Alternative Medicine As the Original Disruptor of Healthcare: Recognizing Self-Care Advocates as Collaborators Instead of Disruptors to Improve Individual Health Outcomes
Recently, Amazon, Berkshire Hathaway and JPMorgan announced they are launching a joint initiative to reduce health care costs in the US. This is significant. Because of the scale of resources they can throw at the problem, their intention to disrupt healthcare should be taken seriously. But, of course, healthcare is already being disrupted, with numerous smaller scale initiatives working to improve the system. This drive towards healthcare innovation extends to the community of self-care advocates. These are the people my naturopathic colleagues and I call our patients. As a naturopathic doctor and holistic public health professional with 20 years experience, I know this community well.
Making use of low tech and natural solutions, alternative medicine (AM) is an obvious disruptor. Unlike the expensive hospital and insurance system, it has no centralized hierarchy to interfere with direct patient provision. Alternative medicine operates as a decentralized system. It is largely self-organizing and powered by practitioners and patient self-advocates. These are tendencies that have been greatly enhanced by the internet, with patients seeking AM care independent of their conventional physician. Critics of AM fault it for prioritizing benevolence over evidence, and lacking the infrastructure needed to make it robust. Regardless, it continues to thrive, and functions largely outside the well-funded centralized system known as healthcare.
Professions and practices of AM are wide-ranging and regulated depending on jurisdiction. Specializations include: naturopathic doctors, doctors of chiropractic, licensed social workers, licensed acupuncturists, physical therapists, registered midwives, nurse practitioners, doctors of osteopathy, nutritionists, massage therapists, homeopaths, yoga therapists, health coaches, hypnotherapists, reiki practitioners, sound healers, flower essence therapists, kinesiologists, spiritual healers, and the list goes on.
In 2010-2011, I participated in a study on the role alternative medical practitioners play in the treatment of rural populations. For over 30 years, traditional/indigenous medicine has been officially recognized to assist with and ameliorate the health of citizens in the rural areas of developing WHO member nations. It is only recently, however, that the role of traditional, complementary and alternative medicine in developed or Western countries has been recognized as significant for rural patient care. The peer-reviewed paper I worked on studied this phenomenon in Canada.
Conventional medicine has developed into a system-centered and protocol-driven approach that alienates many people who can’t or won’t situate themselves within its paradigm. Alternative practices often fill this gap. My research concurred with the findings of other global studies: AM providers play a significant role, due to their safety and efficacy, proximity and access, as well as for the sheer preference shown for these alternatives among rural populations [2,3,4].
Rural women in particular highlight using AM services when they are in poor subjective health and find their needs are unmet . Williams et al found that nearly 20 percent of rural residents consulted with a naturopath or homeopath, with a surprising growth in the use of homeopathic and naturopathic remedies rising from 19.6 percent in urban to 26.6 percent in rural areas . Reasons why rural Canadians would consult a AM provider mirror those reasons offered by Canadians generally, with 1.2 million Canadian adults reporting consulting with a AM provider in 2005 [5,6]. Despite the significant percentage of rural dwellers consulting alternative practitioners, the role of AM in rural care has not been well understood. For example, the relationship and potential interface or “integration” between AM providers, patients and medical providers in rural areas is little known, as are the specific types of care TCAM providers give to patients in areas where conventional services have restricted availability . In Canada, and specifically in the rural/remote areas of Ontario, the roles that AM providers — such as, licensed naturopaths synonymous with naturopathic doctors (NDs) in our study, chiropractors or doctors of chiropractic (DC), midwives or registered midwives (RMs), and healers or traditional healers (THs) — may be playing in both patient and community care and how they connect to existing rural healthcare providers and care models is vastly under-researched.
When conducting our study, we concluded that the function of alternative medicine is not disruption, as historically viewed by the medical establishment, but collaboration for the benefit of the patient. The consumer who finds hybrid solutions to their healthcare needs provides an opportunity for AM to fill gaps in care. In some cases, if AM users feel comfortable with it, it can also help re-introduce them to the healthcare system. Rather than see it as a dangerous disruptor, the healthcare system, as a whole, needs to better recognize not only how healthcare benefits from AM but that this phenomenon is an opportunity for collaboration.
Other studies have shown, adopting the collaborative approach is beneficial for patients and mainstream practices alike. In failing to better integrate with their alternative/mainstream counterparts, healthcare professionals can’t properly recognize and serve the contemporary patient. Studies have found that the consumer of AM is largely female, of a higher socioeconomic status, and holds a Master’s degree or higher. Beyond this, the consumers of AM are a largely unquantified entity, and yet they are knowledgeable about their self-care options and need to be better understood, as well as respected.
An in-depth understanding of the current healthcare landscape informs the goals of Wellpath.me, the pre-seed startup I founded in late 2017. Wellpath.me is a user-centered community of self-care advocates. Our mission is to improve the health of alternative medicine users by incentivizing self-care and chronic disease reduction using technology.
Working with public health and humanitarian agencies, we aim to leverage blockchain technology to help communities unexploited by healthcare. Wellpath.me envisions building a platform that makes best use of the anonymity and security of the blockchain to help seekers and providers of alternative medicine improve health outcomes, at home.
Users of alternative medicine are currently a large decentralized community who, in many cases, access their choice of healthcare independently of the system. With use of the blockchain-based incentives, Wellpath.me sees a future where this disparate group of individuals can improve their health using value-based online and community interventions, while maintaining the onus of care on individual choice. We are in the process of building our first product, a free, downloadable app that allows users to better understand the nutritional detriments of their prescription and OTC medications. Initial interest has been strong. Wellpath.me sees in this response the potential to grow a much bigger community based on a shared demand for individual health needs to be better met. Based on an initial group of subscribers, we plan to do a pilot study about this initial product offering. This group of volunteers forms the seeds of a community that Wellpath.me wants to grow into a global network, based on their own preference for self-care and self-advocacy within a hybrid healthcare system.
1) Hollenberg D, Lytle M, Walji R, Cooley K. Addressing provider shortage in underserviced areas: The role of traditional, complementary and alternative medicine (TCAM) providers in Canadian rural healthcare. European Journal of Integrative Medicine. European Journal of Integrative Medicine 2013;5:15–26.
2) Wardle J, Lui CW, Adams J. Complementary and alternative medicine in rural communities: current research and future directions. Journal of Rural Health 2012;28(1):101–12.
3) Wardle J, Adams J, Lui CW. A qualitative study of naturopathy in rural practice: a focus upon naturopaths’ experiences and perceptions of rural patients and demands for their services. Complementary Therapies in Medicine 2010;12:17–27.
4) Moga MM, Mowery B, Geib R. Patients are more likely to use complementary medicine if it is locally available. Rural and Remote Health 2008;8:1020
5) Williams AM, Kitchen P, Eby J. Alternative health care consultations in Ontario, Canada: a geographic and socio-demographic analysis. BMC Complementary and Alternative Medicine 2011;11:47
6) Southcott C. Retiring in the hinterland. Halifax: Fernwood; 1993.
7) Adams J. Exploring the interface between complementary and alternative medicine (CAM) and rural general practice: a call for research. Health & Place 2004;10:285–7
8) Dodd S, Bulmer S, Murphy A. Consumer value in complementary and alternative medicine (CAM) health care services. Australasian Marketing Journal 2014;22(3)