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The health care industry has a variety of policies and

standards regarding coverages for alternative medicine

modalities. From a sociological standpoint, unconventional,

alternative, or unorthodox therapies refer to medical practices

that are not in conformity with the standards of the medical

community. The New England Journal of Medicine defines

unconventional therapies, “as medical interventions not taught

widely at U.S. medical schools or generally available at U.S. hospitals. Examples include acupuncture, chiropractic, and

massage therapy”(1993). Coverages vary widely among conventional

carriers, preferred providers as well as the omnipresent Health

Maintenance Organizations (”HMO”). The primary emphasis and, for

that matter, the only reason for the existence of insurance

companies is a single word, profit. More specifically, premiums

less costs provide the all important profit margin, the life

blood of the insurance industry. By not providing coverage for

the billion dollar industry of alternative treatments, insurance

companies are keeping the cost of the premiums down but at the

same time not allowing their customers to use complementary

treatments such as chiropractic to prevent or cure illness. The

more rigid and restrictive the policy provisos, the more

assurance for the companies that they will maximize their bottom

lines. Therefore, patients of alternative therapies as well as

doctors must show that such unconventional treatment provides

relief and prevention of illness. “The total projected out-of-

pocket expenditure for unconventional therapy plus

supplements(such as diet pills and megavitamins)was 10.3 billion

dollars in 1990. This is comparable to the out-of-pocket

expenditure for all hospital care in the United States in

1990($12.8 billion), and it is nearly half the amount spent out

of pocket for all physicians’ services in the United States($23.5

billion)”(nemj,1991). From this one may infer that society has

become fed up with inadequate results or side effects associated

with surgery and drugs which accompany the treatment of modern

medicine. So, in an effort to cope with the inadequate treatment

patients are receiving from conventional medicine, they are

seeking alternatives such as chiropractic for chronic illness and

pain. “Although most doctors wince when you mention

chiropractors, some fairly rigorous studies have shown their

manipulations of the spine to be effective in relieving lower-

back pain. Orthopedic surgeons have even been known to refer

patients to chiropractors, and some 30 U.S. hospitals have

chiropractors on staff”(Wallis,1991).

Relevant Policies and/or Practices

“In 1997, 42 percent of all alternative therapies used were

exclusively attributed to treatment of existing illness, whereas

58 percent were used to prevent future illness from occurring or

to maintain health and vitality” (JAMA, 1998). “The magnitude of

demand for alternative therapy is noteworthy, in light of the

relatively low rates of insurance coverage for these services”

(JAMA, 1998). Coverages vary widely depending on the policies

provided by the carriers. In my research, I contacted the Kern

County Superintendent of Schools, (”KCSOS”), Personnel Office to

inquire into the health policies provided to the nearly one

thousand employees of the office. There are a variety of options

available to each employee. The basic hospitalization plan used

by the majority of employees is the Blue Cross Prudent Buyer

Hospital Only plan. As required by State and Federal law, the

office is also required to make available approved HMO’s if

employees request them. To that end, the office has a large

number of employees enrolled in Kaiser-Permanente and Health Net

HMO’s. The administrative agency that provides the programs is

the Self Insured Schools of California, (”SISC”), which is a

cost-containment consortium of hundreds of California school

districts. Currently, SISC provides coverage for more than

thirty-five thousand employees and their eligible dependents. In

addition to medical coverages, the office also provides life,

vision, dental, prescription and mental and nervous policies.

The mental and nervous policy that is provided for each employee

and dependents is described as a “carve-out” benefit. Prior to

this type of policy utilization, the basic Blue Cross medical

plan provided very specific and limited mental and nervous

benefits. Carve-out benefits provide coverages for treatments

that would not be covered otherwise. Several companies came

forward with plans that were more comprehensive and cost-

effective and replaced the medical plan component. An additional

benefit was that there was a net premium savings. Three

companies, Pacificare, MCC and BHA, offer plans at comparable

rates which provide a variety of family and personal counseling

services which are more along the lines of preventative medicine

rather than the hospitalization plans that were offered under the

basic hospitalization plan. Employee unions have been very

receptive to these plans due to the cost-containment provisions

as well as the intervention value for the employees that they

represent. For example, an employee with an alcohol or drug

addiction problem can get confidential assistance to assist in

the resolution of these problems and avoid being disciplined for

job performance problems.

The basic medical plans offered by the KCSOS office provide

various levels of coverage for several forms of alternative

medicine. The Blue Cross Prudent Hospital Only plan provides

coverage as follows: “A doctor of medicine (M.D.) or a doctor of

osteopathy (D.O.) who is licensed to practice medicine or

osteopathy where the care is provided, or one of the following

providers, but only when the provider is licensed to practice

where the care is provided, is rendering a service within the

scope of that license, is providing a service for which benefits

are specified in this Plan Description, and when benefits would

be payable if the services were provided by a Physician as

defined above: a dentist, optometrist, dispensing optician,

podiatrist of chiropodist, psychologist, chiropractor,

acupuncturist(but only for acupuncture and for no other

services), certified registered nurse anesthetist, clinical

social worker*, marriage, family and child counselor*, physical

therapist*, speech pathologist*, audiologist*, occupational

therapist*, respiratory therapist*. Note: Services by the

providers indicated by asterisks (*) are covered only by the

referral of a Physician as defined above”(SISC III, 48).

“Health Net has partnered with American Specialty Health

Plans (ASHP) to offer Chiro Net quality, affordable

chiropractic coverage. With this program, you’re free to

obtain this care by selecting a participating chiropractor

from the Chiro Net directory. Although you’re always welcome

to consult your Primary Care Physician, you won’t need a

referral to see a participating chiropractor.

What’s covered

Office visits

$10 per visit

30 visits per year

There is a $50 annual chiropractic appliance allowance

toward the purchase of chiropractically necessary items such as

supports, collars, pillows, heel lifts, ice packs, cushions,

orthotics, rib belts and home traction units.

What’s not covered

Limitations and exclusions

Air conditioners, air purifiers, therapeutic mattresses,

vitamins, minerals, nutritional supplements, durable medical

equipment, appliances or comfort items

Conjunctive physical therapy not associated with spinal,

muscle or joint adjustment

Diagnostic scanning, MRI, CAT scans or thermography

Exams or treatment of strictly non-neuromusculoskeletal

disorders

Hypotherapy, behavioral training, sleep therapy, weight

programs, educational programs, nonmedical self-help or

self-care, or any self-help physical exercise training

Lab tests, X-rays, adjustments, physical therapy or other

services not chiropractically necessary or classified as

experimental

Pre-employment physical or vocational rehabilitation arising

from employment or covered under any public liability

insurance

Treatment for temporalmandibular joint syndrome (TMJ)

Treatment or services not authorized by ASHP or delivered by

an ASHP provider

This is only a summary”(HealthNet, 7).

Nowhere in the Health Net coverage guide did it mention

coverage, limitation, or exclusion of the numerous treatment

modalities of alternative medicine except for chiropractic

treatment, which it supported in explicit detail. From this one

may conclude that chiropractic is the only alternative treatment

that has established a beneficial reputation in possibly

preventing illness and promoting wellness in the western world.

An extremist might say because Health Net does not include any

other forms of alternative medicine, that these modes of

treatment are not generally accepted by the medical community or

deemed effective or appropriate in treating illness.

Kaiser Permanente’s coverage plan has a significantly larger

number of exclusions and limitations regarding treatment coverage

compared to Blue Cross and Health Net within the SISC

administrative agency. The exclusions section of Kaiser’s

coverage guide states in section i, “Chiropractic services and

services of a chiropractor,” which is in contrast to both Blue

Cross and Health Net, each of which fully recognize and provide

coverage for chiropractic services. In section j of the exclusion

section it seems that Kaiser is attempting to eliminate coverage

of all other alternative medicine treatment by stating,

“Experimental or Investigational Services and those procedures

not generally and customarily provided to patients residing in

the Service Area.”(Kaiser, 13) Their definition of Experimental

and Investigational Services is, “any service or item that is not

recognized in accord with generally accepted medical standards as

being safe and effective for use in the treatment of the

condition in question, whether or not the service is authorized

by law for use in testing or other studies on human patients; or

any service requiring approval by any governmental authority

prior to use when such approval has not been granted prior to

provision of the service or item.” (Kaiser, 27) This seems to be

an attempt to classify all other forms of alternative medicine

treatments, with the possible exclusion of chiropractic, as

experimental forms of treatment. If this proves to be a

fallacious statement, by concluding that section j was an attempt

to deem that alternative medicine as an experimental service;

then one might conclude that Kaiser dismisses alternative

medicine treatment altogether by not including them in their

coverage plan at all. Either way Kaiser must view alternative

medicine as being inadequate or inappropriate treatment for

illness, providing relief of symptoms or improving their patients

degree of health.

Preventive medicine, wellness and alternative therapies are

fundamental components of a growing national trend. According to

a survey conducted by The Journal of the American Medical

Association, “…use of at least 1 of 16 alternative therapies

during the previous year increased from 33.8 percent in 1990 to

42.1 percent in 1997, and the probability of users visiting an

alternative medicine practitioner increased from 36.3 percent to

46.3 percent” (1998). More and more Americans are seeking options

other than conventional forms of medical treatment. Conventional

or modern medicine can be defined as treatment that is widely

accepted by U.S. medical schools and insurance companies as being

beneficial to the treatment of disease and illness with

scientific evidence. “In 1993, the National Institutes of Health

chose Dr. Joe Jacobs to head their new Office of Alternative

Medicine. The office was created last year under pressure from a

Congress alarmed by the soaring cost of high-tech healing and the

frustrating fact that so many ailments such as: AIDS, cancer,

arthritis, back pain, which have yet to yield to standard

medicine”(Toufexis,1993). The cost of standard medical care has

risen dramatically. For example, a simple arthroscopic cartilage

repair on an outpatient basis costs in excess of five thousand

dollars for a thirty minute procedure. A simple Magnetic

Resonance Imaging, (”MRI”), costs over a thousand dollars. In

contrast, a visit to a chiropractor costs less than forty

dollars. The Journal of Occupational Medicine performed a study

comparing costs of treating back injuries with chiropractic and

traditional medicine. Using identical diagnostic codes for 3062

claims, the report reached the following conclusion: “For the

total data set, cost for care was significantly more for medical

claims, and compensation costs were ten-fold less for

chiropractic claims.”(1991).

Major Position or Argument

Is it better to exercise preventive medicine rather than

focus on curing disease after the fact? In response, a growing

number of people have concluded that it is a quality of life

decision for them to opt for optimizing their health rather than

seeking cures. According to the study that represented the use of

unconventional therapy for the 10 most frequently reported

principal medical conditions, published in the New England

Journal of Medicine, “…a full third of the respondents who used

unconventional therapy in 1990 did not use it for any of their

principal medical conditions”(nejm,1991). From this fact we can

infer that a substantial amount of unconventional therapy is used

for non-serious medical conditions, health promotion, or disease

prevention. “The probability that an individual patient who saw a

medical doctor also used unconventional therapy in 1990 was

higher than one in three for patients with anxiety(45 percent),

obesity(41 percent), back problems(36 percent), depression(35

percent), or chronic pain(34 percent), relaxation techniques,

chiropractic, and massage were the unconventional therapies used

most often in 1990″ (nejm,1993). How can the insurance companies

ignore the fact that, “an estimated number of ambulatory visits

to providers of unconventional therapy in 1990 was 425 million?

This number exceeds the estimated 388 million visits in 1990 to

all primary care physicians(general family practitioners,

pediatricians, and specialists in internal medicine) combined.

Also, if one assumes that charges for visits to providers of

alternative therapy were paid in full, Americans spent

approximately 11.7 billion dollars for these services in

1990″(nejm,1993). Nutrition stores have multiplied in the past

few years due to the growing demand for a variety of vitamins and

potions regarded by many as a viable means to fend off disease

and to improve on one’s daily health. Additionally, fitness

centers and exercise facilities have sprung up on every street

corner. Some are open twenty-four hours per day and provide

numerous forms of equipment, technical assistance and even

personal trainers to assist dedicated individuals in improving

their general well-being and appearance. Society has become aware

of the benefits and effectiveness of unconventional therapies

shown by a study that those who sought treatment from providers

of alternative medicine has seen the provider an average of ten

times in the past twelve months(nejm,1991).

Body of Paper

The American Chiropractic Association defines chiropractic

as follows: “Chiropractic is a health care discipline which

emphasizes the inherent recuperative power of the body to heal

itself without drugs or surgery.” “The practice of Chiropractic

focuses on the relationship between structure, (primarily the

spine), and function, (as coordinated by the nervous system), and

how that relationship affects the preservation and restoration of

health. In addition, Doctors of Chiropractic recognize the value

and responsibility of working in cooperation with other health

care providers when in the best interest of the patient.” (ACA,

1998). There can be little doubt that chiropractic treatment is

valuable as both a standard medical treatment and as an

alternative form of medicine. There may very well be some

scientific justification in the manipulation of the spine because

almost every nerve in the body runs through the spinal cord.

Chiropractors maintain that they can treat illness by adjusting

the vertebra of the spinal column to relieve nerve and muscle

tension(Wallis,1991). This position may, at first, seem

contradictory but with further analysis and explanation, it will

become clear that it is a supportable premise. “The visits to

practitioners of alternative therapy in 1997 exceeded the

projected number of visits to all primary care physicians in the

United States by an estimated 243 million; visits to

chiropractors and massage therapists accounted for nearly half of

all visits to practitioners of alternative therapies” (JAMA,

1998).

As an example, a simple on-the-job back strain could be

treated in several ways. The simplest and seemingly least costly

treatment would be for the employee to go home and rest in bed.

However, this form of treatment may actually keep the employee

away from work for the longest period of time which would make

the cost factor to the employer higher in the long run due to

Worker’s Compensation premium costs and the costs associated with

replacing the injured employee such as sick leave benefits and

the costs of providing substitute employees.

The more traditional treatment would be for the employee to

seek treatment from an urgent care facility or from a family

physician. Treatment would generally require X-rays, an MRI or a

CAT scan to assist the physician in diagnosing the source of the

injury. Depending on the nature and severity of the injury,

surgery and rehabilitation through physical therapy may be

required to resolve the injury. Otherwise, in the case of a

minor injury, cold packs, pain medication and rest may be

appropriate treatment. Costs for traditional physician treatment

are generally very high. For example, a standard MRI will cost

at least a thousand dollars. Referral to an Orthopedic Surgeon

and subsequent treatment including possible surgery, medication

and subsequent physical therapy can cost tens of thousands of

dollars and extended periods of lost work time. All of the

medical plans that I examined provide full coverage, less

applicable deductibles or co-payments, for the cost of most forms

of treatment with the exception of those considered to be

experimental.

A third alternative may be acupuncture treatment. The

acupuncturist may or may not be licensed to provide or order X-

ray, MRI or CAT scans. If not, the treatment may be the

traditional acupuncture treatment. Rest is generally

recommended. Generally, the cost of acupuncture is covered,

subject to deductibles and co-payments, by most health plans with

the exception of Kaiser-Permanente.

The fourth and most appropriate treatment, in my opinion, is

chiropractic. A chiropractor has the ability to order or to

provide X-ray examinations as well as to order MRI’s or CAT scans

as necessary. In the event that structural damage such as a

ruptured disc or fracture exists, the chiropractor would refer

the employee to an orthopedic physician. However, if the injury

is due to a subluxation, the chiropractor would typically perform

an adjustment to the spine or other form of manipulative therapy

to realign the spine and remove nerve interference and to relieve

pain and discomfort. The chiropractor may also prescribe cold

packs, rest and, in some cases, physical therapy. The initial

examination, which include: the patient’s history and

assessment, X-rays, spinal adjustment, and recommendations for

improving of making changes in their lifestyle to promote a

healthier life (nutrition, massage therapy, exercise, rest,

etc.). The initial examination costs a few hundred dollars,

which is covered by Blue Cross and Health Net less the

deductibles and co-payments. Follow up exams include spinal

adjustments and recommendation or advice on questions pertaining

to the treatment and your lifestyle. The cost of these exams

usually cost around fifty dollars per visit, which Blue Cross

covers the full amount after the deductible has been paid; Health

Net requires a co-payment of ten dollars per visit up to thirty

visits per year, and Kaiser doesn’t cover any of the expenses of

chiropractic care. According to an article in Kiplinger’s

Personal Finance Magazine, “An initial visit to a chiropractor

could cost $40 to $80, plus the cost of x-rays; follow-ups are

around $40 to $60. Insurance laws in most states require insurers

to reimburse for treatment by chiropractors if they reimburse for

comparable treatment by M.D.’s, and coverage is mandated in

Delaware, Maryland, New Mexico and North Dakota. There is no

requirement in Oregon, Utah and Vermont. Self-insured plans are

exempt from the state-mandated-benefit laws. Also, according to

Don White of the Health Insurance Association of America,

insurers are “much more willing to pay than they used to be” when

alternative therapies are recommended by a doctor after

conventional methods fail”(Clark,1993).

Chiropractic is not without its own set of risks just as

other forms of traditional medicine. Ian Coulter, Ph.D.

identified those risks and facts as follows:

“chiropractors perform more than 90 percent of spinal

manipulations (manipulation is the generic, non specific

medical term for adjustment); the risk of complication with

cervical (neck) adjustments is 6.39 per 10 million

adjustments; the risk of complication with lumbar (low back)

adjustments is 1 in 100 million adjustments. The risk of

complication in some common medical procedures and

medications were not as good: the risk of complication with

the use of NSAIDS (aspirin, tylenol, ibuprofen, etc.) is 3.2

in 1,000; and the risk of complication in cervical spine

surgeries is 15.6 in 1,000. By way of commentary, there has

been a lot of news coverage concerning the dangers of

Chiropractic care over the past few years. This article

clearly points out that Chiropractic procedures are

significantly safer than many common medical procedures. For

the best reflection of how safe Chiropractic is, ask your

Chiropractor how much his/her malpractice insurance costs.

Then ask your medical doctor the same question. The

difference will surprise you.” (Chiropractic America, 1999).

The preceding procedures treat injuries and the pain

associated with the injury in widely differing manners. It is

also important to consider how each form of treatment personally

affects the individual. Obviously, the less invasive the

treatment, the quicker the recovery. Pain control is another

serious consideration. Simply resting may be adequate in some

instances but if a serious injury exists, the long term result

may be negative. Surgery generally generates substantial pain

which requires pain control medication which, in some instances,

can become addictive. In contrast, acupuncture causes very

little, if any, discomfort and may provide a long term solution.

“Acupuncture is most often used to treat pain, and is also used

for ailments such as hypertension and gastrointestinal disorders.

Needles placed on points on the body are said to transmit

impulses to the brain and then to the affected organ. An initial

visit might cost $225; follow-ups run about $75, including a

supply of Chinese herbal medicines, which are part of an

acupuncturist’s treatment”(Clark,1991). However, chiropractic

would be my first choice for treatment because of the immediate

nature of the relief this form of medicine provides. It provides

for safety in that prior to a subluxation adjustment, the

chiropractor would use X-rays to determine the efficacy of this

form of treatment. If a structural injury exists, such as a disc

problem or fracture, the chiropractor would be at liberty to

refer the patient to a physician. Otherwise, chiropractic is

neither invasive nor uncomfortable. In a report released in July

1991 by the Rand Corporation, a prestigious research organization

in Santa Monica, California,

“…a panel of leading physicians, osteopaths and

chiropractors found that chiropractic style manipulation was

helpful for a major category of patients with lower-back

pain: people who are generally healthy but who had developed

back trouble within the preceding two or three weeks. By

some estimates, 75 percent of all Americans will suffer from

low back aches and pains at some point in their lifetime.

The annual cost to U.S. society of treating the ubiquitous

ailment was recently tallied at a crippling 24 billion

dollars, compared with $6 billion for AIDS and $4 billion

for lung cancer. If spinal manipulation could ease even a

fraction of that financial burden, remaining skeptics might

be forced to stifle their misgivings or get cracking

themselves”(Purvis,1991).

In almost all cases, drugs are discouraged so that drug reactions

and addictions are never an issue as a result of treatment.

It is recognized in almost all medical circles that many

illnesses are generated by the mind. “A growing number of doctors

around the country have become more open to alternative

approaches, looking particularly at the way that body, mind and

life-style interact. Andrew Weil, a Harvard-trained M.D. and

author of The Natural Mind, practices this sort of holistic’

medicine in Tuscon”(Wallis,1991). Stress from many sources

including work and family is the cause of many maladies. That is

why it seems very curious that some health organizations ignore

the positive aspects of some or all forms of alternative

medicine. On one hand, the medical community recognizes the

mental side of medicine and then they summarily ignore forms of

treatment that people believe in and that result in healing

whether the source is medical or physical. It seems to be a

territorial response to what the medical community perceives to

be a threat to its existence. Dr. Saper, a neurologist,

“…confirms that lowering a patient’s stress level, with

relation techniques or simply encouraging trust in the doctor,

can be healing. Research suggests that stress triggers the

release of chemical messengers from the brain that suppress the

immune system; relaxation would therefore revive the immune

response”(Wallis,1991). However, the trend seems to be towards

acceptance of alternative medical practices. A telephone poll of

500 American adults was taken from TIME/CNN on October 23, 1991

by Yankelovich Clancy Shulman that contained three questions

about their use of alternative medicine. The results of the

survey were: 31 percent of the poll sought medical help from a

chiropractor, 6 percent sought help from an acupuncturist, 5

percent went to an herbalist, 3 percent visited a homeopathic

doctor, and 2 percent sought help from a faith healer. When those

who had sought medical help from alternative medicine providers

where asked if they would go back to an alternative doctor, 84

percent of them said yes, and only 10 percent answered no, with

the 6 percent of not sures’ being omitted. Among those who had

not sought help from a practitioner of alternative medicine, 62

percent said that they would consider seeking medical help from

an alternative doctor if conventional medicine failed to help

them(Wallis, 1991).

If a high percentage of illnesses are truly psychological

and if these people believe that these forms of alternative

medicine will cure them, then the insurance companies should

provide coverage for them. Ultimately this is cost effective

because in comparison to cost of other forms of medical

treatment, alternative medicines are much less expensive. By

providing coverage for alternative medicine, society should in

fact increase their health either physiologically and/or

psychologically, which will in turn decrease the number of

illnesses and health care premiums will decrease. Maintaining

wellness is a emerging focus of both employers and HMO’s. Use of

at least 1 of 16 alternative therapies during the previous year

increased from 33.8 percent in 1990 to 42.1 percent in 1997.

This shows that society is accepting alternative medicine on an

ever increasing basis. Alternative therapies were used most

frequently for chronic conditions, including back problems,

anxiety, depression and headaches. Also, more than half of these

visits were paid for out-of-pocket, that is health insurance

would not or did not pay for the cost of treatment (JAMA, 11/98).

Incidently, more and more insurance companies are providing

coverage due to member demand. Therefore members who believe in

treatment through alternative medicine should make a concerted

effort to make their demands heard. One study, conducted in

England, found that “for patients with low-back pain in whom

manipulation is not contraindicated, chiropractic almost

certainly confers worthwhile, long-term benefit in comparison to

standard hospital outpatient management.” An extended follow-up

of the same patients found that chiropractic patients continued

to fair better than their medically treated counterparts (Meade,

1431-7). “At three years the results confirm the findings of an

earlier report that when chiropractic or hospital therapists

treat patients with low back pain as they would in day to day

practice those treated by chiropractic derive more benefit and

long-term satisfaction than those treated by hospitals”(Meade,

349-51).

Cost-containment is of vital importance, especially to those

that must pay out-of-pocket for their medical treatments.

According to the JAMA: “The majority of people who saw

alternative therapy practitioners paid all the costs out-of-

pocket in both 1990 (64.0%) and 1997 (58.3%).” Even so, the

trend is apparent. More and more people are turning to

alternative therapies. It must be remembered that the AMA has a

vested interest in the results of such a trend and therefore

would be inclined to put the best “spin” on the survey. “In

1990, a full third of respondents who used alternative therapy

did not use it for any principal medical condition. From these

data, we inferred that a substantial amount of alternative

therapy was used for health promotion or disease prevention. In

1997, 42% of all alternative therapies used were exclusively

attributed to treatment of existing illness, whereas 58% were

used, at least in part, to prevent future illness from occurring

or to maintain health and vitality.” The AMA is apparently

recognizing the fact that many people use alternative therapies

not only to cure but to prevent illness and to improve health.

This is a revealing statement for the medical community to make.

The article goes on to say that: “As alternative medicine is

introduced by third-party payers as an attractive insurance

product, it would be unfair for individuals without health

insurance and those with less expendable income to be excluded

from useful alternative medical services or consultation (eg,

professional advice on use or avoidance of alternative

therapies).” (JAMA, 1998). The AMA is actually recognizing the

value of alternative medicine when it refers to them as:

“…useful alternative medical services….” In fact, the most

impressive statement made by the AMA was: “An increasing number

of US insurers and managed care organizations now offer

alternative medicine programs and benefits. The majority of US

medical schools now offer courses on alternative medicine.”

The Journal of the American Medical Association in a study

conducted by the Stanford Center for Research in Disease

Prevention concluded that: “Research both in the United States

and abroad suggests that significant numbers of people are

involved with various forms of alternative medicine. However,

the reasons for such use are, at present, poorly understood.”

The study went on to say: “Three hypotheses were tested. People

seek out these alternatives because (1) they are dissatisfied in

some way with conventional treatment; (2) they see alternative

treatments as offering more personal autonomy and control over

health care decisions; and (3) the alternatives are seen as more

compatible with the patient’s values, worldview, or beliefs

regarding the nature and meaning of health and wellness.

Additional predictor variables explored included demographics and

health status.” The conclusion of the study was quite

interesting. “Along with being more educated and reporting

poorer health status, the majority of alternative medicine users

appear to be doing so not so much as a result of being

dissatisfied with conventional medicine but largely because they

find these health care alternatives to be more congruent with

their own values, beliefs, and philosophical orientations toward

health and life.” (JAMA, 1998).

Chiropractic, as one of the alternative medicine options,

has proven to be a valuable and viable form of treatment for many

common ailments. It is a relatively painless method for

controlling pain as well as providing long-term relief from

specific symptoms. In support of this proposition: “…the

Agency for Health Care Policy and Research which is an arm of the

U.S. Department of Human Services, developed a clinical practice

guideline for acute low back pain: they looked at the quality and

quantity of research backing common treatments. In the final

guideline, the multidisciplinary panel found that for patients

with acute low back symptoms without radiculopathy (irritation of

the spinal nerve root), the scientific evidence suggests spinal

manipulation is effective in reducing pain and perhaps speeding

recovery within the first month of symptoms.’” (Health Ways,

1998).

Chiropractic is much less costly than traditional medication

and because of its non-invasive nature, recovery is generally

much quicker. Users of chiropractic find that this form of

treatment is more consistent with preventative health patterns

and practices. There is a very low occurrence of side effects and

risk involved compared to traditional medical treatment, which

includes oral medication and surgery. Chiropractic is supported

by a good deal of evidence as mentioned above. Supporters of

Chiropractic would be likely to promote that one should prevent

disease and illness through spinal adjustments, and resort to

drugs as a secondary option to regaining health, and surgery as a

last resort. Society has come to recognize the benefits that

alternative medicine provides. Insurance companies are slowly

coming to the realization of the efficacy and the health benefits

that alternative medicine has to offer. The only way to persuade

the insurance companies to provide coverage is for the users to

voice their opinions.