© 2012 McGraw-Hill Companies. All Rights Reserved. C ONVENTIONAL AND C OMPLEMENTARY MEDICINE Chapter 20

© 2012 McGraw-Hill Companies. All Rights Reserved. S ELF -C ARE Self-assessment Symptoms are often an expression of the body’s attempt to heal itself Carefully observing symptoms lets you identify those signals that suggest you need professional assistance Body’s vital sign Temperature Heart rate Medical self-tests Blood pressure Blood sugar Pregnancy detection Urinary tract infections 2

© 2012 McGraw-Hill Companies. All Rights Reserved. KNOW WHEN TO SEE A PHYSICIAN See a physician for symptoms that you would describe as: 1. Severe 2. Unusual 3. Persistent 4. Recurrent Emergencies include the following: 1. Major trauma 2. Uncontrollable bleeding 3. Intolerable or uncontrollable pain 4. Severe shortness of breath 5. Persistent abdominal pain 6. Poisoning or drug overdose 7. Loss of consciousness or seizure 8. Unexplained stupor, drowsiness, or disorientation 9. Severe or worsening reaction to an insect bite or sting or to a medication, especially if breathing is difficult 3

© 2012 McGraw-Hill Companies. All Rights Reserved. S ELF - TREATMENT Watchful waiting Nondrug options Self-medication Over-the-counter (OTC) drugs Simple guidelines to self-medicate safely: 1. Always read labels 2. Do not exceed the recommended dosage or length of treatment 3. Use caution if you are taking other medications 4. Try to select medications with one active ingredient 5. Try to buy generic drugs 6. Never take or give a drug from an unlabeled container 7. If pregnant or nursing, consult health care provider first 8. Check expiration date 9. Store your medications in a cool, dry place 10. Use caution with aspirin 1. Reye’s syndrome - children 4

© 2012 McGraw-Hill Companies. All Rights Reserved. F IGURE 20.1 R EADING AND UNDERSTANDING OTC DRUG LABELS 5

© 2012 McGraw-Hill Companies. All Rights Reserved. F IGURE 20.2 Y OUR HOME MEDICAL CARE KIT 6

© 2012 McGraw-Hill Companies. All Rights Reserved. P ROFESSIONAL CARE System of broad network of professionals and organizations, including: Independent practitioners Health care providers Hospitals Clinics Public and private insurance programs Complementary and alternative medicine (CAM) Most commonly used CAM therapies: Acupuncture Chiropractic Relaxation techniques Herbal medicine Massage Meditation Yoga Integrative medicine Conventional health care with the addition of unconventional modalities 7

© 2012 McGraw-Hill Companies. All Rights Reserved. C ONVENTIONAL MEDICINE Premises and assumptions of Conventional Medicine Western medicine is based on the belief that disease is caused by identifiable physical factors Identifies: Pathogens Bacteria or viruses Genetic factors Unhealthy lifestyles Based on scientific method of obtaining knowledge Empirical Rational Testable Parsimonious General Rigorously evaluated Tentative 8

© 2012 McGraw-Hill Companies. All Rights Reserved. T HE PROVIDERS OF CONVENTIONAL MEDICINE Medical doctor (MD) Doctor of osteopathic medicine (DO) Podiatrist Optometrist Dentist Allied health care providers: Registered nurse (RN) Licensed vocational nurse (LVN) Licensed practical nurse (LPN) Physical therapist (PT) Licensed social worker (LSW) Registered dietitian (RD) Physician assistant (PA) Nurse practitioner Certified nurse midwife 9

© 2012 McGraw-Hill Companies. All Rights Reserved. C HOOSING A PRIMARY CARE PHYSICIAN Begin making a list of possible choices Check insurance limits Ask for recommendations Family, friends, coworkers, local medical societies, physician referral service Once you have a list of physicians, call their office and find out some information Is the physician covered by your insurance plan? What are the office hours? Which hospitals does the physician use? How many other physicians are available to cover? How long does it usually take to get an appointment? Does the office send reminders for preventive check-ups? Does the physician give advice over the phone? 10

© 2012 McGraw-Hill Companies. All Rights Reserved. G ETTING THE MOST OUR OF YOUR MEDICAL CARE The physician-patient partnership Your physician appointments The diagnostic process Physical exams Diagnostic testing X-rays Biopsies Blood and urine tests Scans Endoscopies Medical and surgical treatments Prescription medications Medication errors Off-label drug use Online pharmacies Costs Surgery Elective surgeries 11

© 2012 McGraw-Hill Companies. All Rights Reserved. F IGURE 20.3 READING AND UNDERSTANDING PRESCRIPTION MEDICATION LABELS 12

© 2012 McGraw-Hill Companies. All Rights Reserved. C OMPLEMENTARY AND ALTERNATIVE MEDICINE CAM tends to focus on an integration of mind, body, and spirit in seeking ways to restore the whole person to harmony Integration = holistic health care, considering the whole person Alternative medical systems Traditional Chinese medicine (TCM) Harmonious flow of qi produces health Acupuncture and herbal remedies QI is believed to flow through the body along several meridians (pathways) Homeopathy Naturopathy 13

© 2012 McGraw-Hill Companies. All Rights Reserved. F IGURE 20.4 T HE C ATEGORIES OF CAM PRACTICES 14

© 2012 McGraw-Hill Companies. All Rights Reserved. M IND - BODY INTERVENTIONS Interventions make use of the integral connection between mind and body Meditation Yoga Visualization Taijiquan Biofeedback Placebo effect Hypnotherapy 15

© 2012 McGraw-Hill Companies. All Rights Reserved. N ATURAL P RODUCTS Also known as biologically based therapies Include substances derived from plant or animal sources Consist primarily of herbal therapies or remedies, botanicals, and extracts from animal tissues Pharmacopoeia Drug-herb interactions 16

© 2012 McGraw-Hill Companies. All Rights Reserved. T ABLE 20.2 C OMMONLY U SED H ERBALS 17

© 2012 McGraw-Hill Companies. All Rights Reserved. M ANIPULATIVE AND BODY - BASED METHODS Based on manipulating or moving one or more body parts Touch and body manipulation are long-standing forms of health care Manual healing is based on the idea that misalignment or dysfunction in one part of the body causes pain or dysfunction in another part Chiropractic medicine 18

© 2012 McGraw-Hill Companies. All Rights Reserved. E XERCISE Exercise for health maintenance, promotion, and disease preventions fits the definition of CAM 65% of Americans would be more interested in exercising if advised to do so by their physicians New program “Exercise Is Medicine” encourages physicians to record a patient’s exercise level as a regular vital sign 19

© 2012 McGraw-Hill Companies. All Rights Reserved. O THER CAM P RACTICES CAM practices also include Movement therapies  Use movement to promote well-being (Feldenkreis method, Alexander technique, Pilates) Traditional healing practices  Based on indigenous theories handed down from generation to generation (Native American medicine man, shaman) Energy therapies 20

© 2012 McGraw-Hill Companies. All Rights Reserved. E NERGY T HERAPIES Forms of treatment that use energy originating either within the body (biofields) or from other sources (bioelectromagnetic fields) Qigong Therapeutic touch Reiki Bioelectromagnetic-based therapies 21

© 2012 McGraw-Hill Companies. All Rights Reserved. E VALUATING COMPLEMENTARY AND ALTERNATIVE THERAPIES Work with your physician Areas to discuss Safety Effectiveness Timing Cost Questions for the CAM practitioner Ask about education, training, licensing, certification Ask why he or she thinks the therapy will be beneficial Describe in detail any conventional treatments you are receiving Ask how long the therapy should continue Ask about the expected cost of the treatment Do your own research 22

© 2012 McGraw-Hill Companies. All Rights Reserved. P AYING FOR HEALTH CARE The current system Combination of private and public insurance plans, patient out-of-pocket payments, and government assistance Health insurance Traditional fee-for-service (indemnity) plans Managed-care plans Health maintenance organizations (HMO) Preferred provider organizations (PPO) Point-of-service (POS) plans Governmental programs Medicare Medicaid Health care reform Affordable Care Act, March

© 2012 McGraw-Hill Companies. All Rights Reserved. C ONVENTIONAL AND C OMPLEMENTARY MEDICINE Chapter 20 24