How to tap the market for alternative therapies

Visits outstrip those to primary care

Plenty of your clients seek complementary therapies outside your center, but if they could find them at your place, they’d switch in a heartbeat. So goes the experience of Jo L. Wheeler, MS, RN, ANP, adult nurse practitioner at Women’s Health-Care Center in the Medical College of Virginia based at Virginia Commonwealth University in Richmond. Wheeler reports that women often make consultation appointments to learn how to sort through the hodgepodge of herbal supplements in retail stores.

There’s an element of trust in the services one finds in a medical setting, according to the center’s director, Judy Collins, RNC, MS. "Some women will come to a medical facility to get a message when they wouldn’t get one otherwise," she says.

According to a New England Journal of Medicine study, the market for alternative healing is impressive.1 It says in 1990, Americans made an estimated 425 million visits to complementary therapists compared with the 388 million visits to primary care physicians. (For a snapshot of the ailments presented to alternative healers in one year, see table, inserted in this issue.)

If you’re ready to integrate one or more alternatives into your women’s health program, read on for hints from a few of the recognized leaders in this area. To wind up with a success story instead of a debacle, cultivate support among your conventional colleagues. "It can kill your program if other providers see it as a threat to their existence and sabotage it," warns Judy Smith, MHA, principal in the women’s and children’s health care management consulting firm of Smith Hager Bajo in Dublin, OH. Garnering support pays off handsomely for the freestanding, nurse practitioner-run Women’s Center for Wellness in Vernon, CT. Two years ago, as Cheri Brady, APRN, MEd, women’s health care nurse practitioner, prepared to introduce hypnotherapy, she voluntarily sought input from the chief psychiatrist at one of the center’s affiliated hospitals.

"We didn’t have to, but we approached the hospital quality assurance boards, and we explained our plans to the hospitals’ physicians and community boards," Brady says.

Today she sees 26 hypnotherapy clients a month in addition to her regular conventional nursing visits.

"We increasingly get referrals from physicians," Brady says. "They send patients for help with angina, chemotherapy side effects, headaches, and weight loss."

Women want options — will they use yours?

What works on the coast might not work in the heartland. Some "integrated conventional-complementary models" have options available on site. One such program is Brady’s. It features therapeutic massage, exercise classes, clinical hypnotherapy, guided imagery, therapeutic touch, stress management, and relaxation.

Brady emphasizes the importance of starting small and building on success. When her facility introduced alternatives 41¼2 years ago, therapeutic massage and exercise classes were the only offerings.

You also can build a thriving program through referral arrangements with other providers, a strategy that has proven successful for Women to Women, now celebrating its 12th year in Yarmouth, ME. Co-owner Marcelle Pick, MSN, RNC, NP, makes acupuncture and homeopathy referrals daily to "a huge number of people in this community." On site, the center does lab work-ups, including adrenal and hormone panels, sells nutritional supplements, and offers nutrition counseling.

A well-wrought business plan will tell you what will work in your market. Consultant Smith advises that you touch the following bases:

1. Survey existing alternative care providers, their services, and their fees.

2. Calculate fees for service if they are offered in your facility.

3. Conduct a market survey of your clients, including the services they would use, their preferred locations and times, as well as the fees they would pay.

After you’re up and running, keep your eye on the bottom line. Smith counsels, "Altruism is important, yet the therapies you provide must truly accomplish both your business and your service missions."


1. Eisenberg DM, Kessler RC, Foster C, et al. Unconven-tional medicine in the United States: Prevalence, costs, and patterns of use. N Engl J Med 1993; 328:246-252. ß