Benefits of Alternative Medicine Overshadowed by Wellness Culture Greed

Yoga, meditation, green tea- to some this may sound like the perfect morning routine; to others, it is a list of different types of Complementary Alternative Medicine (CAM). CAM includes a diverse range of therapies, practices, and products, like acupuncture, chiropractic medicine, and herbal medicine. What unites them and what defines CAM is simply that they are not currently considered conventional medicine. Because of this, the list changes as the therapies and products are proven safe and effective becoming mainstream. 

CAM use is growing, especially among women and those with chronic or recurring conditions who have not found relief with traditional treatments. About half the general population in developed countries uses it, and the majority use it along with conventional medicine. But with more popularity comes more criticism. Skeptics of CAM point to the lack of research and proven efficacy of treatments in clinical trial settings as key problems. They also argue that placebo effects and people’s ability to self-administer some of these treatments may lead people away from scientifically-proven solutions doing more harm than good. For example, relying on garlic supplements rather than prescribed blood pressure drugs. Additionally, because there is little research on the benefits, the risks of treatments of certain treatments are also unknown. 

Increased interest and use of CAM is a double-edged sword. As practices become more mainstream, prejudice against them may lessen. However, with influxes of users, practices can become diluted if the right teachers aren’t followed. Wellness culture, on the surface, promotes a balanced, holistic approach to health, incorporating mind, body, and spirit. This makes it the perfect proponent of CAM. But it is now associated with carefully curated, aesthetically pleasing brands, promising customers their products will help them live natural and holistic Instagram-worthy lives. 

The wellness market is flooded with these celebrity-backed brands. While some may have a vested interest in the practices, there’s no denying money is part of the appeal. The global wellness economy is valued at $4.5 trillion, and CAM accounts for $360 billion of that. Looking at how they become popular through social media and celebrity endorsements, it’s no surprise that the big brands and not local practitioners take the lion’s share of the profits. 

One company that’s earned a lot of attention is goop. Started in 2008 by actress Gwyneth Paltrow, the lifestyle and wellness brand is worth $250 million. It has articles on the benefits of herbal pairings, overcoming first-time acupuncture nerves, and a wellness gift guide complete with an $80 meditation pillow, a 30-day supply of goop brand immune-boosting elderberry extract chews for $55, and a $105 metal whistle that helps with breathing. While it may seem like the website endorses CAM practices, it actually promotes a specific, expensive version of wellness using CAM. When goop elderberry chews cost twice as much as other brands, CAM and wellness become associated with wealth. As an article on the darker side of wellness states, brands like goop are built around “commercialized gurus metamorphosing ancient medicines and practices into an aspirational and desirable lifestyle.” 

This criticism points to bigger trends in the wellness industry. Although the use of CAM has increased, there is an expanding gap “in the rate of CAM use between non-Hispanic whites and African American and Hispanic populations. Whites are more than twice as likely to see a CAM provider than African Americans and Hispanics.” Asians use CAM slightly less than whites. Much of wellness culture is problematic because of who it says wellness is for. When the face of the company is a wealthy, white, Hollywood-elite, only so many people can see themselves stepping into the life portrayed. By making wellness exclusive and exclusionary, these brands give CAM a bad reputation by association. The practices face scrutiny, not from a medical or scientific standpoint, but because they are seen as elitist.   

Another problem: “‘Sometimes Western people take what they think is something powerful used in the Indigenous world, say a plant, an herb, a tea,” says Margaret P. Moss Ph.D., R.N., director of First Nations House of Learning and an associate professor in the school of nursing at the University of British Columbia, ‘without taking the whole system that came with it, that made it work.’” In many cases, these celebrities and influencers simply appropriate practices. They do not take into account the full context and history of where they come from and potentially spread misinformation with little concern for how this could damage the reputation of such practices. The negative opinion people hold of these brands reflects badly on the practices they endorse. 

CAM has real potential to help people. Those that want more autonomy or those with chronic conditions can find real relief. There are a variety of options tailored to meet individuals’ needs. Those with chronic conditions may find CAM treatments beneficial when other, conventional approaches have been exhausted. Furthermore, “as long as alternative treatments are used alongside conventional treatments, the majority of medical doctors find most forms of complementary medicine acceptable.” An article in the National Center for Biotechnology Information argues against the distinction between conventional and alternative medicine. Instead, they propose, “there is only medicine that has been adequately tested and medicine that has not…Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted.” While this is a nice idea when taken too far, arguments like this perpetuate the problems outlined above. It is important to remember where practices come from, their histories and contexts because they don’t just add trivia; they are part of the practices. 

Could Genetic Testing Be Part of Your Next Job Application?

As genetic testing advances, results may predict not just health but personality and intelligence, raising ethical questions about the applications of such information.  

From video calls with doctors to watches that sense irregular heart rhythms medical technology has become increasingly personal. And it doesn’t get any more personal than examining DNA- the essence of every person and what makes them unique. Genetic testing has come a long way since its initial use in the 1950s. It can provide a wide array of information about individuals’ health by looking for mutations in DNA. The results may empower people to seek treatment, adopt healthier habits, and better prepare them for the future. 

A large portion of testing determines individuals’ risk for having, developing, or being a carrier of a genetic disorder. Patients may require genetic testing if they have a family history, belong to an ethnic group at higher risk, or if they present symptoms and their physician wants to confirm a diagnosis. Depending on the reasons for the test, the results are used differently. A positive diagnostic test may mean starting a treatment plan. A carrier test may be useful before having children, especially for heterosexual couples that suspect both partners are carriers.  

Another type of testing used in family planning is preimplantation genetic diagnosis (PGD). This looks for markers of diseases and disorders in an embryo giving parents knowledge about their potential children. PGD has been at the center of much controversy especially for those that believe life begins at fertilization. They make points similar to those used in anti-abortion arguments, that not implanting an embryo disregards or devalues “the sanctity of life.” However, U.S. laws and health policy do not confirm this belief as they progressively place greater moral status on embryos, fetuses, and newborns as they develop. State laws vary in how late abortions may be performed, illustrating that earlier stages of development are viewed differently from later stages. 

Opponents also object to this type of genetic testing believing, over time, the selection of certain traits will lessen genetic diversity. Advocates for those with disabilities endorse this argument, adding that selection also discriminates against those with disabilities sending the message people with them are less valuable or less desirable. Parents may choose to fertilize one sex of embryos if they have a family history of a sex-linked disorder. Those against PGD argue parents will begin selecting based not just on “health” but preference for one sex over the other. They claim this will lead to selection based on other preferences such as appearance, “talent, personality…even though it is not technically possible at this time.”  

While not possible yet, advances in genetic testing have started conversations about what tests may look for in the future and the applications of such results. Discrimination based on genetic testing was a real concern before the passing of the Genetic Information Nondiscrimination Act (GINA) in 2008. The law focuses on protecting people in two key areas of life- employment and health insurance. But one article in the Oxford Academic Journal of Law and the Biosciences explores how more accurate and precise testing may lessen protections in both areas to the benefit of some and detriment of others. For example, “there is some evidence that certain genetic variants are correlated with world-class athletic performance.” Those wishing to become professional athletes may want to have genetic testing to see if they have a variance that would make them more appealing to teams. Similarly, professions that value intelligence and empathy may utilize genetic testing if it advances to predicting such traits. Empathy has proven to be an essential skill in healthcare professions. Medical schools and hospitals could look at results before admitting students and residents. 

Tests may also work against people predicting liabilities rather than assets. In high-risk situations such as driving a school bus or flying planes, employers “may have a legitimate interest in genetic factors that would, hypothetically, significantly increase the chance of suffering an epileptic attack.” However, if genetic information was more widely used and publicized a case could be made for accommodations and protections for those with “liabilities.” Similar to the Americans with Disabilities Act, employees may continue to work but with modifications made to their environments. 

Allowing the use of genetic information in one protected area could have devastating consequences in the other. Some may argue those who have a genetic condition use healthcare services more and therefore should contribute more to the cost of those services through higher premiums. This raises similar points about selecting job candidates. These practices would discriminate against those with perceived or possible disabilities. But unlike choosing job candidates, this concerns profits not safety. This system would punish people for something outside of their control based on possibly inaccurate results. Furthermore, despite certain, outdated arguments against, healthcare is a basic human right. As stated by the World Health Organization (WHO), “When people are marginalized or face stigma or discrimination, their physical and mental health suffers. Discrimination in health care is unacceptable and is a major barrier to development.” Putting barriers to care will not create a healthier society, it will only push those that cannot access care further from the help they need. 

Currently, genetic information is protected. Those wishing to be tested should not fear potential discrimination. While there is still room for error, testing provides useful information for patients and their doctors. A good way to gauge if testing is necessary is by talking with family members, writing down what conditions they have, when they were diagnosed, and what symptoms they experience. Health professionals can then use this information to determine the best course of action. It may include genetic testing or simply earlier and more frequent screenings. Additionally, knowing family history can encourage other preventative actions patients can do on their own, like exercising regularly and maintaining a healthy diet. Since some of these conditions are multifactorial, environmental improvements and lifestyle changes can have a positive effect.       

Healthcare Worker Burnout During COVID-19

Along with the rise of COVID cases has come a wave of mental health crises, especially among healthcare workers. As the pandemic goes on, those on the front lines are, understandably, experiencing sustained levels of stress, anxiety, and frustration, in other words, burnout. Fortunately, conversations about mental health and illness have become more mainstream in recent years leading to a wealth of resources now adapted to address the specific needs of healthcare workers during this time. 

Handling stressful situations, making life and death decisions, and confronting illness are not new for medical professionals. However, the scale and particularities of each have changed. Healthcare workers managing heavy caseloads and working long hours in stressful environments may do so in bursts by running off adrenaline. But over an extended period of time, the adrenaline wears off. This chronic period of elevated stress is “akin to what people might experience during prolonged war or refugee crises.” U.S. Military personnel assisting in New York hospitals even said this is the closest to combat they have seen in a civilian setting.

In regions with high mortality rates, “‘clinicians often describe a feeling of helplessness-an inability to render care…to the fullest extent they would desire.’” Changing safety protocols and information compound feelings of helplessness by making it difficult for workers to feel they are properly caring for patients and adequately protecting themselves. 

Having sufficient protective equipment is not a guarantee. Even with it, workers still worry about their own health and the health of loved ones. That’s why many have sacrificed living with their families and support networks to limit risks. Not only are they separated from their own families, but they are also taking on the roles of patients’ loved ones. Nurses and nursing assistants often act as “conduits for video calls and emotional support” because patients’ families cannot be at their bedsides. Many have “forgone breaks to hold patients’ hands as they die,” says Dr. Jessica Gold, assistant professor of psychiatry at Washington University in St. Louis, Missouri.   

In addition to feelings of helplessness and isolation, healthcare workers are also experiencing high levels of frustration. Many feel the concern and support they provide for others is not reciprocated outside hospitals. An article in the American Cancer Society Journals cited the politicizing of mask-wearing rather than focusing on the science as an example. One doctor even said it feels like “‘nobody’s listening, nobody’s following the rules…and the numbers aren’t going down.’” Refusing to wear masks or follow social distancing has a direct effect on healthcare workers making their jobs more difficult. This results in anger and even PTSD symptoms. A lack of time to process and heal as well as “a culture of stoicism” keep healthcare workers from seeking help.       

It’s important to be able to recognize burnout so healthcare workers can receive help. According to the Minnesota Department of Health signs of burnout may include getting easily frustrated, experiencing sadness, depression, or apathy, disconnecting from others, poor self-care (diet and hygiene), and using unhealthy or unsafe coping mechanisms such as drugs or alcohol.  

While these feelings are normal and valid, healthcare workers do not have to suffer from them. Coping strategies include diving back into old hobbies or picking up new ones, limiting media exposure, exercising regularly, and maintaining good sleep habits. Technology can help by tracking steps, glasses of water, heart rate, and setting alarms to take breaks, even if it’s just for a few moments to breathe.

Co-workers can adopt the buddy system. Partners “monitor each other’s stress, workload, and safety.” This is especially useful for those living alone or away from family by giving a sense of connection and being looked after. Buddies should set a schedule for check-ins either through texts, calls, or video chat. Social media support groups offer places to share, vent, and connect. For professional help, teletherapy companies, Talkspace and BetterHelp, offer healthcare workers 50% off their first month. 

It’s also important to maintain connections outside of work. Have a game night via video chat; Pictionary and charades are great options using minimal supplies. Play video games or host a movie night. Amazon Prime even has a Watch Party feature they say is “almost like watching side-by-side in real life–without having to share your popcorn.” A list of more resources such as live mental health counselors and meditation apps can be found here.     

If you are concerned you or someone you know may want to harm yourself or someone else, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Para obtener ayuda en Español, llama al 1-888-628-9454. Or call the National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224. 

How Do You Really Feel?

This question may feel more appropriate for a therapy session than an annual check-up, but taking time to consider all that it means can improve the healthcare provider-user relationship on both sides.

Lists of suggested books for medical students consistently focus not on human anatomy or how to ace exams but on emotional, intimate looks at illness, mortality, and the meaning of life. Why do so many who have put in the hours of studying and surgery performing recommend books that are only medically adjacent? It may have something to do with the growing importance of empathy in medicine. Healthcare professions naturally attract helpers, people that want to serve others. Unfortunately, sometimes somewhere between the long hours, overcrowded waiting rooms, and mountains of paperwork, that message gets lost creating distance between patient and provider. But research suggests practicing empathy may hold the key to narrowing the gap. 

Empathy, as defined by an article in the National Center for Biotechnology Information (NCBI), is “the ability to understand and share other people’s feelings.” It has cognitive, affective, and behavioral aspects. Cognitive describes the ability to objectively understand others’ situations and see from their point of view. Affective refers to the unconditional acceptance of the other person. And actions aimed at solving problems or relieving pain fall under behavioral. 

This may seem like a lot, but when put in everyday terms, it becomes much simpler. Two friends are talking on the phone. Friend One recently experienced a stressful incident at work- a meeting got moved forward, so they had less time to prepare. Friend Two draws on a similar experience recalling the events and their feelings at the time to help them relate. They encourage Friend One to share openly without questioning or discouraging them. After Friend One finishes their story, Friend Two offers words of encouragement. These types of empathetic interactions happen daily without much thought into the science behind them. 

However, even healthcare professionals that practice empathy with friends and family may struggle to transfer behaviors to their work environments. Studies show that many, as high as 70%, do not know how or find it difficult to connect to users on an emotional level. Even for those that do, this ability gets lost over time. Medical students’ empathy increased during their first year of school but decreased by their third and stayed low through graduation. Professionals cite busy schedules and lack of training as factors negatively impacting their ability to practice empathy. An article in the AMA Journal of Ethics suggested it may also be caused in part by the “clinically detached” physician model recommended in older research and schooling. The argument being that emotions cloud a physician’s judgment leading to poor patient treatment. However, more research now disproves this. 

Practicing empathy results in positive, measurable outcomes. It opens lines of communication, empowering patients to share more about their concerns, medical histories, and other factors that may provide insight into their health. Patients are more likely to participate in crafting and following treatment plans and trust their providers. One study of cancer patients found an empathetic approach resulted in lower levels of stress, depression, and aggressiveness. This extends through all aspects of the healthcare industry. Having an empathetic approach to handling a billing or insurance question makes a stressful or confusing time easier resulting in higher patient satisfaction. In turn, these boost the company’s reputation. By taking care of patients’ emotional and physical health, users rate the entire experience more positively. Additionally, empathy in healthcare benefits professionals. Those that practice empathy report lower levels of burnout and depression.    

In his article on empathy in medicine, Dr. Elliot M. Hirsch recalled role-playing and writing reflections as part of the empathy training he received in medical school. He went on to say that many of his fellow students did not take the lessons seriously, viewing them as a waste of time, time better spent studying. The culture in medicine and medical school dictates that softer skills, like emotional intelligence, communication, and listening, are either not necessary or less valuable than quantifiable subjects. These barriers to practicing empathy point to larger issues within healthcare systems, like limited education and resources. 

To remedy this, institutions can encourage and incentivize treating patients empathetically. When systems reward treating patients quickly or focus on treating symptoms rather than root causes, practitioners receive the message that empathetic behaviors are not valuable and will not lead to success. While reforming entire systems can’t happen overnight, individuals within healthcare can take steps to ensure they improve institutions through their contributions. 

For some, practicing empathy comes naturally. But for those wishing to improve their skills, education is key. It can take many forms including, “journaling, art, and role-play.” These allow students to learn and explore emotions in safe, unique, and creative ways. Training can also include presentations and hands-on workshops about building self-awareness, listening, finding commonalities, and respecting differences. Learning how to be empathetic doesn’t have to take place in a classroom setting or linked to medicine. Just Googling “how to be more empathetic” yields thousands of results for practicing empathy at work, with friends, partners, even strangers. The New York Times has a helpful guide for how to be more empathetic with practical steps and advice to put the suggestions into action.

Practicing medicine and practicing empathy both require study, effort, and time. They involve trial and error and maybe even some discomfort. Connecting the two may not be perfect at first, but it’s necessary for better care.