DECEMBER 18, 2011 LIVING LONGER

"The Art of Living lies not in eliminating but in growing with troubles."

We all have troubles except in the Kit Kat Klub.-Joel Grey and Alan Cumming stated, "...we have no troubles here. Here life is beautiful, the girls are beautiful, even the orchestra is beautiful."

It seems that trouble must exist if you are to live. How you deal with your troubles can vary, but you still must live. When wounds are allowed to heal,the troubles get less. Time does heal everything. Growing with the troubles has made me a better man, despite the pain one must go through. I do not like having any troubles, but I am human. Remember there is no perfection only progress.

This past week my oldest patient died at age 104. Her name was Mary M. She lived in Florida with her son. Mary was a believer in complimentary health care. She took her vitamins, ate very well and exercised. Although from age 98 she didn't exercise as much she continued to read the newspaper, watch her favorite television shows (even if they had to be repeated on
DVD) and listen to the radio. She always took her vitamins. I also have many patients ages 95-99, 2 at age 100 and one at 102.

This past week a European health study was published entitled Patients of Complementary Medicine Physicians in the Netherlands Have Lower Costs and Live Longer by Kooreman, P. and Baars, EW.

Below is a summary of the study as printed by David Levine of the American Botanical Council. It was reassuring to me that I am practicing the medicine I want to practice and that WORKS.
You should reconsider always seeking a second opinion, and consider using other medical therapies.

Although there have been many studies on the effectiveness of complementary and alternative medicine (CAM), there is very little information on whether or not it is cost-effective. In an age where cutting healthcare costs has become a priority, data on CAM's cost-effectiveness are essential. However, the authors of this study say that CAM has been an area of little interest to health economists.

To determine if CAM is cost-effective, the authors compared data on general practitioners (GPs) who had completed certified additional training in CAM after obtaining their medical degrees (GP-CAMs) with those who did not have training in CAM.

The comparisons were based on data provided by the Dutch health insurer Azivo. The database contained dates of quarterly information collected by Azivo on the cost of GP care, hospital care, pharmaceutical care, and paramedic care for 151,952 patients from 2006-2009. Data from 1,913 conventional GPs were compared with data from 79 GP-CAMs: 25 in acupuncture, 28 in homeopathy, and 26 in anthroposophic. The only outcome measure provided by the insurance company was mortality.

The authors found that patients who went to a GP-CAM had between 0-30% lower healthcare costs and mortality rates. The reason for the range was dependent on age and the training of the GP-CAM. For example, the costs were 66 Euros lower per quarter for patients aged 25-49 years whose GP-CAM was trained in acupuncture, but patients who were 75 years of age or older who saw a GP-CAM trained in anthroposophic medicine spent 405 Euros less per quarter. The lower costs for all the groups visiting GP-CAMs were primarily due to fewer hospital stays and fewer prescription drugs.

The data analysis showed that the lower costs of CAM were gender-based and socioeconomic status-dependent. For example, GP-CAMs had a larger percentage of female patients than conventional GPs and fewer patients from disadvantaged neighborhoods.

The authors state that there are several explanations for the lower costs of CAM. These include self-selection of CAMs by people who did not want aggressive treatment, undertreatment, and/or higher out-of-pocket expenses, as well as the focus on prevention and promotion of better health practices by GP-CAMs. Significantly lower mortality rates with CAM (P values not given) suggest that under treatment is not a reasonable explanation for lower costs.

The authors note that this study has important limitations which make it impossible to offer definitive conclusions on the cost-effectiveness of CAM. These limitations include the fact that all the data were from one insurer in a homogeneous Dutch region, the small number of GPs on which the authors had data, and the lack of data on costs such as out-of-pocket expenses, morbidity, work absence, subjective health, and patient satisfaction.

The authors state that further studies need to be done to determine the true cost-effectiveness of CAM. They cite three areas needing further research: "First, replication studies based on similar data sets are needed to confirm the present results. Secondly, further research is needed to determine to what extent selection on unobservable and causal effects explain the lower costs and lower mortality rates of patients with a GP-CAM. Thirdly, more research is needed with regard to the cost-effectiveness of CAM for specific diagnostic categories."


More studies need to be done. Did anyone ever consider spending more money on CAM Therapies versus increasing health care deductibles, taking care of the elderly less and less, and ever rising health care costs ???


Until tomorrow...