Some Basics Medical Pluralism – the existence of more than one health care system operating in the same cultural space. Exercise: How many health care systems can we list for Iowa City? Midwest USA?
Some Basics Roemer’s Principles: –Integral part of culture –Multi functioning Jobs, promote health, improve society –Curative / preventive –Defined by the culture Exercise: Discuss how these apply to ‘your’ involvement in a health care system.
Medicine – substances having an inherent power to transform a condition (SR Whyte 1988) USA definition of a drug – FDA defines as having a physiological effect. Question: What are the differences between these two?
What gives medicine its power? Belief in Outcomes –Not the outcomes themselves What are indicators of Power? –Source –Color –Size –Dosage form –Others???
David Landy’s Classification (1977) Attenuated healing Role Adapted healing Role Emerging healing Role From your knowledge of health care, how does TM fit into this???
Conventional Medicine Medicine that is practiced by holders of MD or DO Degrees and their allied health professionals, such as nurses. Older or less politically correct –Biomedicine –Western medicine –Developed medicine
Popular Care Health Professional Care Lay Professional Care After A. Kleinman
Traditional Medicine Refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being. –WHO
Traditional Medicine TM is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness. –WHO
Complementary and Alternative Medicine CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine – used together with conventional medicine Alternative Medicine –used in place of conventional medicine
Adventure (AKA: Homework) Ms Collins; Mr Johnson Products not from dominant HCS List of products Cost of products What did the ‘attendant’ say? Impact? –New Pi, Chain pharmacy, GNC
Risks Poor quality Incorrect usage Delay conventional treatment Lack of information
TM Safety Issues Can have negative effects –Ma Huang (Ephedra). Treat respiratory Problem: health attacks, stroke deaths –Belgium: wrong species of plant Concept of safety is influenced by culture Concept of efficacy is influenced by culture
Complementary and Alternative Medicine CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine – used together with conventional medicineComplementary medicine – used together with conventional medicine Alternative Medicine –used in place of conventional medicineAlternative Medicine –used in place of conventional medicine
CAM Users (USA 1999) Women > men Increased Education Recently hospitalized (past year) Former smoker (more than smokers or never smoker
Why CAM CAM would improve health – 55% Interesting – 50% Conventional medical treatments would not help – 28% Conventional medical professional suggested – 26% Conventional medical treatments too expensive – 13%
CAM expenses USA Study -- 1997 –$36B - $47B expenses –$12B - $20B out of pocket for CAM healers More than out of pocket for hospitalizations Half of out of pocket paid to physicians –$5B on herbal products
Mind Body Medicine –Patient support group –Cognitive behavioral –Meditation –Prayer –Mental healing –Therapies with art, music, dance –Others??? Biologically Based –Herbs –Dietary supplements –Shark cartilage –Others???
Manipulative & Body –Chiropractic –Osteopathic manipulation –Powwowing –Massage –Others??? Energy / biofield –Qi gong –Reiki –Therapeutic touch Energy / bioelectromagnetic –Pulse fields –Magnetic fields –Electric current