April 7 is the World Health Organization’s World Health Day, focusing on universal health coverage this year. We take a look at how integrative medicine is expanding health care options and its impact on the future of medical care.
A significant shortage of allopathic physicians and specialists, a longer-living older population and the growing use of natural medicine options are among the trends shifting complementary and alternative medicine to the leading edge of health care.
In the United States, approximately 38 percent of adults and 12 percent of children are currently using some form of Complementary or Alternative Medicine (CAM). That number will continue to grow as the U.S. faces a shortage of between 40,800 and 104,900 physicians by 2030, according to a study commissioned by the Association for American Medical Colleges.
The Occupational Outlook from the U.S. Department of Labor reports that chiropractic treatment has become more widely accepted as a result of research, its nonsurgical and nonpharmaceutical approaches, and changing attitudes about alternative health care. This increase in public awareness and acceptance will facilitate more chiropractic integration with allopathic physicians and physical therapists.
In addition, chiropractic care is increasingly covered by insurance and made available through employee benefit programs. For example, according to the American Chiropractic Association:
- Chiropractic care is available to the armed forces at more than 60 military bases in the U.S., and more than 60 Veteran’s Administration (VA) medical facilities.
- The U.S. Congress has authorized that certain chiropractic services be covered by Medicare and Medicaid.
- As many as 87 percent of all insured American workers have coverage for chiropractic services in their health care plans.
The result is that the job outlook for chiropractors is projected to grow 12 percent through 2026, according to the U.S. Department of Labor, faster than the average for all occupations. Massage therapy is an even faster growing field, expected to increase by 26 percent.
On the heels of the emerging opioid crisis, the American College of Physicians (ACP) made a significant update to its guidelines concerning low back pain, recommending alternative therapies that are non-pharmaceutical first. In addition, the Joint Commission, a nonprofit that accredits more than 21,000 U.S. health care organizations and programs, released new pain assessment and management standards in 2017 that require hospitals to either provide or educate patients about nonpharmacologic pain treatment options, including acupuncture, chiropractic care and massage therapy.
Along with chiropractic medicine and massage therapy, studies are demonstrating the effectiveness of acupuncture in treating a wide variety of conditions, including pain management, post-traumatic stress symptoms, pre-surgical stress for children, and post-surgical nausea, among other applications.
At the same time, a study by the Association for American Medical Colleges (AAMC) found that less than 25 percent of U.S. medical schools require nutrition instruction, and they provide limited training in prevention education for conventional medical students. The American Medical Association acknowledges the need to shift to more preventative approaches to health care and proposes that, among other initiatives, this be initiated through the support of other health care providers.
This gap will increasingly be filled by Naturopathic doctors (ND) and other alternative medicine practitioners as the trend toward collaborative integrated care continues to grow. NDs treat a wide variety of medical conditions and can provide both individual and family health care. Currently, 21 states, the District of Columbia, and the United States territories of Puerto Rico and the United States Virgin Islands have licensing or registration laws for Naturopathic Doctors. Licensure ensures that an ND holds a graduate degree from an accredited naturopathic medical school — such as National University of Health Sciences — successfully passed national board exams, and complies with practice and professional standards set forth by state legislators.
Complementary and alternative medicine will continue to be on the leading edge of health care in the United States as it is increasingly covered by insurance, more licensed practitioners become available, and demand for more natural, holistic, preventive approaches becomes the wave of the future.
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