Time To Talk about Complementary and Alternative Medicine
Friday, June 6, 2008
Time To Talk About CAM:
Health Care Providers and Patients Need To Ask and Tell
Provided by: NIH News
The National Center for Complementary and Alternative Medicine (NCCAM), part of the National Institutes of Health (NIH), has launched Time to Talk, an educational campaign to encourage patients—particularly those age 50 or older—and their health care providers to openly discuss the use of complementary and alternative medicine (CAM). CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine, such as herbal supplements, meditation, naturopathy, and acupuncture.
According to a national consumer survey conducted by NCCAM and AARP, almost two-thirds of people age 50 or older are using some form of CAM, yet less than one-third of these CAM users talk about it with their providers. The NCCAM/AARP survey revealed some reasons why this doctor-patient dialogue about CAM does not occur. The most common reasons survey respondents cited were
That the physician never asked
They did not know they should discuss CAM
There was not enough time during the office visit.
More than one-half of respondents who had talked about CAM with their physician said they (not their physician) initiated the CAM discussion. The telephone survey was administered to a nationally representative group of 1,559 people age 50 or older.
"In an era of genomics and personalized medicine, we need to remember that a key ingredient to good health care is the dialogue you, as a patient, have with your providers," said Elias A. Zerhouni, M.D., NIH Director. "And talking about what CAM therapies you use is an important part of that discussion. This is important for people of all ages."
The Time to Talk campaign is aimed at addressing the need for this dialogue to help ensure safe, coordinated care among all conventional and CAM therapies. Talking not only allows integrated care, it also minimizes risks of interactions with a patient's conventional treatments. When patients tell their providers about their CAM use, they can more effectively manage their health. When providers ask their patients about CAM use, they can ensure that they are fully informed and can help patients make wise health care decisions.
"As frequent users of CAM, people 50 and older need to understand the importance of discussing CAM use with their providers to ensure coordinated, safe care. Simply put, it's time to talk," said Josephine P. Briggs, M.D., NCCAM Director. "Giving your health care providers a full picture of what you do to manage your health helps you stay in control."
NCCAM's Time to Talk campaign encourages patients to tell their providers about CAM use and providers to ask about it by offering tools and resources—such as wallet cards, posters, and tip sheets—all of which are available for free on the NCCAM Web site or can be ordered from NCCAM's information Clearinghouse (1-888-644-6226). NCCAM is reaching out to professional associations and consumer organizations to help educate their members about the importance of this dialogue and the availability of NCCAM's campaign materials. As the Federal government's lead agency for scientific research on CAM, NCCAM is committed to educating both consumers and health care providers about the importance of discussing CAM and providing evidence-based information to help with health care decision making.
Patient Tips for Discussing CAM with Providers
When completing patient history forms, be sure to include all therapies and treatments you use. Make a list in advance.
Tell your health care providers about all therapies or treatments-including over-the-counter and prescription medicines, as well as herbal and dietary supplements.
Take control. Don't wait for your providers to ask about your CAM use.
If you are considering a new CAM therapy, ask your health care providers about its safety, effectiveness, and possible interactions with medicines (both prescription and over-the-counter).
Provider Tips for Discussing CAM with Patients
Include a question about CAM use on medical history forms.
Ask your patients to bring a list of all therapies they use, including prescription, over-the-counter, herbal therapies, and other CAM practices.
Have your medical staff initiate the conversation.
For more information on Time to Talk, to order or download materials, or to read the full NCCAM/AARP report on CAM use communication, please visit nccam.nih.gov/timetotalk/.
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The National Center for Complementary and Alternative Medicine's mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. For additional information, call NCCAM's Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov.
The National Institutes of Health (NIH)—The Nation's Medical Research Agency—includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
Also available at: http://nccam.nih.gov/news/2008/060608.htm
Comments
Reese, you're quite something in the field of alternative medicine. Thank you so much for sharing all of this information with us. First of all, the Time To Talk campaign is fascinating and I'm sure there are many women who would love to participate in this campaign.
You are so right, we need to start talking more about CAM. It is becoming more apparent that medicine is not a one-size-fits-all proposition. I for one, take an FDA-approved medication, as well as a compounded medication or what I would consider to be an alternative or complementary. (What would say compounded testosterone for women would be considered? Clearly -- you are in the know -- and I want to know.)
Why wouldn't people talk about their CAM? Because it may directly affect the FDA-approved medication and could cause trouble with that particular medicine. Do you think that the other reason is that they're afraid to tell their doctor they're trying CAM or a complementary medication? And if they're afraid, then we need to get the message out on how to advocate for themselves. And if they're uncomfortable about talking about it, then that to me is a huge red flag.
What that says to me is that they don't have the right doctor because they should be able to tell their doctor everything and anything without fear of being criticized or made to feel less than because they're trying something that their doctor may not know about or agree with...
This is something that I think happens more of the time which is why I think the NIH is doing the Time to Talk campaign.
The take away for me is that if you aren't comfortable talking with your doctor you need to fire him or her. Age doesn't matter because any drug -- whether it's alternative or FDA approved can have an interaction with other things. And an alternative medicine like an FDA approved drug can have side effects.
I think there are a lot of myths and misunderstandings but we are heading in the direction of individualized medicine and it's about time.
You're an incredible writer and an incredible resource. I cannot tell you how much I appreciate you sharing this inf o with our users, not to mention me.
Michelle,
Thank you for your kind comments. While I can't take credit for the great writing in this blog, I thought that the campaign launch would be of great interest to many women on this site. Free discussion kits are available from NCCAM so that everyone can learn how to start a conversation with their doctor.
CAM is pretty much anything that is not accepted as treatment by regular medicine in the United States.
I found an interesting resource on compounded testosterone that you may want to look at if you haven't already:
http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=8059&nbr=4509
I hope that helps!
Reese
The paradigm of western medicine is shifting and at the same time the public is becoming smarter and more educated when it comes to "other" therapies and treatment modalities. The Internet has opened a new world of information! I have been involved personally and professionally with the work of many fine CAM physicians who have committed their lives to educating and treating patients with less pharmacology and more natural approaches. In other cases, patients have benefitted from the combination of both options. Patients seeking CAM therapies should ensure their physician is trained and qualified in this area. There is no Board Certification but there are organizations that offered medical education in CAM through their conferences. The University of Arizona also offers a great Fellowship program for physicians and the demand for this program continues to grow. CAM is also known as INTEGRATIVE medicine, since many physicians will integrate several modalities into the treatment plan of the patient. However, healthcare practitioners who design a medical practice that is opened to discussing and offering CAM treatments are forced to consider the risk of not being able to obtain medical malpractice or get reimbursed by insurance companies. So there is still hesitation in the medical community to openly offer these services. This will change as more and more patients opt for paying out of pocket for this type of treatments. The good news is that we are moving int he right direction with many States having Health Freedom legislation passed and over 53 medical schools now offering courses in CAM/Integrative Medicine. The whole CAM field is also evolving to include mind-body medicine, energy medicine, etc. Recent research has found sufficient scientific evidence to make these two viable complements or alternatives to allopathic medicine (that is the term for mainstream medicine)
Virginia,
You are absolutely correct that CAM is becoming more acceptable and being integrated, although slowly in some cases, into medical education. Even though part of the medical community seems hesitant and rightly skeptical about some alternative therapies, there definitely seems to be a growing acceptance of the treatments that have scientific evidence behind them. I'm pretty hopeful that physicians will get on the ball and patients will learn to mention their health routines during their check ups.
It is true that becoming educated on treatments is a lot simpler with the internet, but there is also a danger in the public getting misinformed. My biggest fear in that case is that many may not be looking at the best sources of information, particulary if it comes from websites selling therapies online. I enjoy blogging about CAM, but I encourage everyone to look towards my references and their health care providers for further information.
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