As most of us know, we Americans are a mess—overworked, overweight, and stressed out.  In addition to the increased demands of our technologically fueled lives and their damaging effects on our wellbeing, we have a health care system in free fall.  In one generation we have seen a shift from low cost, comprehensive coverage to $3000 deductibles, low quality HMOs and escalating numbers of people without any insurance at all. Altogether, these developments have damaged health care outcomes and changed the trust relationships between patients, doctors, employers, and health insurance carriers.

People who have the most health care dollars to spend largely determine the direction of the health care market.  And where this money is spent is largely a function of the beliefs of these health care consumers. Over the past century, allopathic, or western medicine, has claimed this mantle of belief based upon its surgical and pharmaceutical power. Indeed, if a bone is broken, an infection raging, or an appendix bursting, an MD is the person to consult.  But the belief that allopathic medicine can cure all medical problems has not been borne out.

As long as allopathic medicine had minimal competition from other professions, patients had little choice but to submit to the powerful yet limited diagnoses and treatments of their MDs.  However, as more alternative methods become understood and available, the situation is changing. A 1993 study in the New England Journal of Medicine (and updated in 2003) revealed that, in the US, over thirteen billion dollars per year was spent on complementary, or alternative, medicine.  These therapies ranged from spinal manipulation and acupuncture to energy healing and massage therapy. Of this amount, over ten billion was spent out of pocket. That compares to approximately thirteen billion spent out of pocket for conventional medical treatment during the same period.  The study also showed that few patients—only 28%–told their family doctors about their alternative treatments. These numbers reflect a wide gap between allopathic and complementary medicine, both in theory and practice.

One reason for this gap is that the two philosophies of health and healing differ so dramatically. According to complementary medicine, health is defined as a state of wellbeing, an energetic balance of mind, body, and spirit.  It is not, as generally described in allopathy, simply the absence of disease. Complementary medicine holds that the cumulative effects of the stresses of life–mechanical, chemical, and emotional—cause imbalance, which in turn, create illness, or dis-ease.  Treatment is focused on restoring balance rather than the allopathic approach of attacking symptoms.

Allopathic medicine claims its practice is more legitimate than complementary medicine because it is based in science. This suggests that allopathic diagnoses and treatments have all been subjected to the rigors of laboratory testing and scientific methodology. While this assertion is subject to argument, it is true that the power wielded by the medical establishment has allowed it to conduct more extensive research than we have seen in the complementary medical fields. This has enabled proponents of allopathic medicine to dismiss complementary medicine as unscientific.

But patients have discovered that there are many conditions for which allopathy has little to offer and which respond positively to complementary care.  Chronic digestive and respiratory disorders, back pain, allergies, and headaches are often more responsive to Chinese medicine, chiropractic, or nutritional counseling than to drugs and/or surgery, frequently at lower cost, and almost always with fewer side effects. Still, patients sense that their primary MD’s don’t trust alternative medicine, ridicule it, or feel undermined by it, and so feel reluctant to bring it up, even though it is in the best interest of their health to do so.

Despite the gap in philosophies and resistance by the medical establishment, complementary medicine is moving from the fringes toward the center of an evolving medical paradigm. Driven by the proliferation of available information and the economics of patient demand, its worldview has infused and is slowly altering that of allopathic medicine.  Health insurance companies have been compelled to offer alternative services to their members. Advertisements for large medical centers promote wellness and prevention, healthy diet and exercise–all ideas that have emerged from complementary medicine.  We even hear definitions of health broadened, beyond the individual, to the environment, that a healthy body requires a healthy world so we must preserve and protect the environment of which we are all integral parts.

Based on a deep understanding of the philosophy of complementary and alternative medicine, more and more practitioners, including MDs, are creating innovative models that integrate technology and truly comprehensive practitioner networks, a holistic view of the body and the realities of the post-industrial workplace. With these models, patients, providers, employers, and insurers can together more effectively navigate the health care landscape of our twenty first century world.

Dr. Ricky Fishman has been a San Francisco based Chiropractor since 1986.  In addition to the treatment and prevention of back pain and other musculoskeletal injuries, he works as a consultant in the field of health and wellness with companies dedicated to the re-visioning of health care for the 21st century.


Copyright Ricky Fishman 2011

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