Unconventional Medical Approaches: Alternative Medicines

I. Overview of Complementary, Alternative and Integrative Medicines

Aside from the conventional medical practice, there are also complementary medicine together with alternative and integrative medicines that can help the suffering individual alleviate their pains and health problems. The National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health has defined complementary and alternative medicine (CAM) as “a group of diverse health care and medical systems, practices and products that are not presently considered to be part of the conventional medicine” (House Select, 2006 p.10). It is very important to note, however, that Complementary medicine alone is very distinct from alternative medicine alone. According to the NCCAM: Complementary medicine is applied jointly with the conventional medicine such as the use of aromatherapy in reducing the patient's pain after undergoing a surgery while alternative medicine is applied as a substitute for conventional medicine such as the use of special diet to treat cancer instead of following the physician’s recommendation to undergo surgery or chemotherapy.  Integrative medicine, on the other side, is a combined “mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.” (What is CAM?, 2007).

            II. How CAM Flourished in the United States?

Due to beliefs by some millions of Americans that conventional medicine alone is not enough, CAM has gained its footing in the United States (U.S) Aside from this reason, it was found out, through the survey conducted in 2002 by Advance Data From Vital and Health Statistics, that the growth in CAM usage among Americans are attributed to one or more of the following factors: marketing forces, on-line information availability, patients’ desire to be actively involved with their medical and health decision making, and patients’ general dissatisfaction with the conventional medical applications (Barnes, P., E.Powell-Griner, K. McFann, and R. Nahin, 2004, p.1) With these identified growth and popularity factors for CAM, the survey has identified major reasons for such usage. With at least thirty-one thousand respondents, the top five relevant reasons that were identified as posted in the NCCAM website (The Use of CAM, 2007) are the following:

a.                          Fifty-five percent (55%) of the respondents believe that if CAM is used together with the conventional medical applications better health would be achieved.

b.                          Fifty percent (50%) of the respondents have used CAM due to curiosity stating that “CAM would be interesting to try”

c.                          Twenty-eight percent (28%) believe that it would not help anymore to use the traditional treatments of the conventional medicine

d.                         Twenty-six percent (26%) used CAM as a result of their medical professionals or physicians’ suggestion

e.                          Thirteen percent (13%) have used CAM due to unaffordability of conventional medical applications

            It is worth noting that the majority of the respondents have emphasized that they use CAM as a supplement (complementary) or together with conventional medicine and not strictly as alternatives.

            III. Hindrances to CAM’s Acceptance and Success

The fact that CAM is complementary and/or alternative, it suggests that it is not the “real thing”. Not all of the Americans are bold enough to try using this alternative due to a lot of factors. With the truth that majority (if not all) of the CAM treatments are not yet scientifically proven, there is still a strong public hesitation, which is very reasonable, as to its use. According to an exploratory study on CAM written by Neeta and Astin and published by the Journal of Alternative and Complementary Medicine in 2001,the following are the factors that hinder CAM acceptance in the U.S:

a.       Gender and age factors, where male and younger Americans are less likely to use CAM

b.      Lack of physician support that cause a lot of doubts to potential customers/patients of CAM

c.       The general belief that CAM applications are generally ineffective, unlike the proven methods of the conventional medicine

d.      General American perception that CAM causes negative side-effects to patients

e.       The lack of proper knowledge and awareness and accessibility of/to CAM

Although there is a rapid growth of CAM in the U.S the above reasons must be diminished before CAM can achieve greater recognition and application in the country where conventional scientific, and modern medical practices have gained the trust of the general public.

            IV. CAM: The Way I See It

Like the general notion towards CAM I have the same sentiments as the majority. I believe to their effectiveness  and philosophies which are for the health benefit of the many. However, using CAM alone without the conventional medical treatments for serious ailments is not my idea of improving and curing health problems. CAM is best applied when used with the scientifically proven approach. I would prefer using the “complement” side than the “alternative” side of it.

            When it comes to minor health concerns, however, such as cough or a back pain, I am very comfortable with the use of CAM and I often hire the service of Thai masseuse to relieve me of my back pain and I do not hesitate to drink herb extracts for my cough. Moreover, aromatheraphy is also very relaxing and really makes the blood circulate better.

 Another CAM that I am greatly curious with is Acupuncture because of its years of usage. I strongly believe that a medical practice like Acupuncture, be it called an alternative method, is really effective when properly undertaken. Acupuncture would never survive this long if the results are not favorable to patients. I would really like to experience this kind of treatment if given the chance.

References

Barnes, P., E.Powell-Griner, K. McFann, and R. Nahin. (2004). Complementary and Alternative Medicine Use Among Adults: United States, 2002. National Center for Complementary and Alternative Medicine, National Institutes of Health. Retrieved 16 May 2008 from http://www.cdc.gov/nchs/data/ad/ad343.pdf

House Select Study on Complementary and Alternative Medicine, Final Report to the House of Representatives 2007 North Carolina General Assembly. (2006). Retrieved 15 May 2008, from http://www.ncga.state.nc.us/documentsites/legislativepublications/Study%20Reports%20to%20the%202007%20NCGA/Complementary%20and%20Alternative%20Medicine.pdf

Neeta, J. and J. A. Astin (2001). The Journal of Alternative and Complementary Medicine. December 1, 2001, 7(6): 689-696. doi:10.1089/10755530152755243. Retrieved 16 May 2008 from http://www.liebertonline.com/doi/abs/10.1089/10755530152755243?cookieSet=1&journalCode=acm

The Use of Complementary and Alternative Medicine (CAM) in the United States. (2007). NCCAM Publication, NCCAM, National Institutes of Health. Retrieved 16 May 2008 from http://nccam.nih.gov/news/camsurvey_fs1.htm

What is CAM?. (2007). NCCAM Publication No. D347, NCCAM, National Institutes of Health. Retrieved 16 May 2008 from  http://nccam.nih.gov/health/whatiscam/

Well-coordinated cooperation within healthcare professionals will provide patients comprehensive, population-based and cost-effective service and care as well as new emphasis on health promotion and disease deterrence, which are the challenges that “assault” the practice.

Interdisciplinary healthcare is very important be it in serving the health needs of a patient in a family-oriented healthcare facility, a patient in an ambulatory setting or a patient in acute care. The differences arise in the degree of seriousness that the respective patients are suffering. Collaboration in serving families may not be as strong as the collaboration obtained when the situation at hand is about acute care patients. The latter is of more serious case since the period of stay in a healthcare facility means the period where severe occurrence of the illness is happening. Collaboration is more demanded in an acute care than in ambulatory or family care setting because at this stage, medical professionals cannot afford to commit mistakes, even at its slightest.

Since an interdisciplinary collaboration is consist of various practitioners from various area in the profession conflicts may arise. Although all of them share common population and goals for their patients, disagreements may still occur due to factors that are both controllable and not. According to Westberg and Jason (1993) the joint efforts of the professional team- members may result to insights and answers to problems that are rarely achievable by a single health professional. This aspect of collaboration is good but this is where conflicts arise as well. With “different insights and expertise” opinions may differ, which, sadly, is inevitable. These are the barriers to better collaboration. These barriers, according to Grant, et al (2005) on the good side can promote innovation and creativity in solving the problems at hand. If healthcare professionals in the team overcome and resolve these barriers, greater understanding and confidence is achieved in the team. On the bad side, unsuccessful resolution of these can cause anger, burn-out, aloofness, retreat and low morales among each member. Suggested actions in preventing these damaging conflicts and barriers include the following:

1. Setting of standards in accomplishing tasks and identifying rules for the behaviors of the team

2. “Keeping an open door” for silent team members and encouraging them to make their respective contributions as well

3. Seeking harmony in times of conflict occurrence by attentively listening to each others’ opinions, doing brainstorming for ways to resolve the problem and go back to the basic purpose of the team: patients’ well-being and not personal interests

4. Seek for the consensus of the group to come up with best conclusion on what to do

5. Encouraging feedbacks from each other, both favorable and unfavorable

6. Reviewing and assessing the development of the tasks and the results of the decisions

Overall, interdisciplinary healthcare is good for patients of varying health problems. If the task is properly undertaken, both the healthcare professionals, the healthcare institution and most of all the patients can reap the good benefits of this system.

References

Grant RW, Finocchio LJ, California Primary Care Consortium Subcommittee on Interdisciplinary Collaboration. Interdisciplinary collaborative teams in primary care: a model curriculum and resource guide. San Francisco, California: Pew Health Professions Commission, 1995.

Westberg J, Jason H. Collaborative clinical education: the foundation of effective health care. New York: Springer-Verlag, 1993.

Different countries have their own ways in which they offer their health care to their people. Many countries have developed mechanisms in which they make sure that the greatest number of people access medical care services in effective ways despite of their economic or social classes. This paper focuses on health care in Germany.

In Germany, there is policy, which requires everyone who earns less that 3862 Euros per month to join one the three hundred statutory sickness funds that are found in the country. This is with exception of permanent civil servants and the self-employed people. Those people who lie above the mandatory insurance threshold have the room to opt out of the system offered by the state. Most of them buy private insurance although there are also those who decide to remain in the state system. In the country, it is estimated that ten percent of the population are insured voluntariry.The sickness funds in the country are required to be self-sufficient financially. The premiums are usually set as a percent of the total income. The premiums are usually subtracted from the pay where the employer and the employee pay half each (Kirch, 2008).
Since the 1990’s the government has tried to increase competition among the insurers. This is aimed at enhancing provision of high quality services by the insurance companies. The competition has made the insurance to offer services that are affordable to many people. It is possible to make a comparison, of which insurer offers the best services from the Internet, magazines and the ranking, which is usually done by independent consumer organizations. This has led to large scale shift from the traditional dominant funds. However, this competition cannot be compared with the one that exist in the United States of America. Those people who have a great portion of their pay cut each month becomes the patients who demand to have high quality medical services, which can be, compared with the value of the money that they contribute for the services. They tend to go shopping for the best doctors (Tartaglia, 2005). This is because they do not pay any amount of money as they receive the medical services. Their payments are usually reimbursed by the sickness funds. This reimbursement is usually done through their regional physicians associations. However, those people who have private insurance pay by use of invoice for the treatments that they receive. In the provision of medical services, a distinction that is made between those people who have worked and those have who have never worked. Those people who have previously worked are included in the national insurance system. However, it is nit the employers who pays for the medical services of these people but there are agencies who pay. For those people who are unemployed and have never worked, there is social fund where the provision is made. The social funds arrange cover directly with health specialists (Wolper, 2004).

In Germany hospital are diversely owned. This enhances further competition and constant efforts that are made by the health providers to raise the standards of their services. For instance, in 2002, almost fifty-four percent of hospital beds are owned by the public sector, thirty eight percent were owned by the private non-governmental organizations, while eight percent were privately owned for profit bodies. In Germany, there is no queueing, which is common in many countries in order to see a specialist. Germans have the freedom to see and get services from any specialist that they like. They can visit various hospitals or they book for appointments that are booked instantly by the physicians. Consumers also have the right to penalize for any bad service that they may receive. There is a well established system that allows all the patients to have the most effective serves at the appropriate time in all times (Tartaglia, 2005). About half of medical specialists in Germany have their practice outside the hospitals. Most of the hospitals in the country do not provide out patient services. What happens is that there are very many independent clinics, which have sophisticated diagnosis equipments, which makes them to offer high quality medical services. There are also many health specialists in Germany. It is estimated that there are 2.3 practicing specialist out of one thousand people. This is high as compared to other countries for example UK that has 1.5 practicing specialists out of one thousand people (Kirch, 2008).

There are two problems that health care in Germany face at the moment. For instance, there is a shortage of nurses and many Germans have the feeling that the medical health care services are expensive. However, there are reforms that are being carried out in the health care system in the country. For instance, there was the introduction of charges for non-prescription drugs and the elimination of the free treatments for example health farm visits and free tax rides to health centers. These reforms are aimed at reduction in premiums from an estimated average of fourteen to thirteen percent of gross wages annually (Wolper, 2004).


References
Kirch, W. (2008) Encyclopedia of Public Health, New York, Springer.

Tartaglia, R. (2005) Healthcare Systems Ergonomics and Patient Safety, New York, Taylor & Francis.

Wolper, L. (2004) Health care administration: planning, implementing, and managing organized delivery systems, 4th edition, New York, Jones & Bartlett Learning.

Unconventional Medical Approaches

I. Overview of Complementary, Alternative and Integrative Medicines

Aside from the conventional medical practice, there are also complementary medicine together with alternative and integrative medicines that can help the suffering individual alleviate their pains and health problems. The National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health has defined complementary and alternative medicine (CAM) as “a group of diverse health care and medical systems, practices and products that are not presently considered to be part of the conventional medicine” (House Select, 2006 p.10). It is very important to note, however, that Complementary medicine alone is very distinct from alternative medicine alone. According to the NCCAM: Complementary medicine is applied jointly with the conventional medicine such as the use of aromatherapy in reducing the patient's pain after undergoing a surgery while alternative medicine is applied as a substitute for conventional medicine such as the use of special diet to treat cancer instead of following the physician’s recommendation to undergo surgery or chemotherapy. Integrative medicine, on the other side, is a combined “mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.” (What is CAM?, 2007).

II. How CAM Flourished in the United States?

Due to beliefs by some millions of Americans that conventional medicine alone is not enough, CAM has gained its footing in the United States (U.S) Aside from this reason, it was found out, through the survey conducted in 2002 by Advance Data From Vital and Health Statistics, that the growth in CAM usage among Americans are attributed to one or more of the following factors: marketing forces, on-line information availability, patients’ desire to be actively involved with their medical and health decision making, and patients’ general dissatisfaction with the conventional medical applications (Barnes, P., E.Powell-Griner, K. McFann, and R. Nahin, 2004, p.1) With these identified growth and popularity factors for CAM, the survey has identified major reasons for such usage. With at least thirty-one thousand respondents, the top five relevant reasons that were identified as posted in the NCCAM website (The Use of CAM, 2007) are the following:

a. Fifty-five percent (55%) of the respondents believe that if CAM is used together with the conventional medical applications better health would be achieved.

b. Fifty percent (50%) of the respondents have used CAM due to curiosity stating that “CAM would be interesting to try”

c. Twenty-eight percent (28%) believe that it would not help anymore to use the traditional treatments of the conventional medicine

d. Twenty-six percent (26%) used CAM as a result of their medical professionals or physicians’ suggestion

e. Thirteen percent (13%) have used CAM due to unaffordability of conventional medical applications

It is worth noting that the majority of the respondents have emphasized that they use CAM as a supplement (complementary) or together with conventional medicine and not strictly as alternatives.

III. Hindrances to CAM’s Acceptance and Success

The fact that CAM is complementary and/or alternative, it suggests that it is not the “real thing”. Not all of the Americans are bold enough to try using this alternative due to a lot of factors. With the truth that majority (if not all) of the CAM treatments are not yet scientifically proven, there is still a strong public hesitation, which is very reasonable, as to its use. According to an exploratory study on CAM written by Neeta and Astin and published by the Journal of Alternative and Complementary Medicine in 2001,the following are the factors that hinder CAM acceptance in the U.S:

a. Gender and age factors, where male and younger Americans are less likely to use CAM

b. Lack of physician support that cause a lot of doubts to potential customers/patients of CAM

c. The general belief that CAM applications are generally ineffective, unlike the proven methods of the conventional medicine

d. General American perception that CAM causes negative side-effects to patients

e. The lack of proper knowledge and awareness and accessibility of/to CAM

Although there is a rapid growth of CAM in the U.S the above reasons must be diminished before CAM can achieve greater recognition and application in the country where conventional scientific, and modern medical practices have gained the trust of the general public.

IV. CAM: The Way I See It

Like the general notion towards CAM I have the same sentiments as the majority. I believe to their effectiveness and philosophies which are for the health benefit of the many. However, using CAM alone without the conventional medical treatments for serious ailments is not my idea of improving and curing health problems. CAM is best applied when used with the scientifically proven approach. I would prefer using the “complement” side than the “alternative” side of it.

When it comes to minor health concerns, however, such as cough or a back pain, I am very comfortable with the use of CAM and I often hire the service of Thai masseuse to relieve me of my back pain and I do not hesitate to drink herb extracts for my cough. Moreover, aromatheraphy is also very relaxing and really makes the blood circulate better.

Another CAM that I am greatly curious with is Acupuncture because of its years of usage. I strongly believe that a medical practice like Acupuncture, be it called an alternative method, is really effective when properly undertaken. Acupuncture would never survive this long if the results are not favorable to patients. I would really like to experience this kind of treatment if given the chance.

References

Barnes, P., E.Powell-Griner, K. McFann, and R. Nahin. (2004). Complementary and Alternative Medicine Use Among Adults: United States, 2002. National Center for Complementary and Alternative Medicine, National Institutes of Health. Retrieved 16 May 2008 from http://www.cdc.gov/nchs/data/ad/ad343.pdf

House Select Study on Complementary and Alternative Medicine, Final Report to the House of Representatives 2007 North Carolina General Assembly. (2006). Retrieved 15 May 2008, from http://www.ncga.state.nc.us/documentsites/legislativepublications/Study%20Reports%20to%20the%202007%20NCGA/Complementary%20and%20Alternative%20Medicine.pdf

Neeta, J. and J. A. Astin (2001). The Journal of Alternative and Complementary Medicine. December 1, 2001, 7(6): 689-696. doi:10.1089/10755530152755243. Retrieved 16 May 2008 from http://www.liebertonline.com/doi/abs/10.1089/10755530152755243?cookieSet=1&journalCode=acm

The Use of Complementary and Alternative Medicine (CAM) in the United States. (2007). NCCAM Publication, NCCAM, National Institutes of Health. Retrieved 16 May 2008 from http://nccam.nih.gov/news/camsurvey_fs1.htm

What is CAM?. (2007). NCCAM Publication No. D347, NCCAM, National Institutes of Health. Retrieved 16 May 2008 from http://nccam.nih.gov/health/whatiscam/

Acupuncture: An Alternative

I. Introduction

To support the life of an ailing individual and to relieve pain, the application of formal and conventional medical practice is not alone that can help. The application of complementary and alternative medicine may also relieve the patient of such sufferings. The National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health has defined complementary and alternative medicine as “a group of diverse health care and medical systems, practices and products that are not presently considered to be part of the conventional medicine” (House Select, 2006 p.10).

There is a distinction between the complementary medicine alone and alternative medicine alone. Complementary medicine is applied jointly with the conventional medicine such as the use of aromatherapy in reducing the patient's pain after undergoing a surgery while alternative medicine is applied as a substitute for conventional medicine such as the use of special diet to treat cancer instead of following the physician’s recommendation to undergo surgery or chemotherapy.

The NCCAM classifies complementary and alternative medicine into five major categories. They areç

1. Alternative Medical Systems that are built upon absolute systems of theory and practice that have often developed before and apart from the conventional medicine of the U.S.A. Some of these are homeopathy, hydropathy and naturopathy as well as the Chinese traditional medicine and Ayurveda.

2. Mind-Body Interventions that use a variety of procedures intended to enhance the mind's capacity to affect bodily function and symptoms such as meditating, praying, mental healing, and therapies that use creative outlets like art, music, or dance.

3. Biologically Based Therapies that use substances found in nature like herbs, foods, and vitamins. These kinds of therapies include dietary supplements, herbal products, and the use of other so-called natural but non-scientifically proven methods like the use of shark cartilage to treat cancer.

4. Manipulative and Body-Based Methods which is based upon manipulation and/or movement of one or more parts of the body like massage and chiropractic or osteopathic manipulation.

5. Energy Therapies that include the use of energy fields. It is divided into two subcategories, the biofield therapies and the bioelectromagnetic-based therapies. Biofield therapies are intended to affect energy fields that purportedly surround and penetrate the human body such as the application of pressure and/or manipulation of the body by placing the hands in, or through these fields, i.e., qi gong, reiki, and therapeutic touch. On the other hand the bioelectromagnetic-based therapies entail the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating-current or direct-current fields.

According to NCCAM, Acupuncture is an “energy medicine involving putative energy fields”, or the biofields. (Energy Medicine, 2004)

II. What is Acupuncture, Its Philosophies, Purpose, and Treatment Principles?

"Acupuncture can alleviate prolonged pain, discomfort, and anxiety, and end severe dependence on a medical system so huge and impersonal that each patient feels like a forgotten cog in a machine." (Cargill, 1994, p. 3) That is what Acupuncture can do according to Cargill. But what is it? NCCAM defines Acupuncture as “a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques, the most common of which is the penetration in the skin with thin, solid, metallic needles that are either manipulated by the hands or by some electrical stimulation”. (An Introduction)

The philosophical basis behind Acupuncture for traditional practitioners is the “qi” (Birch & Felt, 1999, p. 88) or the so called vital energy. Qi flows through the twelve major energy pathways called meridians, each of these is connected to specific internal organs of the body or organ systems and “three hundred sixty-five to two thousand acupoints” (Freeman & Lawlis, 2001, p. 311). This qi is blocked when there is imbalance of yin and yang, “two opposing and inseparable forces”(An Introduction), in the body thereby causing illnesses. Acupuncture can relieve the ailment by unblocking the qi through the insertion of needles at specific anatomic points in the body. Simply stated, the purpose of Acupuncture is to heal or therapeutic. Some healing results of acupuncture, according to research, include alleviation of low back pain, headache, pain from osteoarthritis, neck pain, musculoskeletal and myofascial pain, organic pain, and pain before and after surgery. It has also been used for the treatment of postoperative and chemotherapy-induced nausea, neurologic dysfunction, gynecologic and obstetric conditions, asthma, and substance abuse. With Acupuncture, illness or sickness is prevented while better health is restored.

III. Brief Summary and Evolution of Acupuncture

Acupuncture evolved from the traditional Chinese medicine (TCM). Earliest evidence regarding this practice can be found in the text, “The Yellow Emperor's Inner Classic (Huang Di Nei Jing), a collection of 81 treatises compiled between 206 BC and 220 AD” (Freeman & Lawlis, 2001, p. 316) However, Freeman and Lawlis further noted that “the oldest surviving classical text dedicated entirely to acupuncture was written sometime in 282 AD by Huang-Fu Mi” entitled, The Comprehensive Manual of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing). This book contains the "combined classical concepts concerning the theories and teachings of acupuncture points, channels, and the cause of illness, diagnosis, and therapeutic needling" (Freeman & Lawlis, 2001, p. 316) It was in 618 AD when the practice reached its peak in China with the foundation of the Imperial Medical College. During this period, the practice was spreading its influence over other Asian nations such as Japan, Korea and Southeast Asia. Acupuncture attained maximum refinements at the end of the sixteenth century.

Although it was in 1971 when Acupuncture became popularly recognized in the United States of America (USA), awareness about this therapeutic practice has been introduced in the country long before this period. The first records and studies of the practice became known to the Americans in 1825 in the publication of Morand's Memoir on Acupuncturation, a document translated from French by Franklin Bache. However, it was in 1971 when the New York Times correspondent James Reston note down his experience about Acupuncture describing how medical professionals in China utilized needles to alleviate his pain after he have undergone surgery.

Currently, the NCCAM reported that in the USA Acupuncture is being "widely" practiced by thousands of related medical practitioners such as physicians, dentists, acupuncturists, and other practitioners mainly for alleviation and avoidance of pain and for other health purposes. In fact it was reported that in 2002, the survey showed that 8.2 million of the American adults have made use of Acupuncture.

IV. Hazards of the Practice and Its Licensing and Regulatory Requirements

The NCCAM provides in its website that the use of Acupuncture has a relatively lower account in terms of health problems and complication despite the huge number of treated individuals in America. Generally the negative complications resulted from the use of inadequately sterilized needles causing serious undesirable effects, including infections and punctured organs. Moreover improper needle placement, patient movements, or a defective needle may cause to tenderness, discomfort, soreness and pain during treatment.

The Food and Drug Administration (FDA) regulates acupuncture needles. These needles should be used by licensed practitioners only and need to be manufactured and labeled according to the required standards on sterilization, nontoxic quality, and must be labeled for single use by qualified practitioners only.

Public hearings held on April 25, 2006 in Asheville, and on September 27, 2006 in New Bern in North Carolina have acknowledged issues regarding the following safety measures in alternative medical practice:

a. Practitioners Training, Qualifications and Credentials of Acupuncturists

b. Consumer Protection of patients

c. Insurance Coverage of patients for possible health problems and side effects

d. An Oversight- Regulatory Board to regulate and control the practice ensuring public safety.

Finally, for public awareness the NCCAM Clearinghouse provides information on CAM and NCCAM, as well as publications and searches of Federal databases of medical and scientific texts in service to the American nation regarding alternative medicines.

References

An Introduction to Acupuncture. (2007). NCCAM Publication No. D404, NCCAM, National Institutes of Health. Retrieved 15 May 2008 from http://nccam.nih.gov/health/acupuncture/

Birch, S. J., & Felt, R. L. (1999). Understanding Acupuncture. New York: Churchill Livingstone. Retrieved May 15, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=100223449

Cargill, M. (1994). Acupuncture: A Viable Medical Alternative. Westport, CT: Praeger Publishers. Retrieved May 15, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=81902256

Energy Medicine: An Overview. (2004). NCCAM Publication No. D235, NCCAM, National Institutes of Health. Retrieved 15 May 2008 from http://nccam.nih.gov/health/backgrounds/energymed.htm

Freeman, L. W., & Lawlis, G. F. (2001). Mosby's Complementary Alternative Medicine: A Research-Based Approach. St. Louis, MO: Mosby. Retrieved May 15, 2008, from Questia database: http://www.questia.com/PM.qst?a=o&d=100735773

House Select Study on Complementary and Alternative Medicine, Final Report to the House of Representatives 2007 North Carolina General Assembly. (2006). Retrieved 15 May 2008, from http://www.ncga.state.nc.us/documentsites/legislativepublications/Study%20Reports%20to%20the%202007%20NCGA/Complementary%20and%20Alternative%20Medicine.pdf