Category Archives: Alternative Medicine

Alternative medicine is defined as any practice that is put forward as having the healing effects of medicine, but is not founded on evidence gathered using the scientific method. Standard care is what medical doctors, doctors of osteopathy, and allied health professionals, such as nurses and physical therapists, practice. The field of complementary and alternative medicine is known as CAM. Complementary medicine can be used together with standard medical care. An example is using acupuncture to help with side effects of cancer treatment.

What is Alternative Medicine

Alternative Medicine is defined as medicine that encompasses any healing practice "that does not fall within the realm of conventional medicine." Commonly cited examples include naturopathy, chiropractic, herbalism, traditional Chinese medicine, Ayurveda, meditation, yoga, biofeedback, hypnosis, homeopathy, acupuncture, and diet-based therapies, in addition to a range of other practices.

Complementary and Alternative Medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. However bear in mind that what are considered complementary or alternative practices in one country may be considered conventional medical practices in another.

According to the NCCAM formerly unproven remedies may be incorporated into conventional medicine if they are shown to be safe and effective.

NCCAM classifies complementary and alternative therapies into five major groups and some overlap.

Whole medical systems cut across more than one of the other groups; examples include Traditional Chinese medicine and Ayurveda.

Many people utilize mainstream medicine for diagnosis and basic information, while turning to alternatives for what they believe to be health-enhancing measures. Studies indicate that alternative approaches are often used in conjunction with conventional medicine. This is referred to by NCCAM as integrative (or integrated) medicine because it "combines treatments from conventional medicine and CAM for which there is some high-quality evidence of safety and effectiveness.

Alternative medicine has been a source of vigorous debate, even over the definition of alternative medicine.

Dietary supplements, their ingredients, safety, and claims, are a continual source of controversy.

In some cases, political issues, mainstream medicine and alternative medicine all collide, such as the case where synthetic drugs are legal but the herbal sources of the same active chemical are banned.

Alternative medicine practices are as diverse in their foundations as in their methodologies. Practices may incorporate or base themselves on traditional medicine, folk knowledge, spiritual beliefs, or newly conceived approaches to healing.

The National Center for Complementary and Alternative Medicine (NCCAM) classified CAM therapies as:

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Alternative Medicine: Types, Uses & Information - Disabled ...

Alternative medicine or fringe medicine are practices claimed to have the healing effects of medicine but are disproven, unproven, impossible to prove, or only harmful. Alternative therapies or diagnoses are not part of medicine or science-based healthcare systems. Alternative medicine consists of a wide variety of practices, products, and therapiesranging from those that are biologically plausible but not well tested, to those with known harmful and toxic effects. Contrary to popular belief, significant expense is paid in testing alternative medicine, including over $2.5 billion spent by the United States government, with almost none showing any effect beyond that of false treatment. Perceived effects of alternative medicine are caused by placebo, decreased effects of functional treatment (and therefor also decreased side-effects), and regression toward the mean where improvement that would have occurred anyway is credited to alternative therapies. Alternative medicine is not the same as experimental medicine.

Alternative medicine has grown in popularity and is used by a significant percentage of the population in many countries. While it has extensively rebranded itself: from quackery to complementary or integrative medicineit promotes essentially the same practices. Newer proponents often suggest alternative medicine be used together with functional medical treatment, in a belief that it "complements" (improves the effect of, or mitigates the side effects of) the treatment. However, significant drug interactions caused by alternative therapies may instead negatively influence treatments, making them less effective, notably cancer therapy. Despite it being illegal to market alternative therapies for any type of cancer treatment in most of the developed world, many cancer patients use them. In the UK complementary therapies are commonly made available to cancer patients.[1][2]

Alternative medical diagnoses and treatments are not included in the science-based curriculum taught in medical schools, and are not used in medical practice where treatments are based on scientific knowledge. Alternative therapies are often based on religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, or fraud. Regulation and licensing of alternative medicine and health care providers varies between and within countries.

Alternative medicine has been criticized for being based on misleading statements, quackery, pseudoscience, antiscience, fraud, or poor scientific methodology. Promoting alternative medicine has been called dangerous and unethical. Testing alternative medicine that have no scientific basis has been called a waste of scarce medical research resources. Critics have said "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", and the problem is not only that it does not work, but that the "underlying logic is magical, childish or downright absurd". There have also been calls that the concept of any alternative medicine that works is paradoxical, as any treatment proven to work is simply "medicine".

Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.[3][clarification needed]

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth. One of the most critical is the placebo effecta well-established observation in medicine.[4] Related to it are similar psychological effects, such as the will to believe,[5]cognitive biases that help maintain self-esteem and promote harmonious social functioning,[5] and the post hoc, ergo propter hoc fallacy.[5]

CAM's popularity may be related to other factors that Edzard Ernst mentioned in an interview in The Independent:

Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. "People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives. "At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth.[6]

Paul Offit proposed that "alternative medicine becomes quackery" in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients' bank accounts, or by promoting "magical thinking."[7]

In a paper published in October 2010 entitled The public's enthusiasm for complementary and alternative medicine amounts to a critique of mainstream medicine, Ernst described these views in greater detail and concluded:

[CAM] is popular. An analysis of the reasons why this is so points towards the therapeutic relationship as a key factor. Providers of CAM tend to build better therapeutic relationships than mainstream healthcare professionals. In turn, this implies that much of the popularity of CAM is a poignant criticism of the failure of mainstream healthcare. We should consider it seriously with a view of improving our service to patients.[8]

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism.[5] Related to this are vigorous marketing[9] of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics.[5][10]

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments.[10] Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine.[11] Medical doctors are also aggressively marketing alternative medicine to profit from this market.[9]

Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative treatments to avoid the adverse effects of conventional treatments.[5][10]

It is loosely as a defined set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine,[n 1][n 2] but whose effectiveness has not been clearly established using scientific methods,[n 1][n 3][15][16][17][18] or whose theory and practice is not part of biomedicine,[n 2][n 4][n 5][n 6] or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine.[15][16][22] "Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine,[n 4] an alternative product or practice does not originate from using scientific methodology, but may instead be based on testimonials, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.[n 3][12][15][16]

In General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, published in 2000 by the World Health Organization (WHO), complementary and alternative medicine were defined as a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system.[23]

The expression also refers to a diverse range of related and unrelated products, practices, and theories ranging from biologically plausible practices and products and practices with some evidence, to practices and theories that are directly contradicted by basic science or clear evidence, and products that have been conclusively proven to be ineffective or even toxic and harmful.[n 2][25][26]

The terms-Alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in some contexts,[27][28][29][30] but may have different meanings in some rare cases.

The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.[15][31] Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions "western medicine" and "eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that don't work.[15]

Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a belief that it improves the effect of treatments.[n 7][12][33][34][35] However, significant drug interactions caused by alternative therapies may instead negatively influence treatment, making treatments less effective, notably cancer therapy.[36][37] Both terms refer to use of alternative medical treatments alongside conventional medicine,[38][39][40] an example of which is use of acupuncture (sticking needles in the body to influence the flow of a supernatural energy), along with using science-based medicine, in the belief that the acupuncture increases the effectiveness or "complements" the science-based medicine.[40]

Allopathic medicine or allopathy is an expression commonly used by homeopaths and proponents of other forms of alternative medicine to refer to mainstream medicine. Specifically it refers to the use of pharmacologically active agents or physical interventions to treat or suppress symptoms or pathophysiologic processes of diseases or conditions.[41] The expression was coined in 1810 by the creator of homeopathy, Samuel Hahnemann (17551843).[42] In such circles, the expression "allopathic medicine" is still used to refer to "the broad category of medical practice that is sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine" (see the article on scientific medicine).[43]

Use of the term remains common among homeopaths and has spread to other alternative medicine practices. The meaning implied by the label has never been accepted by conventional medicine and is considered pejorative.[44] More recently, some sources have used the term "allopathic", particularly American sources wishing to distinguish between Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) in the United States.[42][45] William Jarvis, an expert on alternative medicine and public health,[46] states that "although many modern therapies can be construed to conform to an allopathic rationale (e.g., using a laxative to relieve constipation), standard medicine has never paid allegiance to an allopathic principle" and that the label "allopath" was from the start "considered highly derisive by regular medicine".[47]

Many conventional medical treatments clearly do not fit the nominal definition of allopathy, as they seek to prevent illness, or remove the cause of an illness by acting on the etiology of disease.[48][49]

CAM is an abbreviation of complementary and alternative medicine.[50][51] It has also been called sCAM or SCAM with the addition of "so-called" or "supplements".[52][53] The words balance and holism are often used, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine. Due to its many names the field has been criticized for intense rebranding of what are essentially the same practices: as soon as one name is declared synonymous with quackery, a new name is chosen.[27]

It refers to the pre-scientific practices of a culture, contrary to what is traditionally practiced in cultures where medical science dominates.

"Eastern medicine" typically refers to the traditional medicines of Asia where conventional bio-medicine penetrated much later.

Prominent members of the science[7][54] and biomedical science community[14] assert that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, that the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all.[7][14][54][55]

Others in both the biomedical and CAM communities point out that CAM cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between CAM and biomedicine overlap, are porous, and change. The expression "complementary and alternative medicine" (CAM) resists easy definition because the health systems and practices it refers to are diffuse, and its boundaries poorly defined.[25][n 8] Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Some alternative therapies, including traditional Chinese medicine (TCM) and Ayurveda, have antique origins in East or South Asia and are entirely alternative medical systems;[60] others, such as homeopathy and chiropractic, have origins in Europe or the United States and emerged in the eighteenth and nineteenth centuries. Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions. Treatments considered alternative in one location may be considered conventional in another.[63] Thus, chiropractic is not considered alternative in Denmark and likewise osteopathic medicine is no longer thought of as an alternative therapy in the United States.[63]

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo.[15][64][65][66]

One common feature of all definitions of alternative medicine is its designation as "other than" conventional medicine. For example, the widely referenced descriptive definition of complementary and alternative medicine devised by the US National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH), states that it is "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine."[69] For conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.[n 9]

Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.[72] This can refer to the lack of support that alternative therapies receive from the medical establishment and related bodies regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum.[72] In 1993, the British Medical Association (BMA), one among many professional organizations who have attempted to define alternative medicine, stated that it[n 10] referred to "...those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses."[73] In a US context, an influential definition coined in 1993 by the Harvard-based physician,[74] David M. Eisenberg,[75] characterized alternative medicine "as interventions neither taught widely in medical schools nor generally available in US hospitals".[76] These descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and CAM introductory courses or modules can be offered as part of standard undergraduate medical training;[77] alternative medicine is taught in more than 50 per cent of US medical schools and increasingly US health insurers are willing to provide reimbursement for CAM therapies. In 1999, 7.7% of US hospitals reported using some form of CAM therapy; this proportion had risen to 37.7% by 2008.[79]

An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM),[80][n 11] devised a theoretical definition[80] of alternative medicine as "a broad domain of healing resources... other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period."[82] This definition has been widely adopted by CAM researchers,[80] cited by official government bodies such as the UK Department of Health,[83] attributed as the definition used by the Cochrane Collaboration,[84] and, with some modification,[dubious discuss] was preferred in the 2005 consensus report of the US Institute of Medicine, Complementary and Alternative Medicine in the United States.[n 2]

The 1995 OAM conference definition, an expansion of Eisenberg's 1993 formulation, is silent regarding questions of the medical effectiveness of alternative therapies.[85] Its proponents hold that it thus avoids relativism about differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream biomedicine is solely due to political forces.[85] According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is "intrinsic to the politically dominant health system of a particular society of culture".[86] However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity.[86] If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population.[86]

Normative definitions distinguish alternative medicine from the biomedical mainstream in its provision of therapies that are unproven, unvalidated, or ineffective and support of theories with no recognized scientific basis. These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but are not based on evidence gathered with the scientific method.[12][14][38][39][69][88] Exemplifying this perspective, a 1998 editorial co-authored by Marcia Angell, a former editor of the New England Journal of Medicine, argued that:

This line of division has been subject to criticism, however, as not all forms of standard medical practice have adequately demonstrated evidence of benefit, [n 4][89] and it is also unlikely in most instances that conventional therapies, if proven to be ineffective, would ever be classified as CAM.[80]

Similarly, the public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym "CAM" for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.[91]

The Danish National Board of Health's "Council for Alternative Medicine" (Sundhedsstyrelsens Rd for Alternativ Behandling (SRAB)), an independent institution under the National Board of Health (Danish: Sundhedsstyrelsen), uses the term "alternative medicine" for:

Proponents of an evidence-base for medicine[n 12][94][95][96][97] such as the Cochrane Collaboration (founded in 1993 and from 2011 providing input for WHO resolutions) take a position that all systematic reviews of treatments, whether "mainstream" or "alternative", ought to be held to the current standards of scientific method.[98] In a study titled Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration (2011) it was proposed that indicators that a therapy is accepted include government licensing of practitioners, coverage by health insurance, statements of approval by government agencies, and recommendation as part of a practice guideline; and that if something is currently a standard, accepted therapy, then it is not likely to be widely considered as CAM.[80]

A United States government agency, the National Center on Complementary and Integrative Health (NCCIH), created its own classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy.[99]

The NCCIH classification system is -

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies.[69] Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based.[12][15][22][69] Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, supersition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods.[12][15][16][22] Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.[69]

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world.[69] Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.[69]

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods.[69][121][122] Examples include healing claims for nonvitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng.[123]Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products.[121] It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements".[121] Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.[121] This may include use of known toxic substances, such as use of the poison lead in traditional Chinese medicine.[123]

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as "alternative medicine" beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled "irregular practices" by the western medical establishment.[15][124][125][126][127] It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific and as practicing quackery.[124][125] Until the 1970's, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.[126] In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression "alternative medicine".[15][124][125][126][128]

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s.[15][129][130] This was due to misleading mass marketing of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine.[15][125][126][127][128][130][131] At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation.[124]:xxi[131] By the early to mid 1970s the expression "alternative medicine" came into widespread use, and the expression became mass marketed as a collection of "natural" and effective treatment "alternatives" to science-based biomedicine.[15][131][132][133] By 1983, mass marketing of "alternative medicine" was so pervasive that the British Medical Journal (BMJ) pointed to "an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen".[131] In this 1983 article, the BMJ wrote, "one of the few growth industries in contemporary Britain is alternative medicine", noting that by 1983, "33% of patients with rheumatoid arthritis and 39% of those with backache admitted to having consulted an alternative practitioner".[131]

By about 1990, the American alternative medicine industry had grown to a $27 billion per year, with polls showing 30% of Americans were using it.[130][134] Moreover, polls showed that Americans made more visits for alternative therapies than the total number of visits to primary care doctors, and American out-of-pocket spending (non-insurance spending) on alternative medicine was about equal to spending on biomedical doctors.[124]:172 In 1991, Time magazine ran a cover story, "The New Age of Alternative Medicine: Why New Age Medicine Is Catching On".[130][134] In 1993, the New England Journal of Medicine reported one in three Americans as using alternative medicine.[130] In 1993, the Public Broadcasting System ran a Bill Moyers special, Healing and the Mind, with Moyers commenting that "...people by the tens of millions are using alternative medicine. If established medicine does not understand that, they are going to lose their clients."[130]

Another explosive growth began in the 1990s, when senior level political figures began promoting alternative medicine, investing large sums of government medical research funds into testing alternative medicine, including testing of scientifically implausible treatments, and relaxing government regulation of alternative medicine products as compared to biomedical products.[15][124]:xxi[125][126][127][128][135][136] Beginning with a 1991 appropriation of $2 million for funding research of alternative medicine research, federal spending grew to a cumulative total of about $2.5 billion by 2009, with 50% of Americans using alternative medicine by 2013.[137][138]

In 1993, Britain's Prince Charles, who claimed that homeopathy and other alternative medicine was an effective alternative to biomedicine, established The Prince's Foundation for Integrated Health (FIH), as a charity to explore "how safe, proven complementary therapies can work in conjunction with mainstream medicine".[139] The FIH received government funding through grants from Britain's Department of Health.[139] In 2008, London's The Times published a letter from Edzard Ernst that asked the FIH to recall two guides promoting alternative medicine, saying: "the majority of alternative therapies appear to be clinically ineffective, and many are downright dangerous." In 2010, Brittan's FIH closed after allegations of fraud and money laundering led to arrests of its officials.[139]

In 2004, modifications of the European Parliament's 2001 Directive 2001/83/EC, regulating all medicine products, were made with the expectation of influencing development of the European market for alternative medicine products.[140] Regulation of alternative medicine in Europe was loosened with "a simplified registration procedure" for traditional herbal medicinal products.[140][141] Plausible "efficacy" for traditional medicine was redefined to be based on long term popularity and testimonials ("the pharmacological effects or efficacy of the medicinal product are plausible on the basis of long-standing use and experience."), without scientific testing.[140][141] The Committee on Herbal Medicinal Products (HMPC) was created within the European Medicines Agency in London (EMEA). A special working group was established for homeopathic remedies under the Heads of Medicines Agencies.[140]

Through 2004, alternative medicine that was traditional to Germany continued to be a regular part of the health care system, including homeopathy and anthroposophic medicine.[140] The German Medicines Act mandated that science-based medical authorities consider the "particular characteristics" of complementary and alternative medicines.[140] By 2004, homeopathy had grown to be the most used alternative therapy in France, growing from 16% of the population using homeopathic medicine in 1982, to 29% by 1987, 36% percent by 1992, and 62% of French mothers using homeopathic medicines by 2004, with 94.5% of French pharmacists advising pregnant women to use homeopathic remedies.[142] As of 2004[update], 100 million people in India depended solely on traditional German homeopathic remedies for their medical care.[143] As of 2010[update], homeopathic remedies continued to be the leading alternative treatment used by European physicians.[142] By 2005, sales of homeopathic remedies and anthroposophical medicine had grown to $930 million Euros, a 60% increase from 1995.[142][144]

Since 2009, according to Art. 118a of the Swiss Federal Constitution, the Swiss Confederation and the Cantons of Switzerland shall within the scope of their powers ensure that consideration is given to complementary medicine.[145]

By 2013, 50% of Americans were using CAM.[138] As of 2013[update], CAM medicinal products in Europe continued to be exempted from documented efficacy standards required of other medicinal products.[146]

Much of what is now categorized as alternative medicine was developed as independent, complete medical systems. These were developed long before biomedicine and use of scientific methods. Each system was developed in relatively isolated regions of the world where there was little or no medical contact with pre-scientific western medicine, or with each other's systems. Examples are traditional Chinese medicine and the Ayurvedic medicine of India.

Other alternative medicine practices, such as homeopathy, were developed in western Europe and in opposition to western medicine, at a time when western medicine was based on unscientific theories that were dogmatically imposed by western religious authorities. Homeopathy was developed prior to discovery of the basic principles of chemistry, which proved homeopathic remedies contained nothing but water. But homeopathy, with its remedies made of water, was harmless compared to the unscientific and dangerous orthodox western medicine practiced at that time, which included use of toxins and draining of blood, often resulting in permanent disfigurement or death.[125]

Other alternative practices such as chiropractic and osteopathic manipulative medicine were developed in the United States at a time that western medicine was beginning to incorporate scientific methods and theories, but the biomedical model was not yet totally dominant. Practices such as chiropractic and osteopathic, each considered to be irregular practices by the western medical establishment, also opposed each other, both rhetorically and politically with licensing legislation. Osteopathic practitioners added the courses and training of biomedicine to their licensing, and licensed Doctor of Osteopathic Medicine holders began diminishing use of the unscientific origins of the field. Without the original nonscientific practices and theories, osteopathic medicine is now considered the same as biomedicine.

Further information: Rise of modern medicine

Until the 1970s, western practitioners that were not part of the medical establishment were referred to "irregular practitioners", and were dismissed by the medical establishment as unscientific, as practicing quackery.[125] Irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.

Dating from the 1970s, medical professionals, sociologists, anthropologists and other commentators noted the increasing visibility of a wide variety of health practices that had neither derived directly from nor been verified by biomedical science.[147] Since that time, those who have analyzed this trend have deliberated over the most apt language with which to describe this emergent health field.[147] A variety of terms have been used, including heterodox, irregular, fringe and alternative medicine while others, particularly medical commentators, have been satisfied to label them as instances of quackery.[147] The most persistent term has been alternative medicine but its use is problematic as it assumes a value-laden dichotomy between a medical fringe, implicitly of borderline acceptability at best, and a privileged medical orthodoxy, associated with validated medico-scientific norms.[148] The use of the category of alternative medicine has also been criticized as it cannot be studied as an independent entity but must be understood in terms of a regionally and temporally specific medical orthodoxy.[149] Its use can also be misleading as it may erroneously imply that a real medical alternative exists.[150] As with near-synonymous expressions, such as unorthodox, complementary, marginal, or quackery, these linguistic devices have served, in the context of processes of professionalisation and market competition, to establish the authority of official medicine and police the boundary between it and its unconventional rivals.[148]

An early instance of the influence of this modern, or western, scientific medicine outside Europe and North America is Peking Union Medical College.[151][n 14][n 15]

From a historical perspective, the emergence of alternative medicine, if not the term itself, is typically dated to the 19th century.[152] This is despite the fact that there are variants of Western non-conventional medicine that arose in the late-eighteenth century or earlier and some non-Western medical traditions, currently considered alternative in the West and elsewhere, which boast extended historical pedigrees.[148] Alternative medical systems, however, can only be said to exist when there is an identifiable, regularized and authoritative standard medical practice, such as arose in the West during the nineteenth century, to which they can function as an alternative.

During the late eighteenth and nineteenth centuries regular and irregular medical practitioners became more clearly differentiated throughout much of Europe and,[154] as the nineteenth century progressed, most Western states converged in the creation of legally delimited and semi-protected medical markets.[155] It is at this point that an "official" medicine, created in cooperation with the state and employing a scientific rhetoric of legitimacy, emerges as a recognizable entity and that the concept of alternative medicine as a historical category becomes tenable.[156]

As part of this process, professional adherents of mainstream medicine in countries such as Germany, France, and Britain increasingly invoked the scientific basis of their discipline as a means of engendering internal professional unity and of external differentiation in the face of sustained market competition from homeopaths, naturopaths, mesmerists and other nonconventional medical practitioners, finally achieving a degree of imperfect dominance through alliance with the state and the passage of regulatory legislation.[148][150] In the US the Johns Hopkins University School of Medicine, based in Baltimore, Maryland, opened in 1893, with William H. Welch and William Osler among the founding physicians, and was the first medical school devoted to teaching "German scientific medicine".[157]

Buttressed by increased authority arising from significant advances in the medical sciences of the late 19th century onwardsincluding development and application of the germ theory of disease by the chemist Louis Pasteur and the surgeon Joseph Lister, of microbiology co-founded by Robert Koch (in 1885 appointed professor of hygiene at the University of Berlin), and of the use of X-rays (Rntgen rays)the 1910 Flexner Report called upon American medical schools to follow the model of the Johns Hopkins School of Medicine, and adhere to mainstream science in their teaching and research. This was in a belief, mentioned in the Report's introduction, that the preliminary and professional training then prevailing in medical schools should be reformed, in view of the new means for diagnosing and combating disease made available the sciences on which medicine depended.[n 16][159]

Putative medical practices at the time that later became known as "alternative medicine" included homeopathy (founded in Germany in the early 19c.) and chiropractic (founded in North America in the late 19c.). These conflicted in principle with the developments in medical science upon which the Flexner reforms were based, and they have not become compatible with further advances of medical science such as listed in Timeline of medicine and medical technology, 19001999 and 2000present, nor have Ayurveda, acupuncture or other kinds of alternative medicine.[citation needed]

At the same time "Tropical medicine" was being developed as a specialist branch of western medicine in research establishments such as Liverpool School of Tropical Medicine founded in 1898 by Alfred Lewis Jones, London School of Hygiene & Tropical Medicine, founded in 1899 by Patrick Manson and Tulane University School of Public Health and Tropical Medicine, instituted in 1912. A distinction was being made between western scientific medicine and indigenous systems. An example is given by an official report about indigenous systems of medicine in India, including Ayurveda, submitted by Mohammad Usman of Madras and others in 1923. This stated that the first question the Committee considered was "to decide whether the indigenous systems of medicine were scientific or not".[160][161]

By the later twentieth century the term 'alternative medicine' entered public discourse,[n 17][164] but it was not always being used with the same meaning by all parties. Arnold S. Relman remarked in 1998 that in the best kind of medical practice, all proposed treatments must be tested objectively, and that in the end there will only be treatments that pass and those that do not, those that are proven worthwhile and those that are not. He asked 'Can there be any reasonable "alternative"?'[165] But also in 1998 the then Surgeon General of the United States, David Satcher,[166] issued public information about eight common alternative treatments (including acupuncture, holistic and massage), together with information about common diseases and conditions, on nutrition, diet, and lifestyle changes, and about helping consumers to decipher fraud and quackery, and to find healthcare centers and doctors who practiced alternative medicine.[167]

By 1990, approximately 60 million Americans had used one or more complementary or alternative therapies to address health issues, according to a nationwide survey in the US published in 1993 by David Eisenberg.[168] A study published in the November 11, 1998 issue of the Journal of the American Medical Association reported that 42% of Americans had used complementary and alternative therapies, up from 34% in 1990.[169] However, despite the growth in patient demand for complementary medicine, most of the early alternative/complementary medical centers failed.[170]

Mainly as a result of reforms following the Flexner Report of 1910[171]medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.[n 18] Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.[173] Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine,[174] and engaging in complex clinical reasoning (medical decision-making).[175] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.[176]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.[177] Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration).[98][178] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).[179] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).[179]

The British Medical Association, in its publication Complementary Medicine, New Approach to Good Practice (1993), gave as a working definition of non-conventional therapies (including acupuncture, chiropractic and homeopathy): "...those forms of treatment which are not widely used by the orthodox health-care professions, and the skills of which are not part of the undergraduate curriculum of orthodox medical and paramedical health-care courses." By 2000 some medical schools in the UK were offering CAM familiarisation courses to undergraduate medical students while some were also offering modules specifically on CAM.[181]

In 1991, pointing to a need for testing because of the widespread use of alternative medicine without authoritative information on its efficacy, United States Senator Tom Harkin used $2 million of his discretionary funds to create the Office for the Study of Unconventional Medical Practices (OSUMP), later renamed to be the Office of Alternative Medicine (OAM).[124]:170[182][183] The OAM was created to be within the National Institute of Health (NIH), the scientifically prestigious primary agency of the United States government responsible for biomedical and health-related research.[124]:170[182][183] The mandate was to investigate, evaluate, and validate effective alternative medicine treatments, and alert the public as the results of testing its efficacy.[134][182][183][184]

Sen. Harkin had become convinced his allergies were cured by taking bee pollen pills, and was urged to make the spending by two of his influential constituents.[134][182][183] Bedell, a longtime friend of Sen. Harkin, was a former member of the United States House of Representatives who believed that alternative medicine had twice cured him of diseases after mainstream medicine had failed, claiming that cow's milk colostrum cured his Lyme disease, and an herbal derivative from camphor had prevented post surgical recurrence of his prostate cancer.[124][134] Wiewel was a promoter of unproven cancer treatments involving a mixture of blood sera that the Food and Drug Administration had banned from being imported.[134] Both Bedell and Wiewel became members of the advisory panel for the OAM. The company that sold the bee pollen was later fined by the Federal Trade Commission for making false health claims about their bee-pollen products reversing the aging process, curing allergies, and helping with weight loss.[185]

In 1994, Sen. Harkin (D) and Senator Orrin Hatch (R) introduced the Dietary Supplement Health and Education Act (DSHEA).[186][187] The act reduced authority of the FDA to monitor products sold as "natural" treatments.[186] Labeling standards were reduced to allow health claims for supplements based only on unconfirmed preliminary studies that were not subjected to scientific peer review, and the act made it more difficult for the FDA to promptly seize products or demand proof of safety where there was evidence of a product being dangerous.[187] The Act became known as the "The 1993 Snake Oil Protection Act" following a New York Times editorial under that name.[186]

Senator Harkin complained about the "unbendable rules of randomized clinical trials", citing his use of bee pollen to treat his allergies, which he claimed to be effective even though it was biologically implausible and efficacy was not established using scientific methods.[182][188] Sen. Harkin asserted that claims for alternative medicine efficacy be allowed not only without conventional scientific testing, even when they are biologically implausible, "It is not necessary for the scientific community to understand the process before the American public can benefit from these therapies."[186] Following passage of the act, sales rose from about $4 billion in 1994, to $20 billion by the end of 2000, at the same time as evidence of their lack of efficacy or harmful effects grew.[186] Senator Harkin came into open public conflict with the first OAM Director Joseph M. Jacobs and OAM board members from the scientific and biomedical community.[183] Jacobs' insistence on rigorous scientific methodology caused friction with Senator Harkin.[182][188][189] Increasing political resistance to the use of scientific methodology was publicly criticized by Dr. Jacobs and another OAM board member complained that "nonsense has trickled down to every aspect of this office...It's the only place where opinions are counted as equal to data."[182][188] In 1994, Senator Harkin appeared on television with cancer patients who blamed Dr. Jacobs for blocking their access to untested cancer treatment, leading Jacobs to resign in frustration.[182][188]

In 1995, Wayne Jonas, a promoter of homeopathy and political ally of Senator Harkin, became the director of the OAM, and continued in that role until 1999.[190] In 1997, the NCCAM budget was increased from $12 million to $20 million annually.[191] From 1990 to 1997, use of alternative medicine in the US increased by 25%, with a corresponding 50% increase in expenditures.[169] The OAM drew increasing criticism from eminent members of the scientific community with letters to the Senate Appropriations Committee when discussion of renewal of funding OAM came up.[124]:175 Nobel laureate Paul Berg wrote that prestigious NIH should not be degraded to act as a cover for quackery, calling the OAM "an embarrassment to serious scientists."[124]:175[191] The president of the American Physical Society wrote complaining that the government was spending money on testing products and practices that "violate basic laws of physics and more clearly resemble witchcraft".[124]:175[191] In 1998, the President of the North Carolina Medical Association publicly called for shutting down the OAM.[192]

In 1998, NIH director and Nobel laureate Harold Varmus came into conflict with Senator Harkin by pushing to have more NIH control of alternative medicine research.[193] The NIH Director placed the OAM under more strict scientific NIH control.[191][193] Senator Harkin responded by elevating OAM into an independent NIH "center", just short of being its own "institute", and renamed to be the National Center for Complementary and Alternative Medicine (NCCAM). NCCAM had a mandate to promote a more rigorous and scientific approach to the study of alternative medicine, research training and career development, outreach, and "integration". In 1999, the NCCAM budget was increased from $20 million to $50 million.[192][193] The United States Congress approved the appropriations without dissent. In 2000, the budget was increased to about $68 million, in 2001 to $90 million, in 2002 to $104 million, and in 2003, to $113 million.[192]

In 2009, after a history of 17 years of government testing and spending of nearly $2.5 billion on research had produced almost no clearly proven efficacy of alternative therapies, Senator Harkin complained, "One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving."[193][194][195] Members of the scientific community criticized this comment as showing Senator Harkin did not understand the basics of scientific inquiry, which tests hypotheses, but never intentionally attempts to "validate approaches".[193] Members of the scientific and biomedical communities complained that after a history of 17 years of being tested, at a cost of over $2.5 Billion on testing scientifically and biologically implausible practices, almost no alternative therapy showed clear efficacy.[137] In 2009, the NCCAM's budget was increased to about $122 million.[193] Overall NIH funding for CAM research increased to $300 Million by 2009.[193] By 2009, Americans were spending $34 Billion annually on CAM.[196]

In 2012, the Journal of the American Medical Association (JAMA) published a criticism that study after study had been funded by NCCAM, but "failed to prove that complementary or alternative therapies are anything more than placebos".[197] The JAMA criticism pointed to large wasting of research money on testing scientifically implausible treatments, citing "NCCAM officials spending $374,000 to find that inhaling lemon and lavender scents does not promote wound healing; $750,000 to find that prayer does not cure AIDS or hasten recovery from breast-reconstruction surgery; $390,000 to find that ancient Indian remedies do not control type 2 diabetes; $700,000 to find that magnets do not treat arthritis, carpal tunnel syndrome, or migraine headaches; and $406,000 to find that coffee enemas do not cure pancreatic cancer."[197] It was pointed out that negative results from testing were generally ignored by the public, that people continue to "believe what they want to believe, arguing that it does not matter what the data show: They know what works for them".[197] Continued increasing use of CAM products was also blamed on the lack of FDA ability to regulate alternative products, where negative studies do not result in FDA warnings or FDA-mandated changes on labeling, whereby few consumers are aware that many claims of many supplements were found not to have not to be supported.[197]

In 2014 the NCCAM was renamed to the National Center for Complementary and Integrative Health (NCCIH) with a new charter requiring that 12 of the 18 council members shall be selected with a preference to selecting leading representatives of complementary and alternative medicine, 9 of the members must be licensed practitioners of alternative medicine, 6 members must be general public leaders in the fields of public policy, law, health policy, economics, and management, and 3 members must represent the interests of individual consumers of complementary and alternative medicine.[198]

There is a general scientific consensus that Alternative Therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved.[12][15][199][200] Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed.Selective publication bias , marked differences in product quality and standardisation, and some companies making unsubstantiated claims, call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.[202]

The Scientific Review of Alternative Medicine points to confusions in the general population - a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category.[203]

Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative[204] and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate.[205] Ernst has concluded that 95% of the alternative treatments he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are "statistically indistinguishable from placebo treatments", but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.[206][207]

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis.[208] According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.

As of 2005[update], the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.69% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.[210]

Cancer researcher Andrew J. Vickers has stated:

"CAM", meaning "complementary and alternative medicine", is not as well researched as conventional medicine, which undergoes intense research before release to the public.[212] Funding for research is also sparse making it difficult to do further research for effectiveness of CAM.[213] Most funding for CAM is funded by government agencies.[212] Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable.[212] The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet.[212] Even with the little research done on it, CAM has not been proven to be effective.[214]

Steven Novella, a neurologist at Yale School of Medicine, wrote that government funded studies of integrating alternative medicine techniques into the mainstream are "used to lend an appearance of legitimacy to treatments that are not legitimate."[215] Marcia Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered "alternative" to begin with.[14] It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. A prominent supporter of this position is George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA).[55]

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)[216]

In March 2009 a staff writer for the Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying "One of our concerns is that NIH is funding pseudoscience." They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.[215]

Writers such as Carl Sagan (1934-1996), a noted astrophysicist, advocate of scientific skepticism and the author of The demonhaunted world: science as a candle in the dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment.[217] Barrett has pointed out that there is a policy at the NIH of never saying something doesn't work only that a different version or dose might give different results.[137] Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.[218]

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch.[219] Grounds for opposing alternative medicine include that:

Many alternative medical treatments are not patentable,[citation needed], which may lead to less research funding from the private sector. In addition, in most countries, alternative treatments (in contrast to pharmaceuticals) can be marketed without any proof of efficacyalso a disincentive for manufacturers to fund scientific research.[226]

English evolutionary biologist Richard Dawkins, in his 2003 book A Devil's Chaplain , defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests."[227] Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.[228]

CAM is also often less regulated than conventional medicine.[212] There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients.[212] CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine,[212] and it is often described as an issue of non-maleficence.[229]

According to two writers, Wallace Sampson and K. Butler, marketing is part of the training required in alternative medicine, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.[15][230]

In November 2011 Edzard Ernst stated that the "level of misinformation about alternative medicine has now reached the point where it has become dangerous and unethical. So far, alternative medicine has remained an ethics-free zone. It is time to change this."[231]

Original post:

Alternative medicine - Wikipedia

Medicine (British English i; American English i) is the science and practice of the diagnosis, treatment, and prevention of disease.[1][2] The word medicine is derived from Latin medicus, meaning "a physician".[3][4] Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.[5]

Medicine has existed for thousands of years, during most of which it was an art (an area of skill and knowledge) frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism. In recent centuries, since the advent of modern science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science). While stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.

Prescientific forms of medicine are now known as traditional medicine and folk medicine. They remain commonly used with or instead of scientific medicine and are thus called alternative medicine. For example, evidence on the effectiveness of acupuncture is "variable and inconsistent" for any condition,[6] but is generally safe when done by an appropriately trained practitioner.[7] In contrast, treatments outside the bounds of safety and efficacy are termed quackery.

Medical availability and clinical practice varies across the world due to regional differences in culture and technology. Modern scientific medicine is highly developed in the Western world, while in developing countries such as parts of Africa or Asia, the population may rely more heavily on traditional medicine with limited evidence and efficacy and no required formal training for practitioners.[8] Even in the developed world however, evidence-based medicine is not universally used in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of the interventions lacked sufficient evidence to support either benefit or harm.[9]

In modern clinical practice, doctors personally assess patients in order to diagnose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins an interaction with an examination of the patient's medical history and medical record, followed by a medical interview[10] and a physical examination. Basic diagnostic medical devices (e.g. stethoscope, tongue depressor) are typically used. After examination for signs and interviewing for symptoms, the doctor may order medical tests (e.g. blood tests), take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions.[11] Follow-ups may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue.

The components of the medical interview[10] and encounter are:

The physical examination is the examination of the patient for medical signs of disease, which are objective and observable, in contrast to symptoms which are volunteered by the patient and not necessarily objectively observable.[12] The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia, diabetic ketoacidosis). Four actions are the basis of physical examination: inspection, palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen), generally in that order although auscultation occurs prior to percussion and palpation for abdominal assessments.[13]

The clinical examination involves the study of:

It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.

The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of "utilization review", such as prior authorization of tests, may place barriers on accessing expensive services.[14]

The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.

On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Contemporary medicine is in general conducted within health care systems. Legal, credentialing and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have significant impact on the way medical care is provided.

From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals and the Catholic Church today remains the largest non-government provider of medical services in the world.[15] Advanced industrial countries (with the exception of the United States)[16][17] and many developing countries provide medical services through a system of universal health care that aims to guarantee care for all through a single-payer health care system, or compulsory private or co-operative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.

Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those that can afford to pay for it or have self-insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.

Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice by patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for lack of openness,[18] new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.

Provision of medical care is classified into primary, secondary, and tertiary care categories.

Primary care medical services are provided by physicians, physician assistants, nurse practitioners, or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics, nursing homes, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes.

Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency rooms, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.

Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc.

Modern medical care also depends on information still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

In low-income countries, modern healthcare is often too expensive for the average person. International healthcare policy researchers have advocated that "user fees" be removed in these areas to ensure access, although even after removal, significant costs and barriers remain.[19]

Working together as an interdisciplinary team, many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses, emergency medical technicians and paramedics, laboratory scientists, pharmacists, podiatrists, physiotherapists, respiratory therapists, speech therapists, occupational therapists, radiographers, dietitians, and bioengineers, surgeons, surgeon's assistant, surgical technologist.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry, while considered by some a separate discipline from medicine, is a medical field.

A patient admitted to the hospital is usually under the care of a specific team based on their main presenting problem, e.g., the Cardiology team, who then may interact with other specialties, e.g., surgical, radiology, to help diagnose or treat the main problem or any subsequent complications/developments.

Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in.

The main branches of medicine are:

In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities have their own body or college, which have its own entrance examination. These are collectively known as the Royal Colleges, although not all currently use the term "Royal". The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (such as emergency departments); the new specialty leads to the formation of a unifying body of doctors and the prestige of administering their own examination.

Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most of its subspecialties require preliminary training in Internal Medicine. In the UK, this was traditionally evidenced by passing the examination for the Membership of the Royal College of Physicians (MRCP) or the equivalent college in Scotland or Ireland. "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in General Surgery, which in the UK leads to membership of the Royal College of Surgeons of England (MRCS). At present, some specialties of medicine do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above; for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is attained by sitting for the examination of the Fellowship of the Royal College of Anesthetists (FRCA).

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas (for example, a perforated ear drum). Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery, ophthalmic surgery, cardiovascular surgery, colorectal surgery, neurosurgery, oral and maxillofacial surgery, oncologic surgery, orthopedic surgery, otolaryngology, plastic surgery, podiatric surgery, transplant surgery, trauma surgery, urology, vascular surgery, and pediatric surgery. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology, but are not considered surgical sub-specialties per se.

Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming.

Internal medicine is the medical specialty dealing with the prevention, diagnosis, and treatment of adult diseases. According to some sources, an emphasis on internal structures is implied.[20] In North America, specialists in internal medicine are commonly called "internists." Elsewhere, especially in Commonwealth nations, such specialists are often called physicians.[21] These terms, internist or physician (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.

Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys.[22]

In the Commonwealth of Nations and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of Primary care.

There are many subspecialities (or subdisciplines) of internal medicine:

Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on Medical education and Physician for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one- to three-year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the USA. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.

The followings are some major medical specialties that do not directly fit into any of the above-mentioned groups.

Some interdisciplinary sub-specialties of medicine include:

Medical education and training varies around the world. It typically involves entry level education at a university medical school, followed by a period of supervised practice or internship, and/or residency. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research. In Canada and the United States of America, a Doctor of Medicine degree, often abbreviated M.D., or a Doctor of Osteopathic Medicine degree, often abbreviated as D.O. and unique to the United States, must be completed in and delivered from a recognized university.

Since knowledge, techniques, and medical technology continue to evolve at a rapid rate, many regulatory authorities require continuing medical education. Medical practitioners upgrade their knowledge in various ways, including medical journals, seminars, conferences, and online programs.

In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.

In the European Union, the profession of doctor of medicine is regulated. A profession is said to be regulated when access and exercise is subject to the possession of a specific professional qualification. The regulated professions database contains a list of regulated professions for doctor of medicine in the EU member states, EEA countries and Switzerland. This list is covered by the Directive 2005/36/EC.

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.

Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:

Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members. For example, some argue that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.

Prehistoric medicine incorporated plants (herbalism), animal parts, and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian Medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine.

In Egypt, Imhotep (3rd millennium BC) is the first physician in history known by name. The oldest Egyptian medical text is the Kahun Gynaecological Papyrus from around 2000 BCE, which describes gynaecological diseases. The Edwin Smith Papyrus dating back to 1600 BCE is an early work on surgery, while the Ebers Papyrus dating back to 1500 BCE is akin to a textbook on medicine.[24]

In China, archaeological evidence of medicine in Chinese dates back to the Bronze Age Shang Dynasty, based on seeds for herbalism and tools presumed to have been used for surgery.[25] The Huangdi Neijing, the progenitor of Chinese medicine, is a medical text written beginning in the 2nd century BCE and compiled in the 3rd century.[26]

In India, the surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery.[27][dubious discuss][28][29] Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found.[30][31]

In Greece, the Greek physician Hippocrates, the "father of western medicine",[32][33] laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence".[34][35] The Greek physician Galen was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Early Middle Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

Most of our knowledge of ancient Hebrew medicine during the 1stmillenniumBC comes from the Torah, i.e.the Five Books of Moses, which contain various health related laws and rituals. The Hebrew contribution to the development of modern medicine started in the Byzantine Era, with the physician Asaph the Jew.[36]

After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the Persian polymath, Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine".[37] He wrote The Canon of Medicine, considered one of the most famous books in the history of medicine.[38] Others include Abulcasis,[39]Avenzoar,[40]Ibn al-Nafis,[41] and Averroes.[42]Rhazes[43] was one of the first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine.[44]Al-Risalah al-Dhahabiah by Ali al-Ridha, the eighth Imam of Shia Muslims, is revered as the most precious Islamic literature in the Science of Medicine.[45] The Islamic Bimaristan hospitals were an early example of public hospitals.[46][47]

In Europe, Charlemagne decreed that a hospital should be attached to each cathedral and monastery and the historian Geoffrey Blainey likened the activities of the Catholic Church in health care during the Middle Ages to an early version of a welfare state: "It conducted hospitals for the old and orphanages for the young; hospices for the sick of all ages; places for the lepers; and hostels or inns where pilgrims could buy a cheap bed and meal". It supplied food to the population during famine and distributed food to the poor. This welfare system the church funded through collecting taxes on a large scale and possessing large farmlands and estates. The Benedictine order was noted for setting up hospitals and infirmaries in their monasteries, growing medical herbs and becoming the chief medical care givers of their districts, as at the great Abbey of Cluny. The Church also established a network of cathedral schools and universities where medicine was studied. The Schola Medica Salernitana in Salerno, looking to the learning of Greek and Arab physicians, grew to be the finest medical school in Medieval Europe.[48]

However, the fourteenth and fifteenth century Black Death devastated both the Middle East and Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East.[49] In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Vesalius improved upon or disproved some of the theories from the past. The main tomes used both by medicine students and expert physicians were Materia Medica and Pharmacopoeia.

Andreas Vesalius was the author of De humani corporis fabrica, an important book on human anatomy.[50] Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology.[51] Independently from Ibn al-Nafis, Michael Servetus rediscovered the pulmonary circulation, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris"[52] in 1546, and later published in the theological work for which he paid with his life in 1553. Later this was described by Renaldus Columbus and Andrea Cesalpino. Herman Boerhaave is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). Pierre Fauchard has been called "the father of modern dentistry".[53]

Veterinary medicine was, for the first time, truly separated from human medicine in 1761, when the French veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and other animals.

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900.

The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austria, doctors Rudolf Virchow, Wilhelm Conrad Rntgen, Karl Landsteiner and Otto Loewi made notable contributions. In the United Kingdom, Alexander Fleming, Joseph Lister, Francis Crick and Florence Nightingale are considered important. Spanish doctor Santiago Ramn y Cajal is considered the father of modern neuroscience.

From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet.

In the United States, William Williams Keen, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasabur), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca) and others did significant work. Russian Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids.[54]Pharmacology developed in part from herbalism and some drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc.).[55]Vaccines were discovered by Edward Jenner and Louis Pasteur.

The first antibiotic was arsphenamine (Salvarsan) discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by German chemists originally from azo dyes.

Pharmacology has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by modern global information science, which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.[56]

Traditional medicine (also known as indigenous or folk medicine) comprises knowledge systems that developed over generations within various societies before the era of modern medicine. The World Health Organization (WHO) defines traditional medicine as "the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness."[57]

In some Asian and African countries, up to 80% of the population relies on traditional medicine for their primary health care needs. When adopted outside of its traditional culture, traditional medicine is often called alternative medicine.[57] Practices known as traditional medicines include Ayurveda, Siddha medicine, Unani, ancient Iranian medicine, Irani, Islamic medicine, traditional Chinese medicine, traditional Korean medicine, acupuncture, Muti, If, and traditional African medicine.

The WHO notes however that "inappropriate use of traditional medicines or practices can have negative or dangerous effects" and that "further research is needed to ascertain the efficacy and safety" of several of the practices and medicinal plants used by traditional medicine systems.[57] The line between alternative medicine and quackery is a contentious subject.

Traditional medicine may include formalized aspects of folk medicine, that is to say longstanding remedies passed on and practised by lay people. Folk medicine consists of the healing practices and ideas of body physiology and health preservation known to some in a culture, transmitted informally as general knowledge, and practiced or applied by anyone in the culture having prior experience.[58] Folk medicine may also be referred to as traditional medicine, alternative medicine, indigenous medicine, or natural medicine. These terms are often considered interchangeable, even though some authors may prefer one or the other because of certain overtones they may be willing to highlight. In fact, out of these terms perhaps only indigenous medicine and traditional medicine have the same meaning as folk medicine, while the others should be understood rather in a modern or modernized context.[59]

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Medicine - Wikipedia, the free encyclopedia

Complementary and Alternative Cancer Treatment What is Complementary and Alternative Medicine (CAM)?

Complementary and alternative cancer treatments are often lumped together. But to a cancer specialist, there is a big difference. Complementary therapy is used in addition to mainstream medical treatment. Alternative therapy is used instead of proven treatment. Another term you may hear is integrative medicine. This means combining CAM and standard care to try to treat cancer in a way that involves your body, mind and spirit. Complementary and alternative medicine (CAM) includes:

Complementary medicine is a group of diagnostic and therapeutic disciplines that are used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient's discomfort following surgery.

Complementary medicine is usually not taught or used in Western medical schools or hospitals. Complementary medicine includes a large number of practices and systems of health care that, for a variety of cultural, social, economic, or scientific reasons, have not been adopted by mainstream Western medicine.

Complementary medicine is different from alternative medicine. Whereas complementary medicine is used together with conventional medicine, alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a physician.

Complementary and alternative medicine (CAM) can include the following:

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Complementary and Alternative Medicine (CAM)

Complementary and alternative medicine includes practices such as massage, acupuncture, tai chi, and drinking green tea.

Credit: iStock

Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard medical care.

NCI provides evidence-based PDQ information for many CAM therapies in versions for both the patient and health professional.

Some CAM therapies have undergone careful evaluation and have found to be safe and effective. However there are others that have been found to be ineffective or possibly harmful. Less is known about many CAM therapies, and research has been slower for a number of reasons:

CAM therapies need to be evaluated with the same long and careful research process used to evaluate standard treatments. Standard cancer treatments have generally been studied for safety and effectiveness through an intense scientific process that includes clinical trials with large numbers of patients.

CAM therapies include a wide variety of botanicals and nutritional products, such as dietary supplements, herbal supplements, and vitamins. Many of these "natural" products are considered to be safe because they are present in, or produced by, nature. However, that is not true in all cases. In addition, some may affect how well other medicines work in your body. For example, the herb St. John's wort, which some people use for depression, may cause certain anticancer drugs not to work as well as they should.

Herbal supplements may be harmful when taken by themselves, with other substances, or in large doses. For example, some studies have shown that kava kava, an herb that has been used to help with stress and anxiety, may cause liver damage.

Vitamins can also have unwanted effects in your body. For example, some studies show that high doses of vitamins, even vitamin C, may affect how chemotherapy and radiation work. Too much of any vitamin is not safe, even in a healthy person.

Tell your doctor if you're taking any dietary supplements, no matter how safe you think they are. This is very important. Even though there may be ads or claims that something has been used for years, they do not prove that it's safe or effective.

Supplements do not have to be approved by the federal government before being sold to the public. Also, a prescription is not needed to buy them. Therefore, it's up to consumers to decide what is best for them.

NCI and the National Center for Complementary and Integrative Health (NCCIH) are currently sponsoring or cosponsoring various clinical trials that test CAM treatments and therapies in people. Some study the effects of complementary approaches used in addition to conventional treatments, and some compare alternative therapies with conventional treatments. Find all cancer CAM clinical trials.

Dr. Jeffrey D. White, OCCAM Director, explains the use of complementary and alternative medicine in cancer.

Cancer patients who are using or considering using complementary or alternative therapy should talk with their doctor or nurse. Some therapies may interfere with standard treatment or even be harmful. It is also a good idea to learn whether the therapy has been proven to do what it claims to do.

To find a CAM practitioner, ask your doctor or nurse to suggest someone. Or ask if someone at your cancer center, such as a social worker or physical therapist can help you. Choosing a CAM practitioner should be done with as much care as choosing a primary care provider.

Patients, their families, and their health care providers can learn about CAM therapies and practitioners from the following government agencies:

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Complementary and Alternative Medicine (CAM) - National ...

The state of New Jersey has passed operational laws for medical marijuana. Essentially, this means criminal penalties have been removed at a state-level for the use of medical marijuana by individuals who carry a legal medicinal marijuana card and have been diagnosed with some sort of debilitating illness, or another type of terminal illness with a chance of survival for up to 1 year (as diagnosed by a physician, specialist, or doctor).

Chronic pain is a complex disease, but it takes dedication and a trustworthy relationship between the patient and the treating physician to successfully overcome it. I specialize in treating patients with migraine headaches, trigeminal neuralgia, cervical and lumbar radiculopathy, degenerative disease of the spine. Doctor Andrew Medvedovsky

At New Jersey Alternative Medicine, we utilize alternative medicine treatments to help patients manage chronic pain, nausea, and other related symptoms that result from various types of diseases, illnesses, or conditions. Whether your current medical condition has been diagnosed as debilitating, terminal, temporary, or permanent, our Board Certified physician will partner alongside you as we find a treatment program that best suits your needs.

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New Jersey Alternative Medicine | NJ Medical Marijuana Doctor

"By definition", I begin "Alternative Medicine", I continue "Has either not been proved to work, Or been proved not to work.

You know what they call alternative medicine Thats been proved to work?

Alternative medicine is any medical treatment that is not part of conventional evidence-based medicine, such as one would learn in medical school, nursing school or even paramedic training. Much, if not most of the "alternative medicine" world lacks any scientific proof of its effectiveness, and that which does have real effectiveness, tends to be palliative[note 1] rather than curative. Any alternative medicine with scientific evidence behind it is simply called medicine.

The term "alternative medicine" is also a politically correct term for medical marijuana.

Alternative medicine includes "traditional medicines" (i.e. "medical" systems developed prior to or outside of "Western Medicine", such as traditional Native American remedies, or traditional Chinese medicine), "folk remedies" (e.g., herbalism, tinctures, and rubs that were common place "treatments" often passed around via urban legend), and an ever growing class of "religious" or "spiritual" treatments that have their sources in Eastern Religions, but are filtered through a pay-as-you-go, for-profit (see "New Age") mindset. These terms are still used today to describe the various substances of unclear efficacy sold for a profit through advertising. These cures are not always sold by malicious, deceptive con-men. Many promoters are true believers, making their claims even more convincing.

And if you don't think it's real, or don't think people who have funding to spend notice it, the National Center for Complementary and Alternative Medicine is run by the National Institute of Health.[2]

The rebranding of alternative medicine is analogous to the endless rebranding of creationism to try to evade the First Amendment, or the renaming of racialism to try and avoid the status of "racist". The original term, alternative medicine, was trivially unmasked as alternatives to medicine, and emphasized its being outside of scientific medical practice. There are many legitimate complementary therapies such as massage, counselling and so on, and by claiming to be part of this, rather than acknowledging its status as being apart from medicine, these rebrandings hope to gain a halo effect and imply legitimately place in medical practice. The purpose is to gain greater acceptance, and hopefully funding, for pseudomedicine - a stalking horse for woo.[5]

Critics of alternative medicine have come up with some of their own terms for it:

Often holistic healers will convince their patients to forgo proper medical care, usually combined with misrepresentations of studies or emotional appeals, to undergo holistic therapies. Since there is no valid evidence to support holistic therapies being capable of curing deadly ailments, this kind of malpractice is dangerous to offer patients.

All alternative medicine, even the "effective" therapies have the danger of convincing an unwell person to forgo actual medical treatments because they think they are getting better (which can happen with palliative remedies and placebos) or they choose to trust their alternative practitioner who is offering a "cure". For example, a person with cancer may convince himself to try a homeopathic remedy. Also, many herbal remedies can actually interfere with prescription drugs, lessening their effect or even causing dangerous side-effects. Since almost all alternative medicines are unproven; many advocates (known to some as "alties") tend to appeal to "health freedom," rather than actually try to prove that their nostrums work.

Many practitioners exploit vulnerable patients. They give false hope to people who are incurably sick and frequently charge high prices for useless treatments. The belief that alternative medicines are somehow "less risky" or "less harsh" than conventional medicine has led some to take alternative medicine over conventional medicine. While this may often be true (though don't say that to someone who's lost skin or body parts to black salves sometimes used for skin cancers), the potential health risks of not taking conventional medicine for an illness far outweigh the risks from the side effects of these medicines.

Often, alternative medicine practitioners claim that, unlike "allopathy", they help the body's natural self-healing powers. Yet many of them will describe anecdote after anecdote showcasing medical recoveries (involving such transitory things as colds) while seemingly refusing to believe that the disease could ever have gone away on its own. These recoveries must be due to whatever remedy they used. So on the one hand, they extol the healing powers of the human body, while at the same time denying that illnesses could ever go away by themselves or in other words, that the body could actually heal itself.

Alternative medicines or therapies range from being scientifically provable to scientifically disproven, and can be benign (and often ridiculous) all the way to downright dangerous. Medical science has only recently started to do quality and quantity research into alternative medicine. With the exception of some surprising and exciting treatments that have true medical potential, the vast majority of the therapies do little if anything beyond the placebo effect. Even when the treatment actually does something, the reasons given by practitioners for why the treatment is effective are almost never based on correct scientific information. Benign treatments have the advantage of not directly injuring a patient, other than money and at worst precious time going out the window. The ridiculous cannot possibly have any medical effects (beyond that of the placebo effect at the least), or may be actively dangerous to the patient.

Holistic medical practitioners defend their treatments to the general public that there is documented proof that they work, but when faced with empirical evidence that does not support their claims, certain practicioners often state that holistic medicine cannot be readily tested by scientific means.

In other words: if it's not tested, then they think it works. Once it's tested, they'll tell you the test is wrong and it works.

When a student wants to become a physician, he or she must attend a certified medical school, pass rigorous medical exams, and participate in carefully monitored and regulated internships all regulated by the governmental bodies who license the doctor. For the majority of alternative medicine, no such regulation is in place. For a few specific alternative therapies like chiropractic work and massage therapy, regulatory bodies do exist. However, pretty much every other field of alternative medicine has no regulation at all. Call yourself a color therapist, and lo and behold, you are one.

There is also a lack of regulation in the products sold as "alternative" or "herbal" medicines. You cannot, for example, know what is in a "sleep healing tea", how much of each ingredient, how potent the pills are, or even whether it contains the listed ingredient(s) at all (many herbal products, in fact, do not contain the herb(s) listed on the label).[9] Also, as there is little scientific research, "doses" are always a guess. "Try one pill. If that doesn't work, take two."

Sometimes an alternative medicine supporter will present a scholarly work as "proof" that the alternative medicine works and is being suppressed by "regular" medicine. The problem is the work is either outdated, has been refuted by later research, or (worse) is misrepresented.

Weston Price's work on focal infection and nutrition is a prime example of this type of handwaving. Given what was known at the time his work was perfectly valid...for its time which was 1939 . The thing is the world as well as our understanding of both focal infection and nutrition have changed so drastically that Price's work would have to be reevaluated in a modern framework... something that really hasn't been done. The fact Price himself questioned the focal infection theory is also not brought up by either side or that what Price actually did and what his supporters claim he did (and was) are so different that it is a clear misrepresentation.

Homoeopathy serves as another example as supporters can point to K. Linde, N. Clausius, G. Ramirez, et al., "Are the Clinical Effects of Homoeopathy Placebo Effects? A Meta-analysis of Placebo-Controlled Trials," Lancet, September 20, 1997, 350:834-843...while ignoring the refutiation in "The end of homoeopathy" The Lancet, Vol. 366 No. 9487 p 690. The Vol. 366 No. 9503 issue (Dec 27, 2005) and by 14 studies from 2003 to 2007.[10]

Colloidal silver was used as an antibiotic, germicide and disinfectant clear into the 1940s. Publications such as New Orleans Medical and Surgical Journal (1907), The Journal of the American Medical Association (1918), The Journal of the American Dental Association (1934) all had articles regarding the uses and limits of colloidal silver. Antibiotics were far more effective (and safer) so the use of colloidal silver effectively ended.

In many respects this is the most dangerous form of alternative medicine as it cloaks itself in the garb of genuine medicine using scholarly publications to support its claims.

You can't neatly brush it all into the quack corner. Some of them work, but not all of them.

Manheimer 2003, which studied IV drug users, found that:[17]

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Alternative medicine - RationalWiki

Assessment | Biopsychology | Comparative | Cognitive | Developmental | Language | Individual differences | Personality | Philosophy | Social | Methods | Statistics | Clinical | Educational | Industrial | Professional items | World psychology |

Clinical: Approaches Group therapy Techniques Types of problem Areas of specialism Taxonomies Therapeutic issues Modes of delivery Model translation project Personal experiences

Alternative medicine describes practices used in place of conventional medical treatments. Complementary medicine describes practices used in conjunction and cooperation with conventional medicine, to assist the existing process. The term complementary and alternative medicine (CAM) is an umbrella term for both branches. CAM includes practices that incorporate spiritual, metaphysical, or religious underpinnings; non-European medical traditions, or newly developed approaches to healing.

The National Center for Complementary and Alternative Medicine defines complementary and alternative medicine as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine". It also defines integrative medicine as "[combining] mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness".[1] Ralph Snyderman and Andrew Weil state "integrative medicine is not synonymous with complementary and alternative medicine (CAM). It has a far larger meaning and mission in that it calls for restoration of the focus of medicine on health and healing and emphasizes the centrality of the patient-physician relationship".[2]

The list of therapies included under CAM changes gradually. If and when CAM therapies that are proven to be safe and effective become adopted into conventional health care, they gradually cease to be considered CAM, since adoption and acceptance often take time.

The terms "alternative medicine", "complementary medicine" and "CAM" are generally understood in terms of their relationship to mainstream medicine, as described above.[3]

Other definitions exist that are based on or include other criteria.

Marcia Angell, former editor-in-chief of the New England Journal of Medicine, takes exception to the above definition and relies on an "evidence-based" (EBM) definition, based on its relation to scientifically proven evidence of efficacy (or lack thereof). Angell states that "...since many alternative remedies have recently found their way into the medical mainstream [there] cannot be two kinds of medicine - conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted."[4]

Others like George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA), and Phil B. Fontanarosa, Senior Editor of JAMA, share Angell's use of an EBM definition. "There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is 'Eastern' or 'Western,' is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. As believers in science and evidence, we must focus on fundamental issues-namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy."[5]

Richard Dawkins, Professor of the Public Understanding of Science at Oxford,[6] also uses an EBM definition, defining alternative medicine as a "...set of practices which cannot be tested, refuse to be tested, or consistently fail tests. If a healing technique is demonstrated to have curative properties in properly controlled double-blind trials, it ceases to be alternative. It simply...becomes medicine."[7] He also states that "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."[8]

These three commentators use a definition that is based on the objectively verifiable criteria of the scientific method, not one based on the changing curricula of various medical schools. According to them it is possible for a method to change categories (main stream vs. alternative) in either direction, based on increased knowledge of its effectiveness or lack thereof.

Well-known proponents of evidence-based medicine who study CAM, such as the Cochrane Collaboration and Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, have retained CAM's generally-accepted (social) definition and do not define CAM as Dawkins, Angell and others do. Still, in their view, there can be "good CAM" or "bad CAM" based on evidentiary support.[9][10][11]

Similarly, David M. Eisenberg relies on a "usage-based" definition, based on its inclusion in medical school curricula, and defines it as "medical interventions not taught widely at U.S. medical schools or generally available at U.S. hospitals."[12]

Additionally, what in the West is considered "alternative" medicine may elsewhere be considered "traditional medicine" - for example Chinese medicine and Ayurveda.

The Alma-Alta declaration defines its strategy as "Health for All by 2000 A.D." through primary health care. This is in pursuance of the aims declared at the WHO/ UNICEF sponsored conference at Alma-Alta, USSR. Primary health care has been described as "essential health care based on practical, scientifically sound and socially accepted methods and technology made universally accessible to individuals and the families in the community through their full participation and at a cost that a community and country can afford to maintain at every stage of their development in the spirit of self reliance and self determination". Subsequently, the Alma-Alta declaration outlined that primary health care is based on training and scientific orientation provided to health care workers including physicians, nurses, midwives, auxiliary and community workers and traditional medical practitioners. Therefore, Medicina Alternativa has established guidelines and regulations outlining the code of ethics that healers are expected to follow consequent to their training, certification and membership of Medicina Alternativa.

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Jurisdiction differs concerning which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled health service or reimbursed by a private health medical insurance company.

A number of alternative medicine advocates disagree with the restrictions of government agencies that approve medical treatments (such as the American Food and Drug Administration) and the agencies' adherence to experimental evaluation methods. They claim that this impedes those seeking to bring useful and effective treatments and approaches to the public, and protest that their contributions and discoveries are unfairly dismissed, overlooked or suppressed. Alternative medicine providers often argue that health fraud should be dealt with appropriately when it occurs.

In India, which is the home of several alternative systems of medicines, Ayurveda, Siddha, Unani, and Homeopathy are licenced by the government. Naturopathy will also be licensed soon because several Universities now offer bachelors degrees in it. Other activities connected with AM/CM, such as Panchakarma and massage therapy related to Ayurveda are also licenced by the government now.

Alternative systems of medicine in India do not have scientific decodation and standardization, so people has hasgitation to accept all therapies. same time persons who are angaged with practice of alternative medicine, those people also do practice of allopathic system of medicine. (Raju Dangar)

Edzard Ernst wrote in the Medical Journal of Australia that "about half the general population in developed countries use complementary and alternative medicine (CAM)".[13] A survey released in May 2004 by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, 36% of Americans used some form of alternative therapy in the past 12 months a category that included yoga, meditation, herbal treatments and the Atkins diet.[14] If prayer was counted as an alternative therapy, the figure rose to 62.1%. Another study suggests a similar figure of 40%.[15] A British telephone survey by the BBC of 1209 adults in 1998 shows that around 20% of adults in Britain had used alternative medicine in the past 12 months.[How to reference and link to summary or text]

The use of alternative medicine appears to be increasing, as a 1998 study showed that the use of alternative medicine had risen from 33.8% in 1990 to 42.1% in 1997.[16] In the United Kingdom, a 2000 report ordered by the House of Lords suggested that "...limited data seem to support the idea that CAM use in the United Kingdom is high and is increasing."[17]

Increasing numbers of medical colleges have begun offering courses in alternative medicine. For example, the University of Arizona College of Medicine offers a program in Integrative Medicine under the leadership of Dr. Andrew Weil which trains physicians in various branches of alternative medicine which "...neither rejects conventional medicine, nor embraces alternative practices uncritically."[18] In three separate research surveys that surveyed 729 schools in the United States (125 medical schools offering an MD degree, 19 medical schools offering a Doctor of Osteopathy degree, and 585 schools offering a nursing degree), 60% of the Allopathic medical schools, 95% of Osteopathic medical schools and 84.8% of the nursing schools teach some form of CAM.[19][20][21] A number of independent and private institutions offering courses in alternative medicine have also emerged, including the Upledger Institute and the International Alliance of Healthcare Educators (IAHE). Accredited Naturopathic colleges and universities are increasing in number and popularity in the U.S.A. They offer the most complete medical training in complimentary medicines that is available today[How to reference and link to summary or text]. See Naturopathic medicine.

In the UK, no medical schools offer courses that teach the clinical practice of alternative medicine. However, alternative medicine is taught in several schools as part of the curriculum. Teaching is based mostly on theory and understanding alternative medicine, with emphasis on being able to communicate with alternative medicine specialists. To obtain competence in practicing clinical alternative medicine, qualifications must be obtained from individual medical societies. The student must have graduated and be a qualified doctor. The British Medical Acupuncture Society, which offers medical acupuncture certificates to doctors, is one such example, as is the College of Naturopathic Medicine UK and Ireland.

The NCCAM surveyed the American public on complementary and alternative medicine use in 2002. According to the survey:[22]

Advocates of alternative medicine hold that alternative therapies often provide the public with services not available from conventional medicine. This argument covers a range of areas, such as patient empowerment, alternative methods of pain management, treatment methods that support the biopsychosocial model of health, stress reduction services, other preventive health services that are not typically a part of conventional medicine, and of course complementary medicine's palliative care which is practiced by such world renowned cancer centers such as Memorial Sloan-Kettering.[23]

Advocates of alternative medicine hold that the various alternative treatment methods are effective in treating a wide range of major and minor medical conditions, and contend that recently published research (such as Michalsen, 2003,[24] Gonsalkorale 2003,[25] and Berga 2003[26]) proves the effectiveness of specific alternative treatments. They assert that a PubMed search revealed over 370,000 research papers classified as alternative medicine published in Medline-recognized journals since 1966 in the National Library of Medicine database. See also Kleijnen 1991,[27] and Linde 1997.[28]

Advocates of alternative medicine hold that alternative medicine may provide health benefits through patient empowerment, by offering more choices to the public, including treatments that are simply not available in conventional medicine:

It must be added though that most practitioners do not hold a degree in official medicine or even have a solid understanding of scientific principles, as can be deduced from many of their publications. And, of course, the fact of providing more choice has no bearing whatsoever as to the efficacy of the proposed treatment.

Although advocates of alternative medicine acknowledge that the placebo effect may play a role in the benefits that some receive from alternative therapies, they point out that this does not diminish their validity. Researchers who judge treatments using the scientific method are concerned by this viewpoint, since, according to standard controlled studies, it is an acknowledgement of the inefficacy of alternative treatments.

A major objection to alternative medicine is that it may be done in place of conventional medical treatments. As long as alternative treatments are used alongside standard conventional medical treatments, most medical doctors find most forms of complementary medicine acceptable. Consistent with previous studies, the CDC recently reported that the majority of individuals in the United States (i.e., 54.9%) used CAM in conjunction with conventional medicine.[How to reference and link to summary or text]

Patients should however always inform their medical doctor they are using alternative medicine. Some patients do not tell their medical doctors since they fear it will hurt their patient-doctor relationship. Some alternative treatments may interact with orthodox medical treatments, and ideally, such conflicts should be explored in the interest of the patient. However, many conventional practitioners are biased or uninformed about alternatives, and the exhortations to disclose alternative treatments to one's doctor do not address the complexities involved.

The issue of alternative medicine interfering with conventional medical practices is minimized when it is only turned to after the conventional medicine path has been exhausted. Many patients believe alternative medicine can help in coping with chronic illnesses for which conventional medicine offers no cure and only management. It is becoming more common for a patient's own MD to suggest alternatives when they cannot offer a treatment.

See also List of branches of alternative medicine for specific criticisms of different types of CAM

Due to the wide range of therapies that are considered to be "alternative medicine" few criticisms apply across the board, except possibly that of not being scientifically supported or even testable. Criticisms directed at specific branches of alternative medicine range from the fairly minor (conventional treament is believed to be more effective in a particular area) to incompatibility with the known laws of physics (for example, in homeopathy). Critics argue that alternative medicine practitioners may not have an accredited medical degree or be licensed physicians or general practitioners and make sweeping claims without demonstrated expertise. This cannot always be considered a serious criticism, because unless a new system of medicine becomes established, it does not receive accreditation of any kind, except by its own professional organizations. This is the route homeopathy, ayurveda, siddha, unani, and naturopathy had to follow in those countries where it is now offered by accredited institutions. Proponents of the various forms of alternative medicine reject criticism as being founded in prejudice, financial self-interest, or ignorance. Refutations of criticism sometimes take the form of an appeal to nature.

Evidence-based medicine (EBM) applies the scientific method to medical practice, and aims for the ideal that healthcare professionals should make "conscientious, explicit, and judicious use of current best evidence" in their everyday practice. Prof. Edzard Ernst is a notable proponent of applying EBM to CAM.

Although proponents of alternative medicine often cite the large number of studies which have been performed, critics point out the fact that there are no statistics on exactly how many of these studies were controlled, double-blind peer-reviewed experiments or how many produced results supporting alternative medicine or parts thereof. They contend that many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials; this is not a moot point, since all conventional drugs reach the market only after such trials have proved their efficacy. One is led to wonder why whole categories of drugs or treatments should be excused from these routine tests. Also, some skeptics of alternative practices point out that a person may attribute symptomatic relief to an otherwise ineffective therapy due to the natural recovery from or the cyclical nature of an illness (the regression fallacy), the placebo effect, or the possibility that the person never originally had a true illness.[30]

Critics contend that observer bias and poor study design invalidate the results of many studies carried out by alternative medicine promoters.

A review of the effectiveness of certain alternative medicine techniques for cancer treatment,[23] while finding that most of these treatments are not merely "unproven" but are proven not to work, notes that several studies have found evidence that the psychosocial treatment of patients by psychologists is linked to survival advantages (although it comments that these results are not consistently replicated). The same review, while specifically noting that "complementary therapies for cancer-related symptoms were not part of this review", cites studies indicating that several complementary therapies can provide benefits by, for example, reducing pain and improving the mood of patients.

Some argue that less research is carried out on alternative medicine because many alternative medicine techniques cannot be patented, and hence there is little financial incentive to study them. Drug research, by contrast, can be very lucrative, which has resulted in funding of trials by pharmaceutical companies. Many people, including conventional and alternative medical practitioners, contend that this funding has led to corruption of the scientific process for approval of drug usage, and that ghostwritten work has appeared in major peer-reviewed medical journals.[31][32] Increasing the funding for research of alternative medicine techniques was the purpose of the National Center for Complementary and Alternative Medicine. NCCAM and its predecessor, the Office of Alternative Medicine, have spent more than $200 million on such research since 1991. The German Federal Institute for Drugs and Medical Devices Commission E has studied many herbal remedies for efficacy.[33]

Critics contend that some people have been hurt or killed directly from the various practices or indirectly by failed diagnoses or the subsequent avoidance of conventional medicine which they believe is truly efficacious.

Alternative medicine critics agree with its proponents that people should be free to choose whatever method of healthcare they want, but stipulate that people must be informed as to the safety and efficacy of whatever method they choose. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. Grapefruit seed extract is an example of quackery when multiple studies demonstrate its universal antimicrobial effect is due to synthetic antimicrobial contamination.[34][35][36][37][38]

They state that those who have had success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness. For this reason, they contend that therapies that rely on the placebo effect to define success are very dangerous.

A Norwegian multicentre study examined the association between the use of alternative medicines (AM) and cancer survival. 515 patients using standard medical care for cancer were followed for eight years. 22% of those patients used AM concurrently with their standard care. The study revealed that death rates were 30% higher in AM users than in those who did not use AM: "The use of AM seems to predict a shorter survival from cancer."[39]

Associate Professor Alastair MacLennan of the Department of Obstetrics and Gynaecology in Adelaide University, Australia reports that a patient of his almost bled to death on the operating table. She had failed to mention she had been taking "natural" potions to "build up her strength" for the operation - one of them turned out to be a powerful anticoagulant which nearly caused her death.[How to reference and link to summary or text]

Conventional treatments are thoroughly checked for undesired side-effects, whereas alternative treatments are normally not. Any alternative treatment that has a biological or psychological impact may also have potentially dangerous biological or psychological side-effects. Attempts to refute this sometimes use the appeal to nature fallacy, i.e. "that which is natural cannot be harmful".

Ironically, a therapy such as homeopathy which, in the eyes of all known physics and chemistry, cannot possibly have more effect on the patient than simple water does, is surely safe from all side effects considerations.

Similar problems as those related to self-medication also apply to parts of alternative medicine. For example, an alternative medicine may instantly make problems better, but actually worsen problems in the long run. The result may be addiction[How to reference and link to summary or text] and deteriorating health.

Critics contend that some branches of alternative medicine are often not properly regulated in some countries to identify who practices or know what training or expertise they may possess. Critics argue that the governmental regulation of any particular alternative therapy does necessitate that the therapy is effective. The most sensible course in such a case could be to simply ensure that the sold treatment is not dangerous, but the problem would then remain to know if it does what its proponents say it does.

Integrative medicine is a branch of alternative medicine which limits itself to methods with strong scientific evidence of efficacy and safety. The main proponent of integrative medicine is Andrew T. Weil M.D., who founded the Program in Integrative Medicine at the University of Arizona in 1994 based on a phrase coined by Elson Haas, MD. Responsible alternative health product providers who have had medical studies conducted on their products often publish these studies online. Even so, it is wise to ask for a list of the ingredients used in the products you are considering purchasing.

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Alternative medicine - Psychology Wiki - Wikia

Alternative medicine is becoming ever increasingly popular in this day and age, but what exactly is alternative medicine? It takes on many forms in a wide variety of guises from remedies such as Herbs, Oils, Massage and Chinese Acupuncture, which most of us will have heard of and maybe even tried to Ayurvedic medicine which has widely been used in India for over five thousand years.Alternative medicine was once perhaps given a wide berth by the sceptics but today over 600 million people pay visits to those offering alternative treatments and remedies. What Benefit does Alternative Medicine Have?

Most alternative treatments are based on the use of herbs, oils and massage so its perfectly safe and for thousands of people it has been proven to work time and time again. There are a vast array of different types and treatments available from minor illnesses through to those more severe, some people even suffering life threatening illnesses have benefited from some types of alternative medicine where conventional treatments have failed.

Listed below are some of the types of alternative treatments and therapies available:

Acupuncture treatment is not only the insertion of fine needles into the points on the body but also the detection of disharmony within the body. This is assessed by a series of questions on the persons lifestyle and emotions.

Originating from the Chinese Taoist monks acupressure is similar to acupuncture but without the use of needles, instead finger pressure is applied to the points.

Essential oils taken from plants are used in this treatment which can take the form of massage or inhalation. It is thought to be especially beneficial for those suffering from stress related illnesses.

This type of treatment stems back from India and is a complete system of exercise, diet and detoxification of the entire body.

Chiropractic treatment works mainly for those suffering from joint problems and is performed along the spine by adjusting joints.

There is a vast range of herbs used in treatment which the Chinese have used for thousands of years and are capable of treating a wide variety of illnesses.

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Alternative Medicine | What Is Alternative Medicine?

As opposed to conventional medicine, a career in alternative medicine has its advantages such as better hours and more flexibility, as well as spending more quality time with your patients, many of whom swear that it is beneficial.

"Let's say you've always wanted to help people feel better, but a career in health care has eluded you till now. You're lured by the nursing profession's booming job market and you've thought about medical school, yet traditional Western allopathic medicine doesn't feel quite right.

The good news is that complementary and alternative medicine is on the rise and, with the right course of study, you may practice it in locations ranging from hospitals and integrative medicine clinics to healing centers and nutrition offices.

And you can kick the image of beads and incense; CAM has a home in hospitals, too. According to a recent survey by the American Hospital Association, 42 percent of 714 surveyed hospitals offered at least one complementary or alternative therapy in 2010, as compared with 27 percent just five years earlier. What's more, 42 percent of 714 surveyed hospitals offered at least one complementary or alternative therapy in 2010, as compared with 27 percent just five years earlier. In other words, alternative healing is becoming less alternative." Source: Alternative healing complements health career options, Tribune Media Services, June 7, 2012.

So, why does alternative medicine remain controversial?

"Debate about complementary and alternative therapies has often been polarized, with advocates squaring off against critics and no common ground emerging. There are, in fact, some causes for concern. Many excessive claims are being made for alternative health practices, many therapies are lacking in plausibility, and some are being found to be potentially dangerous. But the field of complementary and alternative medicine is not monolithic. Some therapiesindeed some of those most widely usedare sensible and deserve our attention as we look for methods to help with problems not well managed by conventional medicine.

The most common health problem for which people turn to complementary and alternative approaches is chronic pain. Pharmacological management of chronic pain, while important, has hazards. Evidence is showing, based on carefully controlled studies, that there is promise in certain complementary treatments as adjuncts to conventional pain management. For example, the pain of osteoarthritis may be relieved by acupuncture; tai chi has been found to be helpful in reducing the pain of fibromyalgia; and massage and manipulative therapies can contribute to the relief of chronic back pain...

With acupuncture, for example, a number of studies have shown clear benefit for pain management when compared to conventional care, but only marginal benefit when the control group receives equal attention from a health care provider and a sham intervention that looks and feels like acupuncture. Should we dismiss this as a placebo or acknowledge this source of benefit for patients? A difficult question for which there will not be a single answer."

Source: The Continuing Debate, National Center for Complementary and Alternative Medicine, June 24, 2011.

But, thanks to organizations like the National Center for Complementary and Alternative Medicine and the American Medical Student Association as well as dedicated alternative medicine practitioners, the 'medical establishment' is starting to accept alternative medicine as a viable and integral part of health care system.

"Medicine has long decried acupuncture, homeopathy, and the like as dangerous nonsense that preys on the gullible. Again and again, carefully controlled studies have shown alternative medicine to work no better than a placebo. But now many doctors admit that alternative medicine often seems to do a better job of making patients well, and at a much lower cost, than mainstream careand theyre trying to learn from it.

Rather than going ballistic when they hear that patients believe themselves to benefit under the care of alternative practitioners, argues the Mayo Clinics Victor Montori, doctors ought to be praising, or at the very least tolerating, alternative medicine for the way it plugs gaping holes in modern medicine. Who cares what the mechanism is? he says. The patient will be healthier.

In fact, a more open-minded consideration of alternative-medicine practices has become par for the course at medical schools. In recent years, the American Medical Student Association has co-sponsored an annual International Integrative Medicine Day..."

Source: The Triumph of New-Age Medicine, Atlantic Magazine, July/August 2011

Debate about complementary and alternative therapies has often been polarized, with advocates squaring off against critics and no common ground emerging. There are, in fact, some causes for concern. Many excessive claims are being made for alternative health practices, many therapies are lacking in plausibility, and some are being found to be potentially dangerous. But the field of complementary and alternative medicine is not monolithic.

Medicine has long decried acupuncture, homeopathy, and the like as dangerous nonsense that preys on the gullible. Again and again, carefully controlled studies have shown alternative medicine to work no better than a placebo. But now many doctors admit that alternative medicine often seems to do a better job of making patients well, and at a much lower cost, than mainstream careand theyre trying to learn from it.

The leading online directory for schools of Alternative Medicine.

The good news is that complementary and alternative medicine is on the rise and, with the right course of study, you may practice it in locations ranging from hospitals and integrative medicine clinics to healing centers and nutrition offices.

The Alternative Medicine College of Canada (AMCC) is an educational institution that offers accredited distance learning training in Naturopathy, Homeopathy, and Bioenergetics, providing students world-wide with the training and expertise necessary to become qualified specialists in their desired field.

Noninvasive in nature, focused on prevention and gaining ground among traditional health care providers, alternative medicine has found significant popularity among the masses.

The Program in Integrative Medicine's mission is to lead the transformation of healthcare by creating, educating, and actively supporting a community of professionals who embody the philosophy and practice of Integrative Medicine.

ACHS is recognized as an industry leader in holistic health education worldwide. Our flexible, online programs, highly qualified faculty, diverse student body, and commitment to exceptional online education make ACHS the perfect choice. Your education is legitimately accredited and recognized throughout the holistic medicine community.

The Barbara Brennan School of Healing is a specialized college for the study of hands-on energy healing and personal transformation. Students may choose to earn a Bachelor of Science Degree or a Diploma in Brennan Healing Science.

The Acupuncture diploma Program is a three-year program with 2900 hours of training including traditional Chinese medicine foundation, diagnostic methods, Tui Na massage, acupuncture, western biomedical science, Chinese herbal medicine, Chinese and western medicine clinical courses such as internal, pediatric, gynecological, dermatological illnesses, sports injury, muscularskeleton illnesses, and clinical observation and internship.

Complementary therapies such as acupuncture, Shiatsu and homeopathy were once viewed by the medical establishment as at best ineffective or, at worst, potentially harmful to public health. But seven years since the House of Lords produced its own authoritative analysis of complementary or alternative therapy - concluding that there needed to be clearer regulation arrangements by the various professional bodies - the incorporation of alternative medicine into mainstream healthcare has moved on apace.

Those who have an interest in medical and health professions may want to pursue a career in alternative medicine. Alternative medicine includes naturopathic medicine, complementary medicine, acupuncture, herbal therapy, aromatherapy, holistic medicine, and many more.

In general, health careers in the CAM field take a wholistic approach to patient care; that is, the patient is seen and treated as a whole person, not just a set of symptoms. They also tend to be strongly prevention-oriented and place a high value on the body's natural ability to heal itself.

In general, health careers in the CAM field take a wholistic approach to patient care; that is, the patient is seen and treated as a whole person, not just a set of symptoms. They also tend to be strongly prevention-oriented and place a high value on the body's natural ability to heal itself.

We are an education directory focusing on alternative and natural healing education, such as holistic medicine, Chinese medicine, massage, chiropratic, spiritual healing and related studies. Learn more about these professions at our career center.

Join the alternative medicine revolution. Earn your holistic certification from one of the many accredited alternative medicine/holistic health schools or legally accredited colleges and universities of naturopathy.

In early 2011, a fellow tennis player in Barrie, Caitlyn Lawrence, now a university student in South Carolina, asked me to participate in a career-related Q&A for a class project. I thought that some of the following would be useful to others considering a career in health care. - Ben Kim

Browse our comprehensive list of top alternative medicine and holistic health schools and find the right one for you. Find and compare massage schools, acupuncture schools, chiropractic schools, Chinese medicine schools and more. Our directory makes it easy to research schools and request information from admissions officers.

The evolutionary shift from conventional medicine oriented treatments to alternative medicine has changed the focus of health care as it provides natural and holistic healing methods. As the focus among general population is profoundly escalating towards alternative source of medicine, people are shifting from conventional surgery and medicine, which have already taken backstage in the world of medicines.

Pacific Rim College is a complementary and integrative medical college located on Vancouver Island in beautiful Victoria, British Columbia. The college was founded to provide world-class education, modern research opportunities and premiere clinical services in a variety of medical modalities.

Meet the man your doctor doesnt want you talking to - Dr. Joe Mercola. Hear about his alternative health practices and find out why hes such a controversial figure.

Alternative medicine and wellness is not accepted by everyone. There is, in fact, a great deal of skepticism and even charges of quackery about many of these fields. What needs to be remembered is that alternative medicine and wellness do not offer cures in the same way that traditional allopathic medicine does.

IT IS, you might suppose, always good to have an alternative. In medicine, though, that is a controversial proposition. Alternative and complementary medicine are mostly quackery. Yet they are very popular. Clearly, they have something that mainstream medicine does not. The question is, what?

According to his Guide to Complementary and Alternative Medicine, around 95% of the treatments he and his colleagues examinedin fields as diverse as acupuncture, herbal medicine, homeopathy and reflexologyare statistically indistinguishable from placebo treatments.

The biggest difference between Western medicine and alternative medicine is in the way each discipline views the body. While Western doctors and surgeons treat the body as a conglomeration of organs and systems, alternative medicine doctors look at the body, mind and spirit as a whole.

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Alternative Medicine - healthworldnet.com