The National Center for Complementary and Alternative Medicine (NCCAM) website lists over 600 specific alternative therapies. asian cam models According to Ken Pelletier, PhD, MD (Professor of Public Health, University of Arizona School of Medicine), “When I hear someone in a workplace wellness program say alternative therapies don’t work, I ask: ‘Which therapies, for what conditions, in what populations, and in what situations?’ It really depends on what you are talking about. Then there are people who say, ‘If it’s natural, it must be OK.’ But look at that list of over 600 therapies. A significant number carry a very real potential to do harm.”
Ken has extensively reviewed complementary and alternative medicine (CAM) studies from around the world. “Because of where I work, my research must conform to a standard of best possible evidence as seen in randomized clinical trials. But there are a number of potentially important therapies and interventions that simply don’t lend themselves to that type of analysis.”
Often such studies lack the necessary documentation but still see excellent outcomes. Ken cautions corporate wellness practitioners against discounting such studies and recommends analyzing them using a 3-pronged triage-type approach:
- Is there clear evidence from clinicians that the therapy works well in the patient’s situation?
- What’s available in the literature and online showing what does not work?
- What studies are underway that require us to simply wait and see?
As increasing numbers of CAM therapies gain acceptance in employee health programs, it becomes necessary to develop a common vocabulary. The term Integrative Medicine (IM) describes an evidence-based fusion of conventional and CAM practices. IM is not a physician-centric system — practitioners function in truly integrated or virtual systems with providers of diverse competencies. Together they form a clinical network where outcomes are enhanced from working together, rather than at odds with each other. These networks typically fall into 4 categories:
- Freestanding IM clinics that house multiple disciplines
- Family practice group with a virtual network of respected CAM practitioners for patient referrals
- IM services affiliated within a hospital setting
- Therapeutic disciplines offered through nonmedical settings like worksite health promotion programs, schools, extension programs, and even churches.
According to the 2007 National (US) Health Interview Survey of 23,393 adults and 9417 children ages 17 and under, 38% of adults and 12% of children use some form of CAM. This is reflected by the increasing numbers of health insurance plans that cover such CAM therapies as acupuncture, chiropractic care, naturopathy (in certain states), nutrition counseling, stress management, and behavioral medicine. Even vitamins/minerals, herbals, exercise equipment, books, videos, and fitness club memberships can be found as health plan benefits. Ken points out the reason: it’s what their corporate health and wellness customers want. “Although health plans increasingly counsel corporate clients on CAM coverage trends, the insurance industry is not the point of innovation here; it’s the purchaser. Larger companies form a purchasing coalition based on demands from employees and unions. If there is solid evidence behind the request, they balance the interest with legal issues, costs, and other practical considerations to determine what becomes part of a benefit package.”