Alternative medicine providers seek place in health care reform

Editor’s note: This article has been updated to correct Brian Gibson’s practice to hynotism, not hypnotherapy.

Bonnie Nichols has helped patients with headaches. She has seen spinal patients before and after surgery. She has appeared in post-surgical recovery rooms and works with new mothers who have just come through a caesarean section.

She has sat with the dying to ease their way.

“You can’t be afraid of death, which I’m not,” Nichols said. “There are techniques in Healing Touch that are good for any transition in life, death being the final one.”

Nichols practices Healing Touch, a therapy that uses gentle touch to relax patients, decrease pain and a number of other therapies, at Central Peninsula Hospital. Sometimes, she doesn’t even have to touch them — just “manipulating the biofield” from a small distance works well enough. She was certified for the therapy in 1997 and helps coordinate Healing Touch classes for nurses at the hospital.

Healing Touch is a type of complementary and alternative medicine. While it is recognized by groups such as the American Holistic Nurses Association, it is not recognized as medicine and has been rejected by medical journals as not science-based.

However, many hospitals nationwide still use it, and some doctors request it for their patients. Nichols said she has a standing order with Dr. Craig Humphreys of Kenai Spine, and all the spinal surgery patients are referred for the therapy. She said her most frequent visits are to post-surgical patients to help with pain.

“Healing Touch is within the scope of practice within nursing,” Nichols said. “Even without anybody giving their blessing, the scope of nursing gives nurses the ability to do this work.”

Complementary and alternative medicine models are popular among older adults particularly. According to an October 2010 survey from the AARP and the National Center for Complementary and Alternative Medicine, more than half of the polled 1,000 adults older than 50 reported using alternative or complementary medicine at some point in their lives, and nearly half said they had used it in the past year,

Four years later, the national American Association of Naturopathic Physicians sponsored another survey of 384 individuals older than 65 and found that seniors would be more likely to see naturopathic physicians if Medicare covered it. The association has called for the Centers for Medicare and Medicaid Services to extend recognition to Medicare, which does not currently cover naturopathic services.

How to protect the public from pseudoscience while still allowing them to choose their care has long been a topic of discussion. During the George W. Bush presidency, a White House Commission on Complementary and Alternative Medicine Policy acknowledged this in its advice.

The commission recommended in its report, issued in March 2002, the establishment of an office to coordinate federal activities on complementary and alternative medicine, increased funding for research and for the federal government to increase its emphasis on wellness and prevention for all Americans.


The options

Dawn Lamb starts all her relationships with patients by teaching them how to breathe.

“I went to Peru and got some training in yoga for addiction, I do breath work, I do homeopathy,” Lamb said. “I do things that are for most people way out there, but sometimes, the ‘way out there’ works really well.”

Lamb, who practices in Soldotna, is one of 57 doctors with active naturopath licenses in Alaska and among a handful on the Kenai Peninsula. Natural medicine, as naturopathy is increasingly called, is hinged on the belief that the body can naturally heal itself. Only 18 states license naturopaths as physicians and allow them to receive insurance reimbursements from private insurers and the state’s Medicaid program. However, Medicare does not recognize naturopathy and does not pay for naturopathic treatments.

Every naturopathic doctor practices differently, the same way all doctors run their practices differently, Lamb said. She prefers to get to know patients well and work on their health gradually.

She said she prioritizes relationships with her patients, with appointments often taking one to two hours and discussion of emotional as well as physical issues. Allopathic physicians, as conventional doctors are called, rely on treating many conditions with pharmaceuticals, and while some are necessary, Lamb said she prefers to avoid them and focus on the person’s wellness overall by changing habits, diet, behavior and thinking.

“By the time (patients) come to me, they realize what they’re doing isn’t working,” Lamb said. “When you realize what you’re doing isn’t working, you have to be open enough to realize that what you’re doing is causing you that problem. You have to be open enough to want to change what you’re doing.”

Lamb, a former high school science teacher, had to complete an undergraduate program and graduate from a naturopathic medicine program, which has the same requirements for the first two years as any other medical school. She said she has practiced in Oregon, Arizona and Alaska, all of which have different requirements for naturopaths and how they practice.

Other complementary and alternative medicine providers do not have to jump through all the hoops because they are not licensed by the state. That means they cannot accept Medicaid or Medicare, typically charging fees out of pocket.

Mark Hutton prefers the term “complementary” medicine for his practice — rolfing, a therapy that these days relies mostly on low-level laser therapy and light touches. Soldotna has one of the highest concentrations of rolfers in the country, Hutton said.

Essentially, rolfing focuses on the soft tissues of the body as a whole, working with clients to improve movement and prevent later structural problems. Hutton, who has been practicing in Soldotna for 20 years, said he has clients who come a few times and others who come more than 100 times. He offers free service to veterans, with a priority for World War II and Vietnam War veterans, and for children.

However, it takes effort from both sides — if clients are not willing to participate in their treatment, it becomes an uphill battle, he said.

“I’m not going to wash your car if you’re just going to take it out and drive it through a mud puddle,” Hutton said. “It’s like that — you have to learn how to take care of your body in the first place.”

It’s similar for Brian Gibson, a certified hypnotist practicing in Soldotna. Far from the dramatic hypnosis on stages, Gibson practices hypnotism to coach clients into quitting smoking, losing weight or accomplishing other life goals that they have shared with him, he said. However, it starts with patients being motivated to help themselves.

“What I do is get people past the critical factor, past the analyzing,” Gibson said. “I would say about 95 percent of people can do it, anybody of average intelligence. It’s only if they’re very analytical that they have trouble … you have to trust, and you have to be relaxed.”

Hypnotherapy is used by psychologists and psychiatrists, but is not licensed individually. Gibson practices as a hypnotist, so he does not bill insurance. Gibson said he has been practicing self-hypnosis since his college days and recently decided to be certified through the National Guild of Hypnotists to practice.

Hypnotism is more like a relaxed state than a trance, he said. In a demurely painted office with the sound of trickling water, clients sit in a soft leather chair and talk with Gibson about their goals for losing weight, quitting smoking or anything else they want to achieve. After some time, they enter what he calls an “alpha state,” which aligns with the subconscious mind.

In this state, the client is more attuned to suggestion. Gibson said he only suggests or discusses what the client wants to achieve.

“The success with this is incredible,” Gibson said. “I’ve had people walk in here smokers, and in an hour and a half, they walk out nonsmokers.”


The obstacles

Complementary and alternative medicine generates controversy because the medical community does not recognize many types. Lamb includes Eastern medicine practice in her naturopathic clinic, and says it is an important part of her practice. Lamb says it has a scientific base, just not the type Western medicine recognizes as legitimate, she said.

Though Lamb said she primarily relies on herbal medicines, massage and yoga, she will recommend patients take pharmaceuticals when they have a condition that requires that treatment, such as an acute infection or cancer. But there’s a snag: she cannot write any prescriptions herself in the state of Alaska, not even for birth control. Alaska does not allow naturopaths to write prescriptions.

“In other states as a licensed naturopath, I can write you a prescription for birth control, but in Alaska I cannot,” Lamb said. “I cannot write you a (prescription) for anything, which is frustrating.”

The license fees for naturopaths in Alaska may increase soon, as well — from $470 annually to $1,200 biennially. The increase is to cover increased costs of investigation and operating, according to the Alaska Department of Commerce, Community and Economic Development. The cost of the naturopathic licensing program reported a $56,508 deficit in its October 2015 report to the Legislature.

Medical journals have published articles saying therapies like Healing Touch, which Nichols uses, has no scientific base. Many physicians will not work with complementary and alternative medicine because they do not think it has a scientific base, Hutton said.

However, the charges of illegitimacy do not faze Hutton, he said. He relies in large part on low-level laser therapy, which has been recognized by the U.S. Food and Drug Administration as a legitimate medical device and used by many chiropractors.

The nature of complementary medicine is to work alongside acute care providers and try to make patients better as a whole, Hutton said. The health care reform underway only changes the delivery system, not the health of populations over time — prevention and systemic problems need to be addressed, not just acute symptoms, he said.

However, there is no use in “poking the bear,” he said, referring to antagonizing the medical establishment with naturopathic medicine.

“I have this passion that says, ‘Here’s what our current system is doing,’ and it takes a paradigm shift to change anything, but here’s a few ideas,” Hutton said. “If you want a healthier peninsula, if you want to set an example for the world … here’s what you do.”

Both Hutton and Nichols said the emphasis was to at least avoid doing harm. Nichols said she sees value in integrative medicine both for helping keep patients out of the system in the first place and for providing better care when they are there.

“The new term is integrative medicine,” Nichols said. “I think (the conversation) should be ‘How does this fit?’”


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