| Q: What is your view of true
health care? Borysenko: Larry Dossey's model. Also, I go to Women's Health Centers when I travel and some of those give me an idea of what a healthcare utopia would be in terms of Medical Eras 1, 2, and 3 [See chart below. Click on it for larger image].
I was in a fabulous hospital in Montana and walked into the Women's Health Center and the first thing that struck me was the place was beautiful. It looked like somebody's home, as opposed to a hospital, which can be scary and can put you off. So right away, in this place of beauty, the whole body feels expansive. There were two massage therapy rooms there. It was one of the few times as a speaker that a massage had been arranged for me. It was great. The Yoga room was all done by Feng Shui. It was just gorgeous with candles everywhere. I was thinking, "This is the hospital utopia."
The Woman's Center also did mammograms, pap smears, etc. Often women come here with a friend, they get their mammograms, their pap smears, they go to a Yoga class, have a massage, and go to lunch. Q: What is the greatest obstacle to acceptance of the mind-body-spirit paradigm in health care? Borysenko: The greatest resistance comes at the level of the spirit aspect. Look at healing through prayer, at what Larry Dossey calls nonlocal medicine. This is because it is so different from the scientific paradigm, which is materialistic in nature. In other words, modern medicine says, "Matter comes first and energy is just derivative." When the research is brought forth on "distant intentionality," for example, which suggests that intention and energy are primary (which, by the way, is the paradigm most massage therapists work in) and matter is not primary, it provokes a negative response in the healthcare establishment. It's going to take a lot more time and studies to accept this new way of thinking. Another obstacle is the tendency of people to oversimplify the mind-body-spirit connection. This gives rise to New Age Guilt. Many physicians care about their patients and do not want someone laying a guilt trip on them saying, "If you only thought differently, you wouldn't have this problem." Also, physicians are afraid that the mind-body connection will be taken too far and patients will forgo some allopathic treatment. Interestingly enough, the field of Complementary and Alternative Medicine operates outside the pharmaceutical and insurance controlled medical paradigm. Although the drug companies are now trying to get into the herb and supplemental scene. Since the Eisenberg study,* hospitals and insurance companies have been trying to figure out how to cash in on these popular new modalities. Seeing so much money being spent out of the consumer's pocket* many would like to regulate herbs and supplements and control modalities in CAM, including massage therapy. Q: Do you envision that one day all healthcare practitioners will view one another as teammates, rather than as competitors? Borysenko: I hope so. Certainly within the field of CAM you see a team-like approach. There's the idea that there is a collegial relationship with a wide referral network. When I was at Harvard as director of the Mind Body Clinic we had that collegiality. We had a number of physicians from different specialties referring to the clinic that we, in turn, referred to Yoga classes and massage therapists. |
I had a feeling that kind
of camaraderie was really developing. You'll find it is
well developed in some places and nonexistent in other places. The turf wars, the old mind set that "that patient is mine," is
unfortunately more common in allopathic medicine. The
thinking and focus in CAM is much different. There is
the sense that this person is a whole and the focus is "How can this whole person best be served?" Q: When the mind-body-spirit concept is fully actualized will there be a need for allopathic medicine? Borysenko: Absolutely. Go back to Dossey's Era 1, 2 and 3 medical model. Even if we had the most pristine society on earth, no toxins anywhere, there would be a need for specific treatments that the mind is not developed enough to deal with. We now live in a very toxic world where disease is everywhere. The days when the Native Americans were here, preEuropean, was an era with an enormously healthy society. People lived at least into their 80s and 90s. Many are on record living into their 100s. It's a fallacy to say that modern medicine has caused us to live that long. Theirs was a society that was hygienically clean, not full of toxic chemicals, in touch with the earth. People did live that long. There will always be chronic, acute, and degenerative conditions that can benefit from allopathic intervention. Q: Do you think there will soon be a growing respect for massage therapy from the allopathic community? Borysenko: Acceptance from the allopathic community requires independent research data. Now that the Office of Complementary and Alternative Medicine exists, there is funding for research projects and since massage therapy is in the top three CAM modalities that people commonly use, there is bound to be independent research conducted and that will make a difference with the medical community. Q: There is a move among many in the massage therapy profession to get coverage from insurance companies. Would you comment on what you think this could do for the profession? Borysenko: There are a lot of concerns with insurance companies. Number one, there is an enormous amount of paperwork; second, it leads to less time with patients, and third, it adds more stress to the therapist. From my personal experience as a psychologist in a hospital setting, I can state that the amount of paperwork is an enormous stress. And it is not just the paperwork. There are the procedures to follow. You need a diagnosis, you have to fill out a particular chart, you need progress reports back to the doctor, etc. You are dealing and answering to someone else other than the patient. Insurance coverage would medicalize the present system of massage therapy to a degree that massage therapists may not care for. As I said, dealing with insurance really eats up an enormous amount of time. If you talk with people who already are dealing with insurance, they will tell you this is one of their biggest stresses not only in their profession, but in their life. In addition to that, a tremendous amount of patients? insurance coverage may not include massage therapy since massage is outside of allopathic medicine. So the therapist spends a huge amount of time writing letters to physicians and insurance companies, providing them with the research, data, and then in detail explaining why these massage therapy sessions should be paid for by insurance. Then after all of that, sometimes it may be covered and sometimes not. Either way the therapist has spent a major amount of time dealing with persons other than the patient. Fourth, it may come to the place where a doctor must prescribe massage therapy if someone wants to go get reimbursed for a massage, so the doctor will say, "We'll just give you a basic diagnosis of stress." You would now have a diagnosis on your medical record. If massage therapy is recognized as a reimbursable therapeutic modality, you get in the whole matter of what I think of as Big Brother. Now somewhere in your medical record in some computer is the diagnosis that you are stressed. And you never know when or where that may be come back to you. As a recipient of massage, I would much rather pay out of pocket than have a diagnosis of some sort that will then get into my medical record. So that is another aspect of insurance reimbursement that is not commonly thought of. · · · Debra Brooks, LMT, editor, writer, teacher, singer, pianist, owns NeuroMuscular Therapy Center, and can be reached at P.O. Box 277, Walford, IA 52351-0277, or at Debra_Brooks@mail.ccs.k12.ia.us |
