Alternative Health and The Net: Parallels in Growth
Now having plunged into complementary and alternative medicine (CAM) at the local level, I find interesting parallels between the state of CAM today and that of the Internet in pre-Netscape days of the early 1990’s. These comparisons feel a little sketchy, but the more I think about them, the more telling they appear. (CAM, also referred to as integrative medicine, includes therapies like Chinese and Indian (Ayurvedic) medicines, acupuncture reiki, reflexology, bio-feedback and others that are increasingly finding places alongside conventional care.)
As the net has reshaped the assumptions central to the information and communications industries, this far more amorphous collection of healing therapies and modalities has the potential to have a similar effect on healthcare. In some places it already has.
Consider these similarities:
1. An experienced consumer base, hungry for “more and better” and willing to pay for it:
On the Internet: by the time Netscape appeared in 1994, millions of people had learned how to use their personal computers and modems to get email, find news, chat, participate in forums and download software. The services that created this handy Netscape beta cohort – The Source, CompuServe, Delphi, MCIMail, America Online, The WELL – had several serious limitations:
– customers paid from $6 to $15 per hour for the privilege of being online
– if you had an account on CompuServe, you couldn’t send an email to someone on The Source or anywhere else.
Despite the cost, despite the creaky, confounding technology, the numbers grew from zero in 1979 to some 12 million by 1994.
In Integrative Medicine: In the last 30 years the growth in the number of consumers of natural and holistic therapies couldn’t be more evident. The CDC reported that by 2002 one-third of adult Americans have used some form of “natural or holistic” health service or product. The National Institute of Medicine looked at consumer use of these therapies and reported that people use these practitioners more than they do physician services. And it is all out of pocket.
Despite the cost and the reluctant acknowledgement of the traditional healthcare establishment (although this is changing), the use of holistic therapies has grown like crazy.
2. Federal funding:
On the Internet: The funding of internetworking technology by the DoD and NSF for the ArpaNet and other research networks that formed the basis for the Internet is very well known.
In Integrated Medicine: The NIH through its National Center for Complimentary and Alternative Medicine (NCCAM) has in recent years underwritten more than $20 million $1 billion for research in acupuncture, meditation, and other non-traditional modalities.
We can’t compare these funding regimes or their durations, of course, other than to say that they both reflect public investment in activities considered important to the public and are factors in expansion into the public markets. The NIH funding is relatively new and more overtly challenges prevailing orthodoxy, and so, as one long time CAM expert told me, without the NIH funding, the next piece of this parallel would collapse. And that would be:
3. A national intellectual infrastructure:
Along the Internet: the earliest inter-networks were housed in campus computing centers, connecting researchers to each another and to computing resources located on other campuses and labs. That incipient information infrastructure coursed gradually into deeper corners of academe until, one day (say 1991), someone at a computer far, far away, said, “Hey! Let’s let the kids at Blair High School near DC use the supercomputer!” Thus inspiring the first exclamatory use of the word “awesome!”
Around the same time, the issues of access, content, search and retrieval, email and blending newsgroups into that national research and education network of computing resources (or NREN, as it was then called) were taken up in large part by university librarians and other campus-based end-users.
In Integrative Medicine: there now exists the Consortium of Academic Health Centers of Integrative Medicine, comprised of more than 30 of the nation’s top medical schools and health centers. Just as the technology, applications and ethos of the Internet percolated within academic networks, the elements of integrative medicine are finding their way into clinical work, nursing practices, doctor-patient communications, the physical environment and a new blending of healing and curative traditions.
4. Cracking open an impervious and entrenched industry (or several):
On the Internet: well, here we are.
In Integrative Medicine: It is way too early to predict, and yes the comparison is inexact (I don’t really know when the first exclamatory use of “awesome” took place). In September, the Health 2.0 conference will carry the same vaguely seditious connotations recognizable from early Internet conferences, sporting the title “User – Generated Healthcare.” This feeds the still very amorphous notion that consumers will someday have at their hands the power over their health that Web 2.0 has given them over their Web presence. Or more precisely, will let them make their health status part of that web presence.
Just to underscore this seemingly wild proposition, technology analyst and entrepreneur Esther Dyson went to Health 2.0 to discuss her decision to put her health records and her own DNA and onto the Internet. I don’t quite know what that means. But it is easy to envision a new application in FaceBook called MyStrands. (“Compare your strands with a T-Rex unearthed in Montana!” “Who ARE your closest blood relatives!?”)
I have little doubt that one important reason that alternative medicine has found its way to the doors of the healthcare establishment is the role that the global net has played over the last 20 years or more, connecting people via online support groups, listservs, forums and email.
So not surprisingly, the parallels arrive eventually down the street where we live and work. Earlier this month, NCCAM issued a project concept review entitled, “Outcomes, Cost-Effectiveness and the Decision Making Process to Use CAM.” A primary purpose of this study is “the development of observational studies…in the communities;” which is to say, down the street where we live and work and where healthcare services of all kinds are delivered and experienced.
The local health vertical where we are working should become even more interesting. Especially if the CAM community comes up with its version of Netscape.