A less expensive, more effective alternative?

Complementary and integrative medicines are shedding their label as touchy-feely procedures and offering employers a multi-dimensional approach to employee health care

Story by Gina Mangan

It wasn’t just the peppermint oil-soaked cotton balls that Mayo Clinic nurses used to help quell nausea in postoperative patients that caught the attention of Network Health Plan Medical Director Dr. Edward Scanlan.

During his attendance at a Mayo Clinic Complementary and Integrative Medicine Program seminar, Mayo health care professionals talked about back massage to ease the pain of patients recovering from open heart surgery, and about the acupuncture used to alleviate a variety of ailments ranging from chemotherapy-induced nausea to lower back pain.

Then there was discussion of herbal supplements, meditation, touch therapies and many other practices, many of which stem from Eastern medicine and are now slowly being proven effective in Western research studies. That is especially true of acupuncture, the placement of hair-thin needles into the skin to relieve pain, nausea and other physical ailments.

“Some of the things being done really do seem to work and are not very expensive,” Scanlan said.

And when the world-renown Mayo Clinic talks, the rest of the medical community listens.

Integrative medicine programs like Mayo’s – which embrace non-conventional therapies ranging from acupuncture to relaxation therapies – are springing up in medical centers throughout the United States. The 3-year-old Consortium of Academic Health Centers for Integrative Medicine now includes 41 of the most highly respected academic medical centers in the nation, all of which are committed to scientific research and promoting the blending of complementary and conventional medicine.

In Oshkosh, the Affinity Health System’s Mary Kimball Anhaltzer Center for Integrative Medicine opened in 2005 with funding assistance from Mercy Medical Foundation. The menu of services includes acupuncture, massage therapy and nutrition education, as well as classes in yoga, meditation, massage, tai chi and other relaxation practices.

Across town, the Oshkosh Counseling Wellness Center offers a variety of holistic healing techniques that include conventional counseling services, massage therapy, quantum biofeedback, Reiki energy healing and nutrition education aimed at weight loss and treating adrenal fatigue.

Complementary therapies, such as acupuncture, are often targeted at conditions that are the most difficult to manage and treat, costing employers’ millions of dollars in terms of increased health care insurance premiums and decreased employee productivity.

“I think the medical community is continuously looking for treatments in areas where traditional medicine isn’t all that effective,” Scanlan said. “We really don’t have good treatment for things like chronic headaches and lower back pain. The medications are often not great, are expensive and have side effects.”

Entering mainstream
As a result of the surge of interest in integrative health care, health insurance providers are starting to take notice of practices that in the past had been at best regarded as “alternative” and worst as “woo-woo.”

Between what he learned through the Mayo Clinic and discussions with Dr. Jennifer Norden, medical director of Affinity’s Center for Integrative Medicine, Scanlan became increasingly convinced that his own company should reconsider its exclusion of acupuncture from insurance coverage. After careful review of the research, Network Health Plan chose to allow coverage for acupuncture as a treatment for specific conditions, including chronic headaches and chemotherapy-associated nausea. In January, the Affinity-owned subsidiary will extend acupuncture coverage for the treatment of lower back and neck pain with prior authorization.

Part of the decision to pursue extended coverage was based on a follow-up survey of Dr. Norden’s acupuncture patients who had suffered from chronic headaches. Network Health Plan found that more than half of the patients surveyed found relief through acupuncture, Scanlan said.

“If we can help half of those people with something as simple, safe and inexpensive as acupuncture, I would say that is very beneficial,” he said.

But the benefits and the relationship between cause and effect is not always clear-cut.

“One of the things that was demonstrated at the Mayo seminar is that there are an awful lot of treatments being done without good data to support them,” he said. “Trying to ferret out those treatment options backed by the most solid evidence is the challenge.”

As a result, Network Health Plan is approaching the coverage of integrative medicine options with caution, taking what amounts to “baby steps,” Scanlan said.

It’s insurance providers who determine the level of access complementary therapies found in integrative medicine, said Dr. Richard Klamm, a ThedaCare family practice physician who incorporates acupuncture in his practice with a small number of patients. It is not covered by most insurance carriers found in this region of the U.S., Klamm said.

“If it was covered, I’m pretty sure I would be part of a chronic pain program and more people would be benefit,” he said. “It’s actually one of my life dreams to do more of this.”

Back to basics
Klamm said he views acupuncture in much the same way he does physical therapy in that it is another option for treating certain patients suffering from pain. Ultimately, however, patients should try get to the root of the causes of the pain or illness being treated. Those roots are often stress-related, which is why meditation and yoga have proven to be so effective in managing health problems and preventing serious illness, Klamm said.

“I think these approaches are the best places for many patients to start,” he said.

It’s no coincidence that meditation, guided imagery, yoga and tai chi are components of most integrative medicine programs. These practices not only honor the physical body, but also the spirit and the mind.

It is that recognition of the wellness of the whole person, as well as the activation of natural healing abilities, that is at the heart of complementary therapies, Norden said. Combine the best evidence-based conventional medicine practices with the best evidence-based complementary therapies and you have integrative medicine.

“For example, almost always my cancer patients are undergoing chemotherapy, radiation or surgery, but come to me to find out what they can to feel better and boost their immune systems,” Norden said.

While the majority of Norden’s time is spent practicing acupuncture, she conducts 60-minute consultations with patients to discuss medical and lifestyle histories, nutrition, supplements, wellness and therapies that might be most beneficial based on each person’s personal needs. This careful attention to the patients’ overall well being is one of the central values of integrative medicine.

The Consortium of Academic Health Centers for Integrative Medicine defines integrative medicine as a practice that reaffirms the importance of the relationship between the medical practitioner and patient, focuses on the whole person, is backed by evidence, and makes use of all appropriate therapeutic approaches and medical disciplines to achieve optimal health and healing.

In many ways, integrative medicine is shoring up weaknesses in the conventional health care system, Norden said.
“It’s incredible what our health care system can do as far as technology to treat illnesses, but we’ve lost sight of good nutrition and disease prevention,” she said. “We’re treating symptoms too late. Office visits have been shortened. People aren’t getting the relief they need.”

With its focus on nutrition, stress management, lifestyle and wellbeing, integrative medicine is a return to the basics of taking care of people, Norden said.

Bringing it to business
How can the business community benefit from the broad array of integrative medicine services and treatments becoming increasingly available in the region?

The first step is recognizing the value of healthy employees, said RaChelle Laux, president and director of the Oshkosh Counseling Wellness Center.

“There is no greater resource than healthy and productive employees. They’re priceless,” she said. “They don’t wear out. You don’t have to replace and retrain. There are fewer sick days. There are no surgeries. They aren’t utilizing their health insurance on expensive treatments and medications, so they help keep health care costs lower.”

The second step is to understand that effective health and wellness programs should be more involved than exercise, checking employee blood pressure, and making counselors available for “talk therapy,” Laux said. It’s much more multi-faceted.

“I see wellness as much broader than the narrow definition of suffering from an illness,” said Liz Arafat, a counselor at the center. “It’s being present and in tune with your body, feeling alive in body, spirit and mind. People who are emotionally present and able to connect with their surroundings and other people are much more able to perform in their place of business.”

The Oshkosh Counseling Wellness Center has several “Workplace Wellness Programs” it can deliver directly to area businesses. They include training in nutrition, weight management, smoking cessation, stress management and health risk assessment through quantum biofeedback, a diagnostic tool used for stress management.

Employers can assist their employees by making them more aware of the importance of healthy sleep, hydration, or a diet free of caffeine and sugar, Laux said. They can also better promote the health services available within their local communities. The center, for example, is fully licensed with several services covered by many of the region’s health insurance providers.

“What we do as a center is preventative maintenance,” Laux said. “I think preventative maintenance is something most employers can understand.”

Gina Mangan is a freelance writer based in Oshkosh and is raising three children. Readers can email her at gmangan@tds.net.