Introduction to Complementary and Alternative Medicine Practices

1. Introduction to Complementary and Alternative Medicine Practices Erica Rooks July 10, 2014 Bachelor’s Capstone in Health & Wellness Kristin Henningsen Kaplan University

2. Course Syllabus Course Description: This course is designed to introduce the student to essential concepts related to complementary and alternative medicine. Students will be learning the fundamental terms and ethical practices in this healthcare field. This course explores both common and uncommon areas of the industry. Course Outcomes: By the end of this course, you should be able to: - Identify the difference between complementary and alternative practices - Identify major concepts in complementary and alternative (CAM) professions - Understand the importance of ethical practices and legal standards in this healthcare field

3. Week One: Introduction to Complementary and Alternative Medicine • CAM practices encompass a wide variety of treatments. • some well known (acupuncture, chiropractic care, yoga, etc.) • some not-so-well known (Rolfing and Trager work) • Emphasis of CAM • the whole person as a unique individual with his/her own inner resources • Definition of CAM (per the World Health Organization) • …a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system • Based on this definition, can any of you name any CAM practices you or a loved one has tried? What were your/their experiences with this/these treatments? • Gaining popularity in the US • Many CAM practices are cheaper and less invasive than traditional treatments • More CAM practices becoming covered under insurance policies • More people using CAM each year • natural remedies, meditation, yoga, massage therapy • more people are taking an active role in their own health • For those of you who have not tried any CAM practices, what would it take for you to try one (or a few)? What factors play a role in your decision (money, scientific research, professional support, friend recommendation, etc.? Which of the CAM practices we mentioned this evening would you be most likely to try?

4. Week One: Intro to CAM Handout • Definition of CAM (per the World Health Organization) • “…a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system” • Popular CAM Practices: • Chiropractic Care Acupuncture • Yoga Aromatherapy • Meditation Massage Therapy • Natural Remedies • Less Popular/Newer CAM Practices: • Rolfing Structural Integration • Trager work • Reflexology • Qi Gong • Gaining popularity in the US • Many CAM practices are cheaper and less invasive than traditional treatments • More CAM practices becoming covered under insurance policies • More people using CAM each year • Top 10 used CAM practices: • Natural products, deep breathing, meditation, chiropractic, massage, yoga, diet-based therapies, progressive relaxation, guided imagery, homeopathic treatment • Learn More: • National Center for Complementary and Alternative Medicine (NCCAM) • http://nccam.nih.gov/

5. Week Two: Complementary and Alternative Practices • Definition of Complementary Medicine: • refers to a non-mainstream approach used in conjunction with conventional medicine • IE. Attending a yoga class to relieve stress/anxiety and also taking an anti-anxiety medication prescribed by a primary physician • Definition of Alternative Medicine: • refers to a non-mainstream approach used instead of conventional treatment • IE. Choosing to forego the anti-anxiety medication and attending yoga classes and taking up meditation to relieve stress/anxiety • Categories of CAM • Do you think that any CAM practice (chiropractic care, yoga, aromatherapy, massage therapy, etc.) could qualify as either complementary or alternative, or do you believe that each practice always falls under the same “header”? Why or why not? • Discerning: • A child is diagnosed with ADHD. The parents choose to alter the child’s diet to therapeutically treat the ADHD. Would this be considered complementary or alternative practice? Why? • What if the parents decided to alter the diet and put the child on Ritalin prescribed by the child’s physician? • A cancer patient decides to skip chemotherapy and radiation because of the unappealing side effects. Instead this patient begins seeing a naturopathic physician to combat the cancer. Would this be considered complementary or alternative practice? Why? • For those of you who said last week you had tried CAM practices previously, were they complementary or alternative? What classified it as such? • For those of you who have not tried CAM practices: After distinguishing between complementary and alternative practices this week, are you more likely to try one or the other? Why or why not?

6. Week Two: Complementary & Alternative Practices Handout • Definition of Complementary Medicine: • “…refers to a non-mainstream approach used in conjunction with conventional medicine” • Definition of Alternative Medicine: • “…refers to a non-mainstream approach used instead of conventional medicine” • CAM Practices can be either complementary or alternative • Depending on the circumstances, any CAM practice could be either complementary or alternative. The discernment lies with the patient’s other choices for treatment, if any. • Categories of CAM: • Mind-body medicine Energy Medicine • Whole medical systems Biologically Based Practices • Manipulative & body-based practices • Learn More: • Kaplan University Center for Health & Wellness • http://www.healthandwellness.kaplan.edu/cam.html • Mayo Clinic • http://www.mayoclinic.org/healthy-living/consumer-health/in- depth/alternative-medicine/art-20045267 • Everyday Health • http://www.everydayhealth.com/alternative-health/the-basics.aspx

7. Week Three: Ethical Practices & Legal Standards • A “hands on” approach could mean trouble • Many CAM practices require physical touch • Chiropractic, massage therapy, strain-counterstrain, acupuncture, reflexology • Getting informed consent from the patient prior to treatment is essential • They must understand everything involved in using CAM practices up front • Policies and procedures • Understanding what policies and procedures are in place prior to allowing a practitioner to perform CAM practices is essential • Many practitioners use /recommend CAM practices without express consent of the organization(s) they work for • Check with insurance before undergoing CAM practices • Not all are covered • Conventional physicians and referrals • Complementary medicine often requires that conventional and un-conventional practices work together • Physicians are not always confident in referring patients for CAM treatments because they typically do not have extensive knowledge about them • This poses an ethical dilemma for physicians whose patient(s) may require “other” treatments than what conventional medicine can provide • CAM is (often) not as strictly regulated as conventional medicine • This is yet another reason conventional physicians are hesitant to refer patients for CAM treatments • If your physician was hesitant to refer you for a CAM therapy, would you still seek the treatment? Why or why not? Would it depend on what therapy was in question (chiropractic care versus acupuncture or massage therapy versus meditation)?

8. Week Three: Ethical Practices & Legal Standards Handout • CAM practices often require physical touch • Informed consent absolutely necessary • Definition of informed consent: • Obtaining consent from a patient who was provided with a complete list of risks and benefits associated with a specific treatment or procedure • Policies and Procedures • Understanding what policies and procedures are in place prior to allowing a practitioner to perform any CAM treatment is essential. It is also important to know what your insurance will cover and will not cover (remember not all CAM practices are covered). • Conventional Physicians and Referrals: • Many physicians do not feel confident referring patients for CAM treatments because they are less regulated than conventional treatments. Also many CAM practitioners are not medically trained. • Learn More: • Journal of Medical Ethics • http://jme.bmj.com/content/30/2/156.full.pdf • Nursing Times • http://www.nursingtimes.net/ethics-and-quality-in- complementary-therapy-education/200392.article • Ethics in Medicine • https://depts.washington.edu/bioethx/topics/compl.html#ques5