Important Notice: The Hanford Health Information Network (HHIN) closed in May, 2000. HHIN Web pages are provided as archived information only, and are not currently maintained. Information contained on the HHIN Web pages may be out-of-date.

Current information is available through the Hanford Community Health Project, which is updated by the Agency for Toxic Substances and Disease Registry of the U.S. Centers for Disease Control and Prevention.

Since the Hanford Health Information Lines opened in 1993, many people have asked us about different approaches to improving health and preventing disease other than the health care available from medical doctors. In response to these questions, the Network has prepared this introductory publication.

OVERVIEW

The purpose of this publication is to provide a basic understanding of five health care approaches that may be considered complementary or alternative to conventional medicine practiced by medical doctors (M.D.s) in the United States. Four of these–chiropractic, naturopathy, osteopathy and traditional Chinese medicine–are licensed professions in the United States. The fifth section discusses the approach of tribal healing.

For each, this publication addresses several questions: How is the health care profession or approach defined? How does the approach view the relationship between health and disease? What education and training are required? What kinds of diagnostic, treatment and preventive methods are used? How does the practice view the ways that environmental exposure to radiation affects the body? The final section of this publication addresses the question: Where can people find more information?

Chiropractic, naturopathy, osteopathy and traditional Chinese medicine were chosen for this publication because they are nationally recognized and licensed in many or all states. Licensed health care practitioners must be graduates of an accredited school. Typically, licensing also indicates that the practice has a disciplinary system in place.

Tribal healing was chosen because it is practiced by many American Indians and used among the nine Indian nations that participate in the Hanford Health Information Network.

All five practices view and treat each patient not only as a physical being, but also as an emotional, intellectual and spiritual one. This view is often referred to as holistic thinking or an holistic approach to health care.

Practitioners in these fields treat patients who are in any state of health–actively fighting disease, in the early stages of disease, or in good health. Their emphasis is on preventive care. Each practice shares the view that the body has a natural tendency to be well and that the causes of health problems may be successfully treated before the body enters a disease state.

To prepare this publication, Network staff gathered information from professional associations where available and interviewed a practitioner within each field. The practitioners we interviewed are highly regarded by their colleagues nationally. Information from on-line and other resources supplemented our research.

CHIROPRACTIC

The chiropractic profession views the body's structure and function as interconnected. Chiropractic gives special attention to the nervous system and the relationships among the spine, muscles, brain and heart, as well as other organs and body systems.

Manipulation or adjustment of the spine is typically used by chiropractors to eliminate disturbances of the nervous system. The underlying philosophy is that an impaired nervous system may reduce the body's ability to adapt to environmental change, injury or stress, thus reducing its ability to ward off disease.

To earn a doctor of chiropractic degree (D.C.), students must complete two years of college with a science emphasis and four to five years of chiropractic college. To practice, a D.C. must pass a national board exam and separate licensing exams in the state where he or she intends to work. The chiropractic profession is licensed and officially recognized in all 50 states.

Chiropractic care relies on active communication between the practitioner and the patient. Chiropractors are trained to closely observe how patients' lifestyles may affect health, by taking into account environmental, nutritional, psychological and other factors.

A chiropractor may use interviews, physical exams, postural and spinal analysis, lab tests, patient self-assessments, and X-rays as diagnostic tools. Besides spinal adjustments, chiropractic care may include dietary advice, nutritional supplements, physical therapy, rehabilitative exercises and professional counsel. Chiropractors, by law, may not prescribe medication nor perform surgery. The state of Oregon, however, allows chiropractors to perform minor surgery.

NATUROPATHY

Naturopathic physicians use primarily natural substances and processes–such as nutrition, diet and supplements, herbal medicine, exercise, lifestyle changes, homeopathic remedies and body cleansing–to treat illness and disease and to promote wellness. The underlying purpose is to eliminate the cause of the illness from the body and increase the body's ability to heal itself.

To earn a doctor of naturopathic medicine degree (N.D.), students receive undergraduate training in standard premedical courses, complete four years at an accredited naturopathic medical school, and pass a national board exam.

Naturopathic physicians are trained as primary-care practitioners with an emphasis on preventive medicine and natural therapies. Naturopaths may specialize in a specific treatment method or in a particular problem area such as pediatrics, allergies, natural childbirth or homeopathy.

The legal status of naturopaths varies in different states. Several states have laws to license N.D.s. In states that do not license naturopathy, N.D.s sometimes practice under other medical licenses (e.g., the L.Ac.–licensed acupuncturist).

Like chiropractors, naturopaths emphasize open communication with patients. Diagnostic methods may include a pre-visit questionnaire, patient interview, complete physical exam, lab tests, lifestyle and dietary assessments, metabolic analysis, and allergy tests. Some states allow naturopaths to use X-rays.

Treatments may include counseling, herbal medicine, nutritional supplements, physical therapy, water and moisture therapy, acupuncture, minor surgery, massage, and manipulation of the muscles, bones and spine. In general, naturopaths are not allowed to prescribe medications nor perform major surgery. A notable exception is the state of Washington where naturopaths may prescribe antibiotics, thyroid medicines, progesterone and some other drugs.

OSTEOPATHY

An osteopath is a primary-care physician whose approach includes manipulating patients' muscles, joints and spine. Osteopathy views the body's structure and function as interconnected. Osteopathic theory emphasizes that the motion of joints, muscles and ligaments influences the body's circulatory and nervous systems.

To earn a doctor of osteopathy degree (D.O.), students must complete four years of college with a science emphasis, and four years of osteopathic medical school. Following this classroom training, a D.O. must serve a one-year internship gaining experience in internal medicine, obstetrics/gynecology, family practice, pediatrics and surgery. Many D.O.s then choose to serve a two- to six-year residency specializing in an area such as internal medicine, surgery, pediatrics, radiology or pathology.

Osteopathy is licensed in all states. Osteopaths must pass a national board exam and, like M.D.s, a state medical board exam in order to obtain a license and enter practice.

Diagnostic tools used by osteopaths include lab tests, X-rays, physical exams, postural and spinal analysis, and limb and structural movement observations.

The circulatory system and the nervous system are thought of by osteopaths as the body's tools for regulating and communicating, responsible for the health of organs and tissues. By using a variety of manipulative treatment therapies, osteopaths work to enhance the supply of blood to the body and the flow of information through the body's nervous system. D.O.s are fully trained and licensed to prescribe medication and perform surgery.

Focusing on muscles and the skeleton, osteopaths emphasize preventive medicine and healthy lifestyles. Proper nutrition and exercise are often recommended along with more conventional medical treatments.

TRADITIONAL CHINESE MEDICINE

Like naturopathy, traditional Chinese medicine (TCM) is based on natural substances and processes. Observing the natural world helps TCM practitioners understand the body and how energy flows through it. The underlying philosophy is that balance and harmony for the total person can be achieved, maintained and restored through herbs and acupuncture, but also through lifestyle changes, nutrition, massage and exercise.

In TCM, health is viewed as an ongoing process of maintaining a balanced, harmonious flow of energy through the body. Illness and other symptoms result when the energy flow is blocked or there is an imbalance. TCM works to strengthen the body's ability to resist illness and disease.

Both physicians and non-physicians may practice acupuncture. Generally, physicians who practice acupuncture have completed a minimum of 200 hours of training. Non-physician acupuncturists complete two or more years of training at a recognized or accredited acupuncture school.

The legal status of acupuncturists varies in different states. Thirty-two states currently license, certify or register acupuncturists. Some states limit the practice of acupuncture to M.D.s, D.O.s and D.C.s. Other states allow acupuncture under the supervision of a licensed physician. In a few states, there are no regulations for acupuncture.

The TCM practitioner arrives at a diagnosis by identifying patterns in a patient's signs and symptoms. Patterns can reflect the condition of internal organs and energy flow. The TCM practitioner may examine a patient's tongue, pulse, skin, bones, emotions, demeanor and body build. Each has qualities and nuances that help identify what may be causing the person's symptoms.

Some practitioners arrive at a diagnosis primarily through observations. Others may conduct an interview or use pre-visit questionnaires to get a thorough picture of the pattern of symptoms.

Treatments focus on herbs and acupuncture. Herbs may be prescribed in raw or extract form to be consumed in tea, or in tablet form to be swallowed. Acupuncture is the insertion of small needles into the skin at certain points in the body's energy flow. A few practitioners use electrical stimulation of inserted needles, or burn a specific type of herb on an acupuncture point. Other treatment methods include meditation, Chinese massage and breathing exercises.

TRIBAL HEALING

SELECTED RESOURCES

Books

Cohen, Misha Ruth O.M.D., L.Ac. The Chinese Way to Healing: Many Paths to Wholeness. Berkeley Publishing Group, 1996. 299 pp.

Collinge, William, M.P.H., Ph.D. The American Holistic Health Association Complete Guide to Alternative Medicine. Warner Books, Inc., 1996. 361 pp.

Hammerschlag, Carl. The Dancing Healers. Harper & Row, 1988. 170 pp.

Jones, Bob. The Difference a D.O. Makes, a book available through the Oklahoma Osteopathic Association, (405) 528-4848.

McGill, Dr. Leonard. The Chiropractor's Health Book. Crown Publishers, 1997. 192 pp.

Morton, Mary and Michael. Five Steps to Selecting the Best Alternative Medicine: A Guide to Complementary and Integrative Health Care. New World Library, 1996. 327 pp.

Moyers, Bill. Healing and the Mind. Doubleday, 1993. 363 pp.

Murray, Michael N.D., and Joseph Pizzorno, N.D. Encyclopedia of Natural Medicine. Prima Publishing, 1991. 600 pp.

Weil, Andrew M.D. Spontaneous Healing: How to discover and enhance your body's natural ability to maintain and heal itself. Alfred A. Knopf, 1995. 281 pp.

Available From the HHIN

Coping with Uncertainty and Illness — Concerns of Hanford Downwinders: A Network publication that discusses ways of coping with the physical and emotional concerns expressed by Hanford downwinders (November 1995).

Annotated Bibliography: Coping with Uncertainty and Illness: A bibliography of books about maintaining health and coping with illness; developed as a supplement to the Coping publication listed above (Fall 1995).

Published Summer 1997