Recruiting Emergency CAM Volunteers
Local Health Boards in Massachusetts are currently faced with the daunting task of recruiting and training significant numbers of emergency healthcare volunteers as a precaution against the real possibility of pandemic influenza or bioterrorism. In the event of such emergencies, trained volunteers would work with local health authorities to support medical surge capacity through mass prophylaxis, staffing emergency dispensing sites, public education, and care for the sick.
The sheer number of volunteers this could require is staggering. For example, Plymouth, MA is anticipating a need for 1,000 healthcare volunteers. How can communities begin to find this many healthcare volunteers?
CAM Practitioners: an Untapped Volunteer Resource
One generally untapped volunteer pool has been identified by some communities, but overlooked by most. It is a community’s local complementary/alternative medicine (CAM) practitioners, such as massage therapists, chiropractors, and acupuncturists:
· CAM use in Massachusetts if common and widespread, and CAM practitioners working in the Commonwealth number in the thousands;
· Many of these practitioners advanced degrees and have had basic medical or first aid training;
· Many are concerned with the threat of a flu pandemic striking their community, want to know how to protect themselves and their clients, and want to be of service.
A common way in which CAM practitioners have been integrated into local disaster relief efforts has been through the Medical Reserve Corps (MRC), which has welcomed massage therapists and other CAM practitioners into their ranks of volunteer healthcare professionals in Massachusetts and across the country, with great results.
For example, the Amherst Medical Reserve Corps includes nurses, physicians—and massage therapists. Its members are committed to training to support medical or public health emergency related operations, including Emergency Dispensing Site Operations, clinics, household emergency preparedness education, and community outreach.
Other MRCs across the country have gone even further in involving CAM practitioners. For example, the South West Florida MRC has established a Massage Therapy Strike Team composed of 10 licensed massage therapists, and has been active in hurricane relief efforts. The Team is trained to provide massage therapy relief to first responders, shelter workers, and disaster survivors*.
Local Health Boards should consider these issues when recruiting CAM practitioners as healthcare volunteers:
Certain CAM professions have a track record of responding to disasters. For example, in the wake of Hurricane Katrina, massage therapists and acupuncturists were part of Medical Reserve Corps units and other disaster response teams that headed for the Gulf to provide relief. CAM practitioners who provide disaster relief typically have done so in the form of helping victims suffering from pain conditions or PTSD, and providing care to emergency workers suffering from exhaustion and burn-out.
Some CAM practitioners have had medical training, some have not. Typically, chiropractors and acupuncturists have taken at least pre-med courses to be graduates from their programs. Massage therapists commonly have a basic understanding of anatomy and physiology and have completed basic first aid/CPR training as a certification requirement. Other CAM professionals such as herbalists or energy healers work in unlicensed professions which do not typically involve any conventional medical training, although a significant number are former nurses.
If local health services are overwhelmed in a flu pandemic, citizens will inevitably turn to CAM practitioners seeking relief, so building bridges to these professions should be part of your town’s pandemic planning. During the first wave of a severe flu pandemic, when a vaccine and effective antiviral drugs are likely to be nonexistent or tightly rationed, it is not difficult to imagine that those people unable to receive adequate conventional medical care will seek alternatives. Whether CAM practitioners are integrated into your community’s surveillance and first-case notification system, whether they are practicing proper precautions against catching and spreading the flu virus, and whether they are providing useful and sensible (or at least unharmful) health information to their clients will depend largely on whether you have acknowledged the existence of these local practitioners, both licensed and unlicensed, in your pandemic planning. Offering certain CAM practitioners opportunities to volunteer and train in pandemic preparedness can provide a useful conduit for dissemination of vital healthcare information to their fellow CAM practitioners, and for identifying those practitioners who, in a pandemic, are practicing unethically (e.g. selling “cure-alls”) or in a manner that endangers the public’s health.
Here are some useful tips for how to approach CAM practitioners in your community:
Approach them through their professional networks, schools, and other hubs. For example, members of South West Florida MRC’s Massage Therapy Strike Team described above were recruited when the MRC’s Executive Director spoke to the local chapter of the state’s massage therapy organization, and to students and faculty of a local massage school. Most Massachusetts communities have holistic healthcare centers that can provide appropriate venues for this kind of recruitment.
Place them in positions suited to their skills that meet your real needs. Rather than lament an inevitable shortage of doctors and nurses in a flu pandemic, examine instead the variety of skills you will need to have on hand and consider whether certain CAM practitioners may either already have those skills or be trainable. Many acupuncturists, for example, have completed their studies at the Masters Degree level, and are likely able to learn various medical procedures outside their regular scope of practice, such as vaccination. But also respect that CAM practitioners have much experience caring for people suffering from pain or stress, which in a disaster will of course be endemic, and they will likely want to serve in this capacity as well.
Offer them training, offer them respect. A great recruitment incentive for CAM practitioners is to offer them free training as a benefit of joining your volunteer pool. For example, many CAM practitioners require regular CPR recertification to stay in good professional standing. Offering them First Aid and Psychological First Aid classes are will also appeal. But the greatest incentive of all is to recruit them as you would a local doctor or nurse, by acknowledging that most are ethical and earnest professionals who are seen in their community as playing a valuable healthcare role—even if the efficacy of their healing art has not been completely accepted by the scientific community.
Acknowledge the concerns some may have about licensing. While some CAM professions have statewide licensing (e.g. chiropractic, acupuncture, and massage**), and other professions have municipal licensing (e.g. massage and certain forms of bodywork such as shiatsu), many holistic professions such as herbal medicine, homeopathy, and energy healing have no licensing system in place (owing perhaps to the rarity of harmful outcomes from some of these approaches). These latter unlicensed caregivers may enjoy some assurances from you that their involvement as healthcare volunteers will not jeopardize their livelihoods. If you cannot provide such assurances, it would be better to focus on the licensed CAM professions as a volunteer pool. Opening this new avenue of relationship with your local CAM practitioners, however, might have an added benefit of increasing compliance with existing licensing requirements on the books.
The overwhelming need for volunteer healthcare support in the event of pandemic influenza or bio-terrorism demands new thinking from health boards on where to look for trainable volunteers. The CAM practitioners working in your midst are clearly a useful resource, and working with them can further enrich your planning process and provide unique and useful pathways for the dissemination of important public health information.
*For more information on the South West Florida MRC’s Massage Therapy Strike Team, contact Executive Director Wendy Wilderman at (239) 338-3310 or at email@example.com.
** In June of 2006, the Commonwealth established statewide licensing regulations for massage therapists, to come into effect on or before May 1, 2008. Details can be found at www.mass.gov/legis/laws/seslaw06/sl060135.htm
Published originally in the 2007 edition of the Massachusetts Association of Health Boards' Journal of Local Public Health.
Whole Health Solutions can help Boards of Health and medical centers effectively reach out to the holistic healthcare community in the course of their pandemic planning.