The Future of Nturl Medicine - Essay Example

The future of nturl medicine [Nme of the school] [Nme of the uthor] Contemporry helth cre hs entered the informtion ge nd is now offering vriety of utomted services thought online systems nd telecommuniction. The ptients cn register online in order to receive prescription refills, lb results, ppointments, nd secure emil with clinicins. Some helth systems hve gone even further-by systemticlly delivering clinicl services vi telemedicine, - rpidly developing ppliction of clinicl medicine where medicl informtion is trnsferred vi telephone, the Internet or other networks for the purpose of consulting, nd sometimes remote medicl procedures or exmintions. The future of helth cre nd medicine cn not be predicted, but it will certinly be developing into n Informtion ge, evolving in itself. Prticulrly, the medicl services will be delivered through the Internet nd other innovtive mens of communiction providing qulity nd cre whenever nd wherever needed. In the following pper I will discuss the future of nturl medicine emphsis on e-medicl services. I will lso tlk bout conventionl medicine nd its plce in the future of helth cre. Understnding E-medicine E-medicine refers to the use of telecommuniction tht provides medicl informtion nd services. It my be s simple s two helth professionls discussing cse over the telephone, or s sophisticted s using stellite technology to brodcst consulttion between providers t two distnt loctions, using videoconferencing equipment." (Gustke et l., 20000) The simplest definition of E-Medicine is tht it uses multimedi technology (voice, video nd dt) to deliver medicl services. The lower cost of bnd- width nd improvement in video nd dt compression stndrds hve incresed the number nd types of medicl services tht cn be delivered from distnce to include virtully every specilty. E-Medicine is n ppliction nd not technology. It uses hybrid technology incorporting elements of television, telecommuniction, computers, engineering nd medicine. Services cn be delivered on combintion of technologies with vriety of equipment. The objective of E-medicine "is not n evolutionry concept but revolutionry concept nd t the hert of every revolution, there is the need for sudden mssive chnge, t the core of which is the humn mind." (Merrell, 2004). E-medicine in the future will bring mny benefits to helth cre system, will fcilitte the work of helth cre employees nd improve the response time for ptients. Prticulrly, the benefits of e-medicine include: higher qulity helthcre vilble to trditionlly under privileged popultion. For lrge rurl bsed popultion seprted by lrge distnces the ccess to regulr qulity medicl cre is needed nd cn be provided by e-medicine. E-medicine cn enhnce citizen's equlity in the vilbility of vrious medicl services nd clinicl helth cre, despite these economic nd geogrphic brriers. E-medicine will sve the time wsted by both providers nd ptients in trveling from one geogrphic loction to nother to vil services on time. The ptient who requires immedite specilist consultncy, nd there is no specilist vilble to cter to him, could be utilized for effective helthcre delivery. E-medicine will reduce costs of medicl cre since the rising cost of helthcre is becoming prime concern. The costs relted to ptient cre, i.e. the cost ssocited with fctors other thn the ctul medil cre such s trvel, ccommodtion for reltives, food etc lso contribute substntilly to the overll cost of tretment. In country where helth insurnce is yet to ctch up, ll these re borne by ptients, in mny cses by selling property nd livestock. If hospitls cn reduce these costs ssocited with tretment, it would go long wy in reducing the burden of cre on the ptient. E-medicine seems to be the nswer. dvntges of E-medicine Providing helthcre services vi Internet nd other telecommuniction services gives mny dvntges. It cn mke specilty cre more ccessible to underserved rurl nd urbn popultions. Video consulttions from rurl clinic to specilist cn llevite prohibitive trvel nd ssocited costs for ptients. Videoconferencing lso opens up new possibilities for continuing eduction or trining for isolted or rurl helth prctitioners, who my not be ble to leve rurl prctice to tke prt in professionl meetings or eductionl opportunities. While studies hve yet to confirm this, it ppers tht the use of telemedicine cn lso cut costs of medicl cre for those in rurl res. Brriers to E-medicine There re still severl drwbcks of e-medicine. Mny countries will not llow for exmple out-of-stte physicins to prctice unless licensed in their stte. The medicl institutions still hve severl restrictions for prcticing e-medicine. Mny privte insurers lso will not reimburse, lthough some countries my hve legisltion nd in the future ll countries might hve legisltion regrding reimbursements. There exists fer of mlprctice suits which should dispper in the future. Physicins re not lwys ble to ccept technology since they lck knowledge of computers. The future genertion will be more educted nd will be ble to ccept the technology required for e-medicine (Gustke et l 2000). Mny potentil telemedicine projects hve been hmpered by the lck of pproprite telecommunictions technology. Regulr telephone lines do not supply dequte bndwidth for most telemedicl pplictions. Mny rurl res still do not hve cble wiring or other kinds of high bndwidth telecommunictions ccess required for more sophisticted uses, so those who could most benefit from telemedicine my not hve ccess to it. ll these problems will be solved in the future providing more responsive helth cre services (Peredni, llen, 2004). Mny current e-medicine projects side-step these nd other problems by obtining government funds. However, in the pst three to four yers, in US the federl funding hs become less vilble for telemedicine. In 2005, the Technology Opportunity Progrm (TOP) did not receive funds for telemedicine/telehelth, nd the Office for the dvncement of Telehelth (OT) did not fund ny new progrms. Some legisltion nd grnt ppropritions pssed in response to 9/11 include the use of telehelth, but no direct funding hs been mde vilble. Some privte corportions nd telecommunictions compnies re stepping in to fill the void, however, pressure on the pproprite government nd legisltive gencies is needed before more funding will become vilble. Technology mnufcturers nd telecommunictions compnies re vying with ech other to produce the low-cost equipment nd bndwidth needed. Mny sttes re creting networks which link eduction, government, business nd helthcre. Distnce eduction is commonplce nd most eductionl institutions nd mny compnies lly trvel costs for meetings by using video. So the future of helth cre system is definitely in the direction of informtion ge nd e-medicine. In the contemporry debte over ccountbility rules in helth cre, contrct proponents rgue tht the mrket will give consumers wht they wnt. These scholrs lso express wht Jcobson lbels "deep version" to the tort system. The chrges leveled ginst tht system include tht it is "inefficient nd rndom in providing compenstion, hs high dministrtive costs, does not deter wrongdoing, sets stndrds of cre too high, nd provides benefits tht consumers would generlly not be willing to py for in the mrket" (p. 112). Yet the cse for contrct depends upon the vilbility to consumers of dequte informtion bout options, nd Jcobson rgues tht this condition is not stisfied t present. Further, Jcobson is skepticl bout the very possibility of informed choice in helth cre, given the difficulty people my hve in nticipting their needs nd their lck of brgining power. It is cler tht Jcobson likes tort: "On blnce, contrct regime will fvor institutions (in prt becuse of superior brgining power nd informtion resources), while tort, for ll of its shortcomings, helps level the plying field by holding institutions ccountble for their decisions" (p. 120). chnging socil structure nd culture The rise of the helth nd beuty industry is one of the cuses of, nd lso n index of, tht chnge in society which hs been vriously lbelled 'high modernity' by those who consider it is the extension of processes pprent in modernity, or 'postmodernity' by those who consider the socil form is so different it constitutes qulittive chnge from the modern. Whtever lbel is pplied, theorists gree tht it hs certin chrcteristics: it is globl; people living in it exhibit heightened wreness of risk; nd it emphsises both individul self-cretion nd responsibility s well s consumption rther thn production. I will briefly describe ech of these chrcteristics of postmodern society before, in ech cse, spelling out their implictions for conventionl medicine. The ide of globlistion, originlly chmpioned by Robertson (1992), is now commonplce in the chrcteristion of postmodern society. Globlistion refers not just to the physicl connection of plce to plce but to the cretion of consciousness of the world s globl entity. Its iconic imge is the picture brought bck by the mericn stronuts of erthrise. One of the prdoxicl effects of globl wreness is n incresed wreness of the locl nd the prticulr. This, coupled with feture of the postmodern culturl movement tht sserts tht Western rtionl modes of thought, stemming from the enlightenment, cn no longer clim preeminence, hs led to n incresed wreness of modes of thinking other thn Western science. Wht this hs ment for conventionl medicine is tht Western scientific medicine hs been shken from the pedestl it briefly occupied in the middle yers of the lst century rightly point out, this medicl dominnce ws only short-lived historicl phenomenon). Other medicines hve begun to be ccepted s of equl vlidity or, in extreme cses, s of greter vlidity thn orthodox medicine. It is not just other complete medicl systems, such s trditionl Chinese medicine, homeopthy, chiroprctic or yuverdic medicine tht hve been ccepted. lso ccepted re 'ntive' medicines. When such ntive medicines re ssocited with the 'nturl' (see below), they re prticulrly likely to be vlorised. Postmodern society is lso chrcterised by heightened wreness of risk: Whether our personl sfety is ctully more t risk now thn in the pst is doubtful, but eqully, mny people believe it to be so nd re confirmed in this by the pronouncements of politicins nd publicists. Moreover there seems little we or the sme politicins nd publicists cn do bout it. The cuses of our discomforts nd discontents pper remote nd impersonl, lmost like nturl forces. Crime, unemployment, mysterious helth hzrds, uncivilized cities nd spoilt beuty spots ll seem resistnt to ny prcticl ction we could tke. They result pprently from the rcne opertions of fceless multintionl compnies nd foreign governments whose policies we re powerless to ffect. (Kumr 1995:161) One uthor considers this spect so importnt tht he lbels contemporry society 'risk society'. Beck points to science nd technology s mjor contributors to such developments on two counts. First, they crete risk through the development of such technologies s nucler power. In prticulr, he points to the unseen nture of mny risks creted by developing technology. For exmple, it requires expert scientific dvice to understnd the dngers of nucler power-rdition is not visibly dngerous. In society dominted by technology, ly people cn not ssess the risk to themselves. nd second, scientific nd technicl experts continully disgree in their ssessment of risk. This leds mny people to be ferful of technology nd to seek solutions tht do not require scientific expertise. In terms of helth nd helthcre, this mens people re looking for helth-promoting therpies tht re non-technologicl nd non-invsive. Furthermore, they re looking for therpies tht they cn grsp s ly people: therpies tht they cn understnd in their own terms. There is consequently wriness of medicl technology through fer of its unseen potentil dngers. Medicl drug use in prticulr is seen s potentilly dngerous (it is lso seen s not nturl- concept which is explored further below). In such circumstnces people turn to conventionl medicine s it ppers to offer mens of mintining helth tht is both sfe nd in conformity with ly notions of helth nd disese: The science of complementry medicine, unlike the science component of biomedicine, does not mrginlize or deny humn experience; rther it ffirms ptients' rel life worlds. When illness (nd, sometimes, biomedicine) thretens ptient's cpcity for self-knowledge nd interprettion, lterntive medicine reffirms the relity of his or her experience. (Kptchuk nd Eisenberg 1998:1062-3) For exmple, homeopthy presents mjor chllenge to scientific thinking becuse it clims efficcy for remedies tht cn not be ssyed. However, the mssive dilution tht is centrl feture of homeopthic remedies mens tht mny ly people re convinced they re sfe. Furthermore, the fundmentl premise of homeopthy-tht like is used to tret like-resontes with ly notions of illness nd cure. Conventionl medicine nd socil chnge Consumption in postmodern society is chrcterised by the commodifiction of culturl vlues. To exmine which vlues re being commodified in conventionl medicine we need to look t the profound vlue shift tht it is suggested occurred in the ltter hlf of the twentieth century. One of the first writers to describe such shift ws Cowrd (1989). She rgued tht 'new consciousness' ws emerging tht chllenged mny of the tken-for-grnted ssumptions of the Western world. The elements of this new consciousness were preference for the 'nturl' over the scientific nd technicl, rejection of expertise, n incresing wreness nd concern bout risk (discussed bove), morl impertive to tke responsibility for one's ctions nd, coupled with this, vlution of personl choice. The empiricl work tht exmines Cowrd's contentions in reltion to this vlue shift nd conventionl medicine hs come primrily from ustrlin uthors using smll smples. Gustke et l, 2000) ddressed the issue most directly. Using telephone interviews of smll probbility smple of residents of n inlnd mrket town, using the sme technique throughout the stte of Victori (in 1999), he evluted the differentil influences of wht he clled 'postmodern vlues' (relting his work bck to the postulted emergence of postmodern society) on ttitudes towrd 'lterntive' medicine. He lso exmined disstisfction with medicl outcomes nd disstisfction with the medicl encounter. He found the postmodern vlues of preference for the nturl, the rejection of the technicl nd vlution of choice were ssocited with positive ttitude towrd lterntive medicine. belief in individul responsibility for one's own helth nd hving holistic view of helth were lso identified in the lrger stte-wide study. In neither study were the vribles of disstisfction with medicl outcomes or the medicl encounter significnt. Ryner nd Esthope (2001) were more specific thn Sihpush nd exmined not the bstrct concept of lterntive medicine but the purchse of lterntive medicines. Interviews with 100 purchsers of lterntive medicines t vriety of outlets (orthodox chemists, helth-food shops nd homeopthic chemist) found tht such purchsers could be crudely ctegorised into two min groups. The first group did not hold the vlues posited by Cowrd (1989) nd demonstrted by Sihpush (1999). They believed in expertise, they did not vlue personl control or the nturl nor did they demnd choice. These tended to be purchsers of evening primrose oil nd herbl medicines. The second group, who were likely to purchse romtherpy nd homeopthic products, were however committed to holism, choice, nturl remedies nd individul control of their lives. It is this second group, younger thn the first, who pper to hold the 'postmodern' vlues delineted by Cowrd nd Sihpush. It ws certinly this second group t whom the sellers of the products were iming their dvertisements. content nlysis of the dvertisements in the shops found tht the two highest ctegories (excluding brnd nme nd mention of specific conditions) were 'nture' (by fr the lrgest) nd 'individul responsibility'. In these retil outlets, nture nd individul responsibility were clerly being commodified. lthough these re smll smple ustrlin studies their detiled findings re echoed in studies elsewhere. For exmple, UK study of 160 consumers (eighty visiting GPs nd eighty visiting lterntive prctitioners) found tht those visiting lterntive prctitioners, when compred with those visiting GP, hd higher helth consciousness, sw the prctitioners' tsk s being to del with helth mintennce s well s sickness, believed they hd control nd were more criticl of GPs' efficcy. lthough, disstisfction with their GP did not led them to lterntive therpists. In the US n nlysis of the responses of three representtive smples (Wolsko et l. 2002) found tht use of lterntive medicine ws predicted by poor helth nd specific chronic helth conditions such s bck problems. The stin study (1998) lso found tht believing in the importnce of body, mind nd spirit in treting helth, hving trnsformtive personl experience nd being 'culturl cretive' were predictors of use (s in other studies, disstisfction with orthodox medicine ws not significnt predictor). The term culturl cretive referred to set of vlues nd commitments which include commitment to the environment nd feminism, involvement in esoteric spiritulity nd personl growth psychology, self-ctulistion nd self-expression nd love of the foreign nd exotic. recent study lso concluded: 'Needs for wellness nd preventive cre re emerging s fctors of prime importnce to conventionl medicine users'. In brief, these ustrlin, British nd mericn studies pper to be describing people who re dopting the chnged vlue orienttions described initilly by Cowrd (1989). Of course not everyone hs dopted these orienttions, s ll the empiricl studies indicte. The doption of helth s consumption item is differentilly distributed mong the popultion. One study tht explored this ws undertken in the UK by Svge et l. (1992) who nlysed helth s lifestyle nd consumption relted, nd rgued tht lifestyle nd consumption re brodly relted to socil loction. Using frmework of economic, culturl nd orgnistionl ssets to demrcte different consumer groups, they rgued tht different groups utilised different mixes of helth behviour s prt of consumption lifestyle. They stted tht: 'Promotion of the "self" in the form of fitness nd helth is n investment in the storing of culturl ssets s distinct from property ssets or orgnistionl ssets' (Svge et l. 1992:112). The globlistion of contemporry society nd the cretion of risk society (Beck 1986) hve provided milieu in which CM cn thrive s both globlistion nd risk wreness chllenge the unthinking cceptnce of scientific medicine. Further chllenges re presented by vlue shift in which the nturl is preferred over the technicl, expertise is rejected nd choice vlued (Cowrd 1989). llied to this it hs been rgued by mny uthors tht consumption is centrl in postmodern society nd tht self-identity construction is chrcteristic of those living in such society. When it is rgued further, tht centrl spect of such identity construction nd consumption is the body, it is cler why conventionl medicine should grow in this fertile ground. Conclusion In the end it is not difficult to relize fter the discussion provided in this pper tht the future of helth cre nd medicine lies in e-medicine nd conventionl medicine. The helth cre system of the future cn be now seen s the combintion of online services tht increse the response time for ptients nd improve the services. In the future it hs been theorized tht ptients could hve 'Personl Dignosis System' s prt of home entertinment centers. This system would monitor people's dily helth sttus nd utomticlly notify helth professionl if someone becomes ill. (Kurtz 1994) Fifteen or twenty yers go people hd no ide tht helth cre system would rely lot on fxes, nswering mchines nd e-mil, tools which re now low-tech nd tken for grnted. In erly 2005, e-medicine still hd not reched its potentil. However, informtion bout e-medicine continully increses, there re mny progrms in opertion since 1994, nd e-medicine technology is usully included in hospitl remodels or new hospitls. In the mid-90's Ronld C. Merrell, from Yle University School of Medicine sid, "The innovtions we will encounter s we step beyond fesibility re dzzling in their potentil." (Merrell 1995) In 2005, the potentil of e-medicine, telehelth nd e-helth is still left to people's imgintions. Bibliogrphy: 1. Cowrd, R. (1989) The Whole Truth: The myth of lterntive helth , London: Fber & Fber. 2. Gustke S S, Blch D C, West V L, Rogers L O. Ptient stisfction with telemedicine. Telemedicine Journl, Spring, 2000, 6(1): 5-13. (Link lst checked on June 10, 2004). 3. Kumr, K. (1995) From Post-industril to Postmodern Society , Oxford: Blckwell. 4. Kurtz G L. The future of telecommunictions in rurl helth cre. Helthcre Informtion Mngement, Summer, 1994, 8(3): 5-9. (Link lst checked on June 10, 2004). 5. Kptchuk, T.J. nd Eisenberg, D.M. (1998) 'The persusive ppel of lterntive medicine', nnls of Internl Medicine 129, 12:1061-4. 6. Merrell R C. Telemedicine in the 90's: Beyond the future. Journl of Medicl Systems, 1995, 19(1): 15-8. (Link lst checked on June 10, 2004). 7. Peredni D , llen . Telemedicine technology nd clinicl pplictions. JM, Feb 8, 1995, 273(6): 483-8. (Link lst checked on June 10, 2004). 8. Robertson, R. (1992) Globliztion , London: Sge. 9. Ryner, L. nd Esthope, G. (2001) 'Postmodern consumption nd lterntive medictions', Journl of Sociology 37, 2:157-76. 10. Sihpush, M. (1999) 'Why do people fvour lterntive helth' ustrlin nd New Zelnd Journl of Public Helth 23, 3:266-71. 11. Svge, M., Brlow, J., Dickens, P. nd Fielding, T. (1992) Property, Bureucrcy nd Culture: middle-clss formtion in contemporry Britin , London: Routledge. Read More