Who Will Step in When Physician Shortage Hits?

posted by Pivotal Health Solutions on Friday, December 19, 2014

As a primary physician shortage looms ahead, one resource that practitioners and patients can turn to is complementary medicine. Patients can look to massage, physical therapy/athletic training, chiropractic and modalities like low-level laser therapy to help them manage and even prevent their pain in a cost-effective manner. A recent article on Massage Today reviews the beneficial relationship between pain and complementary medicine. 

The growth in the number and proportion of older adults in the U.S. has reached unprecedented levels, creating a number of issues for baby boomers, including a rise in chronic conditions, greater demand for pain relief, overuse of pharmaceuticals and high prescription expenditures. According to a Manhattan Institute for Policy Research report, “Rhetoric and Reality, The Obamacare Evaluation Project: Access to Care and the Physician Shortage,” population growth, demographic changes and an expansion of insurance spurred by health care reform will contribute to a significant shortage in primary care physicians over the coming decade. The report projects that by 2025, the U.S. will experience a shortage of roughly 30,000 primary care physicians.

Americans in Pain

Pain is the most frequent reason patients visit an emergency department. Whether stemming from an overuse injury, postoperative reaction, sports injury or another cause, pain is responsible for more than 70 percent of such visits, according to an International Association For the Study of Pain fact sheet, “Global Year Against Pain”—yet fewer than half of post-operative patients receive adequate pain relief, despite the fact that poor pain management puts patients at risk, creates needless suffering, and increases costs of care.

Seniors living with chronic pain bear the considerable burden of pain, in terms of quality of life, cost and social consequences. Fortunately, complementary and alternative medicine (CAM)—including massage therapy, chiropractic, acupuncture, nutritional medicine, naturopathy, herbalism, ayurveda, reiki, laser therapy and electrotherapy—offers more affordable, drug-free options for short and long-term pain relief. These factors have contributed to the dramatic rise in CAM practices in recent years.

CAM Fills in the Gaps

These factors have contributed to the dramatic rise in CAM practices in recent years. The National Institutes of Health states that an estimated 18 million Americans receive massage therapy each year, according to the TIME magazine article, “Alternative Medicine: Your Guide to Stress Relief, Healing, Nutrition and More,” (April 4, 2014), while chiropractors treat more than 30 million people annually.

Licensed massage therapists, chiropractors, acupuncturists and naturopathic physicians continue to be sought after as accessible and cost-effective health care solutions. According to the National Institutes of Health study, “Comparison of Health Care Expenditures Among Insured Users and Nonusers of Complementary and Alternative Medicine in Washington State: A Cost Minimization Analysis,” among insured patients with back pain, fibromyalgia and menopause symptoms, those who use CAM have lower insurance expenditures than those who do not use CAM. The study noted that CAM therapies avoid high technology and offer inexpensive remedies. CAM providers in this study included licensed massage therapists, chiropractors, acupuncturists and naturopathic physicians.

The results of the study suggested that, because individuals with high disease burden typically drive the majority of claims expense, the potential for savings is much greater for CAM users. What’s more, the trend toward the integration of CAM into standard care will improve access to care for many baby boomers.

What Makes CAM Different

CAM therapies encourage the natural healing ability of the body and focus on preventing disease rather than simply treating disease. According to the U.S. News & World Report article, “Top Hospitals Embrace Alternative Medicine,” academic hospitals and centers of excellence, such as the Ann & Robert H., Lurie Children’s Hospital of Chicago, Mayo Clinic, Duke University Medical Center, and the University of California-San Francisco offer CAM services that often include massage therapy. 

Studies show that massage therapy increases endorphins and serotonin, chemicals that act as natural painkillers and mood regulators. Massage therapy also reduces levels of the stress hormone cortisol, and turns off genes associated with inflammation and its associated pain, which in turn relieves muscle soreness, according to the TIME article.

Moderate- to deep-pressure massage can activate the vagus nerve to regulate heartbeat, helping seniors experience pain relief for a number of conditions. Studies also show that massage helps reduce anxiety, pain and nausea in cancer patients by 44 percent, and also raises the level of cancer-fighting white blood cells, according to the TIME article.

Chiropractic treatment of neck and back pain, which is common among aging Americans, provides more relief than over-the-counter drugs like aspirin and ibuprofen. In one study, after 12 weeks of treatment more than half treated reported at least 75 percent reduction in pain compared with one-third in the drug group, according to the TIME article.

According to the National Center for Complementary and Alternative Medicine, “Acupuncture: What You Need To Know,” acupuncture has also been shown to relieve a wide range of pain conditions that impact seniors, including back and neck pain, osteoarthritis/knee pain and headache.

CAM helps move patients toward complete wellness, enabling them to discover and understand the hidden causes of health issues, create a customized and comprehensive treatment plan, and invest in healthy aging to achieve lower disability rates down the road.

Kray Kibler is chief operating officer and chief financial officer for Scrip Companies. He joined Scrip in May 2006, gaining broad and deep experience throughout the business with responsibility for oversight of the company’s financial, IT, human resource, customer service, distribution operations and field/corporate sales.