Alternative Medicine in the U.S

Alternative Medicine in the U.S

اسلاید 1: www.tabaye.ir

اسلاید 2: Alternative Medicine in the U.S.James G. Anderson, Ph.D.Purdue University

اسلاید 3: Introduction Alternative Medicine encompasses approaches to patients and illnesses that are either not widely taught or practiced in conventional medical schools or that challenge commonly assumed viewpoints of the dominant professional health care system in the United States. (Hughes, Ellen M.D, 1997)Treating the patient’s whole body using a “holistic approach”“The 1993 Eisenberg Study revealed that about one-third of Americans were using alternative therapies and spending nearly $14 billion annually for health care.” (Budrys, Grace, 2001)

اسلاید 4: IntroductionAlternative medicine is broken up into subcategories:Mind/Body ControlAlternative Systems of Medical PracticeManual HealingHerbal MedicineAccording to the NCCAM, Americans mostly use it for back, neck, head, or joint aches. Also to treat or prevent musculoskeletal conditions or other conditions involving chronic or recurring pain.

اسلاید 5: Types of Alternative MedicineAcupunctureAromatherapyChiropracticHerbal MedicineHomeopathyMassageNutritional Supplements

اسلاید 6: IntroductionIt is becoming more widely used, and socially and politically accepted in the United States.The supply of alternative medicine clinicians are expected to grow by 88 percent between 1994 and 2010.According to a survey given by Dr. John Astin, clients usually use alternative medicine for the following three reasons:They are dissatisfied in some way with conventional treatment.Alternative health care offers more personal control.The alternatives are more compatible with the patients’ values and beliefs.

اسلاید 7: Alternative Health Care: A New Social MovementLies outside of the existing institutional arrangementsInformation is shared through Web sites, cooperative stores, organic farming, health fairs, lectures, etc. Opportunities for miracle cures, scams and frauds blossom when the movement is non-institutionalized

اسلاید 8: Studies of Unconventional Medicine in the U.S.David Eisneberg 1993David Eisenberg 1998Goldstein 1999

اسلاید 9: ObjectiveTo document trends in alternative medicine use in the U.S. between 1990 and 1997.

اسلاید 10: DesignNationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively.A total of 1539 adults in 1991 and 2055 in 1997.Prevalence, estimated costs and disclosure of alternative therapies to physicians were measured.

اسلاید 11: Other countries % of population who used alternative medicine during the past 12 months10% Denmark15% Canada33% Finland49% Australia

اسلاید 12: Types of Alternative TherapiesRelaxation techniquesHerbal medicineMassageChiropracticSpiritual healingMegavitaminsSelf-help groupImagery

اسلاید 13: Types of Alternative TherapiesCommercial dietFolk remediesLifestyle dietEnergy healing HomeopathyHypnosisBiofeedbackAcupuncture

اسلاید 14: ResultsUse of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997.The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3%.

اسلاید 15: ResultsTherapies increasing the most included:herbal medicineMassagemegavitaminsself-help groupsfolk remediesenergy healinghomeopathy

اسلاید 16: Results Alternative therapies used most frequently for:Back problemsAnxietyDepressionHeadaches

اسلاید 17: Disclosure of Alternative Therapies to Physicians1990: 38.5%1997:38.5%

اسلاید 18: Percentage of Users Paying Entirely Out-of-Pocket for Alternative Therapies1990:64%1997:68.3%

اسلاید 19: Total Visits to Alternative Medicine Practitioners in the U.S.Alternative Practitioners1990:427 million1997:629 millionPrimary Care Physicians1990:387 million1997:385 million

اسلاید 20: Estimated Total Expenditures for Alternative Medicine Services1990:$14.6 billion1997:$21.2 billion

اسلاید 21: Why Patients use Alternative MedicineNational study of why people in the U.S. use alternative medicine.Objective – to investigate predictors of alternative health care use.

اسلاید 22: Hypotheses People seek alternative medicine because:(1) they are dissatisfied with conventional treatment.(2) they see alternative medicine as offering more personal autonomy and control over health care decisions. (3) the alternatives are seen as more compatible with their beliefs, values, and world view.

اسلاید 23: DesignWritten survey examining use of alternative health care and attitudes toward conventional medicine. 1035 individuals were randomly selected who lived throughout the United States.

اسلاید 24: Results Predictors of use of alternative medicine:More educationPoorer health statusChronic health problemsHolistic orientation to healthExperience that changed their world viewMembership in cultural groups such as environmentalism, feminism, spiritualismBelieving in the importance of body, mind, and spirit in treating health problemsPerceived efficacy (relief of symptoms)

اسلاید 25: Results Predictors of use by those who primarily use alternative medicine:Distrust of conventional physicians and hospitalsDesire for control over health decisionsDissatisfaction with conventional practitionersBelief in importance of one’s inner life

اسلاید 26: Legitimating Alternative Health CareThe U.S. Congress prohibited the FDA from regulating herbal productsProfessional Associations formed, e.g., American Holistic Medical Association NIH created the National Center for Complementary and Alternative Medicine Today 64% of medical schools have at least one course on alternative medicineGrowing third-party reimbursement

اسلاید 27: Resistance to Alternative MedicineMedicine feels a threat to their scientific legitimacy. They argue there is no scientific evidence to support most alternative medicine Demonstrating effectiveness of alternative medicine through clinical trials runs counter to the holistic emphasis on patient empowerment, individualized treatment regimens, multiple modalitiesAlternative medicine threatens physicians’ income

اسلاید 28: The Future of Alternative MedicineInstitutionalization of alternative medicineThe pharmaceutical companies are profiting from the increased popularity of herbs, minerals, vitaminsAlternative/Complementary health care practitioners and clinics will focus more on profit making services

اسلاید 29: The Future of Alternative MedicineManaged care organizations and HMOs have begun incorporating elements of alternative medicine in order to reduce costsAlternative health care practitioners will adopt the model of expertise that characterizes the medical profession where the doctor is the expert and monopolized information

اسلاید 30: The Future of Alternative MedicineAlternative health care modalities that are the least holistic are likely to be the only ones that survive the scrutiny of biomedical research.Branches of alternative medicine that are fundamentally incompatible with conventional medicine will be marginalized. The movement will lose its creativity and innovativene