Demand drives more hospitals to offer alternative therapies
■ Executives rate patient satisfaction higher than improved health outcomes when evaluating complementary medicine programs.
The number of hospitals offering complementary and alternative medical services has tripled since 2000, driven principally by patient demand for low-risk therapies such as massage, guided imagery, meditation and the "healing touch" practice known as Reiki.
Forty-two percent of the 714 hospitals surveyed said they provide unconventional therapies, and executives listed patient demand as the top criterion in choosing which therapies to offer, according to a report released in September by the American Hospital Assn.'s Health Forum and the Samueli Institute, a think tank that supports alternative medicine. In 2000, just 14% of hospitals told AHA researchers that they provided complementary therapies.
"They are responding to the needs of their patients and the communities they are serving, while trying to differentiate themselves in the marketplace," said Sita Ananth, a Samueli Institute researcher who wrote the report. "These hospitals are really trying to see how they can address the needs of the person as a whole -- mind, body and spirit."
Nearly two-thirds of hospitals offering alternative services provide massages on an outpatient basis, and half offer pet therapy in the hospital. About 40% of these hospitals offer acupuncture or music and art therapies, said the report, based on a survey conducted in March 2010 (link).
One in five alternative-friendly hospitals provides Reiki, which the National Institutes of Health's National Center for Complementary and Alternative Medicine describes as a Japanese therapy in which "practitioners place their hands lightly on or just above the person receiving treatment, with the goal of facilitating the person's own healing response." A systematic review of nine randomized controlled trials, which was published in the June 2008 International Journal of Clinical Practice, said, "The evidence is insufficient to suggest that Reiki is an effective treatment for any condition" (link).
Patient satisfaction is paramount
Though 70% of executives at hospitals providing unconventional therapies said they are doing so because they are clinically effective, only 42% said they use patients' health outcomes to gauge the success of the alternative medicine programs. Instead, they are principally using patient satisfaction and volume as evaluation metrics, the report said. The programs were most often started by hospital administrators, with physicians championing the idea 20% of the time.
The alternative therapies are intended to supplement conventional medical interventions, Ananth said.
"Many of these services are low-risk," she said. "Patients are looking for the best of what both conventional and complementary therapies can offer, and hospitals are responding by offering these choices."
Patients usually pay for these services out of pocket, although hospitals offer them free 44% of the time, the report said. They usually are not covered by third-party payers. Alternative medicine programs usually cost less than $200,000 to start, but most executives said their programs are not breaking even, and two-thirds said they do not expect them to make a profit anytime soon.
A 2007 National Center for Complementary and Alternative Medicine survey found that more than one-third of American adults used some kind of alternative therapy, most often to alleviate back, neck and joint pains.
The American Medical Association has policy stating, "There is little evidence to confirm the safety or efficacy of most alternative therapies." The Association supports well-designed research to evaluate the effectiveness of unconventional services and advises physicians to educate themselves about the risks and benefits of such therapies. The AMA says doctors should ask patients whether they are using alternative services and should warn them of the risks of delaying or quitting conventional medical treatment.