From Total Health http://www.totalhealthmagazine.com/home.html
June, 2001
Imagine you could live in a world
where the medical community would utilize the strength of all of its different
licensed practitioners toward one common goal-the good of the patient. Imagine
that all of the economic turf battles, professional jealousies and
narrow-mindedness could be transcended. Is this idealistic new age babble or is
this in fact an achievable goal?
Clearly the American public,
in survey after survey, has indicated that it is not comfortable with its
healthcare system as it currently exists. The office visits to alternative
medicine practitioners already exceeds the number of visits to traditional
medical doctors. In fact, one could argue that we do not have a “healthcare
system” at all. Rather we have a “disease-care system”, a system where the
patient only addresses his or her medical situation in the midst of a crisis.
The educated and intuitive
consumer has already begun to seek wellness and prevention elsewhere from the
mainstream medical community. Why then is the medical community so entrenched
in a model that fails to meet the public’s needs? These are questions that need
to be scrutinized closely.
As a practicing physician of
19 years who is board certified in my specialty, I often find myself pondering
these philosophical issues:
1. Why
do we ascribe to a “disease-care system,” where the patient only accesses care
during crisis, instead of proactively engaging in prevention?
2. Given
that “lifestyle choices” create or aggravate 50-75 percent of illnesses, why do
we only allocate one percent of the National Institute of Health (NIH) annual
budget to research on prevention?
3. Why
does it go virtually unnoticed that pharmaceuticals are the fourth leading
cause of death in the United States and the FDA routinely allows new drugs to
come to market which 30 percent of the time are found to be seriously morbid or
fatal within two to three years of their introduction (GAO Review).
4. Why
do we embrace a system that spends the most money per capita on health care and
ranks between 20th and 37th worldwide when our outcomes
are assessed by the World Healthcare Organization (WHO)?
To answer these questions I
founded an “integrated alternative medicine” Independent Practitioners
Association (IPA), contracting with BlueCross BlueShield HMO Illinois in
1997. The IPA is called Alternative
Medicine, Inc. (AMI) and was designed as a scientific pilot project.
Our platform was to recognize
the inherent value in both alternative and allopathic medicine, using each for
its unique strength. But unlike our current system, where alternative medicine
is used as a last resort, we wanted to structure a system where the entry point
heavily favors a non-pharmaceutical/ non-surgical approach.
We believe alternative medical
practitioners provide a model of wellness, the missing foundation to a
healthcare system designed to treat illness. We appreciate the life-giving
intervention that allopathy can offer in cases of acute injury,
life-threatening conditions or end-stage disease. Allopathy, however, has not
recognized that it fails to provide a technology for wellness. Screening for
early manifestations of disease, while necessary, is not sufficient. It is
lifesaving to find a positive stress test in an asymptomatic patient rather
than having sudden death be the first symptom of cardiac disease (as it is in
50 percent of patients). Yet it is even more profound to alter the future by
making lifestyle adjustments which will eradicate the need for a stress test
altogether.
It was our hope that by
integrating these disparate medical systems we could arrive at a whole that is
greater than the sum of the parts. We purposefully chose managed care to
clinically test our new model because of the inherent checks and balances,
which provide safety as well as automatic accountability.
AMI’s mission was to scientifically
document whether the integration of alternative medicine with traditional
allopathic medicine could deliver a higher quality of care at reduced costs
compared to normative values. Our model coordinates care between MDs/DOs/RNs
and DCs networked as a team throughout the greater
After 7000 member months of
data, compiled over 24 consecutive months (1991) in a classical gatekeeper HMO
model compared to normative values as published by BlueCross BlueShield HMO
Illinois, our integrative medicine IPA has reduced:
v
hospitalizations by
over 60 percent
v
outpatient surgery
and procedures by 85 percent
v
pharmaceutical usage
by 56 percent.
v
Nearly 70% overall
health care savings!
*Demographic analysis of sex,
age and diagnosis reveals a neutral bias of sampling in our experimental group
compared to their cohorts.
Note: Similar numbers were
published in the June ’06 edition of the Journal of Manipulative and
Physiological Therapeutics (JPMT)-JT
We accomplished these
impressive statistics by increasing access to care, not by restricting it.
Our patients see their primary
care physician once every two to three weeks on average until this intensity
required to make true lifestyle changes is no longer needed. At that point the
interval of future care is decided together between the primary care physician
and the patient and may approximate a physician encounter once every four to
six weeks.
Our ultimate goal is to
empower the patient to have all the tools necessary at his or her disposal to
lead an autonomous happy, healthy and productive life. Even our true
“healthcare system” should only be accessed on an “as needed” basis for
strategic prevention or disease state management where prevention has already
failed.
While our model may be labor
intensive initially, it only makes sense that the most work must be done in a
proactive fashion. Not only has our preliminary research substantiated the
intuitive claims that the alternative/ complementary medicine industry has
always hoped could be documented but they were achieved with overwhelming
patient satisfaction as well.
Patient satisfaction surveys
are mailed out by BlueCross BlueShield HMO Illinois annually looking for
classic benchmarks such as: “thoroughness of exam,” “accuracy of diagnosis,”
“length of time for physician response to patient phone calls,” and “overall
satisfaction with office physicians and ancillary personnel.” We are happy to
report that in all cases our integrated alternative medicine IPA out-performed
its traditional medical allopathic counterparts.
Furthermore, when BlueCross
BlueShield onsite nurse auditors came to “look under the hood,” AMI achieved
utilization management scores of 100 percent in medical management and 99
percent in administrative management. These scores earned AMI “blue ribbon”
status in the BlueCross BlueShield HMO Illinois listing directory in its first
year of eligibility.
Given the overwhelming success
of our initial HMO pilot, and the scientific credibility it now gives our
medical management and credentialing model, AMI has now begun offering its
programs nationwide on a client specific basis. In keeping with the current
trends of the marketplace, AMI now preferentially offers a Preferred Provider
Organization (PPO) program where the same type of medical management and
physician credentialing are packaged for individual clients, whether they be
self-funded corporations, unions, state or federal agencies/employers or
programs.
My personal sense is that at this
juncture in history most of the various medical leaders have recognized the
mistakes and narrow-mindedness of the past and are attempting to align
themselves together in a real partnership.
This partnership is the birth
of true integrative medicine, not “traditional” versus “alternative” but just
good evidence-based medicine combining the best medicine of all the healing
arts.
What AMI has done is to
provide a credible scientific basis for a vision of the future as to how an
integrative medical model can exist which is accessible nationwide. Our model
is not restricted to specific integrative clinic geography nor is it a “pseudo
benefit” such as is offered by the many discount affinity programs. These
programs merely discount services at the expense of the providers, without
giving true integration or actual insurance coverage benefits.
The credibility of our data
has been appreciated by such entities as the White House Commission on
Alternative/Complementary Medicine and our major corporate clients. We have
been designated as the national credentialing authority of the
As a devoted fan of John
Lennon, I never shrank from the responsibility of imagining a better world. AMI
has proven that one can imagine a vision way ahead of its time and bring it to
concrete reality in a rather short time frame. We encourage all of you as
readers to imagine its rapid adaptation by your company as well. The easiest
way to spread this model nationwide is to lobby your own healthcare payor, be
it an insurance company, self-funded corporation or union, to adopt an
integrative medical model such as AMI’s. We will be open to sharing our data
with any and all interested parties. We can be contacted at 847-433-9946 or our
Web site www.alternativemedicineinc.com
Remember, the future is now .
. . why delay?
Richard L. Sarnat, M.D.
President of Alternative Medicine,
Inc.
Dr. Richard L. Sarnat is a
board-certified ophthalmologist and author of Physician Heal Thyself; What
Every Practitioner Should Know About Alternative Medicine.
Nationally recognized as a
leader in the field of alternative medicine, Dr. Sarnat often speaks at medical
conventions and business symposiums nationwide to discuss “bridging the gap”
between mainstream medicine and alternative care. In 2000 Dr. Sarnat received
the “Presidential Citation Award” from the National College of Chiropractic and
the 2000 “Leadership Award” from the
He is also a trustee of the
National University of Health Sciences. Dr. Sarnat received his undergraduate
degree at