Why Do We Spend $34 Billion in Alternative Medicine?

A national study shows how much America spends on alternative care, but not why.

July 31, 2009— -- Chances are that one out of every three people you see in the grocery store, on the street or at work have tried alternative medicine, and they're spending quite a bit for it.

The National Institutes of Health (NIH) announced Thursday that Americans spent $34 billion on complementary and alternative medicine in 2007. The study queried more than 70,000 people across the country about 36 various forms of alternative treatments.

But researchers say they still don't know exactly why people are turning to these therapies.

"Since this was a point of time survey, we weren't necessarily asking people about why or how they made their decision," said Richard Nahin, an author of the study released by the NIH and the National Center for Complementary and Alternative Medicine (NCCAM).

The $34 billion spent on complementary and alternative medicine pales in comparison to the $2.2 trillion spent on health care annually, but alternative therapies accounted for up to 10 percent of out-of-pocket health costs.

Yet, at the same time as Americans are embracing alternative medicine, the American Medical Association's (AMA) policy on the matter far from endorses the treatments.

"There is little evidence to confirm the safety or efficacy of most alternative therapies," the AMA policy states. "Much of the information currently known about these therapies makes it clear that many have not been shown to be efficacious. Well-designed, stringently controlled research should be done to evaluate the efficacy of alternative therapies."

Without an explanation for exactly why an estimated 38 percent of the population in the United States has expanded their health spending beyond "Western medicine" doctors, NCCAM is simply trying to analyze where the money goes so the center may propose research to test whether it is safe or effective.

Anecdotally, the reasons why people choose alternative therapies range from the relatively cheap cost, the affinity for plant products and a mistrust of the medical establishment.

But an emergency room physician in Mesa, Ariz., who has recently turned to naturopathic care for his family, believes much of it has to do with chronic illness.

"At least my world in the allopathic medicine [a practice sometimes called Western medicine], we do much better with acute care than we do with chronic care," said Dr. Thomas Kupka. "I think for Americans as a whole, more and more of our health care is shifting into the chronic illnesses."

Kupka doesn't see alternative therapies as a replacement to Western medicine for chronic illnesses such as diabetes, hypertension or cancer. However, he did turn to a naturopathic doctor when oncologists said they had done all they could do for his cancer-stricken father.

Why People May Choose Alternative Therapies

"It's just my perspective that not one modality has all the answers. There's some aspects we understand rigorously and scientifically, and some we don't," said Kupka. "Basically it comes down to if you try one and it doesn't work, you try to find an answer on the other side."

Kupka said his father continues to see his oncologist but that he has improved since he started receiving care from a naturopathic doctor, or N.D.

"They gave him six weeks to live 15 weeks ago. His blood work all looks better than when they sent him home," said Kupka.

According to the NCCAM study, only one-third of the out-of-pocket costs that adults spend on alternative complementary medicine went to practitioners such as naturopaths. The other two-thirds went to "self-care" purchases of alternative medicine products, which include classes such as yoga and nonvitamin, nonmineral, natural products such as fish oil, glucosamine and echinacea.

Despite the widespread acceptance of alternative medicine in recent years, some naturopaths say they are worried about self-care purchases of supplements.

"The use of them is very complex. There is a lot of science that goes into choosing the right one," said Marnie Loomis, N.D., a director of professional formation at the National College of Natural Medicine in Portland, Ore.

"There are so many people out there thinking that natural equals safe, and that's not true," Loomis said.

Naturopathic doctors are recognized as licensed health care providers in 15 states, up from just a handful a few years ago.

The association of accredited naturopathic medical colleges defines naturopathy as a do-no-harm holistic approach to medicine that "combines many methodologies, such as acupuncture, massage, chiropractic adjustment, homeopathy and herbal cures, along with sensible concepts such as good nutrition, exercise and relaxation techniques."

Loomis said in states where they are licensed, patients' care is almost uniformly coordinated with a mainstream doctor. But, her patients consistently say their dissatisfaction with their current doctor was the reason they chose to come to her.

Naturopaths Growing in Popularity

"From my personal experience in my practice, the phrase I heard most often was 'this is what I thought a doctor's office should look like,'" said Loomis.

"The visits are long, we talk about their entire health history as well as their lifestyle, what food they're eating, what are their exercise habits," she said. "Of the diseases out there -- cancer, diabetes, obesity -- they [patients] keep hearing that lifestyle is part of it, but they don't know how to do it. It is a learned skill."

Loomis said about two-thirds of her patients say extra attention to lifestyle was what motivated them to try her office. Anecdotally, some people who have lost their health insurance come to Loomis for a cheaper alternative.

But one-third comes out of frustration with their current treatment plans. Paul Mittman, N.D., president of South West College of Naturopathic Medicine and Health Sciences in Tempe, Ariz., said he's heard the occasional bristling against mainstream medicine.

"There are some people who come in with a mistrust of medicine, and it's often ironic because they expect to have a sympathetic ear, then I'll tell them, 'I think you need to go ahead and have that surgery,'" said Mittman, who noted four medical doctors who work alongside naturopaths at his institution.

"That's one of the myths that persist, that it has to be oppositional," he said. "Integrating health care, integrating naturopathic medicine into patients' care is really the best way to practice."