01/14/2018
The Rise of Complementary Alternative Medicine (CAM) in Nova Scotia
Health Promotion vs. Disease Management
Having lived in Nova Scotia since 1989, and working in the field of complementary medicine as a registered massage therapist and manual osteopath, I have witnessed a striking phenomenon which has gone unreported by our mainstream news: There has been and continues to be a dramatic increase in the demand for complementary medical services. Rather than waiting until chronic and acute health care problems show up, and then waiting in line for medical intervention, people are choosing to emphasize their own health and well-being now.
Our centralized health-care system does its best to provide an excellent service to all Nova Scotians without exception. However, our current medical model, which is specifically oriented toward the treatment of acute care, is struggling to keep pace with increased patient needs and demands who are experiencing chronic health problems. We are aware of this problem via the well-reported increase in doctor shortages and corresponding increase in wait times for a majority of medical services. Of additional concern is the cost of providing ever-increasingly sophisticated medical services to our population. Currently, the annual cost of our public health-care system for Nova Scotia is approximately $4.214 billion; this translates into 41% of the total provincial budget. This figure will only increase as our population continues to age, and as ever more sophisticated medical technologies become available. How are we to sustain this? The common-sense answer is that the cost of our current health-care system is not sustainable and the burden of chronic illness is growing.
We have been aware of the burden of chronic illness for a long time. In 2004, a study presented to our own provincial government reported that:
“It is estimated that 40% of chronic illness can be prevented. Epidemiological studies indicate that 25% of all direct medical costs – or nearly $9.7 billion (C$ 2002) a year in Canadian costs of chronic diseases – are attributable to a small number of excess risk factors such as smoking, obesity, physical inactivity, and poor nutrition. [The Cost of Chronic Disease in Canada, GPI, 2004]
The Province of Nova Scotia Department of Health and Wellness researched and published in 2012 a document titled, “Thrive. A Plan For A Healthier Nova Scotia”.
“Like many other places in North America, Nova Scotia is facing epidemic levels of childhood obesity, inactivity and unhealthy eating. Diseases like Type 2 diabetes that used to turn up mainly in adults are being seen more and more in our children and young adults. Nova Scotians already face some of the highest rates of chronic, preventable disease in the country and left unaddressed, childhood obesity could drive these rates even higher. The health-care system may deal with the consequences of unhealthy lifestyles, but the causes are deeply rooted in society. And all of us own the solutions.”
Four Strategic Directions were articulated in this document:
1. Support a Healthy Start for Children and Families
2. Equip People with Skills and Knowledge for Lifelong Health
3. Create More Opportunities to Eat Well and Be Active
4. Plan and Build Healthier Communities
One area of health care that is currently not supported by the provincial government, yet may offer a partial solution to our impending health care crisis is in the area of Complementary Alternative Medicine (CAM). As mentioned, there has been an exponential increase in the number of CAM practitioners in Nova Scotia.
The underlying common theme of each of these various complementary medical professions, is the emphasis on supporting health. This growth in demand for complementary medical services has been completely driven by the needs of our population – it represents a “grass-roots” movement; occurring without any government support. Nova Scotians are seeking to support their own health. I suggest that use of complementary medical therapies by our population is already saving our provincial government money in public health-care expenditures. In addition to our citizens, businesses are recognizing that it's worth the expense to provide "supplementary insurance" to their employees because it cuts down on 'sick time' / absenteeism.
In exploring this subject, it is vitally important to acknowledge that complimentary medical therapies are currently only available to individuals who have supplemental insurance through their work place, or can afford out of pocket expense. Therefore, a necessary challenge is to look at how these services can be made available to everyone.
Common sense tells us that lifestyle can be changed, and healthier people cost our health care system less. But, is our current government implementing these recommendations? We literally cannot afford to ignore the obvious issue of preventing chronic and acute illness before it arises. The financial costs are too burdensome.
Hypothesis: The dramatic increased use of CAM therapies in the last 30 years represents the public’s self-initiated antidote to providing themselves with better health.
We have no hard data on the current impact of CAM therapies. 9 Questions we should be asking (both government and our population of citizens):
1- How much money is the healthcare system currently saving per year from Nova Scotian’s use of CAM therapy? 5%? 7%? 10%? 20% of total healthcare budget?
2- How many people are utilizing CAM therapies instead of using vital time and resources of the healthcare system in the ER or going to see doctors?
3- How many lost days of work have been reduced through the use of CAM therapies?
4- What percentage of debilitating or life-threatening illnesses could be prevented through early use of CAM therapies?
5- What is the effectiveness of CAM therapies at treating various conditions vs that of the conventional model? Clinical reporting shows the following conditions respond better to CAM therapies rather than our current medical approach that relies upon pharmacology or surgery: muscle and joint strains and sprains, headaches caused by postural inefficiency, obesity, diabetes, chronic pain, gut inflammation from poor food choices, etc.
6- What’s is the cost of obesity on our medical system? Diet and exercise have been shown in numerous studies to be more effective than prescription drugs in ameliorating this condition.
7- What is the cost of medication prescribed every year for chronic pain, and how effective is CAM therapy at mediating the individual’s pain?
8- What’s the role of education in a ‘prevention-based’ approach?
9- Do CAM therapy users cost the public health system more or less than people who do not use CAM therapy? The current hypothesis is that the answer is clearly “less”, therefore ‘freeing up time’ within our public health care system for others who are in greater need.
The use of CAM therapies is growing. Many businesses are encouraging the use of CAM therapies by providing ‘supplemental health insurance’ benefits to their employees. All CAM therapies emphasize supporting and promoting intrinsic health. Are there ways that our government can support the inclusion of CAM therapies in the public health-care system? The unavailability of this care for our entire population actually costs our health-care system more money in the long term.
Peter Goodman, MA, RMT, DOMP – Manual Osteopath
