Hartford Business Journal

Continued on next page acupuncture amounts to "theatrical placebo" and should not be offered in hospitals. His fight, however, appears to be an uphill battle as many community hospitals and large academic medical centers in Connecticut and beyond — including his own employer, Yale New Haven Health — have launched integrative departments that offer alternative health treatments. Integrative medicine is a term used to describe a combination of conventional western medicine with non-standard treatments. Hospitals push back against the notion that integrative medicine is ineffective. ey say the treatments help patients every day, mainly with pain and stress. "I feel really comfortable that not only what we offer in our center has great science behind it, but it also has a substantially lower risk than the majority of what is offered in western medicine," said Mueller when asked about Novella's criticisms. Safety is also top of mind, she added. Her center would never, for example, do something like recommend acupuncture or reiki to a cancer patient instead of chemotherapy. "First, do no harm. at's my job," Mueller said. As integrative treatments become accepted into medical guidelines and offered in hospitals, they're clearly becoming more mainstream. e federal government stepped into the fray 26 years ago when it established the National Center for Complementary and Integrative Health Research. NCCIH funds research and educates consumers about how to read scientific studies. NCCIH says "research suggests that acupuncture can help manage certain pain conditions, but evidence about its value for other health issues is uncertain." In updating its back-pain guidelines, the American College of Physicians (ACP) reviewed 14 acupuncture studies and dozens of others related to the condition. Lower-back pain typically improves over time regardless, ACP said, so non-drug treatments are the best first-line approach. e guidelines say to mix superficial heat — a recommendation with "moderate-quality evidence" — with acupuncture, massage or spinal manipulation, which ACP says have "low-quality evidence." Connecticut growth According to the most recent survey data available from the Centers for Disease Control and Prevention (CDC), Americans spent more than $30 billion out of pocket in 2012 on complementary health practitioners, natural product supplements, homeopathic medicine and related educational materials. While the CDC doesn't break out complementary health data by state, there is evidence that such treatments are growing in Connecticut. For example, there are now 385 acupuncturists in the state, up from 318 a decade ago and 107 in 1998. Both St. Francis and Hartford HealthCare built their integrative departments on free inpatient acupuncture and massage — mainly to reduce pain and stress, oen in cancer and surgery patients. Each has since expanded to offer outpatient integrative services. In the past few years, Hartford HealthCare has opened dedicated space for its integrative department in Avon, with another suite in the health system's new Bone & Joint Institute. Hartford HealthCare's integrative department, part of its cancer institute, is now billing insurance companies for roughly 60 percent of its services, said Eric Secor, associate medical director of integrative medicine. at's a dramatic change from just several years ago, when most services were either billed out of pocket or provided free. Secor, a naturopathic doctor who has a master's degree in public health, joined Hartford HealthCare Licensed acupuncturists in Connecticut Source: Department of Public Health 0 50 100 150 200 250 300 350 400 Number of licenses Year 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 Dr. Kathleen Mueller, St. Francis Hospital and Medical Center Lower-Bank Pain Treatment Options Earlier this year, the American College of Physicians issued new guidelines for noninvasive treatments of lower-back pain. The top recommendations included: • Given that most patients with low back pain improve over time regardless of treatment, clinicians and patients should select non- drug treatment with superficial heat, massage, acupuncture or spinal manipulation. If non-drug treatment is desired, clinicians and patients should select nonsteroidal anti-inflammatory drugs or muscle relaxants. • For patients with chronic low back pain, clinicians and patients should initially select non-drug treatment with exercise, rehabilitation, acupuncture, mindfulness- based stress reduction, tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, cognitive behavioral therapy or spinal manipulation. I M A G E \ \ N A R I N P H A P N A M , S H U T T E R S T O C K . C O M GREATER HARTFORD HEALTH • Fall 2017 13

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