3 Alternative ‘Paths’ in Medicine

3 Alternative ‘Paths’ in Medicine

Author: Mark Parkinson RPh:  President  AFC-CE

Credit Hours 1- Approximate time required: 60 min.

 

Educational Goal:

To explain the medical practices of Homeopathy, Osteopathy and Naturopathy . 

Educational Objectives:

Define Homeopathy, Osteopathy and Naturopathy

Explore the aspects of managing alternative medical therapies in an Adult Foster Care setting

Procedure:

Read the course materials.  2. Click on exam portal [Take Exam].  3. If you have not done so yet fill in Register form (username must be the name you want on your CE certificate).  4. Log in  5. Take exam.  6. Click on [Show Results] when done and follow the instructions that appear.  7. A score of 70% or better is considered passing and a Certificate of Completion will be generated for your records.

Disclaimer

   The information presented in this activity is not meant to serve as a guideline for patient management. All procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this article should not be used by care providers without evaluation of their patients’ Doctor. Some conditions and possible contraindications may be of concern. All applicable manufacturers’ product information should be reviewed before use. The author and publisher of this continuing education program have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. Nutritional products discussed are not intended for the diagnosis, treatment, cure, or prevention of any disease.

 

3 Alternative ‘Paths’ in Medicine

Our world is filled with amazing advances in science and medicine.  But for some, the more advanced our society becomes, the more unnatural it seems to them.  They long for a simpler approach to life, one based on organic, not artificial, elements. There are also others who cannot afford the cost of more advanced medical choices and have to turn to ‘old fashion,’ less expensive alternatives. Then there are others who never saw the need to change to more advanced methods and remained with what worked best for them.

Regardless of the reason, there are many who have chosen an alternative approach to medical care. An approach that contains unconventional choices or complementary elements to mainstream medicine.  As a caregiver, you may be faced with having to understand and manage these alternative therapies. This course is designed to help you learn about three of those choices: Naturopathy, Homeopathy, and Osteopathy—three alternative ‘paths’ in medicine.

The first step—define alternative medicine.

According to the National Institute of Health (NIH) of the US Department of Health and Human Services:

Many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches developed outside of mainstream Western, or conventional, medicine. When describing these approaches, people often use “alternative” and “complementary” interchangeably, but the two terms refer to different concepts: If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.” If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.” True alternative medicine is uncommon. Most people who use non-mainstream approaches use them along with conventional treatments.

For the purposes of this article, I will be describing the three ‘paths’ as alternative medicine, but in adult foster care reality, you will only see elements of these approaches as complementary to mainstream medicine.

Alternative vs. Mainstream

The difference between mainstream medicine and alternative medicine is in how they approach the problem of healing the patient.  Mainstream is also called Western medicine, allopathic, biomedicine, or scientific medicine. At its core is an evidence-based approach to solving health problems. In essence, when a health problem arises, a theory is put forth on how to solve it. The theory is tested until it is more or less proven effective at solving the problem according to government standards. It is then approved for general use by licensed practitioners.  The strengths of this approach are its proven effectiveness and repeatability. Its weakness is, it tends to have a very narrow focus on a problem, ignoring the individual as a whole. Also, the medicines are artificial and may have side effects.

Alternative medicine, which includes naturopathy, homeopathy, osteopathy, chiropractic, and the eastern medicines of India and China, is known for its holistic approach to solving medical problems. Generally, it looks at the whole body and tries to determine what is out of harmony. Bringing the whole body back into sync enables the body to heal itself. When medicine is used, herbs are a preferred choice. There is also an emphasis on eliminating toxins from the diet and environment. The strengths of the holistic approach are the promotion of healthy living and feeling good. Its weakness is the lack of clinical evidence of efficacy in solving health issues. 

One could say that with evidence-based medicine, you are cured, but you might feel worse, and with holistic medicine, you might not get cured, but you feel better about it.  All joking aside, I am not making a judgment statement about any form of medicine in this article. This article is intended for educational purposes only. As with most health professionals, I am trained in evidence-based medicine, but I personally use herbal and homeopathic supplements from time to time.

Naturopathy

According to the American Association of Naturopathic Physicians:

Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing process.  The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.

The association also states that the goals of naturopathic therapy are:

• First, do no harm—use substances that minimize side effects and use the least force possible to diagnose and treat.
• Use the healing power of nature, utilizing the body’s innate healing power.
• Treat the underlying cause of the disease, not just the symptoms.
• Treat the whole person with a holistic approach to health.
• Educate the patient about their health to gain their cooperation in establishing a healthy lifestyle.
• Focus on preventing disease, not just curing it.

Currently, there are six colleges that give a doctoral degree in the United States. Though there is a doctoral degree issued, the medical training is not as rigorous as traditional medical degrees. Colligate candidates do not have to take the Medical College Admissions Test (MCAT) or Graduate Record Examination (GRE) for entrance, and postgraduate residencies are optional. According to the American Academy of Family Physicians, the number of training hours’ difference between a family physician and a naturopath is between 15,195–15,215 total hours. There are colleges in Washington, Oregon, and California. Sixteen states license naturopathic doctors, including Oregon, Washington, and California. Naturopaths are not licensed to perform major surgeries. There are unlicensed naturopaths that practice medicine, but only licensed practitioners have the designation ‘ND’ after their name.

A typical visit to a naturopath would include a lengthy first visit (1−2 hours) that would be followed by briefer follow-up visits. The state of the patient would be determined through questioning and multiple diagnostic tests. Therapies would be prescribed, which may or may not include medicines, and which may or may not be based on clinically-proven studies. NDs are trained to utilize prescription drugs, although the emphasis of naturopathic medicine is on the use of natural healing agents such as herbal or homeopathic supplements. Clinically unproven folk remedies may also be utilized.  Most herbal supplements are not regulated by the Food and Drug Administration (FDA) of the United States.

Homeopathy

Homeopathy is a system of medicine based on the principle: “like cures like.” In practice, a patient suffering from a disease is given extremely small amounts of substances that produce the same symptoms as the disease. In theory, the body’s own defense and homeostatic mechanisms are then stimulated to work harder at ridding itself of the original disease.  In essence, homeopathy is trying to make the body heal itself. Like naturopathy, homeopathy tends to focus on the whole individual (holistic), with an emphasis on maintaining a healthy lifestyle.

At the core of homeopathic medicine are the homeopathic preparations. These are powerful, often toxic, substances that are diluted down to extremely small quantities. Often the quantities measure in just molecules of the active substance. If there are no molecules of the active ingredient, the profession claims that the water retains a memory of the substance that still retains its effectiveness. In the United States, homeopathic drugs are regulated by the FDA.

According to the American Institute of Homeopathy:

 Homeopathic medicines are included in the Food, Drug and Cosmetic Act of 1938 (see SEC. 201. (g)(1) of the Act 21 U.S.C. §321), and therefore fall within the regulatory authority of the FDA, which recognizes the Homeopathic Pharmacopoeia of the United States (HPUS) as their official compendium.  The HPUS is also recognized in the Controlled Substances Act (21 U.S.C. § 802).  Approximately 98% of homeopathic medicines are classified as non-prescription drugs.  Our members are duly licensed to prescribe medicines contained in the USP and HPUS, in accordance with our respective DEA licenses.

Currently, there are three homeopathic colleges in the U.S. In addition, other health profession colleges teach courses in homeopathy. No state issues licenses for homeopathic doctors.   There are medical boards that issue board-certified specialty certificates upon completion of a board exam. For example, the American Board of Homeotherapeutics issues Diplomates Specialty Certification to licensed medical and osteopathic doctors. Passing the board exams grants the specialty status of D.Ht.

Osteopathy

Osteopathy is a system of medicine that is based on the holistic theory that diseases and maladies are caused by the loss of structural integrity of the body.  Normal body integrity can be restored by manipulation of body parts and by additional therapeutic measures such as surgery and the use of prescription drugs. 

According to the American Osteopathic Association:

Doctors of Osteopathic Medicine (DOs) are fully licensed physicians who practice in every medical specialty. They provide a full range of services, from prescribing drugs to performing surgery, and they use the latest medical tools. But DOs offer something special—their unique approach to patient care. Osteopathic physicians are trained to:

• Teach patients how to prevent illness and injury by maintaining a healthy lifestyle.
• Look at the whole person to reach a diagnosis without focusing just on symptoms.
• Help the body to heal itself.
• Believe that all parts of the body work together and influence one another. DOs are specially trained in the nervous system and the musculoskeletal system (muscles and bones).
• Perform osteopathic manipulative treatment (OMT), a hands-on approach to diagnosing, treating, and preventing illness or injury.

In the U.S., there are 34 accredited osteopathic colleges in 32 states. Collegiate candidates must fulfill premed school requirements and take the MCAT exam.  Students get basically the same medical education as traditional doctors, with emphasis on the holistic approach and about 200 class hours of OMT training. Graduates leave school with a Doctorate of Osteopathic medicine degree or DO. DOs can continue their medical education by participation in medical residency programs. Doctors of Osteopathy are licensed in all 50 states. They have been given full prescriptive authority and can legally perform major surgeries.  

Integrated Medical Practice

The NIH states: There are many definitions of “integrative” health care, but all involve bringing conventional and complementary approaches together in a coordinated way. The use of integrative approaches to health and wellness has grown within care settings across the United States. Researchers are currently exploring the potential benefits of integrative health in a variety of situations, including pain management for military personnel and veterans, relief of symptoms in cancer patients and survivors, and programs to promote healthy behaviors.

Integration of mainstream medicine and alternative medicine can be seen in regular doctors, pharmacists, and nurses getting specialty degrees and certificates in alternative medicine. Also, clinics and hospitals are hiring licensed alternative medical staff. 

Adult Foster Care and Alternative Medicine

There are many licensed and unlicensed alternative medical practitioners in the U.S. today. Popular culture and the internet have made it easier for patients to seek out different medical options. Of course your residents have the right to choose any legal medical treatment that they want.  But what does that mean to you, the caregiver? As a licensed medical professional, you have some government mandated responsibilities to consider:  1) Follow medical orders; 2) Refer choosing which therapies to use to the doctor; 3) Monitor the health of your resident.  

If one of your residents is choosing to participate in alternative medical therapies, you have a legal duty to notify the resident’s primary medical doctor. If the primary medical doctor approves of the alternative therapy, or if the therapist is licensed by the state you live in, you now have to manage that alternative therapy. Herbal and Homeopathic supplements will have to be charted in the MARs and PRN logs. Dietary orders will have to be followed. Herbal supplements and Homeopathic remedies will not come with med info sheets from the pharmacy. You have to ask if there are any concerns to monitor for. You can ask the doctor, pharmacist, or licensed therapist. If the therapist is not licensed, it would be wise to confirm what is said with someone who is licensed.  One more final thing to understand about this subject is: if you do not report the alternative therapy to the doctor, in essence, you are approving the therapy instead of the doctor, which will only get you in trouble.

Conclusion

An increasing number of residents in adult foster care homes are choosing health care approaches developed outside of mainstream Western or conventional medicine. In addition, more and more medical professionals are integrating holistic medicine into their practices. Caregivers in adult family, mental health, and developmentally disabled homes are being required to manage these therapies.  That means asking question and researching until they are comfortable with their understanding. Be careful to notify the doctor and verify all claims with licensed professionals.

As always,

Good Luck with your caregiving efforts!

Mark Parkinson BS Pharm

 

References:

Definition of Naturopathic Medicine. The American Association of Naturopathic Physicians. http://www.naturopathic.org/content.asp?contentid=59

About Naturopathic Medicine. Bastyr University. http://bastyr.edu/academics/naturopathic-medicine/about-naturopathic-medicine

Greg Martin. Family Physicians versus Naturopaths. American Academy of Family Physicians .https://www.aafp.org/dam/AAFP/documents/advocacy/workforce/gme/ES-FPvsNaturopaths-110810.pdf

Russel Faust MD. Alternative Medicine Labels: Homeopathy, Naturopathy, Osteopathy, Chiropractic, Ayurveda. …Ask the Boogordoctor. http://www.boogordoctor.com/definitions-homeopathy-naturopathy-osteopathy-chiropractic-ayurveda/

What’s The Difference Between Osteopathic And Homeopathic Medicine?. Home Remedy Network. http://home-remedy-network.com/alternative-medicine/whats-the-difference-between-osteopathic-and-homeopathic-medicine

Naturopathic Diet

Cathleen Calkins. Naturopathic Diet. Livestrong.com. Oct. 3,2017.https://www.livestrong.com/article/130374-naturopathic-diet/

Lora Bennett. MD. Alternative vs Traditional Medicine Providers. Advance Family Health PPLC.  http://advancedfamilyhealth.org/alternative-vs-traditional-medicine-providers/

Complementary, Alternative, or Integrative Health: What’s In a Name?. U.S. Department of Health & Human Services, National Institutes of Health,https://nccih.nih.gov/health/integrative-health

The American Institute of Homeopathy. http://homeopathyusa.org/

Currently Accredited Homeopathic Schools . Accreditation Commission of Homeopathic Education in North America.  http://www.achena.org/Schools.htm

Osteopathic medicine in the United States. Wikipedia. https://en.wikipedia.org/wiki/Osteopathic_medicine_in_the_United_States

 

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