Conventional and Complementary Medicine: Skills for the Health Care Consumer

1. Conventional and Complementary Medicine: Skills for the Health Care Consumer Chapter 15

2. Health Care System • Physicians • Nurses • Hospitals • Medical laboratories • The remaining health care system

3. Self-Assessment: Managing Medical Problems • Effectively managing medical problems. • Self-Assessment. • Observing symptoms. • Medical self-tests.

4. Decision Making: Knowing when to See a Physician • Evaluating Symptoms • Severe • Unusual • Persistent • Recurrent

5. Getting Professional Assistance • Major trauma. • Uncontrollable bleeding. • Intolerable pain. • Severe shortness of breath. • Persistent abdominal pain. • Poisoning or drug overdose. • Loss of Consciousness. • Stupor, drowsiness. • Severe or worsening reaction to an bite, sting or medication.

6. Self-Treatment: Many options • Watchful waiting. • NonDrug options • Self-medication • OTC • Generic • The home pharmacy

8. Conventional Medicine • “Standard Western Medicine” • “Bio-medicine” • Based on the findings of a variety of biological sciences.

9. Premises and Assumptions of Conventional Medicine • Hippocrates • Every disease is defined by a certain pathology and set of symptoms and the symptoms are similar in most patients suffering from that disease. • Pharmaceuticals • Scientific explanation • Empirical • Rational • Testable • Parsimonious • General • Tentative

11. Providers of Conventional Medicine • Medical doctors (M.D.) • Doctors of osteopathic medicine (D.O.) • Podiatrists (D.P.M.) • Optometrists (O.D.) • Dentists (D.D.S.) or (D.M.D.) • Allied health care providers • Registered nurses (R.N.), licensed vocational nurses (L.V.N.), physical therapists, social workers, registered dietitians (R.D.), physician assistants (P.A.), nurse practitioners, and certified nurse midwives

12. Choosing a Primary Care Physician • Coordinator of your medical care. • Information about your Primary care doctor. • Personal feelings after meeting your chosen primary care physician. • Choosing a Medical Facility.

13. Getting The Most Out Of Your Medical Care • Knowing when to seek professional care. • Good communication • Physician • Health care providers • Insurance company • The Physician-Patient Partnership • Your appointment with your physician. • The Diagnosis Process

14. The Diagnostic Process • Step one – Medical history • Step two – Physical examination • Step three – Medical tests

15. Medical and Surgical Treatments • Prescription medications • Surgery • Elective surgeries • Mortality rate • Morbidity rate • In patient versus out patient procedure

17. Complementary and Alternative Medicine • Alternative medical system. • Traditional Chinese medicine (TCM). • Acupuncture • Homeopathy • Hypnosis • Biological-based therapies • Herbal therapies

18. Complementary and Alternative Medicine • Manipulative and Body-Based Methods. • Touch and body manipulation • Osteopathic • Massage acupressure • Feldenkrais • Rolfing • Chiropractic • Energy Therapies • Qigong • Therapeutic touch • Reiki

20. Traditional Chinese Medicine(TCM) • The two primary treatments in TCM are herbal remedies and acupuncture. • There are about 5,800 herbal remedies which contain plant products, animal parts, and minerals. • Like everything else in TCM, herbal remedies have yin and yang, they are balanced and interconnected. • Acupuncture • The WHO has compiled a list of over 40 conditions in which acupuncture may be beneficial. The NIH found evidence that acupuncture was effective in relieving nausea and vomiting after chemotherapy and pain after surgery.

21. Homeopathy • Developed about 200 years ago by Samuel Hahnemann • Based on “like cures like” and “remedies become more effective with greater dilution” • Homeopathy is a highly individualized form of therapy. Each treatment is determined by the overall condition of the patient rather than by specific symptoms. • Critics report homeopathy’s effectiveness is due to a nonspecific “placebo effect.”

22. Mind-Body Interventions • These interventions make use of the integral connection between mind and body and the effect each can have on the other. They include: • Meditation; yoga; visualization; tai chi; biofeedback; psychotherapy; support groups; prayer; and art, music, and dance therapy. • The placebo effect is one of the most widely known examples of mind-body interdependence. • Hypnosis • Some forms of hypnotherapy for certain conditions have been accepted for over 40 years by the AMA

23. Biological Based Therapies • Herbal remedies are sometimes referred to as materia medica, Latin for “medical matter.” • For the vast majority of botanicals, there are almost no reliable research findings on efficacy and safety.

24. Manipulative and Body Based Therapies • Manual healing methods are an integral part of osteopathic medicine • The most commonly accepted CAM manual healing method is chiropractic • Chiropractic (spinal manipulation) has been shown to be effective in acute low back pain and has shown promising results neck pain and headaches • There are no well controlled studies showing chiropractic effectiveness for asthma, gastrointestinal problems, infectious diseases, or other non mechanical problems

25. Energy Therapies • Qigong • Therapeutic touch • Reiki • Bioelectromagnetics

26. Evaluating Complementary and Alternative Medicine • Working with Your Physician. • Safety • Effectiveness • Timing • Cost • Questioning the CAM practitioner. • Doing your own research. • Why do consumers use complementary medicine? • The Future: Conflict, Convergence, or Collaboration?

27. Working withYour Physician • Safety • Effectiveness • Timing • Cost

28. Questioning the CAM Practitioner • Ask the practitioner why he or she thinks the therapy will be beneficial for your condition. Ask for a full description of the therapy and any potential side effects. • Describe in detail any conventional treatments you are receiving. • Ask how long the therapy should continue before it can be determined if it is beneficial. • Ask about the expected cost of the treatment. Does it seem reasonable? Will your health insurance pay some or all the of the cost?

29. Why Do Consumers Use Complementary Medicine? • CAM may offers hope to people who have been disappointed by Western medicine or who have chronic conditions that are incurable by conventional methods. • CAM practitioners often spend more time with patients • CAM may provide support for underlying beliefs and cultural assumptions: These may be grouped as follows: • Theme one: Belief in the benevolent power of nature • Theme two: Connection to vital energy or life-supporting forces • Theme three: “Science,” though not in the Western sense • Theme four: A quest for health helps patients find meaning, purpose, and connection with the universe

30. Paying For Health Care • The Current system • Combination of private and public insurance plans, patient out-of-pocket payments, and governmental assistance. • Health Insurance • Traditional Fee-for-Service (Indemnity) Plans • Managed-Care Plans • Health maintenance organizations (HMOs) • Preferred provider organizations (PPOs) • Point-of-service (POS) plans • Government programs • Choosing a Policy

32. Health Insurance • Traditional Fee-for-Service (indemnity) plans • Managed-care plans • Government programs

33. Traditional Fee-for-Service (Indemnity) Plans • Any medical provider can be selected • Deductibles usually must be met before the insurance company starts to cover costs • Monthly premiums are paid by an individual or employer

34. Managed Care Plans • Health maintenance organizations (HMOs) • Medical providers must be chosen from an approved list • Insured person pays a small co-payment for each health care service • Participating physicians accept restrictions on fees • Preferred provider organizations (PPOs) • Point-of-service (POS) plans

35. Government Programs • Medicaid • Medicare

36. Thank You!