Dr.P.S. Prasad, MD.MPH, Ph.D
Physician and Professor of Medicne, Occupational Mediicne and Public Health
Health Plan for Rural India
- Health is the real Wealth
- Prevention is the better than cure was the old saying
- But the new dictum is PREVENTION IS THE BEST CURE.
As there are several definitions of Health given by various countries and organizations like WHO, CDC, NIH etc. but the simple definition of Health I have invented from my experience is
“ Fitness, Nutrition with Balanced diet, Hygiene, and Spirituality” Constitutes best Health for any person.
Keeping the above philosophies in Health I developed new concept which is beneficial to the Indian Population, particularly to the rural and tribal Indian population. This New concept is the Wellness centers as the PHC concept didn’t give expected results.
The new concept of Health in the 21st century is Fitness, Nutrition and Balanced diet associated with Hygiene is called the real Health. Once these parameters are added with Spirituality the true Health is achieved. As the cost of Health care is skyrocketing every day, it is better to have complete curative system which is nothing but of integrated approach(combination of different approaches to get good health).
It is practically impossible to any government to provide the corporate level high-tech medicine to all the 75% rural population in India. Therefore a better method, a curative method, a rejuvenating method and a fully keeping fit procedure and preventing many health care problems come into the picture what I Call “Integrated Health and Medicine” or Alternative Medicine or Complimentary Medicine. In My approach I am not neglecting the Conventional Medicine which is used for Medical Emergencies. Therefore I am fulfilling the American Cancer societies’ approach.
Medical disciplines that integrates the therapies from all the Medicines of Health care with those practiced by mainstream medical practitioners. Any therapy that is typically excluded by conventional medicine, and those patients use instead of conventional medicine, is known as “Alternative Medicine.” It’s a catch-all term that includes hundreds of old and new practices ranging from Ayurvedic Medicine to Homeopathy to Naturopathy to iridology ( Eyes are the windows of the Mind). Generally Alternative therapies are closer to nature, cheaper and less invasive than conventional therapies, although there are exceptions. Some alternative therapies are scientifically validated, some are not. An alternative medicine practice that is used in conjunction with a conventional one is known as a “complementary” medicine. Example: using ginger syrup to prevent nausea during chemotherapy. Together, complementary and alternative medicines are often referred to by the acronym CAM.
Integrative Medicine as defined by the National Center for Complementary and Alternative Medicine at the National Institutes of Health, integrative medicine “combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness.”
In other words, integrative medicine “cherry picks” the very best, scientifically validated therapies from both conventional and CAM systems. In his New York Times review of Dr. Weil’s latest book, “Healthy Aging: A Lifelong Guide to Your Physical and Spiritual Well-Being,” Abraham Verghese, M.D., summed up this orientation well, stating that Dr. Weil, “doesn’t seem wedded to a particular dogma, Western or Eastern, only to the get-the-patient-better philosophy.”
So this is a basic definition of integrative medicine. What follows is the complete one, which serves to guide both Dr. Weil’s work and that of integrative medicine physicians and teachers around the world:
Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.
The principles of Integrated Medicine (IM):
- A partnership between patient and practitioner in the healing process
- Appropriate use of conventional and alternative methods to facilitate the body’s innate healing response
- Consideration of all factors that influence health, wellness and disease, including mind, spirit and community as well as body
- A philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically
- Recognition that good medicine should be based in good science, be inquiry driven, and be open to new paradigms
- Use of natural, effective, less-invasive interventions whenever possible
- Use of the broader concepts of promotion of health and the prevention of illness as well as the treatment of disease
- Training of practitioners to be models of health and healing, committed to the process of self-exploration and self-development
IM combines mainstream medical therapies with non-conventional complementary therapies. However, IM only uses complementary therapies for which there is some high-quality scientific evidence of safety and effectiveness. In short, IM utilizes all appropriate, evidence-based therapies to achieve health.
This common sense but scientifically rooted concept is catching on with the American public, who now partner with their family physicians to include evidence-based, non-conventional treatments (IM) in their healthcare regimes. Practice of IM has become so credible that the American Hospital Association states that more than 16% of hospitals, including leading medical facilities at Harvard, Mayo, and Duke, feature IM centers as part of their institutions. Among hospitals not currently offering IM, 24% stated that they planned to do so in the future.
So are there distinct differences between this “new medicine” (IM) and its forerunners, alternative or complementary medicine?
Yes. The National Center for Complementary and Alternative Medicine (NCCAM) defines complementary and alternative medicine (CAM) as “a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.” While some scientific evidence exists regarding some complementary and alternative therapies, many still require well-designed scientific studies to definitively answer questions about safety and efficacy.
NCCAM also offers the following key difference between complementary and alternative medicine:
- Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor.
- Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient’s discomfort following surgery.
So although IM utilizes complementary therapies, the stringent requirement that these treatments have a solid scientific basis exists, making it “once removed” from complementary or alternative systems. However, many practitioners and patients look forward to the day when the practice of using all evidence-based methods becomes commonplace and the IM designation is no longer required.
It’s also important to note that IM, like most healthcare systems, is more than simply a list of treatments or therapies. IM values all aspects of a person’s health – mind, body, and spirit – and reaffirms the importance of an open relationship between practitioner and patient. Those who practice IM consider a patient’s overall satisfaction with life, pointing to irrefutable proof that stress management and good mental hygiene positively affect healing and health. Finally, instead of focusing solely on curing disease and illness, IM also emphasizes preventing disease and/or living well with chronic disease.
Integrated Health and Medicine is an art of different disciplines incorporated to fulfill the need of the patients for a successful relief, cure and well being of an individual. This new concept of different disciplines of Health measures what are available are incorporated what we call an ALTERNATE MEDICINE. As conventional Medicine is used widely in the present world and its stoppage limiting to cure for some diseases and the sufferers are looking for alternative avenues where Alternative Medicine or (complimentary) Medicine emerged into the present world. Alternative Medicine emphasis that disease is due to the result of physical, emotional, spiritual, social and environmental imbalance and should be corrected to attain the final result what we call THE CURE. This integrated Medical disciplines are now widely used in the present world. 40% of the world population is looking into these disciplines after the limited result achieved by the conventional ( allopathic) medicine.
Disciplines of Integrated Health and Medicine has its roots in several ancient healing traditions that stress healthy living and being in harmony with nature. In this aspect this sounds like Holistic medicine but the concept may look same but the approach of treatment modalities are different. In this Alternative or Integrated Health system the above said Fitness, Nutrition and Hygiene with Health education and Promotion are focused mainly and lacking in Holistic Medicine. In the Holistic approach like the conventional medicine it is costly matter for the person who is suffering in length as well as burden on the Government, family and the insurance companies. The main idea of introducing the integrated Health is to Give better and quick cure as well as to Reduce the Health care cost. More over the scientific evidence is more in Integrated Health system/ Alternative medicine rather than Holistic approach.
Socrates promoted a different approach. Plato was another advocate of completeness, advising doctors to respect the relationship between mind and body. Hippocrates emphasized the body’s ability to heal itself and cautioned doctors not to interfere with that process. All these great persons are right when they Spoke in the BC ( 427, 460 and 467 BC.) I am not debating the basic principles what they observed and worked in their epoch. From those olden days to now majority of science is changed and new Technologies are developed in Health care sector which is easing the identification of the disease process and at the same time the treatment part also changed for the betterment.
In spite of new methods applied in Medicine many disease are not completely cured because one discipline of Medicine is not able to cure all human suffering, where one of the other discipline having the capability to cure that Particular disease.
In Integrated Health and Alternative medicine is THE COMBINATION OF HEALTH DISCIPLINES are incorporated what are totally different from Holistic Medicine.
Difference between Integrated/Alternative Medicine and Holistic Medicine:
The above two words appears similar but the difference may be recognized before one can look into Integrated Health.
- Integrated Medicine and Holistic Medicine look alike but not.
- There are differences between the two entities.
- In-depth studies proved that these two disciplines are different by practice.
- In Holistic Fitness, Nutrition and Hygiene are not discussed.
- Holistic Medicine opposes Conventional Medicine, but Integrated Medicine utilizes conventional Medicine when ever needed and part of it.
- In Holistic Medicine the procedures varies from doctor to Doctor but in Integrated Method the procedures are almost same.
- In Integrated Medicine these three components, Fitness, Nutrition and Hygiene are mainly focused along with Therapy procedures, but in Holistic Medicine the procedures are different as by the Physician can think.
- Integrated Medicine is Practiced by qualified persons, but Holistic Practice is by Quakes without proper degree or with Fake Degrees.
- Integrated Medicine is not much bothered about spirituality and leave this to the discretion of the person but Holistic medicine is more spiritual approach than scientific.
- In Holistic majority treatments are not proved scientifically but in Integrated Medicine most of the proven treatments are established.
- In Holistic certain planned programs or methods are followed irrespective of the outcome because of this the cure rate is delayed or the final goal may not be reached, but in Integrated medicine if the response is not appropriate the direction of the treatment plan is changed to another discipline without wasting time.
- Integrated medicine is more preventive and curative, but in Holistic preventive measures are zip to zero and curative basis by applying medicine from the very beginning.
- In holistic approach is aimed at cure but outcome is uncertain, where in integrated system the outcome of cure is eminent.
- Dangers often holistic healers will convince their patients to forgo proper medical care, usually combined with misrepresentations of studies or emotional appeals, to undergo holistic therapies. Since there is no valid evidence to support holistic therapies being capable of curing deadly ailments, this kind of malpractice is dangerous to offer patients.
- In some of the disciplines of Integrated Health the treatments are not yet proven scientifically and this mission aim is to do research in such disciplines of particular cases. Though scientifically not commenced the proven work, but in practical these remedies proved. Such kind of one medication I have tested in US Lab and proven for HIV/AIDS, and further studies needed on human clinical trials.
In the Integrated System of Health Medicinal part comes in the latter stage than in the starting phase. Human body have the capacity to RE JUVINATE once the system itself is allowed to remove the etiological factor or factors and restore the normal Physiological functions.
As India touched 120 billion Population and most of them are living in the rural villages, so they have no proper Health care system as well as this population cannot afford the corporate hospital treatments. The middle class Family person admitted in the corporate Hospital and once he/she came out of the hospital, the Middle class family turns to poor. The corporate Hospital are increasing the price tag day after day and it is practically impossible for most of the families to afford once they are sick. In his Recent Speech his Excellency Governor of AP state Sri. Narshiman, commented about the charges collected by the Hospitals and the Doctors.
Fitness plays an important role in the Human Health. This truth everyone agrees but to implement this program in the schools, colleges and Universities there is no mandatory rule Therefore I urge the authorities and Law makers to make the Law that sport and game and in turn fitness should be make mandatory in all the educational institutions. President Dwight D. Eisenhower was the 34th president of the United States who made mandatory law for school physical fitness program immediately after he was elected president of USA in 1957. This kind of Legislation is needed in Indian school system that all our school going students are fit and having good Health. Fitness is the part of Health. But Unfortunately the Private schools are not caring physical fitness and limiting the students for their class rooms and grinding them for their institutional ratings.
Apart from the above my plan is to set up one Integrated Health centre in Each Mandal
( Population 50,000 ) with all the needed infrastructure.
This Health Scheme Have Few components given Below:
Disciplines of Alternative Medicine includes
- Health Education and Health Promotion from the elementary schools to all the colleges
- Fitness programs, sporting activity and games
- Balanced Diet and Nutrition.
- Hygiene( personal and surrounding).
- Allopathic Medicine for (Emergences, Trauma, accidents, surgeries etc.)
- Naturopathy to detoxify the human system, Yoga, Meditation,
- Ayurveda ( Pancha karma, and other medicines)
- Homeopathy( Using medicines for certain proven diseases of cure but not for emergencies)
- Unani ( medicines, same like above)
- Acupuncture( For Immediate relief of pain)
- Herbal supplements( medicines)for strength
- Massage Therapy for better circulation.
- Energy products consumed are to Enhance cell Energy.
- Prevention is more focused here
- Finally Women and child Health what is very poorly developed in the Rural India.
These above components all together form Integrated Medicine or Alternative Health Care system.
The below centre covers up to 50,000 Population where multiple centers are needed to cover the 75% population who are Living in Rural India.
This centre is established as a role model to the society as the PHC concept didn’t yield great Outcome. This not only serves as a Initial Family care centre but also a training centre for fitness, Nutrition and Hygiene. This centre is also act as an educational Health centre by conducting Health Courses to the Public without any extra cost. Women Health and Child Health are the main focus of this centre where WHO is now focusing how to Reduce Infant and Maternity Mortality in the public.
Finally this centre will help to cut the cost o fthe Public as the present Health care costs are skyrocketing whre common man can’t afford.
SEE THIS VIDEO
- Land of Three acres
- A Fitness centre with proper equipment.
- A senior Citizen Home to accommodate 10 persons in each centre.
- All the disciplines of Health Care are incorporated in this centre with needed infrastructure..( all 15 items written above).
In this discipline of medicine, it is believed that the spiritual aspect should also be taken into account when assessing a person’s overall well-being.
Some of the practices of alternative health include, but are not limited to:
Few items focuses on how the physical, mental, emotional, and spiritual elements of the body are interconnected to maintain wellness, When one part of the body or mind is not working properly, it is believed to affect the whole person, but what discipline of medicine should be adopted is not known before but This Integrated Health specifies the selection of the sub sect of the list mentioned in this presentation. This approach differs from Holistic approach in treatment point of view.
Available scientific evidence does not support claims that IM, when used without mainstream or conventional medicine, is effective in treating cancer or any other disease. However, many health professionals promote healthy lifestyle habits such as exercising, eating a nutritious diet, not smoking, and managing stress as important in maintaining good health. Alternative Medicine methods are becoming more common to adopt into the mainstream care and may be used as complementary therapy or preventive care.
In Mainstream Medicine, an Alternative approach generally means a more inclusive approach to a person’s health by Life style, one that includes the patient’s social and cultural situation as well as his or her illness. This term Alternative is used to reflect a focus on a person’s overall health, a focus that includes prevention, fitness, Nutrition, rehabilitation, and other approaches, rather than illness alone. Nurses, for example, may speak of the “bio-psychosocial sphere” of a patient. This means that a person’s health includes the mind, body, and spirit, as well as the surrounding culture and environment. This can include one’s family situation, housing, employment, insurance, and more, since these all have an impact on the patient and his or her health. If all these factors are taken into account when a person is treated for cancer, it may make treatment easier and improve chances of success.
How is it promoted for use?
Integrated medicine approaches health and disease from several angles. The approach suggests that a person should treat not only the illness but the whole self to reach a higher level of wellness. For example, practitioners may treat cancer by changing diet and behavior and adding social support groups and counseling. Others may suggest taking botanical supplements and using complementary therapies, such as art therapy, hypnosis, imagery, meditation, psychotherapy, spirituality and prayer, and yoga. These approaches can be used with conventional medical treatments such as chemotherapy, surgery, radiation therapy, and hormone therapy. Combining these different methods can help a person take control of his or her situation and attain a feeling of total wellness –Fitness, Nutrition, Cell energy enhancement, spiritually, and boosting Psychological strength.
Some supporters of holistic medicine claim, however, that conventional medicine does not work, and that only the holistic approach to cancer and other diseases is effective. In my opinion both are wrong and an Alternative measures and combination of an Alternative measures are focused. They may offer a “cure” based on individual stories of success or personal experiences, which are very hard to prove. Some of the types of cancer that they claim can be cured by holistic methods include cancers of the bone, breast, tongue, liver, lung, throat, skin, testicle, prostate, ovary, uterus, stomach, intestine, colon, brain, pancreas, spleen, kidney, and bladder, as well as leukemia, lymphoma, and melanoma, but scientific evidence in this regards is slim. I differed with conventional Medicine and Holistic approach and Introduced Alternative Medicine and Therapy where I got excellent improvement.( eg: Supra Teritorial Brain Atrophy?), Muscular Dystrophy etc.)
What does it involve?
The field of Alternative Medicine is very diverse and broad. Some providers define it looks like Holistic as including emotional and spiritual care, but none of them are not in the reachable in the range of Alternative methods of treatment .while others focus on these aspects to the exclusion of the physical. There are many different techniques and approaches in holistic medicine, depending on the practitioner, the person, and the illness, however, stress the use of treatments that encourage the body’s natural healing system and take into account the person as a whole.
The use of conventional and alternative therapies but focuses mostly on lifestyle changes. In this approach to stomach cancer might include reducing sodium intake, increasing intake of antioxidants through food or vitamins, eliminating Helicobacter pylori (type of bacteria found in the stomach), quitting smoking, improving oral hygiene, avoiding foods that contain geno-toxic agents, and increasing the amount of vegetables and fruits consumed.
In this Alternative Medicine Therapy we can also include natural supplements that cause the same changes as conventional drugs. For instance, synthetic interferon is currently used to treat some people with cancer, but to take high doses of intravenous vitamin C instead, in an attempt to stimulate the body’s production of its own interferon.
The Healthy lifestyle habits will improve a person’s energy and vitality. Those habits might include exercising, eating a nutritious diet, getting enough sleep, learning how to breathe properly, taking antioxidants and supplements, and using acupuncture, acupressure, healing touch, cranio sacral therapy, yoga, qigong, and other methods.
Role of the Practicing Physician:
The Physician in this system recognizes that our discomforts or pains are merely symptoms of an imbalance. The imbalance from the external Environment and internal Environment. This Imbalance is Balanced the person should not get any disease. could be a physical issue, the result of abusing the physical body through an unhealthy diet, lack of exercise, or too little sleep. Or, the imbalance may be the result of mental, emotional, or spiritual needs not being met. No aspect (mind, body, spirit, or emotions) of a person is overlooked when this treatment is sought.
What is the evidence?
Although there has been research on various Alternative methods that may be considered part of a holistic approach, scientific research generally does not focus on holistic medicine by itself as a cure for cancer or any other disease. Available scientific evidence does not support the idea that alternative practitioners are more effective than conventional physicians in persuading their patients to improve their lifestyle. Nor have available scientific studies shown that any of these approaches are effective or cost-effective against any disease if holistic methods are used without conventional medical treatment.
Some health care professionals suggest that cancer pain and some side effects of treatment can be managed with a holistic approach that includes the physical, psychological, and spiritual factors involved with each person. Increasingly, the health care team comprises a diverse and varied group of health care professionals. Members of this team are drawn from the specialties of medicine, nursing, surgery, radiation therapy, oncology, psychiatry, psychology, and social work. In addition, the team may call on dietitians, physical therapists, and the clergy for support. Health professionals realize that a person’s health depends on the balance of physical, psychological, social, and cultural forces. However, available scientific evidence does not support claims that holistic medicine alone can cure illness.
Are there any possible problems or complications?
Some substances may not have been thoroughly tested to find out how they interact with medicines, foods, or dietary supplements. Even though some reports of interactions and harmful effects may be published, full studies of interactions and effects are not often available. Because of these limitations, any information on ill effects and interactions below should be considered incomplete.
Adopting healthy habits related to diet, exercise, emotional, and spiritual well-being is considered important to maintaining good health. In fact, studies have shown that certain dietary changes and regular exercise can reduce your risk of some kinds of cancer. However, relying on healthy habits or holistic measures alone and avoiding or delaying conventional medical care for cancer may have serious health consequences.
Guidelines for Using Alternative Medicine Methods
Alternative are terms used to describe a number of products, practices, and systems that are not part of mainstream medicine. They can include things like herbs and dietary supplements, body movement, spiritual approaches, pills, extracts, and creams or ointments. Some are done by a person with formal education and training, such as art or music therapy. Others may be recommended by the person who is selling the product in a store or online, such as botanicals and exotic types of juice. The methods can involve everything from enemas, like colon therapy, to no-touch “energy work”. Some take a lot of time or cost a lot of money, such as strict diets or travel to another country for special treatments. Others are fairly cheap and easy to use, like vitamins or homeopathy. Some can be done at home on your own, such as meditation and prayer, and others require another person to give them, like massage or acupuncture. Some almost never cause harm, while others can be dangerous and have even caused deaths.
You may hear about one or more of these treatments from friends, family, co-workers, salespeople, and others. The treatment may be something you’ve never heard of before, and it can be hard to get good, unbiased information about it. Here we will go over what you need to know before you decide to try one of these unconventional treatments. We will give you some ideas about how to look at these methods and what questions you might want to ask as you think about what might be best for you. It may also help you find out more about the treatments that interest you. In this Medicine More Research should be accomplished in the coming months and years.
The American Cancer Society considers complementary and alternative medicine to be different from each other:
Alternative medicine is used instead of standard or mainstream medical treatment, often with serious outcomes for the patient.
Complementary medicine is used along with mainstream medical care. If carefully chosen and properly used, some of these can improve your quality of life without causing problems with your regular cancer treatment.
People with cancer might think about using alternative and complementary methods for a number of reasons:
To relieve the side effects of mainstream cancer treatment without having to take more medicine
To find a less unpleasant treatment approach that might have few side effects
To take an active role in improving their own health and wellness, because they prefer alternative theories of health and disease, as well as alternative treatments
The decision to use alternative methods is an important one, and it is yours to make. We have put together some guidelines to help you think through the issues and make the most informed and safest decision possible.
How Alternate Medicine is Helping What’s the Latest Development?
Clinics that offer alternative medical treatments like acupuncture and homeopathy are now eligible to receive federal funding in USA if they combine those treatments with traditional medicine. Some M.D.s are up in arms, decrying practitioners of alternative treatments as hucksters and con-artists. Such treatments, they say, have never been proven to work more frequently than the placebo effect whereas traditional medicine is supported by evidence from clinical trials. Author David Freeman says the picture is not so black and white and that even some highly respected traditionalists are reevaluating alternative medicine.
What’s the Big Idea?
The success of the medical establishment cannot be denied in its ability to combat infectious diseases. But the illnesses of today that pose the biggest threat to patient health are not easily remedied with vaccines and surgeries. Afflictions like heart disease, cancer and Alzheimer’s often respond better to lifestyle changes—ones that alternative medicines incorporate directly into their regimes—than to traditional medicine’s most sincere attempts at a cure. Procedures offered by traditional medicine typically respond to disease only after it has set in while alternative treatments can reduce risk factors associated with disease before they form.
Explaining the demand for naturopathy in rural health: affinity with rural patients and populations
The participants explained how their practice constituted a popular treatment option attracting good numbers of local and regional patients. As the quotes below illustrate, the naturopaths often made reference to what they perceived as the ‘open-minded’ and/or ‘independent’ outlook or approach of rural patients as a factor for demand for their services .
I think country people are generally more open-minded and less cynical about things than city people… so I think they’re more willing to give things a go.
I don’t think they’re exposed to as much of the negativity as city people, you know they’re not bombarded with media or advertising so they have to make up their own minds.
These perceptions were further explained by some naturopaths in terms of the stoic approach of rural patients not just to health but also to life generally. As the quotes below illustrate, this stoic approach is often associated with a preference for preventive measures and self-care – a preference that naturopaths’ claim fits comfortably with their perspective and practice
Rural people brought up with this idea that you don’t seek help until the last minute and I think they enjoy the fact that you teach them to look after themselves rather than telling what to do.
I really think that that preventative role of naturopathy can really help country people… they work themselves into the ground so much until… they die and they aren’t often able to get away from their farms to see you. So if you can teach them to look after themselves. they really appreciate that aspect.
As this last quote suggests, the constraints and logistics of rural work and life may also be instrumental in establishing a convenient affinity between the preventive and empowering tenets of naturopathic care and the needs and abilities of rural patients with regard to accessing health services.
Some naturopaths pointed to the extensive time commitment and support provided by naturopathic consultations as another ‘pull factor’ for rural patients in seeking their services. As the following quotes illuminate, these claims referred to logistics and the commitments associated with accessing health care in rural locations:
‘Some of these people are driving seven or eight hours to see a healthcare professional… [if the consultation only lasts for] 15 minutes and [costs] 200 bucks they get very disappointed… I think that’s why they like coming to see someone like us… we try to make the trip worthwhile.
Rural Population have a larger sense of commitment. I’ve found that if I… include their family members and include their story… that’s half their healing…. They don’t get heard in the medical establishment because it’s 5 minutes, 15 minutes if they’re lucky, I’ve found that country people want to talk first.
Likewise, the quote below pointed to the affinity with closer personal relationships among rural populations as cementing the demand for their naturopathic services.
‘They’re more inclined to see me because I listen and because I remember the story the next time they come or if I meet them down the street they will tell me and I have to remember those little pieces. it’s very different [from patient-practitioner relationships in urban communities].
Others suggested that another key factor driving rural patients to seek complementary therapists was the fact that complementary therapists, more so than conventional health practitioners, were often originally from the areas they practiced in, with deep cultural roots in the community. Practitioners not originally from the area often mentioned that they were only accepted after they had become ‘locals’. This connection to and understanding of the culture of the community may help deeper therapeutic relationships with their patients, as illustrated in this quote:
‘I definitely think that the fact that I’m originally from here made a huge difference… patients automatically feel more comfortable because they know you’re aware of issues that arise from living in the area. I think if I was someone coming up from the city they wouldn’t have been anywhere near as open to start with.
This connection to the community was perceived to be more important than the type of practitioner they were. The community perception of who is a ‘foreign doctor’ could apply equally to a medical graduate from Brisbane, Sydney or Melbourne as it could to an international medical graduate. However, international medical graduates (who make a significant proportion of the Australian rural medical workforce) may present issues of their own in relation to local Alternative Medicine use that disconnected them from their patients, as the following quote illustrates:
Not only do close therapeutic relationships serve as significant pull factors for naturopathic consultations, in some patients they also serve to differentiate the naturopaths from conventional medical practitioners, as this quote from a participant illustrates:
‘It’s always “she doesn’t listen” or “he doesn’t listen” or “they’ve always got their face on the computer”, or “how do they know me if they don’t talk to me”… There’s always a bit of a hinge first how the doctor treated them last time. people come to see me because I’m not a doctor.
Meanwhile, other naturopaths appeal to a notion of historical affinity to explain the high use of naturopathy in rural populations. As one participant suggested:
Western people are far more open… natural therapies have always been a part of their lives… some of the founding fathers of naturopathy started out in places like this… that culture is still alive here… it never died out.
I think people in the country still have access to all those old grandma cures.( The Tennis Legend Pete Sampras was cured his Shoulder pain from the Herbal Treatment from His Grand mother from Mexico)
I mean they haven’t lost that part of their culture like people in the city have.
Linked to this notion of rural communities as characterized by closer personal relations, some naturopaths highlighted how both rural patients and naturopaths share a broader conception of health and illness, one that places emphasis on family, community and social ties and acknowledges the relationship between health and wider environment. This conception of health is characterized by these practitioners as holistic and supporting a version of holistic practice:
The naturopaths’ explanations of this pragmatic attitude towards the complex interactions and inter-connections affecting health seems to stem more from lived experiences and attitudes in rural areas than from new age or esoteric philosophies often attributed as pull factors for CAM in the broader community:
The people here are much closer to nature and the natural cycle, they believe in the power of it… they see things get sick and die they’re just more earthier people
However, not all explanations of naturopathic practice in rural communities were couched in entirely positive terms and as the next section of analysis outlines, there were a number of perceived challenges associated with providing naturopathic services to the wider rural community.
Barriers and challenges to use Integrated Medicine in Rural Population:
Despite their overall presentation of Alternative Medicine and its sub sections as well suited to rural patients and populations.
Several practitioners outlined how the resourcefulness and independence of rural people may produce challenges in providing timely treatment – a difficulty acknowledged as facing both conventional and complementary practitioners but were particularly a problem for working in the competitive private sector where treatment costs are entirely out of pocket and borne solely by the patient.
As one Alternative Treatment Physician explained.
I found people were much happier paying for the service Similarly, another Physician described how rural people are proud and how their self-reliance can be a challenge to providing care. This can be seen as the flip side to the positive affinity between a patient’s self reliance and a preventive approach as illustrated earlier by Alternative measures applied.
Another informant explained how in her experience rural patients
need to feel in control and be central to decision-making in their healthcare, and how this influences her approach to providing care.
Rural population is very strong, they do prefer their own counsel you can’t push them very much If they feel as though they are doing this themselves then you have their compliance. If you keep telling them what to do they don’t really want to know. So This population need Health Education and Health Promotion give them reading matter… handout sheets, they have a chance to go and think about t, seems to be a need to be in self-control.
Conclusion: In conclusion the wellness center with Integrtative Methods by clubbing with Conventional Medicine and also with Health Education and Health Promotion are important to give better Health by adopting Fitness, Nutrition and Hygiene to the Rural Population.
Purpose of the integrated WELL NESS health center
To provide a health care center that has integrated multi specialty and multi disciplinary approach to different formats of medicines with a win – win approach providing health with fewer burdens on the pockets of the patients.
The amenities expected from the health center are
- The needed land ( with 30% to 40% from the owners and others from government and FDIs)
- The structure (building for the center)with construction cost of Rs 1500/- per square yard
- Lifts and pathways
- The beds for old age patients for their care center(20Nos)
- The ambulances (2Nos)
- The doctors for allopathic, naturopathy, homeopathy, Ayurveda, Physio Therapy experts and consultants
- The sub-staff
- The equipment required to do the needed diagnostic study
- Medical Pharmacy
- Canteen/ cafeteria
Establishment costs To do today’s price structure)
|S.No||Factor under consideration||Cost per unit||Total cost|
|1.||Land 3 Acres|
|2.||Building cost (10,000 S.q.ft)||2500per sq.ft||Rs. Cr.2.5cr|
|3.||Lifts and pathways(if any)|
|4.||The beds for the old age patients||20 rooms||20,00000|
|6.||The doctors recruitment(allopathic, Naturopathy, Homeopathy, Acupuncture expert, nutrition specialist etc.,)||Going rates in the market||Rs. 32.40,000|
|7.||Equipment costs – X –ray machines, scanners and other diagnostic tools, oxygen cylinders,||50, 00000|
|9.||Canteen given out side as lease|
|10||Medical store Given out side shop|
|11||Generators x1||Rs 20,00000||20,00000|
|12.||Fans, Acs, TVs, Water purifiers and other facilities.||10,00000|
|ONE TIME COST||Rs. Cr. 3, 13, 40,000|
|S.No||Factor under consideration||Cost per month||Cost per year|
|1.||Salaries of the doctors||Rs 80,000||9, 60,000|
|2.||Salaries of sub – staff (nurses, paramedics and drivers)||100,000||12,00000|
|3.||Maintenance of the equipment and lawns|
|5.||Diesel for ambulances and generators|
|6.||Canteen maintenance costs|
|8.||Basic amenities and medicines cost|
Revenues generation will be from: Out Patients, Treatments, Lab investigations, Nutrition Classes, Senior citizen Room Rent and other facilities Like Physio Therapy, Pancha Karma etc.
All the 50,000 population should be provided Health Insurance.
Patients who come for various treatments
Seniors citizens who stay in the clinic Campus for care = 20X5,000 per month = Rs.100,000 x12= Rs.12,00000
How much are you charging?
What is the extra profits you are earning?