The Age of Personalized Health Care
Natural Healing Moves into the Mainstream
With conventional treatments unable to get to the root of many medical problems, mainstream hospitals are increasingly embracing holistic therapies, and altering the way patients receive care.
Natural Healing Moves into the MainstreamBy Yin-chuen Wu, Ming-ling Hsieh
From CommonWealth Magazine (vol. 412 )
The medical world is being turned upside down. In mainstream hospitals, where once you would only encounter inpatient wards, outpatient clinics, emergency rooms and surgical facilities, now music and paintbrushes can be found.
Patients resigned to taking medicine and getting shots to treat specific symptoms have begun to dance, draw, paint freely, and do deep breathing exercises to cure their ills.
On the 11th floor of Taiwan Adventist Hospital in Taipei, a winding corridor leads to seven small rooms that play host to therapy classes featuring dance, the visual arts and music. The classes have drawn more than 30,000 visits in the past three years.
Art therapist Li-Wen Wang, who works at the hospital's Expressive Arts Therapy Center, is no longer willing to follow the standardized procedures of Western medicine and refuses to automatically prescribe medication to ailing patients. She prefers to choose the most suitable therapy based on patients' individual needs, opting, for instance, to have patients draw as an outlet for their emotions.
In another sign of the new trend toward holistic care, National Taipei College of Nursing has begun requiring juniors in the Exercise and Health Science Department to take one of the following three electives: sports medicine, aromatherapy or reflexology, more commonly known as foot massage. The college's School of Nursing plans to include a course on reflexology among its electives in two years.
Alternative therapies once barred from reputable hospitals and holistic care concepts spurned by medical educators have suddenly reached the inner sanctums of venerable institutions, sparking a re volution in the United States and Canada and now in Taiwan. Their rise has also created new commercial opportunities for health care providers.
The Most Rapidly Growing Field in Medicine
The growing interest in alternative medicine has spawned a sharp increase in specialization in the field – at the expense of Western medicine, which has traditionally dominated the medical sector.
Health care is one of the few sectors in Taiwan that appears recession-proof and immune to the heavy layoffs plaguing other industries. According to the Directorate General of Budget, Accounting and Statistics' monthly statistical survey on employment for October, employment in the health care sector was up 4.67 percent for the month from a year earlier, two to three times higher than in other industries. (Table 1)
Yet when it comes to Western medicine, the number of individuals receiving certification as specialists has been on the decline recently, with 22 percent fewer individuals certified last year than four years ago. In contrast, certifications are being awarded at a soaring rate for alternative medicine specialists such as physical therapists (63 percent), nutritionists (57 percent) and Chinese medicine practitioners (130 percent). (Table 2)
This labor market supply trend reflects the new phenomenon slowly emerging in Taiwan's medical sector: mainstream medicine is giving way to alternative medicine.
A study by Chih-Yin Lew-Ting, an associate professor at National Taiwan University's School of Public Health, found that three-quarters of respondents had resorted to alternative medical care in the previous year and that combining mainstream and alternative medicine had become common practice.
"Individuals have already integrated the two on their own. Today, they use one method; tomorrow, something else," Lew-Ting says.
Opening the Door to Alternative Healing
The opening of new health care facilities amid the economic downturn reflects this new consumer trend in the medical market.
National Taiwan University Hospital (NTUH) – the country's temple of mainstream medicine – made major headlines in the medical community in November when it formally consigned one floor of its old building to alternative medicine, formally
establishing a "Complementary and Integrated MedicineCenter."
Following the lead of several hospitals that had set up Chinese medicine or traditional medicine centers, the conservative NTUH, long an adherent to Western and evidence-based medicine, finally took its first plunge into researching and understanding therapies beyond the realm of Western medicine.
"NTUH reached a crossroads in its history and truly faced a pivotal choice," acknowledges Chia-li Yu, an internist and the director of the integrated medicine center.
"Maybe you don't believe in it, or don't agree with it, but you can't ignore it," Yu says of alternative medicine, an attitude derived from years of seeing evidence-based medicine fail to come up with answers to ailments such as rheumatoid arthritis.
Taiwan Adventist Hospital was the first mainstream hospital in Taiwan to accept the new trend of integrated medicine.
"In the future, health care will be flexible and diversified. Every person should be able to look around and choose on their own," says Chin-Lee Hong, the director of Taiwan Adventist Hospital's Expressive Arts Therapy Center.
The ascendance of holistic care has shattered the previously respected notion of the primacy of Western medicine in Taiwan's health care field. Integration is the trend of the future, and the education system is changing along with this new wave.
On a Thursday afternoon, 16 juniors in National Taipei College of Nursing's Exercise and Health Science Department concentrate on Dr. Eugene Cheng's description of where the thyroid's reflex zone is on the foot, what other spots must be massaged, the proper technique to use and how much pressure to apply in treating patients.
An ancient form of healing, the practice of foot reflexology can be found in the Yellow Emperor's Classic of Medicine dating back 2,500 years and was popular in ancient Egypt more than 2,000 years ago. Today, the traditional therapy has been revived and is available almost anywhere in Taiwan.
CAM Gaining Traction in U.S. Market
The trend toward complementary and alternative medicine (CAM) is not solely a Taiwanese phenomenon.
According to the results of the U.S. National Institutes of Health's latest survey released in December, 38 percent of adult Americans used some form of complementary and alternative medicine in 2007, even though the treatments are not covered by insurance. The non-conventional treatments, more widely used among adult women (42.8 percent) than adult men (33.5 percent), included herbal supplements, meditation, yoga, massage, chiropractic or osteopathic manipulation, deep breathing exercises and acupuncture.
The survey also found that the main consumer segment driving the new wave are 50-something women with relatively higher levels of education (master's degree or better) and income who generally do not smoke and live on the West Coast.
Another stunning finding of the report was that one in nine children in the U.S. received some form of alternative medical treatment in 2007, with herbal supplements, chiropractic manipulation, and deep breathing exercises the most common therapies. Richard L. Nahin, acting director of the National Center for Complementary and Alternative Medicine's Division of Extramural Research, said that since children are normally healthy, the fact that so many used alternative therapies was "pretty amazing."
To meet the rising demand, U.S. medical centers and mainstream hospitals have joined with alternative medicine over the past decade to provide "integrated" medical services in their facilities, such as acupuncture-assisted anesthesia or chiropractic care.
The main reason behind alternative medicine's popularity is widespread dissatisfaction with mainstream medicine, especially in treating rare or chronic ailments such as aches, allergies, or weakened immune systems. When Western medicine fails to treat these problems effectively, patients turn to alternatives in search of a viable therapy.
The book Against Medical Advice, which ranked second on the New York Times bestseller list for non-fiction in November, chronicles one such journey taken by a family to find an accurate diagnosis and effective treatment for their son, who suffered from Tourette's syndrome and obsessive-compulsive disorder.
The son, Cory Friedman, began taking medicine for his condition when he was five, but his uncontrollable urges to shake his head only grew worse. At one point, he was even sent to a psychiatric facility for treatment. Through the intervention of his father, Cory, suffering from severe depression, was finally checked into an alternative medicine center. As he regained his confidence, the traumatic headshakes eased and became less frequent, and today, he rarely takes medicine.
Even physicians themselves are starting to doubt the effectiveness of mainstream medicine.
Looking like a Horse?
Jonathan Wright, who pioneered the use of bioidentical hormones, was admitted to Harvard Medical School at the age of 16. After graduating, he became a doctor at a Seattle hospital and gradually became convinced that vitamins were all patients needed to treat their ailments and naturally regain their health, rather than the more common prescription drugs or surgical procedures.
Because of that, he left the hospital and founded the Tahoma Clinic in 1973 to promote natural therapies. One day in the early 1980s, a woman going through menopause asked if she could be given a prescription for natural hormones to ease her pain. As Wright wrote the prescription, the patient questioned whether what he was recommending was natural, so he explained that the hormone he was prescribing, called Premarin, came from horses and horses were natural.
"The lady looked me in the eyes and asked: Do I look like a horse?" Wright recalls. He immediately realized that the healthiest supplements were only those substances most closely approximating natural human hormones.
Wright then began to flip through his textbooks from medical school to learn more about the estrogens composing women's hormones. "But the proportion of the three estrogens weren't listed in my college textbook," he says.
So Wright took hormone samples from women and rushed them to a lab for chemical analysis. Once he got the results, he sent letters to pharmaceutical companies across North America, asking if they could replicate the formula in a natural hormone supplement.
Vancouver-based Kripps Pharmacy, a manufacturer and pharmacy that has been around since 1947, replied that it could find natural substances to formulate the bioidentical hormone requested by Wright.
Since then, Wright has been selling his Tri-estrogen natural hormone supplement that replaces declining estrogen levels in women as they age and helps alleviate the symptoms of menopause without the side effects, including a greater risk of cancer, often produced by synthetic hormone therapies.
Innovative Therapies Heal More than the Mind
Today, the Tahoma Clinic has 80 employees and annual revenues of US$8 million (NT$260 million), with branches in Europe and Japan. In her new book Breakthrough, actress-turned-health advocate Suzanne Somers trumpets Wright's natural bioidentical hormone replacement therapy as a cutting-edge, wise and innovative therapy.
At the clinic, which has a parking lot full of upscale vehicles and well-dressed patients coming and going, Wright admits to CommonWealth Magazine that his innovative therapy in fact integrates traditional Chinese medicine and evidence-based medicine commonly relied on in the West.
Still, mainstream medicine continues to harbor a skeptical attitude toward alternative medicine, to the point of suggesting that alternative therapy is merely a type of spiritual sustenance or faith. To these skeptics, providing integrated therapy in hospital cancer wards is simply a way to relieve patients' mental and psychological stress.
The more scientists study the brain, however, the more they discover that people's mental states have a major influence on their health. One example is aching pain.
Chronic pain is one of the world's most lethal killers of productivity. The amount of time spent by American workers in the doctor's office, on leave or suffering at work because of aching pain costs the United States US$60 billion in productivity a year. Pain usually arises from injuries, but brain researchers suggest that injuries leave pain pathways in the brain and spine, so that even when a wound heals, the pain can persist.
This chronic post-traumatic pain is an ailment that needs to be treated because of the scarring suffered by the nervous system. Vancouver aromatherapist Marlene Smith specializes in treating chronic pain and has used essential oils to handle her own battle with constant aching pain.
Smith developed an interest in playing with essential oils when she worked in London as an accountant for the Mars candy corporation, and it came in handy five years ago when she contracted Lyme disease from her dog. After the swelling at the base of her neck abated, her neck began aching severely.
Curing Pain with Olfactory Memory
Smith got shots and took medicine, but nothing worked to ease her pain. She then tried chiropractic adjustment of her spine, and for several months she also meditated to the smell of essential oils.
"Suddenly, I forgot the pain completely, because aromatherapy has the ability to transform us to a totally different space of memory," Smith recalls.
The aromatherapist says the use of essential oils is so effective because noses have the greatest memory retention capability of any organ. Even those who have lost their sense of smell can benefit from therapies based on olfactory memory.
Smith's business, Essential Oil Techniques, though located in the not-so-upmarket North Burnaby district of Vancouver, has still seen revenues grow 45 percent this year. That may be because aromatherapy has been proven to be most effective in treating virus-induced illnesses (like the common cold) and pain, which often leave Western medicine at a loss.
An increasing number of people are paying attention to the alternative and integrated medicine wave, forcing mainstream physicians to take a hard look at themselves and their methods.
Bringing Change to Mainstream Medicine
"In the future, medicine will be a service industry," says Sien Hung Yang, the chief of Chang Gung Memorial Hospital's Department of Traditional Chinese Medicine. He believes that doctors will have to be more humane and treat patients as they would their friends, focusing more on how to make them feel better. Such a trend will require the integration of different specialties and therapies.
Andrew T. Huang, president of the Koo Foundation Sun Yat-sen Cancer Center, likens the rise of alternative medicine to a "knock on your head" for mainstream medicine. That patients are turning to alternative medicine reflects their dissatisfaction with Western medicine physicians, he says.
Huang believes that Western medicine in fact also emphasizes the whole being and personalized care, and acknowledges that not all illnesses can be cured by prescribing medicine or diagnostic tests or performing surgical procedures. But he suggests that the distorted values and goals of medical education and the health insurance system have led practitioners of Western medicine to forget the importance of holistic concepts.
In this new era of integrated medicine, it is important for mainstream physicians to step beyond conventional boundaries and understand concepts used in alternative therapies.
Dr. David L. Katz, director of the Yale University School of Medicine Preventive Research Center, says that because alternative medicine is drawing greater attention, physicians need to better understand its possibilities and limitations, and offer better direction to their patients. Why?
"Because it is here that patients most need expert guidance," he says. "Doctors and patients alike should approach the many offerings of CAM with open-minded skepticism."
Translated from the Chinese by Luke Sabatier
Chinese Version: 你可以掌握自己的健康 自然療癒