1. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 23 Complementary and Alternative Medicine: Health Choices in a Changing Society

2. © 2007 McGraw-Hill Higher Education. All rights reserved. Conventional Medicine Refers to the dominant health care system in the United States, Canada, and much of Europe Refers to the dominant health care system in the United States, Canada, and much of Europe Terms associated with this system include: Terms associated with this system include: Western Medicine Western Medicine Biomedicine Biomedicine Allopathic Medicine Allopathic Medicine Health is restored when the medical practitioner treats the illness with either drugs, vaccine, or surgery Health is restored when the medical practitioner treats the illness with either drugs, vaccine, or surgery Practitioners include: Practitioners include: M.D. or D.O. (medical degrees) M.D. or D.O. (medical degrees) Other providers such as dentists, optometrists, nurses, etc. Other providers such as dentists, optometrists, nurses, etc.

3. © 2007 McGraw-Hill Higher Education. All rights reserved. Complementary and Alternative Medicine (CAM) Complementary Medicine 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 is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine Alternative Medicine are groups of practices used as an alternative to conventional medicine Alternative Medicine are groups of practices used as an alternative to conventional medicine Integrative Medicine is the use of conventional medicine in combination with CAM practices that have been proven safe and effective Integrative Medicine is the use of conventional medicine in combination with CAM practices that have been proven safe and effective

4. © 2007 McGraw-Hill Higher Education. All rights reserved. Characteristics of CAM The body is believed to have an inherent balance or ability to heal itself The body is believed to have an inherent balance or ability to heal itself The whole person is treated (physical, mental, emotional, and spiritual) The whole person is treated (physical, mental, emotional, and spiritual) Each person is unique, so treatment is individualized Each person is unique, so treatment is individualized Many practices use a complex combination of interventions, often involving the administration of multiple medications at the same time Many practices use a complex combination of interventions, often involving the administration of multiple medications at the same time

5. © 2007 McGraw-Hill Higher Education. All rights reserved. Domains and Factors of CAM There are four domains identified as part of the CAM There are four domains identified as part of the CAM Mind-body interventions Mind-body interventions Biologically based therapies Biologically based therapies Manipulative and body-based therapies Manipulative and body-based therapies Energy therapies Energy therapies Factors considered important in the use of CAM are: Factors considered important in the use of CAM are: Desire of patients to be actively involved in the health decisions Desire of patients to be actively involved in the health decisions Access to information about CAM on the Internet Access to information about CAM on the Internet Dissatisfaction with the limitations of conventional medicines in treating chronic conditions Dissatisfaction with the limitations of conventional medicines in treating chronic conditions

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Traditional Chinese Medicine A well-developed medical system that has been in existence for over 3,000 years A well-developed medical system that has been in existence for over 3,000 years Focuses on restoring the physical, mental, and spiritual well- being of the individual Focuses on restoring the physical, mental, and spiritual well- being of the individual Illness occurs when your “chi” or energy force is disturbed or imbalanced (Yin-Yang Principle) Illness occurs when your “chi” or energy force is disturbed or imbalanced (Yin-Yang Principle) Diagnosis involves evaluating an individual for signs of imbalances Diagnosis involves evaluating an individual for signs of imbalances Treatment methods are: Treatment methods are: Herbal Medicine Herbal Medicine Acupuncture (long thin needles that can stimulate the flow of ‘chi’) Acupuncture (long thin needles that can stimulate the flow of ‘chi’)

7. © 2007 McGraw-Hill Higher Education. All rights reserved. Ayurveda One of the oldest healing systems in the world One of the oldest healing systems in the world Has been practiced in India for over 5,000 years Has been practiced in India for over 5,000 years Emphasizes balance among the body, mind, and spirit Emphasizes balance among the body, mind, and spirit Three energy sources known as doshas are believed to exist in everyone Three energy sources known as doshas are believed to exist in everyone Vatta (energy of movement/consists of space and air) Vatta (energy of movement/consists of space and air) Pitta (energy of metabolism and digestion/fire and water) Pitta (energy of metabolism and digestion/fire and water) Kapha (energy that forms body structure and holds cells together/earth and water) Kapha (energy that forms body structure and holds cells together/earth and water) When your three doshas are in balance, you are considered in good health When your three doshas are in balance, you are considered in good health

8. © 2007 McGraw-Hill Higher Education. All rights reserved. Homeopathy A set of principles developed by a German chemist and physician Samuel Hahnemann based on the idea that the body can heal itself A set of principles developed by a German chemist and physician Samuel Hahnemann based on the idea that the body can heal itself Remedies are derived from natural sources Remedies are derived from natural sources Diagnosis is based not only on the medical aspect but also on personality characteristics Diagnosis is based not only on the medical aspect but also on personality characteristics There does not appear to be significant risk associated with homeopathy and is used in conjunction with other medical practices in the United States There does not appear to be significant risk associated with homeopathy and is used in conjunction with other medical practices in the United States

9. © 2007 McGraw-Hill Higher Education. All rights reserved. Naturopathy This is a philosophy and way of life as much as a health system This is a philosophy and way of life as much as a health system Its main principle is that the body has the ability to heal itself Its main principle is that the body has the ability to heal itself Its goal is to stimulate the body to do so, especially through nutrition Its goal is to stimulate the body to do so, especially through nutrition Treatments include dietary modification, nutritional supplementation, and herbal remedies Treatments include dietary modification, nutritional supplementation, and herbal remedies Only limited data for evaluating naturopathy as a complete system is available Only limited data for evaluating naturopathy as a complete system is available

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Folk Medicine Also known as traditional healing systems; has flourished in all cultures long before Westernized medicine development Also known as traditional healing systems; has flourished in all cultures long before Westernized medicine development Various forms exist from Native American tribes to other ethnic groups Various forms exist from Native American tribes to other ethnic groups A common theme is the natural environment and the spiritual world A common theme is the natural environment and the spiritual world Some include ‘healers’ who have an ability to cure illness Some include ‘healers’ who have an ability to cure illness Techniques used include: Techniques used include: Dream interpretation Dream interpretation Purification ceremonies Purification ceremonies Herbal teas Herbal teas Healing rituals Healing rituals

11. © 2007 McGraw-Hill Higher Education. All rights reserved. Mind-Body Practices Mind-Body practices are based on the premise that the mind influences the body in ways that can promote or detract from well-being Mind-Body practices are based on the premise that the mind influences the body in ways that can promote or detract from well-being Such popular practices include: Such popular practices include: Hypnosis Hypnosis T’ai Chi Ch’uan T’ai Chi Ch’uan The risks appear minimal as an adjunct to conventional medicine and can be considered expensive but easy to learn The risks appear minimal as an adjunct to conventional medicine and can be considered expensive but easy to learn

12. © 2007 McGraw-Hill Higher Education. All rights reserved. Biologically Based Practices Biologically Based Practices include the use of the following: Biologically Based Practices include the use of the following: Dietary supplements Dietary supplements Herbal remedies or botanicals Herbal remedies or botanicals Therapeutic food plans involve the reduction or removal of certain types of foods for a set time period Therapeutic food plans involve the reduction or removal of certain types of foods for a set time period Dietary alterations are usually used as an adjunct or complement to other forms of therapy Dietary alterations are usually used as an adjunct or complement to other forms of therapy

13. © 2007 McGraw-Hill Higher Education. All rights reserved. Manipulative and Body-Based Practices Manipulative and Body-Based Practices focus on the body’s structures and systems such as bones, joints, or muscles Manipulative and Body-Based Practices focus on the body’s structures and systems such as bones, joints, or muscles These practices include the following: These practices include the following: Osteopathic Medicine (considered a form of conventional medicine) Osteopathic Medicine (considered a form of conventional medicine) Chiropractic Medicine (belief that illnesses are the result of subluxation of the spine) Chiropractic Medicine (belief that illnesses are the result of subluxation of the spine) Massage Therapy and Bodywork (pressure aimed at increasing blood flow and inducing relaxation) Massage Therapy and Bodywork (pressure aimed at increasing blood flow and inducing relaxation)

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Energy Therapies Energy Therapies are typically considered the most controversial Energy Therapies are typically considered the most controversial Based upon the premise that humans are infused with energy and that this energy can be modified to influence health Based upon the premise that humans are infused with energy and that this energy can be modified to influence health Some examples include: Some examples include: Magnetic-Field Therapies (use of magnets to increase energy flow) Magnetic-Field Therapies (use of magnets to increase energy flow) Qigong (channeled breathing with movement) Qigong (channeled breathing with movement) Therapeutic Touch and Reiki (healing touch concept) Therapeutic Touch and Reiki (healing touch concept)

15. © 2007 McGraw-Hill Higher Education. All rights reserved. How to Choose the Right CAM? Conventional medicine, CAM, and Self-care are 3 intersecting areas of healthcare Conventional medicine, CAM, and Self-care are 3 intersecting areas of healthcare Consumers need to do the following: Consumers need to do the following: Consult with their conventional care physician Consult with their conventional care physician Research the therapy Research the therapy Use their critical thinking skills in evaluating the safety issues Use their critical thinking skills in evaluating the safety issues Check the overall cost of treatment Check the overall cost of treatment Consider the overall effectiveness towards their main goal Consider the overall effectiveness towards their main goal

16. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter 23 Complementary and Alternative Medicine: Health Choices in a Changing Society