Garlic chicken soup was once the standard cold remedy, and peppermint was used to soothe an upset stomach rather than going to the pharmacy for an over-the-counter pill. Grandma’s remedies are making a comeback: About 59 million Americans spend out-of-pocket on complementary health approaches, totaling about $30.2 billion a year, according to information provided by the National Center for Complementary and Integrative Health (NCCIH) – a US government agency hosted by the National Institutes of Health that explores integrative and alternative medicine.
Complementary medicine (also called integrative) is when a non-traditional practice is used in conjunction with conventional medicine. Alternative medicine uses non-traditional practices in place of conventional medicine. They are often referred to together as complementary and alternative medicine (CAM) and have a similar goal: to find and treat the underlying causes of health problems rather than just treating the symptoms.
CAM practitioners use holistic and preventative approaches to relieve and heal conditions ranging from the common cold to inflammatory conditions like arthritis. CAM treatments include herbs, whole food nutrition, and preventative lifestyle habits to support health, such as exercise, avoidance of processed foods and smoking, stress management, and light or no alcohol intake. CAM also includes chiropractic, yoga, meditation, vitamins, minerals, and natural anti-inflammatories and antioxidants, as well as ancient healing approaches such as acupuncture.
Carol Brown is a Doctor of Osteopathic Medicine. She had worked in conventional medicine as a primary care physician before training in integrative methods. Sixteen years ago, she started her own integrative practice in Oak Creek, Wisconsin, CMB Health Specialties (formerly known as the Center for Integrative Health Care). Brown uses holistic approaches such as nutritional support, specialized lab testing to detect food allergies and hormonal imbalances, and intravenous nutritional therapy. She uses conventional medicine as needed and can refer patients to practitioners of alternative services, such as acupuncture or massage, or to conventional medicine physicians.
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“Integrative medicine comes back to physiology; how does the body work and what do we need to do to make it work? Brown said. “It’s about nutrition, providing what the body needs and looking for underlying causes. If someone has a headache, there are headache pills, but we want to know Why they have a headache. It could be gluten intolerance, lack of sleep, or any number of underlying issues.
Brown notes that there is a population of people who are not helped by everyday medicine and who are driven to seek care outside of conventional approaches. “They are looking for another way to help themselves. There is also a population of older patients who know what medicine was like in the old days, where there was more time to get to the bottom of your health. Young people are suspicious because everyday medicine has become so commercial. A lot of people are afraid to take medication and they want to get better without medication if possible,” she says.
Naturopathic approaches and licensing-monitoring
Sarah Axtell is a naturopathic physician and founder of Lakeside Natural Medicine in Shorewood, Wis. A licensed naturopathic physician is a primary care physician trained to diagnose and prescribe, as opposed to the “traditional” naturopath who can do neither.
She also sees a growing demand for CAM approaches. “With a shortage of primary care physicians, exponentially rising health care costs, epidemics of chronic lifestyle diseases and obesity, and growing dissatisfaction with conventional medicine, doctors of naturopathy are a valuable solution in light of these critical shortages,” she says.
Naturopathic approaches emphasize direct care, prevention, wellness, and health promotion. Axtell holds a Doctor of Naturopathic Medicine from the National University of Natural Medicine and is certified by the North American Board of Naturopathic Examiners. She is currently licensed as a primary care physician in the state of Oregon, one of 22 states that have naturopathic physician licensing or registration laws.
Axtell notes that a licensed naturopathic physician attends graduate-level naturopathic medical school for a four-year residency; studies conventional, holistic and non-toxic therapeutic approaches; is trained in the same basic sciences as an MD or DO (Doctor of Medicine or Doctor of Osteopathic Medicine); has three years of supervised clinical training as part of medical school; and pass rigorous national and professional examinations. She is one of several licensed naturopathic doctors in the state advocating for naturopathic licensure in Wisconsin.
“We are gaining momentum here in Wisconsin and hope to get licensed in the near future,” says Axtell. “The Wisconsin Naturopathic Doctors Association has generated great support from Democrats and Republicans in both houses of the Legislature. They have worked hard to educate legislators on the importance of licensure for NDs. When lawmakers fully grasp the positive impact of naturopathic medicine on the health of Wisconsin residents, lawmakers will in turn support licensure, which will increase access and ensure safe childbirth care by highly qualified natural medical providers The Association hopes to see a licensure bill introduced in the 2021 session.
The Wisconsin Department of Safety and Professional Services is the state agency that licenses healthcare professionals, including physicians, physicians, nurse practitioners, and dieticians. They also license professionals practicing alternative medicine modalities such as chiropractic, acupuncture, and massage. There is currently no state license required to practice alternative therapies like aromatherapy, biofeedback, herbalism, or nutrition counseling. Training in these methods often ranges from self-study to certification through professional organizations or associations that offer online distance learning to in-person courses and workshops that issue certification.
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Research and insurance coverage
It’s easy to get lost on the internet when researching the effectiveness of CAM therapies, and like any subject, there are articles supporting and criticizing it. The NCCIH was established for the purpose of conducting and supporting research and providing information about complementary health products and practices. Brown likes to refer people to PubMed, a comprehensive database of scientific and medical journals documenting peer-reviewed studies, many of which have researched CAM topics.
“There’s actually a ton of research out there,” Brown says, and she cites the Cleveland Clinic’s Department of Integrative Medicine and Lifestyle as an example of a large hospital system that has implemented approaches CAM. She notes that countries like Germany, Sweden, Italy and Japan have done advanced research on CAM therapies, but here in the US, pharmaceutical companies have deep pockets to fund a myriad of studies. scale that eclipse unprofitable natural approaches. But some of the strongest evidence that CAM therapies work has come from its users. “Evidence of improvement is evidence enough,” Brown says.
Most major health insurance plans do not cover CAM therapies and quickly label them as “experimental” or not “medically necessary.” Some cover CAM therapies such as chiropractic care with restrictions or co-pay or include CAMs in flexible spending accounts (people are advised to check with their insurance company first to find out which services are covered). Most practices offering integrative or naturopathic care – or services considered “alternative”, such as acupuncture, massage or nutrition counseling – do not accept insurance and are privately paid, which can be prohibitively expensive for some people.
But some alternative medicine providers are working to make their services more affordable. Community Acupuncture of Milwaukee is a 501(c)(3) nonprofit organization that offers acupuncture on a pay-per-view model, with a sliding scale of $20 to $50 per visit. Amy Severinsen is a licensed acupuncturist who co-founded Milwaukee Community Acupuncture with Oliva Crane. Severinsen realized the need for affordable acupuncture after visiting China and visiting acupuncture clinics and seeing how affordable it was for people there, so people came more frequently.
“Before, I had a private practice and people were responding very well, but because they were paying out of pocket, they couldn’t afford to keep coming,” she says. Acupuncture works best when a patient receives a series of treatments. Because it is not necessary to undress to receive acupuncture treatment, Milwaukee Community AcupunctureProfessionals can see more than one person per hour in a group setting, making their community model profitable. The COVID-19 pandemic forced them to modify their activity to see fewer patients in the treatment room at a time; check the website for safety measures related to COVID-19.
Severinsen thinks most insurance companies don’t cover alternative therapies such as acupuncture because more studies are needed to support its effectiveness. “Once they see those results, I think they’ll offer to cover more,” she says. “I also think it’s hard to fit acupuncture into the coding and diagnostic system because it’s a different way of diagnosing people and looking at the body.”
Sheila Julson is a freelance writer who enjoys capturing the stories behind Milwaukee’s food, drink and urban farming scenes. She also writes articles on holistic health, green living, sustainability, and human interest features.