CHAPTER 27 COMPLEMENTARY AND ALTERNATIVE CAREERS Allopathic Biofeedback Chiropractic Holistic Homeopathic Hydrotherapy Megavitamin Subluxation Journal question: What personal characteristics might make a person a candidate for a career in an alternative or complementary therapy?

Chapter 27 Learning Objectives Define at least eight terms relating to careers in complementary and alternative medicine (CAM). Specify the role of selected complementary and alternative care providers, including personal qualities, levels of education, and credentialing requirements.

Chapter 27 Learning Objectives Describe the methods used in allopathic, holistic, and homeopathic health care. List five domains of complementary and alternative health care as described by the National Institutes of Health.

Careers Therapies are based on wellness and natural treatment. Complementary medicine Alternative medicine Holistic health Complementary health care is used simultaneously with conventional medicine. Alternative health care is used in place of conventional medicine. Nonvitamin, nonmineral, and natural products are the most frequently used complementary and alternative (CAM) therapy. Deep breathing, meditation, massage and yoga practices have increased significantly.

Conditions That Draw Consumers to Complementary Medicine Chronic pain Arthritis Addiction Headache Anxiety Chronic fatigue Sprains Muscle strains

Five Domains of CAM Practices The National Institute of Health (NIH) organizes CAM practices into five domains: Whole medical systems Mind-body interventions Biologically based treatments Manipulative and body-based methods Energy therapies

Complementary and Alternative Methods

Five Domains of CAM Practices Many health care workers specializing in CAM have other health career backgrounds. Holistic practitioners Nurses Physicians Veterinarians Pharmacists Chiropractor and naturopath professions have specific educational requirements.

Chiropractor or Doctor of Chiropractic (DC) Treats health problems associated with muscular, skeletal, and nervous systems Uses holistic approach to treatment, which is drugless and nonsurgical Adjusts spinal column to correct subluxations Education Minimum of 2 years of college 4- to 5-year chiropractic program Licensure by state required Certification (diplomate) for specialties When appropriate, the chiropractor may refer a patient to an allopathic practitioner.

CAM Careers: Educational Cost and Earnings

Areas of Diplomate Certification for Chiropractors

Naturopathic Doctor (ND) Naturopathic doctors (NDs) are primary care physicians who focus on treatment of the whole person with emphasis on wellness and disease prevention. An ND does not use synthetic medicine or perform major surgery. Education 4 years of graduate medical school Receive a degree of doctor of naturopathy In addition to the standard medical curriculum, naturopathic doctors study nutrition, homeopathy, botanical medicine, and hydrotherapy.

Other CAM Practitioners Massage therapist Works with manipulation of muscle, skin, tendon, and ligaments Applies light, water, or vibration devices Education Varies from state to state 13 states require licensure Forms of massage include Swedish, polarity, sports, infant, facial, and scalp.

Other CAM Practitioners Hypnotherapist Uses hypnosis to help clients overcome bad habits and treat emotional problems Licensure is not required, but a permit to practice may be required. Many hypnotherapists are licensed in related fields: Medicine Nursing Psychology Methods of hypnosis vary greatly from one practitioner to another.

Other CAM Practitioners Acupuncturist Inserts needles into peripheral or surface nerves to Control pain Relieve symptoms Modify psychosomatic disorders Training or education varies greatly. May include 2 to 3 years of study after completion of a minimum of 2 years of college Usually hold credentials in another health care field Trained in the application of needles Acupuncture has been in use for 5000 years. It originated with the Chinese.

Acupuncture FIGURE 27-3 Acupuncture has been in use for 5000 years. (From Bonewit-West: Today’s medical assistant, ed 1, Philadelphia, 2009, Saunders.)

Other CAM Practitioners Biofeedback practitioners Teach patients to use conscious control to change normally involuntary reactions of the body Education Certification through the Biofeedback Certification Institute of America (BCIA) Requires applicant to be licensed or working under a licensed health care practitioner Biofeedback practitioners may practice other areas of health care, such as nursing or medicine.

Applications for Biofeedback

Whole Medical Systems Whole medical systems Acupuncture Herbal medicine Oriental massage Other systems developed by Native Americans, Africans, and Central and South Americans Many developed before the conventional biomedical approach and are still practiced by cultures throughout the world Ask the students if they or family members have used whole medical systems and discuss.

Mind-Body Interventions Mind-body interventions are designed to help the mind treat the body. They are not recognized by the National Institutes of Health (NIH) to be complementary and alternative medicine. Discuss why mind-body interventions are not recognized to be complementary and alternative medicine by the NIH.

Biologically Based Therapies Biologically based therapies that are considered to be CAM overlap with conventional medicine. Involve special dietary supplements or programs Herbal therapy (use of plants) Special diets Atkins diet Pritikin diet Weil diet Orthomolecular therapy: uses chemicals and vitamins Biologic therapies use laetrile and shark cartilage to treat cancer. Bee pollen is used as biologic therapy for treating autoimmune and inflammatory diseases.

Energy Therapy Energy therapy is divided into two groups: Bioelectromagnetic-based therapies Use energy fields that come from an external force Use pulse fields, magnets, and alternating or direct electrical current devices Biofield therapies Come from the body (biofields) Involve pressure and manipulation of the body Include Qi gong, Reiki, and therapeutic touch External sources of therapy include pulsed fields, magnets, and alternating or direct electrical current devices.

Reiki Reiki is based on the idea that there is a universal source of energy that allows the body to heal. Can be received from someone else or as a form of self-care Education Three degrees (or levels) of training Training and certification is not regulated Reiki originated in Japan.

Performance Instruction Biofeedback techniques are designed to change Blood pressure Muscle tension Heart rate Other body functions that are not normally under voluntary control

Performance Instruction Biofeedback techniques Electromyography to measure muscle tension Galvanic skin response (GR) to monitor sweat production Skin temperature sensors Electroencephalography (EEG) to measure brain activity Stress dots Measures the change in temperature of skin Made of liquid crystal When using stress dots, the temperature of the hand becomes warmer, indicating a more relaxed state.

Relaxation Response

Biodot Color Chart FIGURE 27-4 The Biodot color chart shows how temperature corresponds with relaxation.

Summary Many complementary and alternative care providers have education, credentials, and characteristics of other health professions. Chiropractors manipulate the spine. Naturopathic physicians are doctors who focus on treatment of the whole patient.

Summary Allopathic health care is treatment designed to produce effects that are different from a disease. Holistic health care is treatment of the whole person. Homeopathic health care uses treatments designed to produce effects similar to those caused by a disease.

Summary The five domains of complementary and alternative health care Alternative medical systems Mind-body intervention Biologically based therapy Manipulative and body-based methods Energy therapies

Review Therapies based on wellness and natural treatment are all of the following except: a. Alternative medicine b. Holistic medicine c. Complementary medicine d. Allopathic medicine e. Megavitamin therapy

Review Therapies based on wellness and natural treatment are all of the following except: a. Alternative medicine b. Holistic medicine c. Complementary medicine d. Allopathic medicine e. Megavitamin therapy

Review The term chiropractic medicine pertains to: a. The adjustment of the spine by hand b. Treatment with water c. The nerves and muscles d. Treatment with a similar disease e. Treatment with odors

Review The term chiropractic medicine pertains to: a. The adjustment of the spine by hand b. Treatment with water c. The nerves and muscles d. Treatment with a similar disease e. Treatment with odors