Jun 26 2011

Patients whose GP knows complementary medicine tend to have lower costs and live longer.

Published by
Under Healthcare Policy | Science Stuff

Eur J Health Econ. 2011 Jun 22. [Epub ahead of print]

Kooreman P, Baars EW.

Department of Economics, Tilburg University, Warandelaan 2, 5037 AB, Tilburg, The Netherlands, p.kooreman@uvt.nl.

BACKGROUND:

Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost-effectiveness of CAM.

OBJECTIVE:

To explore the cost-effectiveness of CAM compared with conventional medicine.

METHODS:

A dataset from a Dutch health insurer was used containing quarterly information on healthcare costs (care by general practitioner (GP), hospital care, pharmaceutical care, and paramedic care), dates of birth and death, gender and 6-digit postcode of all approximately 150,000 insurees, for the years 2006-2009. Data from 1913 conventional GPs were compared with data from 79 GPs with additional CAM training in acupuncture (25), homeopathy (28), and anthroposophic medicine (26).
RESULTS:

Patients whose GP has additional CAM training have 0-30% lower healthcare costs and mortality rates, depending on age groups and type of CAM. The lower costs result from fewer hospital stays and fewer prescription drugs.

DISCUSSION:

Since the differences are obtained while controlling for confounders including neighborhood specific fixed effects at a highly detailed level, the lower costs and longer lives are unlikely to be related to differences in socioeconomic status. Possible explanations include selection (e.g. people with a low taste for medical interventions might be more likely to choose CAM) and better practices (e.g. less overtreatment, more focus on preventive and curative health promotion) by GPs with knowledge of complementary medicine. More controlled studies (replication studies, research based on more comprehensive data, cost-effectiveness studies on CAM for specific diagnostic categories) are indicated.

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Jun 15 2011

Licensure for NDs in NY Could Pass This Session

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May 18 2011

Big, Historic Day in Naturopathic History!

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Our amazing team of NDs, patients, family and employees put on a successful lobby day in Albany yesterday. We had over 60 meetings, signed on many new sponsors for the bill AND the licensing bill passed the Senate Higher Education Committee, 16 voted yes, 2 no and 1 without recommendation.

See this article in the Albany Times Union today!

What is next?

We’ll be meeting with the State Education Department and the Senate Finance Committee members. Goal is for the bill to pass the Senate in the next few weeks.

What can you do?

Post comments about why licensure for NDs in important in this blog

Post this link in your Facebook and Linkedin page asking everyone in NY to send an email to their legislators:

The message:

  • Naturopathic Doctors fill a GAP in the health care system in New York
  • NDs know how to prevent chronic illness, and thus decrease health care costs
  • NDs need to be licensed to diagnose and treat so that patients have access to their care

We are in this together! Your participation matters.
Dr. Doni Wilson

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Apr 23 2011

North Dakota Licenses Naturopathic Doctors!

Published by
Under Healthcare Policy

By Gene McGill, Director of State Government Relations

The North Dakota Legislative Assembly has passed SB 2271 for the licensure of naturopathic physicians and, as of this printing, the bill has made its way to the governors office and is schedule to be signed by North Dakota Governor Jack Dalrymple.

Congratulations to all involved in this tremendous accomplishment!

There is a saying that to get legislation passed you need a good sponsor, a good grassroots operation, and a good lobbyist. All those things were present in the passage of SB 2271.

Senators Margaret Sitte and Tim Mathern worked in a bipartisan manner to move the legislation through the chambers. Upon passage, Senator Sitte said, “I’m so happy for our state that we have a new tool in medical care.”

North Dakota Association of Naturopathic Doctors President Faye Johnson, Treasurer Lezlie Link and Beth Allmendinger, ND Candidate (Bastyr), were crucial in the grassroots operation of finding additional sponsors, gathering community support, and the executing the email campaign. Also lending support were Kathleen Allen, ND, and Stephanie Nishek, ND. Special thanks to the other students who joined in the grassroots organization Sara: Christopherson (Bastyr), Brooke Halgren (NCMN), Scott Just (SCNM), and Sara Larson (NCMN).

The lobbying, planning, and organizing the push for licensure was all the work of Beth Allen, ND. Beth also serves as the secretary of NDAND. She worked tirelessly over the past several months to defend the bill, present testimony, and work with the legislature to ensure changes did not compromise the final legislation. Beth personally spent in excess of four hundred hours this year working on licensure.

SB 2271 will create “the state board of integrative health care.” The board will consist of a minimum of five members. Each profession regulated by the board must have one member on the board. Additionally, the board will consist of an MD or DO, a pharmacist, an advanced practice nurse, and up to two laypersons. A subgroup must be established for each profession being regulated with three to five members, all licensed or licensable in the regulated profession. The board as a whole may take no action that impacts a regulated profession unless they first consult with the subgroup.

The practice of naturopathic health care in North Dakota will permit nonprescriptive natural therapeutic substances, food, vitamins, dietary supplements, topical drugs, health-care counseling, nutritional counseling, and barrier devices for contraception. Naturopathic doctors may also perform or order for diagnostic purposes a physical or orificial examination, ultrasound, phlebotomy, clinical laboratory tests, and any other noninvasive diagnostic procedure commonly used by physicians in general practice and authorized by the board.

SB2271 offers NDs in North Dakota a very solid base to build upon. Congratulations again to everyone that that worked so hard to make it happen.

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Mar 15 2011

What is[n't] Naturopathic Medicine?

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Under Healthcare Policy

by Dr. Michael Long

Originally posted here

If defining a multi-factorial concept is terribly difficult, then defining naturopathic medicine is a fruitless task. Not because it is difficult to understand; more so because each person has their own preconceived ideas, whether based on fact or arrogant assumption. When something is deemed ‘non-mainstream’, it has a higher tendency to be disregarded by default, despite the available evidence. **Shot to your Ego Warning** This type of reasoning, called prereflective judgment (1), is the most rudimentary type of thinking, where a person merely assumes, as they are either unable to differentiate fact from belief, or they choose not to. Conclusions are based on what ‘feels right’, and have nothing to do with the actual evidence. Each truth is contradicted by a number of mistruths. Because of this, we cannot easily define naturopathic medicine based on what it is. So instead, I am going to define it based on what it isn’t.

I have heard naturopathic doctors described in many fashions—ranging from highly accurate to completely absurd. We are not witch doctors, quacks, hippies, or miracle curers. We do not have voodoo dolls, cauldrons, or potions. In actuality, we are rooted in science, requiring Bachelor of Science degrees as a prerequisite for entry in to naturopathic doctor programs. We have numerous peer reviewed journals that investigate our medical interventions, allowing us to use the latest natural evidence-based medicine with our patients. Natural medicine is not stagnant, grasping on the whim of historical findings—just like all branches of medicine, trusted therapies of old are refined continually as the evidence evolves—out with the old, in with the new.

Licensed naturopathic doctors do not recieve their training on the internet. Naturopathic medicine is full of fraudulent individuals lurking in jurisdictions unregulated by the government, giving the profession a bad name. These people have no real clinical training, and are dangerous to the public. Real naturopathic doctors graduated from a rigorous four year program at 1 of 7 naturopathic medical schools, accredited by the Association of Accredited Naturopathic Medical Colleges. Practitioners in regulated provinces and states are governed by a licensing body that serves to protect the public. If you live in an unregulated area, ensure your natural health practitioner received their training at an accredited institution, and is insured and licensed by a regulatory body.

Our education is not a joke, and in no way resembles Hogwarts. It may actually surprise you to learn that our clinical training is comparable to or exceeds that of influential medical schools (see comparison here). We are deeply trained in clinical sciences, as well as conventional and naturopathic interventions. We are primary care doctors with a defined scope of practice, and the ability to prescribe prescription drugs in many jurisdictions. Some medical doctors are negative critics of naturopathic medicine, despite zero training in our therapies (see prereflective judgments above). I personally would not take my car difficulties to my hairdresser; so be careful who you get your natural health information from!

Our medicine cannot reliably cure or even be directly beneficial to every disease process (obviously)—if you are being led on this way, you may be getting scammed or lied to. All branches of medicine have limitations, so be weary of practitioners who offer lofty medical promises. Despite this, natural medicine can help in most any situation. Who do you know, healthy or otherwise, that would not benefit from personally tailored nutrition plans, better sleep, or more energy?

Does naturopathic medicine have some controversial treatments? Absolutely! Every treatment modality has differing levels of evidence and reliability. A good doctor will be very transparent about effectiveness from research and will not offer concrete promises. Likewise, a good patient does not blindly follow; they are inquisitive and prudent participants in the treatment process. While many practitioners report tremendous success with certain low evidence interventions, my personal philosophy is to only use interventions strongly supported by the peer reviewed evidence.

Does naturopathic medicine have some quirky/edgy practitioners? Absolutely! All professions do. I have met just as many quirky medical doctors as naturopathic doctors. And, as is human nature, these outliers tend to get most of the press because they are interesting. But in reality, they rarely represent the general consensus of the profession. Do not allow these people to dictate your overall impression.

Reflective judgement is considered the most advanced form of rational thinking (1). Here, opinions are critical assessments, formulated by weighing all available evidence before reaching a conclusion. When this is done, most of naturopathic medicine is of sound reasoning (some is not). I challenge you to use your reflective judgement when assessing naturopathic medicine, not falling for the false rhetoric based on uneducated prereflective ideations. Only then can we properly define naturopathic medicine for what it is, and not argue about what it isn’t.

Works Cited

1. Developing reflective judgment: Understanding and promoting intellectual growth and critical thinking in adolescents and adults. King, P and Kitchener, K. San Francisco : Jossey Bass, 1994.

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Mar 14 2011

Naturopathic Awareness Day at the Capitol in Albany, NY

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Join us: Tuesday, May 17, 2011

NYANP’s Annual Lobby Day is more than a trip to Albany.

It is an opportunity to share our story with legislators and show the strength of the support that we have built for licensure of naturopathic doctors.

RSVP By Email: Please include your name, address(es) in NY, and cell phone number.

Support Lobby Day from Home!

Licensure Fund: Click here to contribute to the License Fund. Your generous gift will help us pay the costs associated with Lobby Day and support our year-round advocacy efforts and outreach to elected officials and state agencies.

TAKE ACTION: Click here to email your NY legislators today!

JOIN OUR MAILING LIST: Click here to receive updates throughout the legislative session.

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Feb 27 2011

Ginseng Boosts Memory Function After Stroke

Ginseng may help improve memory in patients with mild dementia following a stroke, according to the results of a randomized pilot study reported at the American Stroke Association’s 28th International Stroke Conference.

Chinese ginseng has been used for centuries in China to treat disease and aging.

Chinese ginseng strikingly improves learning and memory following transient cerebral ischemia in rats. It increases the activity of brain acetylcholine and choline acetyltransferase in aged mice, while reducing the activity of acetylcholinesterase in the cerebral cortex and hippocampus.

Panax ginseng

In this randomized, double-blind, controlled clinical trial, 40 patients with mild and moderate dementia after ischemic stroke (26 men and 14 women) received one tablet of compound Chinese ginseng (n = 25) or one 40-mg tablet of almitrine + raubasine (n = 15), three times daily for 12 weeks.

The ginseng compound was extracted from Chinese ginseng roots, leaves, and panax notoginseng. The combination of almitrine and raubasine is thought to increase oxygenation in brain tissue.

After treatment with Chinese ginseng, mean scores on the HVLT and total memory scores increased significantly (P < .05 and P < .001, respectively).

Improvements in episodic memory function assessing immediate and delayed story recall, delayed word recall, verbal learning and verbal recognition, and visual recognition were greater in the ginseng group than in the almitrine + raubasine group.

"There is currently great interest in studying herbs used in traditional forms of medicines, and the problem of dementia after stroke is a significant one," says Robert J. Adams, MD, chairman of the Stroke Council of the American Heart Association. "This work showing that ginseng may improve memory after stroke needs to be further studied, with larger sample sizes. A placebo-controlled study would also be the next step.

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Jan 27 2011

Balance Your Blood Sugar and Feel Better!

Published by
Under Health News | Tools and Tips

Donielle Wilson, ND

Blood sugar is one of the best first steps to healing most health issues, including anxiety, fatigue, weight gain, high cholesterol, menstrual irregularities and digestive complaints. Even when standard blood tests show that your blood sugar is normal, you will find that efforts to minimize the fluctuations in blood sugar levels throughout the day will help you to feel better.

Quick ideas for balancing blood sugar:

  • Eat every 3 to 4 hours
  • Include protein every time you eat, especially in the morning
  • Carry foods with you that contain protein. Examples include: protein shake, protein bar, nuts, sunflower seeds, and nut butter.
  • Choose a variety of complex carbohydrates (whole grains, brown rice, quinoa), which are high in fiber.
  • Sample meal: Brown rice, broccoli with fish/chicken/turkey
  • Try to eat right when you start to feel your blood sugar dropping instead of waiting until it is really low.
  • When your blood sugar is low avoid eating something high in sugar, which may raise your blood sugar too much. Choose a snack as described above instead.

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Dec 12 2010

Children, chemicals, and cancer

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Under Health News | Healthcare Policy

Children under 2 years of age have a much greater chance of getting cancer from exposure to certain chemicals than do adults, the Environmental Protection Agency concludes in a new risk assessment.

According to the analysis, which focused chemicals that cause damage to genes, the risk of a future cancer is 10 times greater for a child under age 2 than for an adult who is similarly exposed. Children from 3 to 15 years of age face a risk at least three times greater than adults when exposed to these chemicals, the proposed EPA guidance said. The analysis was confined to so-called mutagenic chemicals that cause damage to genes thereby making a person more susceptible to getting cancer later in life.

Kids are more at risk from environmental chemicals than we thought.

But EPA scientists said children may well be more vulnerable when exposed to other types of cancer-causing chemicals as well, although the scientific data is not yet sufficient to make any conclusions on that.

Nevertheless, the proposed guidance would represents a major change in how cancer risk to children is viewed by EPA regulators. Currently the agency assumes in when assessing a chemical that children are no more vulnerable to cancer than adults if exposed to the substance.

“This (new assessment) is really a significant step forward in understanding how environmental exposure affects our children,” said Ramona Trovato, an EPA official who has spent the last five years studying environmental pollution and children.

The proposed guidelines on children is to be reviewed by the EPA science advisory board, probably in May, with a final guidance likely to be issued this summer, said Bill Farland, the EPA’s acting assistant administrator for science.

“We think this guidance on assessing children’s cancer risk is going to evolve for a number of classes of compounds … as we get more information. “We have long talked about the need to assure that we’re protecting sensitive sub-populations and sensitive life stages.”

The EPA assessment notes that children generally are expected to have exposures to chemicals that are different from adults because differences in their size, physiology and behavior. Children and adults exposed to the same concentrations of a chemical also may receive different internal doses because of differences in intake and absorption rates, the assessment said.

The EPA assessment was based mainly on a review of animal studies involving five mutagenic compounds and from data collected in studies of survivors of atomic bomb blasts in Japan at the end of World War II, said James Cogliano, an EPA scientist.

Most of the chemicals that were studied involve industrial applications, ones to which infants would not likely be easily exposed, said Farland.

One of them, benzopyrene, is a carcinogen found in cigarette smoke and auto exhausts; another, benzidine is used in the manufacture of dyes, while a third, vinyl chloride, is used in making plastics.

But the findings suggest, when more studies come in, the same disparity on risk between adults and the very young may well be observed although in existing studies “you see mixed results,” said Cogliano. “Sometimes there was a higher cancer risk, sometimes there was not.”

Environmentalists embraced the new focus on children.

“We’re very happy that they’ve recognized that children under 2 years of age are really very susceptible,” said Jennifer Sass, a scientist in the public health program at the Natural Resources Defense Council.

EPA officials said the new guidelines will more accurately reflect cancer risks than methods now in use.

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Nov 12 2010

Weight Gain May Be in the Genes

Published by
Under Health News | Science Stuff

Despite all the public service announcements telling people how unhealthy it is to be fat, Americans just keep larding on the pounds. Studies have shown that as many as 60 percent of the U.S. population is overweight, while almost 30 percent is classified as obese. Some say the fast-food industry is to blame while others fault super-sized meal portions. But is it just a problem of unhealthy lifestyles or is there something else going on deep down in our cells?

Why the sudden change in weight-loss philosophy? It’s simple. Scientists have learned that while willpower is important, much of what, when and how much we eat is dependent on our genes. In addition, the urge to exercise may also be related to the DNA we inherit.

When it comes to losing weight, we’re fighting against a body regulatory system that has evolved over hundreds of thousands of years to keep us functioning no matter how sparse food becomes. And, scientists have been learning, this genetic influence is stronger in some people than others.

As a prime example of the role of genetics, researchers point to two groups of Pima Indians, one living in Arizona and the other in Mexico’s Sierra Madre Mountains. The Pimas in Arizona have long been known for high rates of obesity, diabetes (almost 50 percent suffer from this disease) and high cholesterol.

The Pimas in Mexico, where food is more sparse and manual labor more common, tend to be lean and have a much lower rate of diabetes than those in Arizona. But despite their healthier lifestyles, the Mexican Pimas still have higher rates of obesity and diabetes than the general population, a finding that leads researchers to point to genes as the culprit.

What's the use?

After studying groups like the Pimas, scientists have developed a theory known as “The Thrifty Gene Hypothesis.” This idea suggests that some of us are born with the Honda of metabolisms — we can go a long way with little fuel.

Other, more fortunate people — fortunate, that is, in times of plenty — have metabolisms that more closely resemble gas-guzzling SUVs. They burn fuel fast leaving bodies slim.

In 1994, when researchers discovered the chemical compound leptin, they thought they had come up with a cure for people with thrifty genes. Leptin is released by fat cells and the larger fat cells get, the more leptin they release. Normally, when the brain gets a surge of leptin, it concludes that the body has a safe store of fat and sends out a message to dampen appetite.

But, much to their dismay, when scientists tried giving overweight people more leptin to see if it would kill appetite and cause weight loss, the experiments failed.

Most obese people already have high levels of leptin,” explains Dr. Jeffrey Friedman, an investigator with the Howard Hughes Medical Institute at The Rockefeller University in New York City. “But they seem to be insensitive to it.”

Friedman suspected that there might be a way to bypass leptin by looking at enzymes the hormone regulates. Last summer, he and his colleagues found an enzyme related to weight control called SCD-1 and studied the effects of the enzyme in mice genetically engineered to be deficient in it. These mice tended to stay thin, even though they ate more than normal mice, because they had faster metabolisms.

Apparently, the body needs SCD-1 in order to store fat and, without the enzyme, most fat is burned instead of being stashed away.

Another factor in determining whether someone will be heavy or not is the amount time they spend working out. But new research suggests that whether one chooses to become a couch potato may also be the result of their DNA.

Researchers looking at a gene labeled Nh1h2 found that mutations of the gene impacted the impulse to exercise. Mice with certain mutations of Nh1h2 tended to be lethargic.

“Basically, if you put a normal mouse in a cage with an exercise wheel, he’ll run,” explains Deborah Good, an assistant professor of vertebrate molecular genetics at the University of Massachusetts in Amherst.

“But the mutant ones, if you put them in a cage with a wheel, they’re not interested in running,” says Good. “There’s nothing physically wrong with them. They did as well or better in tests with forced exercise. They just don’t want to run.”

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