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Chronicles of Health Creation: RAND Report Begs New Look at Integrative Medicine and Health Professionals in the Triple Aim Era

By |November 20, 2015|Complementary and Alternative Medicine|

Excerpted from Huffington Post
John Weeks

A recent report from the RAND Corporation describes how regular medicine reduced complementary and alternative medicine professionals to “thing” status — as “modalities” — in the first years of the integrative medicine era.

The title of the report is “Complementary and Alternative Medicine: Professions or Modalities?” The discussions among policy makers, practitioners and delivery system leaders synthesized in the 75-page document beg a more significant question: Does the emergence of values-based medicine urge a major re-think regarding the potential contributions of these professionals?

The case statement by RAND’s Patricia Herman, ND, PhD and Ian Coulter, PhD begins with a blunt irony. “One of the hallmarks of complementary and alternative medicine (CAM) is treatment of the whole person.” Yet in the fee-for-service procedure and production orientation of the medical industry, licensed practitioners of chiropractic, acupuncture and Oriental medicine, and naturopathic medicine were typically stripped of this core value — treating the whole person — before being put to any use.

Regular medicine’s dominant influence when “CAM” integration by medical delivery organizations began in the mid-1990s was the industrial value of service production. Mayo Clinic’s director of innovation captures this concisely when he recently spoke of medicine’s historic focus on “producing” services rather than on “creating health.”

In such an industrial setting, a chiropractor became a thing to be use sparingly. Chiropractor = spinal manipulation for low back pain.

A precedent for this boiling down of a chiropractor’s potential value in human health to thing status was set for chiropractors decades earlier in Medicare. In that even more intransigent fee-for-service era, only adjustment of the spine for low back pain made the grade. Unremunerated was the time that a chiropractor spends in evaluation and management. Most of the chiropractic professional’s education and practice rights were dumped overboard. No value was placed on a chiropractor’s counseling of patients on diet, lifestyle, dietary supplements, or ergonomics, for instance.

Getting into Medicare at all back then was a victory for the field. But a consequence of this limited economic relationship was the rack ’em and crack ’em – as fast as possible method of treatment. Produce!

 

Chiropractic and Complementary and Alternative Medicine

By |October 25, 2015|Chiropractic Care, Complementary and Alternative Medicine|

Chiropractic and CAM Utilization: A Descriptive Review

The Chiro.Org Blog


Chiropractic & Osteopathy 2007 (Jan 22);   15:   2 ~ FULL TEXT

Dana J Lawrence and William C Meeker

Research Department,
Palmer College of Chiropractic,
1000 Brady Street,
Davenport, IA 52803, USA.
dana.lawrence@palmer.edu


OBJECTIVE:   To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions

DATA SOURCES:   A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations.

DATA SELECTION:   A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions.

DATA SYNTHESIS:   Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form.

RESULTS:   Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker’s compensation papers.

CONCLUSION:   Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.


From the FULL TEXT Article:

Background

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Coenzyme Q10: A Building Block of Healthy Aging

By |June 27, 2013|Complementary and Alternative Medicine, Health Promotion, Nutrition|

Coenzyme Q10: A Building Block of Healthy Aging

The Chiro.Org Blog


SOURCE:   Dynamic Chiropractic

By Holly Lucille, ND, RN


Supporting biologic activity as we age with ubiquinol, the active form of CoQ10.

Coenzyme Q10 has gained enormous attention in recent years, and with good reason — it’s the Energizer Bunny of the cellular world.

This essential quinine molecule is found in the mitochondria of every single cell in the body, where it plays a key role in energy production. CoQ10 not only assists in the production of adenosine triphosphate (ATP), but also scavenges free radicals. [1]   To carry out these critical tasks, mitochondrial CoQ10 continuously cycles from ubiquinone, its ATP production state, to ubiquinol, its reduced active state. [2]

More than 4,000 published studies suggest that high CoQ10 levels are essential for optimal health — and this is especially true for the heart and brain. Since both of these organs require huge amounts of energy, supplementation can often help support their high biologic activity. [2, 3]   Research shows that CoQ10 supplementation can improve energy production and extend cell life by enhancing cellular mitochondrial levels of CoQ10. In turn, this supports not only the heart and brain, but also periodontal, skin, reproductive, and immune health. [4-9]   However, before you advise patients to add CoQ10 to their daily routine, be aware that there’s a catch to taking this multitalented nutrient in supplemental form.

CoQ10’s Critical Conversion

Creating ATP inside the mitochondria is quite complicated and involves a series of biochemical reactions. Since the body cannot store ATP, this multi-step process — known as the electron transport chain — ensures that this critical energy source is continually replaced. [1, 10]   Here’s how it works: Ubiquinone contributes to ATP production by passing electrons from one enzyme complex to another, much like a bucket brigade. [3]   During this process, ubiquinone is converted to its reduced active state, ubiquinol.

Surprisingly, our mitochondria are the most important cellular source of free radicals. [11]   While most of the oxygen radicals generated by the mitochondria stay with its membrane folds, about 2 percent “escape” and create toxins that can threaten the health and survival of the entire cell. [11-13]   Ubiquinol is able to neutralize these free radicals, both within the mitochondria and the cell membrane itself. [14]

There are many more articles like this @ our:

Coenzyme – Q10 (Co–Q10) Page

which is just one page from our

Nutrition Section

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The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

By |November 17, 2012|Chiropractic Care, Complementary and Alternative Medicine, Cost-Effectiveness|

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

The Chiro.Org Blog


SOURCE: Med Care. 2012 (Dec); 50 (12): 1029–1036

The Geisel School of Medicine at Dartmouth & Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, NH


BACKGROUND:   Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES:   To estimate the total and spine-specific medical expenditures among CAM and non-CAM users
with spine problems.

RESEARCH DESIGN:   Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS:   Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES:   Survey-weighted generalized linear regression and propensity matching to examine penditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS:   A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. (more…)

The Use of Botanicals During Pregnancy and Lactation

By |June 10, 2012|Complementary and Alternative Medicine, Supplementation|

The Use of Botanicals During Pregnancy and Lactation

The Chiro.Org Blog


SOURCE: Alt Ther in Health and Med 2009 (Jan); 15 (1): 54-58 ~ FULL TEXT

Tieraona Low Dog, MD

Arizona Center for Integrative Medicine,
University of Arizona Health Sciences Center, Tucson


Women are the largest consumers of healthcare, and this extends to their utilization of complementary and alternative medicine (CAM). Researchers have attempted to uncover the reasons why women turn to CAM in general and to botanical medicine in particular. Desire to have personal control over their health has been cited as the strongest motive for women to use herbal medicine. Second was dissatisfaction with conventional treatment and its disregard for a holistic approach, as well as concerns about the side effects of medications. [1]

These concerns may explain, in part, the fact that many women use herbal remedies during pregnancy. A survey of 578 pregnant women in the eastern United States reported that 45% of respondents had used herbal medicines, [2] and a survey of 588 women in Australia revealed that 36% had used at least 1 herbal product during pregnancy. [2] Women probably feel comfortable using herbal remedies because of their perceived safety, easy access, and the widespread availability of information about them (ie, Internet, magazines, books).

While it is true that many botanicals are mild in both treatment effects and side effects, the data regarding safety during pregnancy are very limited. Given the small sample sizes in clinical trials studying botanicals in pregnant women, only large differences in measures of pregnancy outcomes would likely be detected. For example, if an herb were thought to increase the rate of spontaneous abortion from 6% to 7%, a sample size of more than 19,000 women would be needed (to actually demonstrate that effect). It is highly unlikely that there will be any studies of a botanical (or any drug for that matter) with this large a sample size. (more…)