Say the word “healthcare,” and most of us think of a trip to the clinic or hospital. But Anne Dellenbaugh takes the term literally — as in caring for her health.
Dellenbaugh, a wilderness guide in Brunswick, Maine, starts each morning with meditation, a breakfast of cooked fruit and a bit of yoga. Some mornings include a walk outdoors or some pleasure reading before settling into her workday. Evenings, she reads or plays the cello, and then meditates once more as she prepares for sleep. Once a month she sees an acupuncturist, and, less frequently, she seeks treatment from an osteopath to sustain her energy. For Dellenbaugh, 55, this is all part of her quest not just to maintain, but to optimize, her health.
Over the course of the past few decades, health-savvy consumers like Dellenbaugh have been gradually expanding the definition of healthcare. Their definition goes well beyond the old “disease care” model to include a host of self-care strategies — strategies supported by consultations with naturopaths, herbalists, homeopaths, acupuncturists, massage therapists and other healing professionals whom they see as allies in their commitment to optimal health.
Many of these motivated health seekers have embraced meditation and yoga, whole foods, nutritional supplements, stress-reduction plans, and fitness regimens as the foundation of their health-maintenance programs. Some seek chi-balancing treatments or cranial-sacral work when they are under extra stress, consult chiropractors or massage therapists when their bodies feel a little of out whack, and might even check in with a “medical intuitive” when a major health concern arises.
Call it what you will — extreme self-care, obsessions of the “worried well” or educated self-preservation — this approach to wellness is not just a stopgap measure for symptoms of illness or chronic pain. It’s a regular, ongoing practice designed to create optimal wellness and vitality. And often it involves the use of complementary and alternative medicine (CAM), holistic healing, integrative medicine, and other care modalities, not so much as a stand-in for conventional medical interventions, but rather as a preventive measure designed to keep the need for those interventions to an absolute minimum.
Health-motivated folks like Dellenbaugh may pay visits to health practitioners and healing-arts professionals more regularly and frequently than their less-healthy counterparts, and yet they prefer to embrace integrative practices, not to address entrenched symptoms or to recover from illnesses, but rather to achieve and maintain a level of optimal well-being.
These proactive healthcare consumers regard a high level of energy and vitality not as some pie-in-the-sky goal, but as their baseline-normal birthright — and they’re willing to put some effort (and if necessary, some out-of-pocket expense) into claiming it.
A Higher Standard of Health
Although the most recent large-scale research into CAM-usage patterns dates to the late ’90s, that data sheds light on preferences and motivations that persist today, and that are particularly well represented within the ranks of the empowered health seeker.
A 1993 study led by the director of the Osher Institute at Harvard Medical School, David Eisenberg, MD, showed that, in 1990, one in three U.S. adults regularly used some form of complementary and alternative medicine and spent $10.3 billion in out-of-pocket expenditures on CAM treatments (which is comparable to the $12.8 billion in out-of-pocket money spent on hospitalizations in the same year).
A 1998 follow-up study Eisenberg conducted showed that the prevalence of CAM use had increased from 33.8 percent in 1990 to 42.1 percent in 1997. A National Health Interview Survey (NHIS) in 1999 found that most CAM therapies were used in conjunction with conventional medical services. The most recent large-scale data collection regarding CAM dates to a National Health Interview Survey in 2002, which indicated that 36 percent of 31,044 respondents had used one of the 27 CAM treatments mentioned in the survey in the previous 12 months.
In his 1998 research, Eisenberg found that CAM use was higher among those with some college education (50.6 percent) — findings confirmed by a 2002 NHIS study — and those who earned annual incomes over $50,000 (48.1 percent). Eisenberg attributed one-third of all CAM use to “disease prevention and health promotion,” especially among baby boomers. NHIS data indicated that CAM use increases with age (70.3 percent of CAM use was found among those 85 and older) and that individuals who more frequently saw conventional practitioners were also more apt to use CAM.
Researchers are careful to point out that motivations for using CAM are hard to tease out of surveys and that reasons for using it are complex and can change over time, but analysis of these large-scale studies has shown that the “pursuit of wellness” is a major contributor to CAM use and that an interest in “health promotion and disease prevention” is another driving force.
In a 1998 paper on the appeal of alternative therapies, Eisenberg and his Harvard colleague Ted Kaptchuk, MD, wrote that CAM, when used as a treatment for illness, offers patients a “participatory experience of empowerment and authenticity when illness threatens their sense of intactness.”
More Than a Cure
In some cases, CAM users are simply substituting natural remedies for conventional treatments — taking an herbal decongestant instead of NyQuil, for example, or seeing an acupuncturist for back pain instead of taking pain killers.
But others, like Dellenbaugh, have moved beyond the notion of treating a specific symptom or illness and have become more invested in a broader concept of whole-person health. These individuals tend to see themselves as the captains of their own healthcare team, with professionals offering valuable counsel and care whenever their support is needed.
“Health is not about what you do one time or what you do for a week,” says Dellenbaugh. “Health is an issue of habits; it’s about what you do over the long haul with your life.”
Dellenbaugh started down her own health-sustaining path 12 years ago, when she was diagnosed with terminal cancer. Today, she is cancer-free, but she says she didn’t so much discover a “cure” as find new ways to optimize her health and vitality — vitality that ultimately proved more powerful than her disease.
Savvy healthcare consumers like Dellenbaugh tend to reject the notion that good health is simply the absence of symptoms or illness: To them, being healthy means living at your full potential — physically, emotionally and spiritually. It means having the energy to embrace the life of your highest choosing, and the resilience to weather whatever challenges come your way.
Taken in the context of the dominant medical model, which even many conventional doctors have taken to describing as “sick care,” such viewpoints are far from mainstream. But they sound increasingly appealing to many, and in a society burdened by exploding healthcare costs and the pressures of widespread chronic disease, they also offer real, practical promise.
By better understanding how these highly motivated, self-directed health seekers approach their own health-care needs, we can all inch a little closer to optimal health ourselves.
Treating the Whole Person
Prudence Tippins was in her mid-30s when she noticed something strange happening to her normally clear complexion. The skin on her back and chest turned raw, red and bumpy. When the rash spread to her cheeks, forehead and nose, Tippins went to see a doctor who diagnosed her with a dermatological condition called rosacea. He told her that no one knows what causes it, and that there is no cure.
Tippins’s doctor prescribed an antibiotic, but it didn’t work. When she returned, his only offer was a stronger antibiotic, and at that point she decided to seek an alternative. “I had never really thought about my health or cared much about it,” she says. “But this felt like my body was trying to tell me something.”
To decipher her body’s message, however, Tippins couldn’t remain a passive patient. Instead, she began actively researching and pursuing healthier behaviors — not simply to relieve her rosacea symptoms, but to build the kind of vitality that characterizes a truly healthy person.
The combination of Tippins’s dissatisfaction with conventional treatment, her curiosity about the root cause of her problem, her willingness to pursue alternative approaches and information, and her interest in allowing her condition to become a catalyst for healthier choices all fit the empowered health-seeker model. And in her view, they were all essential in helping her achieve the health improvements she sought.
Over the years, the 43-year-old Viroqua, Wis., writer has learned a great deal about health, and she’s adopted a number of proactive tactics to improve her well-being, including eating a mostly raw-foods diet and embracing the healing effects of herbal homeopathy. She also does yoga and meditates every day.
Tippins says that what began as a quest to improve her complexion has now become a deep commitment to a health-centered lifestyle — one that has calmed her skin, but also keeps her feeling more vibrantly well than she has ever felt before.
“I’ve become very intuitive about what my body is telling me,” she explains, “and the healthier I’ve become, the healthier I want to become.”
This attitude is typical of many empowered health seekers, who might initially go looking to clear up a particular problem, but then, once they’ve found relief from those symptoms, find themselves surprised and excited by how good they feel overall. As a result, they become motivated to achieve even greater health gains.
In Tippins’s case, the rosacea still comes and goes — she sees the inflammatory disorder as a barometer of her health at any given time — but her new approach to healthcare has left her feeling better in every aspect of her life, including her mental and spiritual health. “I’m just a lot happier than I was,” she says. “My energy level is better, my relationships have improved, because I’m so much more patient than I used to be. My entire life is better.”
To achieve these kinds of results, Tippins had to be willing to change her daily behaviors and to look beyond the pat answers that conventional medical wisdom provided. She also had to discard the notion that she was simply treating her malady — a notion deeply ingrained in those of us raised on Western (or allopathic) medicine — and instead embrace the idea of caring, in a more holistic and proactive way, for her self.
Most of us pay visits to health professionals only when there is something wrong with us. Dellenbaugh, Tippins and other optimal-health seekers typically prefer a more proactive approach. They are far more likely to seek support either as a matter of maintenance (some have standing weekly or monthly appointments for vitality-enhancing bodywork treatments, for example) or at the first signs of distress, as opposed to waiting for a symptom to become urgent or entrenched.
They also develop long-term relationships with health professionals they trust — professionals who encourage them to take an active role in their treatment and who take time to advise them about the likely underlying causes of whatever problems they may be facing.
The most empowered health seekers among us share a set of common attitudes and values about health and well-being that inform their healthcare strategies. Here are four basic approaches that anyone can adopt on his or her way to a healthier life:
Empowered Approach No. 1: Take an interest in how your body works, and why it may be acting up.
Savvy healthcare seekers are motivated by a deep desire to understand how their bodies function, and what treatments, practices and approaches are likely to work best for them based on their health challenges. Holistic practitioners can be valuable partners in this effort. They’re generally eager to explain their methods, help educate you about your body and point you in the direction of helpful resources, like books and trusted Web sites, where you can learn more on your own. But experience may be the best teacher of all. Only by trying acupuncture or massage or homeopathy — or by being willing to make recommended dietary and lifestyle changes — can you tell how well these approaches might work for you.
Empowered Approach No. 2: Become a full partner in your own care.
Expert advice and guidance is indispensable on the journey to better health, but conscious healthcare consumers maximize that guidance by actively partnering with their healthcare providers. Whether you’re in your allopathic dentist’s chair or you’re visiting the homeopath, you benefit by sharing with your practitioner what you know about your body, including symptom patterns, possible causes and preferred treatment approaches. Ask questions, raise concerns and talk openly about any tactics you’ve already tried. It’s also perfectly acceptable to inquire about the experience, training and treatment philosophy your care provider brings to the table, and to tell him or her about concerns or fears you may have.
“The model has shifted from a paternal relationship [between doctor and patient] to a partnership,” explains Brent Bauer, MD, director of complementary and integrative medicine at the Mayo Clinic in Rochester, Minn., and the medical editor-in-chief of the Mayo Clinic Book of Alternative Medicine (Time Inc., 2007). “Today’s patients are much more informed. Half my patients show up with their latest Internet search for a diagnosis, and half the time they’re correct. Sometimes I learn things from them. So the relationship is more of a collaboration.”
Most integrative practitioners — and, increasingly, their conventional counterparts — see themselves more as guides than absolute experts. They want patients to share the kind of deep knowledge necessary to craft an effective healthcare strategy.
Empowered Approach No. 3: Pay attention to symptoms, but treat root causes.
Health-savvy individuals listen to what their symptoms tell them about their general health and then address the root causes of those symptoms. An ulcer, for example, can be controlled with medication, explains Paul Bergquist, MD, the director of CAM at Vernon Memorial Hospital in Viroqua, Wis. “But if you can’t get at the underlying cause, as soon as you take away the medicine, the ulcer can come right back,” he says. The empowered approach is to understand what’s causing your ulcer, and why you are
vulnerable to it, and then address both to prevent recurrence.
This kind of integrated lifestyle approach requires a patient’s commitment to understanding that a given condition or symptom may be the result of his or her body’s response to chronic nutrition-and-lifestyle stresses.
High cholesterol, high blood pressure and back pain may not be the real problems, in other words, but rather symptoms of an underlying vulnerability or imbalance, the resolution of which may provide both the relief of those symptoms and the return of vibrant health.
Empowered Approach No. 4: Insist on a whole-person approach.
In conventional allopathic practice, healthcare is divided into specialties — gastroenterology, oncology, dermatology. There are neck doctors, mouth doctors and chest doctors. But empowered health seekers prefer health professionals who see all of the body’s systems as connected. And they seek out practitioners who treat individuals as whole people, not simply as a collection of symptoms or independently operating mechanical and chemical systems.
Responsible health professionals, in the view of empowered health seekers, see their patients in the contexts of their daily lives, habits, relationships, thoughts and attitudes — so they take an active interest in all of them.
“The most important thing is that each person is [treated as] an individual, and not as a set of symptoms,” explains Bergquist. “Each person has a whole set of beliefs and programming, and illness or health can develop out of that set of beliefs.”
Healthy and Whole
Whether or not you’d define yourself as an empowered health seeker today, there’s no doubt that playing an active and informed role in your own healthcare is worthwhile. So is upgrading your definitions of what health is all about: not just the absence of symptoms and disease, but the experience of optimal vitality, balance and overall well-being.
It’s the kind of well-being that’s expressed not just by the body, but by the person as a whole. As Dellenbaugh puts it, “We tend to evaluate our health from the outside: How many miles can I run, or what does my body look like?” Optimal wellness, on the other hand, is about feeling your best, inside and out.
With guidance from those who have already mastered the art of feeling great, it seems likely that that kind of vitality can be within more people’s reach.
According to the Institute of Medicine (part of the National Academy of Sciences, which advises the federal government on health issues), five chronic conditions — mood disorders, diabetes, heart disease, asthma and high blood pressure — account for more than half of all U.S. health expenditures, and these are some of the same disorders that conventional medicine often struggles to treat successfully.
A National Health Interview Survey in 2002 found CAM treatments were most often sought out for health problems that lack definitive cures, that have an unpredictable course and prognosis, and that are associated with pain or side effects from prescription drug medication.
While integrative approaches can be employed to treat all types of illness — from the common cold to cancer, the conditions that respond especially well to alternative and complementary approaches include many of those that conventional medicine has typically had less success in resolving. They include:
- Fibromyalgia and chronic fatigue
- Depression and anxiety
- Digestive and gastrointestinal health issues
- Skin problems (eczema, psoriasis, acne)
- Chronic back and joint pain and arthritis
- Headaches and migraines
- Hormone imbalances
- Lifestyle- and nutrition-related conditions like heart disease, diabetes and obesity
- Stress-related conditions like high blood pressure, insomnia, rashes and ulcers
Want to learn more? Check out these Web sites and books:
Consortium of Academic Health Centers for Integrative Medicine (www.imconsortium.org) — A membership organization (including 42 major academic research hospitals) devoted to advancing integrative medicine. Includes a well-organized, vetted list of links to Web sites exploring integrative treatments for various conditions.
National Center for Complementary and Alternative Medicine (http://nccam.nih.gov) — This U.S. government agency sponsors clinical trials to test the claims of alternative practitioners. Many studies, resources and publications are available online.
Complementary and Alternative Medicine Index (www.umm.edu/altmed) — This Web site from the University of Maryland Medical Center provides basic information about most common forms of alternative medicine with links to other resources and medical research.
Alternative Medicine Center at the Mayo Clinic (www.mayoclinic.com/health/alternative-medicine/CM99999/) — A medical Web site offering detailed information on alternative treatments.
The Institute for Functional Medicine (www.functionalmedicine.org) — IFM seeks to promote and educate healthcare providers and the public about functional medicine. The site also offers a searchable database of FM practitioners.
Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine (Time Inc., 2007) — A basic primer on alternative medicine for the uninitiated.
Encyclopedia of Natural Medicine by Michael Murray, ND, and Joseph Pizzorno, ND (Prima, 1998) — A classic, popular and comprehensive book on how to treat a variety of ailments and improve your overall health through natural methods.|
Breaking the Money Barrier
Because many alternative therapies aren’t yet covered by health insurance, they can seem expensive — $50 or more for a session of massage therapy, acupuncture or chiropractic services. Throw in elective lab tests, herbal remedies and nutritional therapies, and you can be looking at some significant bills. That can be a major disincentive to people who either can’t afford the out-of-pocket expense or who see that seeking a prescription might net them a short-term cost savings. But seen another way, proactive alternative treatments often prove to be affordable investments in good health. Here are some examples of how empowered health seekers think (and budget) differently from your average healthcare consumer:
The average patient says: I can’t afford out-of-pocket expenses for self-care and alternative practitioners. It just costs way too much!
The empowered health seeker says: I can’t afford not to get the health support that really works for me. Good health is my most valuable asset, and the cost of maintaining it is low, relative to the importance of my vitality and well-being. Plus, the cost of most self-care strategies and integrative treatments are relatively affordable compared with the cost of a trip to the emergency room, or to the long-term treatment costs associated with a chronic condition. My health insurance is there primarily for accidents and other dire health emergencies. For my daily health maintenance and support services, I’m willing to pay cash, just like I do for healthy food or my gym membership. Someday, maybe these cost-effective services will be better covered by insurance and my flex plan. Until then, I’ll budget what I need in order to stay well. In the long run, it’s a bargain.
The average patient says: If I let myself get sick enough, my insurance will have to cover the costs of treatment.
The empowered health seeker says: I’m not waiting until someone else tells me it’s time to get treated; I’d rather seek help at the first sign of trouble and learn what I need to do to take care of myself. If I invest in my health now, I have more and better choices about the kinds of interventions I’m willing to undergo, and I’ll avoid the inevitable expenses and sacrifices that accompany poor health. By economizing and shifting my spending from unhealthy habits to proactive, health-supporting strategies, I can avoid the suffering and expense of a chronic illness, as well as the stresses a health crisis would put on those around me. I’ll also have a better shot at avoiding the side effects involved with long-term prescription drug use.
The average patient says: I’m not sick and I feel well enough to get by. Why bother spending money on treatments if they’re not in direct response to major symptoms?
The empowered health seeker says: I choose to feel better than so-so. Besides, optimal health pays off in so many ways: more energy, clearer thinking, better moods, better productivity. I know that feeling a general lack of vitality is one of the first warning signs that my body is in need of better care. Why wait for marked symptoms to emerge before I get the care my body is trying to tell me it needs now?