200, headache relief $250, etc.) then you are client-focused.

#7 - Health Insurance Must Change to Include Holistic Healthcare

The day that health insurance begins to include holistic practices will be a major step towards our becoming the major healthcare system in North America.

Health insurers are well-advised to include holistic practices like naturopathy, massage therapy and herbal remedies into their programs. Their insured clients will be healthier, will cost less, and happier.

However, there is a limit to what insurance should provide. Insurance, by definition, is meant for expenses that we (the insured) can't pay for ourselves. That means that when a car accident occurs, and my legs are broken in five places, this is a time for insurance. When I am diagnosed with multiple sclerosis, insurance needs to be there for me. When I fall down the stairs and need an emergency room visit, insurance should help.

But insurance is NOT for day-to-day health needs. The yearly or twice-yearly trip to the doctor or naturopath should NOT be covered by insurance. Monthly massage therapy appointments should not be included in health insurance, unless they are a defined part of a recovery from injury or trauma.

Why? Because if we include regular medical needs in our insurance plans, the costs will be unaffordable. There is no reason to pay your insurance company extra money, only to have them pay it right back to your doctor, naturopath, massage therapist or nutritionist. It doesn't make sense. The insurer will take their cut out of the money and you'll be paying much more for that regular care than if you had paid the practitioner out-of-pocket. Insurance has no place in the world of day-to-day prevention, health maintenance and wellness.

I feel very strongly on this point, and I hope that insurance companies take heed as they begin to step into the world of holistic healthcare. I've written a book on this subject called "Health Insurance Off the Grid," which you can reference at the bottom of this article.

#8 - Separate Holistic Healthcare From New Age Religion

To look at a person holistically, it means that you see the person's body, mind and spirit. The last one, spirit, seems to say that religion must somehow be involved in healthcare.

That assumption can be a costly mistake. Many Americans and Canadians are frightened of holistic healthcare for exactly that reason. They think the holistic practitioner will try to “convert them” to some new and exotic religion , which they don't want. They're perfectly happy being Protestants, Catholics or Muslims. They don't want religion encroaching on their healthcare, they just want a reiki session.

Practitioners must understand this. Religion of any type, but especially new age religions, must be kept away from the practices of holistic healthcare. Yes, spirit is involved in any type of healing, but that doesn't mean the practitioner needs to feature it front-and-center and go on and on about their particular religious icons, symbols and beliefs.

Mixing religion and healthcare is bad for business. I urge holistic practitioners to separate the two. Holistic healthcare will never thrive in the U.S. or Canada unless it is decoupled from religion.

#9 – Practitioners and Clinics Must Focus on Quality Marketing

The majority of holistic practitioners and clinics I've been exposed to have poor marketing practices. There often is no marketing plan, and the practitioners and clinic owners often have a distaste for the overall idea of marketing and sales.

No business can survive without high-quality sales and marketing. There does not need to be anything distasteful about marketing or sales. In fact, it is easy to see that these activities are actually “acts of love” in many ways.

I urge all holistic practitioners and clinic owners to learn everything possible about marketing and sales. The best sales training I've found is at the Sandler Sales Institute. You will not find a more “holistic approach” to sales. I can also say that the Sandler approach is decidedly a low pressure approach and something that anyone can feel comfortable working with in a holistic practice. Locally, here in Ohio, I can say for certain that the best sales training affiliate of Sandler Sales is Growth Resources, serving Central Ohio.

#10 - We Need High-Quality, Long-Term Apprenticeship Programs

In China, when a person decides to become a practitioner of Traditional Chinese Medicine, they go to school to learn the basics and then they become an apprentice of an experienced practitioner for many years before striking out on their own. The same is true for ayurvedic practitioners in India.

Although North America has a variety of schools teaching various modalities from massage to acupuncture to polarity therapy to energy healing, we do not have any long-term apprenticeship programs. Holistic healthcare modalities that I've encountered are multifaceted, complex therapies that often require years to master. The best practitioners are those who have practiced for many years, and who have attended one training class after another, year after year. They also usually found a mentor who was willing to teach them the subtle details of the modality, the art of it.

If we are to produce high-quality practitioners, we need a strong apprenticeship program like China and India. This will take time to create and may be resisted by young practitioners who wish to jump into independent practice too quickly. But it's a very necessary step to making holistic healthcare more popular in North America.

These are my thoughts about the ten major problems facing holistic healthcare today. What can you do? Can you join a Health Freedom group in your area? Can you help your holistic clinic become more client-focused? Can you help to change health insurance to include holistic alternatives?

Please consider what you can do to help holistic healthcare to become the major healthcare system in North America. This is something that will save many lives, people who are now dying because they aren't being helped by drugs and surgery, and yet aren't aware of the options.

Daryl Kulak is the author of "Health Insurance Off the Grid", a book to help people buy health insurance that will maximize the out-of-pocket money available for holistic services and products.

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1 comment:

lelandra said...

On apprenticeship - I agree completely. I am a massage therapist - I graduated from massage school in the summer of 2006. I have found a sort of apprenticeship in that I am working in the practice of, and learning massively from, a medical exercise specialist. We also have periodic visits from another much more experienced massage therapist. I am much more aware of what I know and don't know since I am not alone. There are still conditions that the more experienced massage therapist has more effect at than I do, but the proportion of cases decreases steadily. This setup is something I just stumbled into when I got out of school. School sets up two expectations - immediately start your independent practice, or be an employee in a non-clinical environment like a spa (if you are in an area that has a spa). Massage is a manual craft, and it would be much more helpful if we would get over our societal prejudice against manual crafts and use the apprenticeship model. Instead, the "school" part of training keeps increasing in hours but there's nothing formal but weekend workshops once you are out of school. It would be better to have a shorter "school" and a longer supervised practice before expecting to be completely independent.