When considering the most ethical model for the relationship between mainstream and alternative medicine, one that allows for all approaches to coexist within the current landscape of U.S. health care should be considered. The current state of mainstream medicine is a varied system that already has created a precedent for various practice models to arise. Imposing change on this will inevitably marginalize some providers and their disciplines.
Some conventional doctors have chosen to opt-out of contracts with insurance companies and third-party payers and deal directly with patients themselves. This approach, for all intents and purposes in the context of this analysis, is analogous with an opposition model. Whether collecting fees at the time of services rendered or as a retainer system like in direct primary care, both mainstream and alternative providers are already choosing to practice outside the mainstream insurance payment model.
An integrative approach is ethical to include in health care as it widens the marketplace and offers more services to benefit patients and potentially reduce overall costs for payers. An integrative model typically implies a collaborative multi-disciplinary approach to integration and not an opportunity for complete assimilation of one form medicine by another. This would need to hold in order to respect ethical concerns related to practitioners’ boundaries and scope of practice issues.
Plauralism offers a compatible model aligned with the values of today’s health care industry. If the U.S. decides to move to a universal coverage system, tolerance for the opposition model would still be most ethical, however, regulation of quality and safety of services would still be needed if those type of providers want to self-identify with practicing with medically-based relevance.
A health care system that reinforces an open exchange of ideas and cooperative efforts can support progress in methodology and policy arenas, both of which are imperative to address as ongoing reform continues.