Why are M.D.s (insurance companies) so unwilling to support/pay for alternative !


Question:

Why are M.D.s (insurance companies) so unwilling to support/pay for alternative therapies for chronic pain?

The public pays huge amounts out of pocket for chiro, massage, acupuncture for chronic muskuloskeletal pain. Physical therapy is just as important as any alternative therapy I've seen, but it and other aspects of the traditional, western medical approach falls short in many areas. What are your thoughts?


Answers:

First, separate M.D.s from insurance companies. They are not each other's friends or colleagues. M.D.s are supposed to care for the patient's health, while insurance companies provide payments but act in the interest of the company (revenues matter most).

You may feel that M.D.s (the doctors) hesitate to pay for alternative treatments. M.D.s are waiting for good scientific data for these treatments before they prescribe them. Good data comes from independent (not funded by large pharmaceutical/equipment companies) "random controlled trials". Anecdotal data ("I know a guy who...") is just not good science.

Insurance companies are balancing effectiveness of the treatment with the cost. If a treatment is 30% effective but costs $1000 AND is not necessary (life-saving/life-prolonging), then they won't pay for it. If a treatment is 80% effective, costs $100 and is medically necessary, they are more likely to pay for it. There are plenty of other statistical computations they do before they decide to pay. In general, the company is trying to minimize *their* cost (thus maximize their profits).

The good news is that the National Institutes of Health has a relatively new division http://nccam.nih.gov/ that studies alternative treatments. Good science will be applied to old but untested remedies. M.D.s will be able to prescribe these methods, comfortable with the fact that they have good science behind them. Sham treatments will be exposed as useless, and will not harm the patients who use them (by harming them directly or by delaying effective treatment).




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