Americans still pay out of pocket for complementary and alternative medicine

Garlic chicken soup was once the standard cold remedy and peppermint was used to soothe an upset stomach rather than going to the pharmacy to buy an over-the-counter pill. Grandma’s remedies are making a comeback: About 59 million Americans spend out-of-pocket on complementary health approaches, totaling about $30.2 billion annually, according to information provided by the National Center for Complementary Health and Integrative Medicine (NCCIH) – a U.S. government agency hosted by the National Institutes of Health that explores integrative and alternative medicine.

Complementary (also called integrative) medicine involves using a non-traditional practice in conjunction with conventional medicine. Alternative medicine uses unconventional practices in place of conventional medicine. They are often called complementary and alternative medicine (CAM) and have a similar goal: finding and treating the underlying causes of health problems rather than just treating the symptoms.

CAM practitioners use holistic and preventative approaches to relieve and heal conditions ranging from the common cold to inflammatory conditions like arthritis. CAM treatments include herbs, a whole-food diet, and preventive lifestyle habits to support health, such as exercise, avoidance of processed foods and tobacco, stress management, and light or no alcohol. ACM also includes chiropractic, yoga, meditation, vitamins, minerals, and natural anti-inflammatories and antioxidants, as well as ancient healing approaches such as acupuncture.

Carol Brown is a doctor of osteopathic medicine. She had worked in conventional medicine as a primary care physician before training in integrative methods. Sixteen years ago, she started her own integrative practice in Oak Creek, Wisconsin, CMB Health Specialties (formerly known as the Center for Integrative Health Care). Brown uses holistic approaches such as nutritional support, specialized laboratory testing to detect food allergies, sensitivities and hormonal imbalances, and intravenous nutritional therapy. She uses conventional medicine where appropriate and can refer patients to practitioners of alternative services, such as acupuncture or massage, or to conventional medicine physicians.

“Integrative medicine goes back to physiology; how does the body work and what do we need to do to make it work? Brown said. “It’s about nutrition, providing what the body needs and finding the underlying causes. If someone has a headache, there are headache pills, but we’re figuring that out. Why they have a headache. It could be gluten intolerance, lack of sleep, or any number of underlying issues.

Brown notes that there is a population of people who are not helped by everyday medicine and are driven to seek care outside of conventional approaches. “They are looking for another way to help themselves. There is also an older patient population who know what medicine used to be like, where you had more time to get to the bottom of your health. Younger people are wary, because everyday medicine has become very commercialized. Many people are afraid of taking medication and want to get better without medication if that is possible,” she says.

Naturopathic Approaches and Licensing Oversight

Sarah Axtell is a naturopath and founder of Lakeside Natural Medicine in Shorewood, Wisconsin. A licensed naturopath is a primary care physician trained to diagnose and prescribe, as opposed to a “traditional” naturopath who can do neither.

She also sees growing demand for CAM approaches. “With a shortage of primary care physicians, exponentially increasing health care costs, epidemics of lifestyle-related chronic disease and obesity, and growing dissatisfaction with conventional medicine, naturopathic physicians are a valuable solution in light of these critical shortages,” she says.

Naturopathic approaches emphasize direct care, prevention, wellness and health promotion. Axtell holds a Doctor of Naturopathic Medicine degree from the National University of Natural Medicine and is certified by the North American Board of Naturopathic Examiners. She is currently licensed as a primary care physician in the state of Oregon, one of 22 states with licensure or registration laws for naturopathic physicians.

Axtell notes that a licensed naturopathic physician attends a graduate-level naturopathic medical school in residency for four years; studies conventional, holistic and non-toxic therapeutic approaches; is trained in the same basic sciences as an MD or DO (Doctor of Medicine or Doctor of Osteopathic Medicine); completed three years of supervised clinical training as part of his medical studies; and passes rigorous, national and professional exams. She is one of several licensed naturopathic physicians in the state advocating for naturopathic licensure in Wisconsin.

“We are gaining momentum here in Wisconsin and hope to be licensed in the near future,” Axtell says. “The Wisconsin Association of Naturopathic Physicians has generated great support from Democrats and Republicans in both houses of the legislature. They have worked hard to educate legislators about the importance of licensure for NDs. When lawmakers fully understand the positive impact of naturopathic medicine on the health of Wisconsinites, they will in turn support licensure, which will increase access and ensure safe childbirth care by highly qualified natural medicine providers. The Association hopes to see a licensure bill introduced in the 2021 session.

The Wisconsin Department of Safety and Professional Services is the state agency that licenses health care professionals, including physicians, physician practitioners, nurse practitioners, and dietitians. They also license professionals practicing alternative medicine modalities such as chiropractic, acupuncture and massage. No state license is currently required to practice alternative therapies like aromatherapy, biofeedback, herbalism, or nutritional coaching. Training in these methods often ranges from self-study, certification through professional organizations or associations offering online distance learning, to in-person courses and workshops providing certification.

Insurance research and coverage

It’s easy to get lost on the Internet when researching the effectiveness of CAM therapies, and as with any topic, there are articles supporting and criticizing it. The NCCIH was established for the purpose of conducting and supporting research and providing information on complementary health products and practices. Brown likes to refer people to PubMed, a comprehensive database of scientific and medical journals documenting peer-reviewed studies, many of which have studied traditional medicine topics.

“There’s actually a ton of research,” Brown says, and she cites the Cleveland Clinic’s Department of Integrative and Lifestyle Medicine as an example of a large hospital system that has implemented CAM approaches. She notes that countries like Germany, Sweden, Italy and Japan have conducted advanced research into CAM therapies, but here in the United States, pharmaceutical companies have the financial wherewithal to fund a myriad large-scale studies that overshadow unprofitable natural approaches. But some of the strongest evidence for the effectiveness of CAM therapies comes from its users. “The evidence of improvement is proof enough,” says Brown.

Most major health insurance plans do not cover CAM therapies and quickly consider them “experimental” or not “medically necessary.” Some cover CAM therapies such as chiropractic care with restrictions or co-payment or include CAM in flexible spending accounts (people are advised to check with their insurance company first to find out what services are covered). Most practices offering integrative or naturopathic care – or services considered “alternative,” such as acupuncture, massage or nutritional counseling – do not accept insurance and charge a fee, which can be an expense. prohibitive for some people.

But some alternative medicine providers are working to make their services more affordable. Milwaukee Community Acupuncture is a 501(c)(3) nonprofit organization offering acupuncture on a pay-what-you-can model, with a sliding scale of $20 to $50 per visit. Amy Severinsen is a licensed acupuncturist who co-founded Milwaukee Community Acupuncture with Oliva Crane. Severinsen realized the need for affordable acupuncture after visiting China and visiting acupuncture clinics and seeing how affordable it was for people there, so people came more frequently.

“I used to have a private practice and people were very responsive, but because they were paying out of pocket, they couldn’t afford to keep coming,” she says. Acupuncture works best when a patient receives a series of treatments. Because it is not necessary to undress during an acupuncture treatment, Milwaukee Community AcupunctureProfessionals can see more than one person per hour in a group setting, making their community model profitable. The COVID-19 pandemic has forced them to modify their activities to see fewer patients at the same time in the treatment room; check the website for COVID-19 safety measures.

Severinsen believes that most insurance companies do not cover alternative therapies such as acupuncture because more studies are needed to support their effectiveness. “Once they see these results, I think they will propose covering more,” she says. “I also think it’s difficult to integrate acupuncture into the coding and diagnosis system because it’s a different way of diagnosing people and looking at the body.”

Sheila Julson is a freelance writer who loves capturing the stories behind Milwaukee’s current food, drink, and urban farming scenes. She also writes articles on holistic health, green living, sustainability, and human interest features.