Offer complementary medicine to draw Boomers
Looking for care that examines all the options
(Editor's note: This article is the second in a series about the impact of the aging Baby Boom generation on health care.)
Baby Boomers are not only dissatisfied with waiting times and amenities, but they also want more access to and information about alternative, or complementary care, according to a recent Press, Ganey report, The Boomer Generation and Health Care.
To remain competitive, health care systems of the future will need to address traditional patient satisfaction issues as well as offer a delivery system that addresses the mind and spirit as well as the body, says Bruce Clark, DrPH, senior vice president of Age Wave Health Services.
For example, in 1990, Americans' out-of-pocket expenses for alternative therapies came to more than $10 billion annually - only $5 billion less than that spent for traditional hospital care, according to a study in the New England Journal of Medicine. The study also reported Americans made 425 million visits to alternative care providers in 1990, 37 million more visits than were made to conventional primary care physicians.
"This was a wake-up call for traditional medicine," says Clark. (See list of hospitals conducting research for National Institutes of Health Office of Alternative Medicine on p. 70.)
Yet boomers are demanding more than the referral to a chiropractor or prescription for massage therapy. They want the best of both worlds, explains Christina Stemmler, MD, medical director for the Center for Integrated Medicine, a Houston practice offering a combination of Western and Chinese medicine.
"Many of this generation are very sophisticated and well-educated. They have read widely and searched the Internet, so they know what is available. Yet in their journey through the medical system, they have been thoroughly disappointed," she explains.
While boomers appreciate conventional or allopathic medicine's ability to deal with trauma and bacterial infections, they remain frustrated with its inability to help with disorders such asthma, chronic pain, and autoimmune diseases.
"I see many patients who have already run the gamut seeking help but not finding it, especially for chronic fatigue syndrome, fibromyalgia, PMS, menstrual irregularities, hepatitis B, genital herpes, shingles, and irritable bowel syndrome," she notes.
Next on the dissatisfaction list is conventional health care's paternalistic - and now rushed - nature, adds Stemmler. "[Patients] resent being herded in and out of the office quickly. And they don't want a system in which everyone gets the same treatment for similar symptoms, where care is not customized, where the uniqueness of a patient and his or her condition is not understood or even considered," she points out.
Baby Boomers are also frustrated with conventional medicine because of what she classifies as a propensity to treat the symptoms of disease, rather than the cause.
"I hear again and again concerns from patients whose symptoms of pain or inability to sleep were addressed with medication, but the root cause of these symptoms went undetected," Stemmler says.
Treating mind and body
And patients are downright furious about a reductionist mentality that sees the body as a series of parts, ignoring the mind and spirit.
"A doctor who is concerned only with objective symptoms and signs can only talk about physiology, CAT scans, and lab results. These are important points about the patient, but they are not the patient," says Mitchell L. Gaynor, MD, director of medical oncology at Strang-Cornell Cancer Prevention Center. "Despite my traditional training, it became evident to me as far back as my internship that modern medicine ignored two critically important facets of good health: nutrition and attention to the mind-body connection.
Gaynor, author of Healing Essence: A Cancer Doctor's Practical Program for Hope and Recovery says he is seeing the split between mainstream and holistic medicine lessen.
For example, vitamin levels of Strang's cancer patients are routinely monitored to determine how much supplementation is needed.
"By incorporating the best of science, mind-body healing, and nutrition, we can truly focus on the patient, and not just the disease," he says.
David Edelberg, MD, agrees. "Health and disease are a function of physical, emotional, and spiritual factors," says the founder of American WholeHealth, the nation's only multi-unit operator of outpatient health facilities that blend conventional medical techniques. "The best health care draws on the broadest range of tools in addressing all the factors that play a role in influencing health."
Edelberg also believes humans have an inherent ability to assist in their own healing and that many non-Western healing traditions are based on the idea of "unleashing and the body's own self-healing abilities," he says.
"A health care center that honors a patient's own value system and right to self-determination will be more effective in engaging the patient in his or her own healing process," he says.
American WholeHealth differs from most holistic centers in the United States today, in that it is not a loose affiliation of alternative practitioners.
"We are a tightly integrated multispeciality group of physicians and practitioners practicing together under one roof, all under the supervision of conventionally trained physicians experienced in integrative medicine," he says.
The physician, he explains, is a "gate-opener," a specialist in medical diagnosis with an understanding of an access to a full range of therapeutic possibilities. "As a result, he or she is able to work with others on the multidisciplinary team to identify best treatment choices, including chiropractic, acupuncture, massage therapy, nutritional counseling, herbal pharmacology, and clinical counseling," he says.
American WholeHealth physicians use the "biography before biology" approach when developing customized "healing path" for each patient. "We spend about three times longer with a patient than conventional practitioners taking a medical history because we believe that many chronic conditions are rooted in a patient's personal biography and are more effectively treated by addressing root causes rather than symptoms alone," Edelberg explains.
Information, please
Physicians and providers who offer integrated care must also be prepared to dispense massive amounts of information on the various healing modalities as well as the health and disease process itself.
"This is a generation that was raised on self-help books, so they expect lots of material as well as referrals to other sources of information," stresses Clark, who directs The Alliance for Healthy Aging.
One of the most effective services for aging Baby Boomers would be for health care providers to develop and distribute guides to credible web sites for health information, he adds.
Stemmler provides a wealth of similar information in her waiting rooms. "We not only give patients packets of information on acupuncture, herbs, and movement when they come for a visit, but we are constantly faxing and mailing them new information as we come across it ourselves she explains. "My goal is to disseminate as much information as possible."
Some health care systems, such as Beth Israel in Boston, are developing their own alternative medicine programs. Medical staff are working to blend these two worlds, but those who have begun work on these projects admit there are challenges in what their medical staffs are willing to accept. If your facility plans to offer alternative therapies or information about such therapies, medical staff must be involved up front, perhaps even finding a champion among the doctors on staff to ease the way. But remember that your physicians are facing the same pressures from patients as your health care system. They, too, are getting the questions and the concerns about alternative therapies. You might find them more receptive than you would think.
Stemmler often develops customized reading lists for her patients, she adds.
The objective is to teach them to make better and safer decisions regarding health, to help them learn about truths, myths and options that are out there," she explains. "Baby Boomers want to know how to analyze and interpret information from health care professionals. They want to be put back in charge as the leader of their own health care."
[Editor's note: To obtain a copy of the Press, Ganey report, The Boomer Generation and Health Care, call (800) 232-8032. Web site: http://www.pressganey.com.]
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