1. Chapter 44 Complementary and Alternative Medicine Medical Assisting
PowerPoint® presentation to accompany:
Medical Assisting
Third Edition
Booth, Whicker, Wyman, Pugh, Thompson

2. Learning Outcomes 44-1 Define CAM.
44-2 Compare complementary and alternative medicine to conventional medicine.
44-3 Discuss how CAM and conventional medicine are used together.
44-4 Identify various types of complementary and alternative medicine.

3. Learning Outcomes (cont.)
44-5 Describe how a medical assistant may use his or her knowledge of CAM.
44-6 Explain why patients and health-care practitioners are turning to complementary treatments.
44-7 Discuss insurance and payment for CAM treatments.
44-8 Explain how CAM is regulated.
44-9 Describe health fraud.

4. Introduction
More than 30% of adults use complementary and alternative therapies
Relieve problems
Promote wellness
No relief from traditional treatments
Some physicians use a combination of CAM and traditional therapies

5. What Is CAM?
A group of practices and products that are not part of conventional medicine
Allopathy – conventional medicine or common and usual practice
Complementary medicine – used with conventional medicine
Alternative medicine – used instead of conventional medicine

6. What Is CAM? (cont.)
Scientific evidence concerning safety and effectiveness
Available for some CAM therapies
Research continues so information changes
Integrative medicine
Evolves as CAM therapies are adopted by conventional medicine
Combination of both

7. Apply Your Knowledge Impressive!
Define CAM and state why these therapies are not in wide use by practitioners of conventional medicine.
ANSWER: CAM is a group of practices and products not considered part of conventional medicine. They are not widely used by physicians because there is not a lot of scientific evidence of their safety and effectiveness.
Impressive!

8. Types of CAM Shared similarities Categories
Individualized treatments, good nutrition, and preventative health practices
Holistic
Promote self-care and self-healing
Recognition of one’s spiritual nature
Categories
Alternative medical systems
Mind-body interventions
Biologically-based therapies
Manipulative and body-based methods
Energy therapies

9. Types of CAM: Alternative Medical Systems
Evolved apart from conventional medicine
Homeopathic medicine
Treating syndromes and conditions with remedies that produce similar syndromes and conditions in healthy people
Remedy
Produces the symptoms it is given to treat in order to stimulate the body’s natural defenses to heal itself
Must meet FDA standards

10. Types of CAM: Alternative Medical Systems (cont.)
Homeopathic medicine
Looks at individuals, not diseases
Initial in-depth assessment
Follow-up – how they are responding
Medical assistant role
Similar to other medical offices
Have knowledge of common remedies

11. Types of CAM: Alternative Medical Systems (cont.)
Naturopathic medicine
Relies on the healing power of the body to establish, maintain, and restore health
Primary health care
Nutritional / lifestyle counseling
Dietary supplements / medicinal plants
Exercise
Homeopathy / traditional Chinese medicine

12. Types of CAM: Alternative Medical Systems (cont.)
Naturopathic medicine
Medical assistant – understanding of treatments
Traditional Chinese medicine
Balanced qi (vital energy)
Flow of qi along meridians (energetic pathways)
Acupuncture – insertion of hollow needles along meridians
Ayurveda – provides guidance regarding food and lifestyle; India

13. Types of CAM: Mind-Body Interventions
Enhance the mind’s capacity to affect bodily function and symptoms
Support groups and cognitive-behavioral therapy now part of traditional medicine
Scientific support
Placebo effect – WW II
35% of therapeutic response is due to belief

14. Types of CAM: Mind-Body Interventions (cont.)
Most commonly used forms of CAM
Types
Prayer
Yoga
Meditation
Hypnosis
Biofeedback

15. Types of CAM: Biologically-Based Therapies
Use substances found in nature
Dietary supplements
Herbal products
Foods
Medical assistant
Keep up-to-date about dietary and herbal products
Be able to provide reliable resources for patients

16. Types of CAM: Biologically-Based Therapies (cont.)
Dietary supplements
Manufacturers –> no evidence of effectiveness or safety
No standardization to ensure consistency and quality
Types
Vitamins
Minerals
Herbals – no established recommended daily amount
Recommended daily amount established by the FDA

17. Types of CAM: Biologically-Based Therapies (cont.)
Patient education for using supplements
Report all supplements as they would prescription medications
Take supplement bottles to appointments
Document patient’s use of supplements in the medical record

18. Types of CAM: Manipulative and Body-Based Methods
Based on the manipulation and/or movement of one or more parts of the body
Types
Massage therapy
Chiropractic manipulation
Reflexology
Alexander technique
Bowen technique
Craniosacral therapy
Feldenkrais method
Rolfing
Trager bodywork
Tui Na

19. Types of CAM: Manipulative and Body-Based Methods (cont.)
Massage
Pressure, kneading, stroking, vibration, and tapping to positively affect health
Effects
Relaxation
Counteracts effects of stress
Lowers heart rate and blood pressure
Reduces pain / relaxes muscle spasms
Improves concentration
Promotes restful sleep
Helps the mind relax

20. Types of CAM: Manipulative and Body-Based Methods (cont.)
Swedish massage
Stimulates circulation and lymph flow
5 basic strokes
Neuromuscular massage
Release tension, relieves pain and pressure on nerves, and increases blood flow
Trigger point therapy
Seated massage
Focuses on back and neck

21. Types of CAM: Manipulative and Body-Based Methods (cont.)
Chiropractic medicine
Adjustments
Manual treatments to re-align the vertebra and restore function of spinal nerves
Chiropractor
Performs an exam and takes a history
Tests
X-rays
Muscle testing
Analyzes posture

22. Types of CAM: Energy Therapies
Bioeletromagnetic-based therapies
Balances the electromagnetic fields of the body
No scientific evidence of efficacy
Magnetic therapy
Most common type
Magnets are used to correct disturbances of electromagnetic fields and restore health
FDA – no medical value but relatively harmless
Avoid for patients with pacemaker or defibrillator

23. Types of CAM: Energy Therapies
Biofield therapies
Manipulate energy field surrounding the body
Reiki
Based on qi
Visualization and touch balance energy flow to bring healing energy to organs and glands
Therapeutic touch
“Laying-on of hands”
Hands direct human energies to help or heal
No scientific evidence of efficacy

24. Apply Your Knowledge Excellent! ANSWER: Match to types of CAM:
___ Therapeutic touch A. Energy therapies
___ Chiropractic medicine B. Mind-body therapies
___ Dietary supplements C. Body-based therapies
___ Yoga and meditation D. Biologically-based therapies
___ TCM E. Alternative medical systems
___ Herbal supplements
___ Homeopathy / naturopathy
___ Magnetic therapy
___ Hypnosis
___ Massage C D B E D E
Excellent! A B C

25. Patients Seeking CAM Therapy
Use is increasing
Less expensive
Have fewer side effects
More accessible
Increase in spirituality
Personal growth
Environmentalism
Preventive health care
Reasons for seeking CAM therapy
Failure of traditional medical interventions
Treat side effects of conventional medicine’s treatments

26. Patients Seeking CAM Therapy (cont.)
Patients with chronic debilitating conditions
Improve quality of life
Improve ability to cope with stress and illness
Cultural differences in CAM use
Hispanics
Native Americans
Accept patient’s right to choose CAM therapy

27. Apply Your Knowledge Super job!
Mr. State is complaining about chronic back pain. He says that the medication only helps a little and asks you if there is anything else you could recommend that will help him. What should you tell him?
ANSWER: If your employer is not averse to CAM therapies, you can tell him that there are CAM therapies that may help with the pain or at least help him cope better with it. He could try mind-body techniques, acupuncture, manipulative and body-based techniques, or energy therapies.
Super job!

28. Insurance and CAM Coverage varies
Lack of research and documentation of efficacy
Emphasis on physiological or biochemical response to therapies
Alternative health insurance companies emerging in response to need

29. Insurance and CAM (cont.)
Medical assistant
Know whether or not CAM treatments are covered by insurance
Resources
Insurance companies
State agency that regulates the insurance industry

30. Regulation of CAM Therapies
National Center for Complementary and Alternative Medicine (NCCAM)
Research
Training and career development
Conferences and educational programs
Integration of scientifically proven CAM therapies into conventional medicine

31. Regulation of CAM Therapies (cont.)
White House Commission on Complementary and Alternative Medicine Policy (WHCCAMP)
Funding for research
Communication between CAM and conventional practitioners
Availability of CAM practitioners
State review and evaluation of CAM practitioners
Insurance coverage options

32. Yippee! 2 for 2! Apply Your Knowledge
Why do insurance companies not reimburse for most CAM therapies?
ANSWER: Insurance companies do not reimburse for CAM therapies because of the lack of research and documentation of effectiveness of these therapies.
What are the federal agencies tasked with regulation of CAM therapies?
ANSWER: They are the NCCAM and WHCCAMP.
Yippee! 2 for 2!

33. Health Fraud
Articles of unproven effectiveness promoted to improve health, well-being, or appearance
Deception or trickery for profit
Plays on emotions and desperation
Regulation
FDA – safety, manufacturing, and labeling
FTC – advertising

34. Health Fraud (cont.) Health claims
Unproven claims must include a disclaimer
FDA-approved claims for food and supplements
Based on scientific evidence
Only reduces risk / does not treat or cure

35. Health Fraud (cont.) FDA-Approved Health Claim Supplement / Food
Reduce risk of some cancers
Low-fat diets
Fruits, vegetables, fiber-containing grain products
Whole grains
Reduce risk for hypertension
Low-sodium diets
Potassium
Reduce risk for osteoporosis
Calcium

36. Health Fraud (cont.) FDA-Approved Health Claim Supplement / Food
Reduce risk of heart disease
Low-sodium diets
Decreased saturated fat and cholesterol
Soluble fiber and whole grains
Soy protein / plant sterols / stanol esters
Reduce risk for neural tube defects
Adequate folate
Reduce tooth decay
Decreasing between-meal consumption of foods high in sugars and starches

37. Health Fraud (cont.) Recognizing health fraud
Check with the BBB or attorney general’s office
Check with appropriate health-care group
Contact the FDA
If it sounds to good to be true, it probably is not true
If unproven, get a second opinion
Be aware of “secret cures”

38. Bravo! Apply Your Knowledge
Why do people fall victim to fraudulent health claims?
ANSWER: These claims target people who are emotional and desperate. They are hoping to find a cure, improve their health, or just look better.
Bravo!

39. In Summary CAM is therapy outside conventional medicine
Complementary medicine is used with conventional medicine
Alternative medicine is used in place of conventional medicine
5 classifications
Medical assistant must understand
CAM therapies
Insurance reimbursement
Health fraud

40. End of Chapter 44
There is a magnet in your heart that will attract true friends. That magnet is unselfishness, thinking of others first; when you learn to live for others, they will live for you.
~ Paramahansa Yogananda