Alternative medicine is any practice that aims to achieve the healing effects of
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
despite lacking
biological plausibility
In epidemiology and biomedicine, biological plausibility is the proposal of a causal association—a relationship between a putative cause and an outcome—that is consistent with existing biological and medical knowledge.
Biological plausibility ...
,
testability
Testability is a primary aspect of Science and the Scientific Method and is a property applying to an empirical hypothesis, involves two components:
#Falsifiability or defeasibility, which means that counterexamples to the hypothesis are logicall ...
,
repeatability, or evidence from
clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, diet ...
s. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine attempt to combine alternative practices with those of mainstream medicine. Alternative therapies share in common that they reside outside of medical science and instead rely on
pseudoscience
Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable clai ...
.
Traditional practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Frequently used derogatory terms for relevant practices are ''new age'' or ''pseudo-'' medicine, with little distinction from
quackery
Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, ...
.
Some alternative practices are based on theories that contradict the established science of how the human body works; others resort to the
supernatural or
superstitious to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive
risk-benefit outcome probability. Alternative medicine is distinct from scientific medicine, which employs the
scientific method
The scientific method is an empirical method for acquiring knowledge that has characterized the development of science since at least the 17th century (with notable practitioners in previous centuries; see the article history of scientific ...
to test plausible therapies by way of
responsible and ethical clinical trials, producing repeatable
evidence of either effect or of no effect. Research into alternative therapies often fails to follow proper research protocols (such as
placebo
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures.
In general, placebos can af ...
-
controlled trials,
blind experiments and calculation of
prior probability
In Bayesian statistical inference, a prior probability distribution, often simply called the prior, of an uncertain quantity is the probability distribution that would express one's beliefs about this quantity before some evidence is taken into ...
), providing invalid results.
Much of the perceived effect of an alternative practice arises from a belief that it will be effective (the
placebo effect
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures.
In general ...
), or from the treated condition resolving on its own (
the natural course of disease). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
or
HIV infection
Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ma ...
, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g.
cyanide poisoning
Cyanide poisoning is poisoning that results from exposure to any of a number of forms of cyanide. Early symptoms include headache, dizziness, fast heart rate, shortness of breath, and vomiting. This phase may then be followed by seizures, sl ...
from
amygdalin
Amygdalin (from Ancient Greek: ' "almond") is a naturally occurring chemical compound found in many plants, most notably in the seeds (kernels) of apricots, bitter almonds, apples, peaches, cherries, and plums.
Amygdalin is classified as a cy ...
, or the intentional ingestion of
hydrogen peroxide
Hydrogen peroxide is a chemical compound with the formula . In its pure form, it is a very pale blue liquid that is slightly more viscous than water. It is used as an oxidizer, bleaching agent, and antiseptic, usually as a dilute solution (3% ...
) or actively interfere with effective treatments.
The alternative medicine sector is a highly profitable industry with a strong lobby, and faces far less regulation over the use and marketing of unproven treatments. Its marketing often
advertises the treatments as being "natural" or "
holistic
Holism () is the idea that various systems (e.g. physical, biological, social) should be viewed as wholes, not merely as a collection of parts. The term "holism" was coined by Jan Smuts in his 1926 book '' Holism and Evolution''."holism, n." OED On ...
", in comparison to those offered by
medical science
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
. Billions of dollars have been spent studying alternative medicine, with few or no positive results. Some of the successful practices are only considered alternative under very specific definitions, such as those which include all
physical activity
Physical activity is defined as any voluntary bodily movement produced by skeletal muscles that requires energy expenditure.Global Recommendations on Physical Activity for Health, 2009. World Health Organization. Geneva, Switzerland. Accessed 13/ ...
under the umbrella of "alternative medicine".
Definitions and terminology
The terms ''alternative medicine'', ''complementary medicine'', ''integrative medicine,'' ''holistic medicine'', ''natural medicine'', ''unorthodox medicine'', ''fringe medicine'', ''unconventional medicine'', and ''
new age
New Age is a range of spiritual or religious practices and beliefs which rapidly grew in Western society during the early 1970s. Its highly eclectic and unsystematic structure makes a precise definition difficult. Although many scholars consi ...
medicine'' are used interchangeably as having the same meaning and are almost synonymous in most contexts.
Terminology has shifted over time, reflecting the preferred branding of practitioners.
[Gorski, David (August 15, 2011)]
"Integrative medicine": A brand, not a specialty
sciencebasedmedicine.org. (Retrieved March 25, 2022). For example, the
United States National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1 ...
department studying alternative medicine, currently named the
National Center for Complementary and Integrative Health
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
(NCCIH), was established as the ''Office of Alternative Medicine'' (OAM) and was renamed the ''National Center for Complementary and Alternative Medicine'' (NCCAM) before obtaining its current name. Therapies are often
framed as "natural" or "holistic", implicitly and intentionally suggesting that conventional medicine is "artificial" and "narrow in scope".
![Marcia](https://upload.wikimedia.org/wikipedia/commons/0/06/Marcia.angell.jpg)
The meaning of the term "alternative" in the expression "alternative medicine", is not that it is an effective alternative to
medical science
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.
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 do not work.
Alternative medicine
Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
, but whose
effectiveness
Effectiveness is the capability of producing a desired result or the ability to produce desired output. When something is deemed effective, it means it has an intended or expected outcome, or produces a deep, vivid impression.
Etymology
The ori ...
has not been established using
scientific method
The scientific method is an empirical method for acquiring knowledge that has characterized the development of science since at least the 17th century (with notable practitioners in previous centuries; see the article history of scientific ...
s,
or whose theory and practice is not part of
biomedicine
Biomedicine (also referred to as Western medicine, mainstream medicine or conventional medicine) , or whose theories or practices are directly contradicted by
scientific evidence or
scientific principles used in biomedicine.
"Biomedicine" or "medicine" is that part of medical science that applies principles of
biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
,
physiology
Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
,
molecular biology
Molecular biology is the branch of biology that seeks to understand the molecular basis of biological activity in and between cells, including biomolecular synthesis, modification, mechanisms, and interactions. The study of chemical and physi ...
,
biophysics
Biophysics is an interdisciplinary science that applies approaches and methods traditionally used in physics to study biological phenomena. Biophysics covers all scales of biological organization, from molecular to organismic and populations. ...
, and other
natural sciences to
clinical practice
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practice ...
, using scientific methods to establish the effectiveness of that practice. Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on
hearsay
Hearsay evidence, in a legal forum, is testimony from an under-oath witness who is reciting an out-of-court statement, the content of which is being offered to prove the truth of the matter asserted. In most courts, hearsay evidence is inadmiss ...
,
religion
Religion is usually defined as a social- cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatural, ...
, tradition,
superstition, belief in
supernatural energies,
pseudoscience
Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable clai ...
,
errors in reasoning,
propaganda,
fraud, or other unscientific sources.
Some other definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.
This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to
research funding
Research funding is a term generally covering any funding for scientific research, in the areas of natural science, technology, and social science. Different methods can be used to disburse funding, but the term often connotes funding obtained th ...
, sympathetic coverage in the
medical press, or inclusion in the standard
medical curriculum.
For example, a widely used definition devised by the
US NCCIH calls it ''"a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine"''.
However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training;
alternative medicine is taught in more than half of
US medical schools and
US health insurers are increasingly willing to provide reimbursement for alternative therapies.
Complementary or integrative medicine
Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with mainstream functional medical treatment in a
belief
A belief is an attitude that something is the case, or that some proposition is true. In epistemology, philosophers use the term "belief" to refer to attitudes about the world which can be either true or false. To believe something is to take ...
that it improves the effect of treatments.
For example,
acupuncture
Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientif ...
(piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time.
Instead, significant
drug interaction
Drug interactions occur when a drug's mechanism of action is disturbed by the concomitant administration of substances such as foods, beverages, or other drugs. The cause is often the inhibition of the specific receptors available to the drug, ...
s caused by alternative therapies may make treatments less effective, notably in
cancer therapy
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bl ...
.
Besides the usual issues with alternative medicine, integrative medicine has been described as an attempt to bring pseudoscience into academic
science-based medicine
''Science-Based Medicine'' is a website and blog with articles covering issues in science and medicine, especially medical scams and practices. Founded in 2008, it is owned and operated by the New England Skeptical Society and run by Steven N ...
,
leading to the pejorative term "
quackademic medicine". Due to its many names, the field has been criticized for intense
rebranding of what are essentially the same practices.
CAM is an abbreviation of the phrase ''complementary and alternative medicine''.
The 2019
World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries."
The Integrative Medicine Exam by the
American Board of Physician Specialties The American Board of Physician Specialties (ABPS), the official certifying body for the American Association of Physician Specialists (AAPS) is a non-profit umbrella organization for sixteen medical specialty boards that certifies and re-certifies ...
includes the following subjects:
Manual Therapies,
Biofield Therapies, Acupuncture, Movement Therapies, Expressive Arts,
Traditional Chinese Medicine
Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
,
Ayurveda
Ayurveda () is an alternative medicine system with historical roots in the Indian subcontinent. The theory and practice of Ayurveda is pseudoscientific. Ayurveda is heavily practiced in India and Nepal, where around 80% of the population rep ...
,
Indigenous Medical Systems,
Homeopathic Medicine,
Naturopathic Medicine,
Osteopathic Medicine
Osteopathy () is a type of alternative medicine that emphasizes physical manipulation of the body's muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths.
Osteopathic manipulation is the core set of techniques in ...
,
Chiropractic
Chiropractic is a form of alternative medicine concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially of the spine. It has esoteric origins and is based on several pseudosci ...
, and
Functional Medicine.
Other terms
Traditional medicine refers to the pre-scientific practices of a certain culture, in contrast to what is typically practiced in cultures where medical science dominates. The 2019 WHO report defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences
indigenous
Indigenous may refer to:
*Indigenous peoples
*Indigenous (ecology), presence in a region as the result of only natural processes, with no human intervention
*Indigenous (band), an American blues-rock band
*Indigenous (horse), a Hong Kong racehorse ...
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."
Holistic medicine is another rebranding of alternative medicine. In this case, the words ''balance'' and ''holism'' are often used alongside ''complementary'' or ''integrative'', claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine.
Challenges in defining alternative medicine
Prominent members of the science
and biomedical science community
say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all.
Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. 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. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.
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
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like saline), sham surgery, and other procedures.
In general, placebos can af ...
.
John Diamond wrote that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't",
a notion later echoed by Paul Offit
Paul Allan Offit (born March 27, 1951) is an American pediatrician specializing in infectious diseases, vaccines, immunology, and virology. He is the co-inventor of a rotavirus vaccine. Offit is the Maurice R. Hilleman Professor of Vaccinology, ...
: "The truth is there's no such thing as conventional or alternative or complementary or integrative or holistic medicine. There's only medicine that works and medicine that doesn't. And the best way to sort it out is by carefully evaluating scientific studies—not by visiting Internet chat rooms, reading magazine articles, or talking to friends."
Types
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. Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based. Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, 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. 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.
Unscientific belief systems
Alternative medicine, such as using naturopathy
Naturopathy, or naturopathic medicine, is a form of alternative medicine. A wide array of pseudoscientific practices branded as "natural", "non-invasive", or promoting "self-healing" are employed by its practitioners, who are known as natur ...
or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.
Traditional ethnic systems
Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine
Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of acti ...
(TCM), Ayurveda in India, or practices of other cultures around the world. 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.
Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work – such as knowing that the practice is based on superstition.
Supernatural energies
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.
Herbal remedies and other substances
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. Examples include healing claims for non-vitamin supplements, fish oil
Fish oil is oil derived from the tissues of oily fish. Fish oils contain the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), precursors of certain eicosanoids that are known to reduce inflammation in the b ...
, Omega-3 fatty acid
Omega−3 fatty acids, also called Omega-3 oils, ω−3 fatty acids or ''n''−3 fatty acids, are polyunsaturated fatty acids (PUFAs) characterized by the presence of a double bond, three atoms away from the terminal methyl group in their chem ...
, glucosamine
Glucosamine (C6H13NO5) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is part of the structure of two polysaccharides, chitosan and chitin. Glucosamine is one of the most ...
, echinacea
''Echinacea'' is a genus of herbaceous flowering plants in the daisy family. It has ten species, which are commonly called coneflowers. They are found only in eastern and central North America, where they grow in moist to dry prairies and open ...
, flaxseed oil, and ginseng
Ginseng () is the root of plants in the genus '' Panax'', such as Korean ginseng ('' P. ginseng''), South China ginseng ('' P. notoginseng''), and American ginseng ('' P. quinquefolius''), typically characterized by the presence of ginsenosides ...
. Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products. It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as "nutritional supplements". 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.
Religion, faith healing, and prayer
NCCIH classification
The US agency NCCIH
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
has created a 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
In physics, energy (from Ancient Greek: ἐνέργεια, ''enérgeia'', “activity”) is the quantitative property that is transferred to a body or to a physical system, recognizable in the performance of work and in the form of hea ...
medicine: ''veritable'' which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy
Light therapy, also called phototherapy or bright light therapy is intentional daily exposure to direct sunlight or similar-intensity artificial light in order to treat medical disorders, especially seasonal affective disorder (SAD) and circad ...
) and ''putative'', which invokes physically undetectable or unverifiable energy. None of these energies have any evidence to support that they affect the body in any positive or health promoting way.
# Whole medical systems: Cut across more than one of the other groups; examples include traditional Chinese medicine, naturopathy, homeopathy, and ayurveda.
# Mind-body interventions: Explore the interconnection between the mind, body, and spirit, under the premise that they affect "bodily functions and symptoms". A connection between mind and body is conventional medical fact, and this classification does not include therapies with proven function such as cognitive behavioral therapy.
# "Biology"-based practices: Use substances found in nature such as herbs, foods, vitamins, and other natural substances. (Note that as used here, "biology" does ''not'' refer to the science of biology
Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
, but is a usage newly coined by NCCIH in the primary source used for this article. "Biology-based" as coined by NCCIH may refer to chemicals from a nonbiological source, such as use of the poison lead
Lead is a chemical element with the symbol Pb (from the Latin ) and atomic number 82. It is a heavy metal that is denser than most common materials. Lead is soft and malleable, and also has a relatively low melting point. When freshly cu ...
in traditional Chinese medicine, and to other nonbiological substances.)
# Manipulative and body-based practices: feature manipulation or movement of body parts, such as is done in bodywork, chiropractic, and osteopathic manipulation.
# Energy medicine: is a domain that deals with putative and verifiable energy fields:
#* Biofield therapies are intended to influence energy fields that are purported to surround and penetrate the body. The existence of such energy fields have been disproven.
#* Bioelectromagnetic-based therapies use verifiable electromagnetic fields, such as pulsed fields, alternating-current, or direct-current fields in a non-scientific manner.
History
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. It includes the histories of complementary medicine
Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...
and of integrative medicine
Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alte ...
. 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. Until the 1970s, irregular practice became increasingly marginalized as quackery
Quackery, often synonymous with health fraud, is the promotion of fraudulent or ignorant medical practices. A quack is a "fraudulent or ignorant pretender to medical skill" or "a person who pretends, professionally or publicly, to have skill, ...
and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments. 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".[Quack Medicine: A History of Combating Health Fraud in Twentieth-Century America, Eric W. Boyle]
/ref>
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
New Age is a range of spiritual or religious practices and beliefs which rapidly grew in Western society during the early 1970s. Its highly eclectic and unsystematic structure makes a precise definition difficult. Although many scholars consid ...
of the 1970s. This was due to misleading mass marketing
Mass marketing is a marketing strategy in which a firm decides to ignore market segment differences and appeal the whole market with one offer or one strategy, which supports the idea of broadcasting a message that will reach the largest number o ...
of "alternative medicine" being an effective "alternative" to biomedicine, changing social attitudes about not using chemicals
A chemical substance is a form of matter having constant chemical composition and characteristic properties. Some references add that chemical substance cannot be separated into its constituent elements by physical separation methods, i.e., wit ...
and challenging the establishment
''The Establishment'' is a term used to describe a dominant group or elite that controls a polity or an organization. It may comprise a closed social group that selects its own members, or entrenched elite structures in specific institution ...
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 effect
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
s of science-based medicine. At the same time, in 1975, the American Medical Association
The American Medical Association (AMA) is a professional association and lobbying group of physicians and medical students. Founded in 1847, it is headquartered in Chicago, Illinois. Membership was approximately 240,000 in 2016.
The AMA's sta ...
, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation. 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. 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".
An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (1965–1999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals. Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health).
Medical education
Mainly as a result of reforms following the Flexner Report
The ''Flexner Report'' is a book-length landmark report of medical education in the United States and Canada, written by Abraham Flexner and published in 1910 under the aegis of the Carnegie Foundation. Many aspects of the present-day American m ...
of 1910 medical education in established medical schools
A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians. Such medical degrees include the Bachelor of Medicine, Bachelor of Surgery (MBBS, M ...
in the US has generally not included alternative medicine as a teaching topic. Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology. Medical schools' teaching includes such topics as doctor-patient communication, ethics, the art of medicine, and engaging in complex clinical reasoning (medical decision-making). 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
Pathophysiology ( physiopathology) – a convergence of pathology with physiology – is the study of the disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury. Pathology is th ...
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.
By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US. Exceptionally, the School of Medicine of the University of Maryland, Baltimore
The University of Maryland, Baltimore (UMB) is a public university in Baltimore, Maryland. Founded in 1807, it comprises some of the oldest professional schools of dentistry, law, medicine, pharmacy, social work and nursing in the United States ...
, includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration). 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). All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).
Efficacy
There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved. 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.
''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
The regression (or regressive) fallacy is an informal fallacy. It assumes that something has returned to normal because of corrective actions taken while it was abnormal. This fails to account for natural fluctuations. It is frequently a special ki ...
) 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.
Edzard Ernst
Edzard Ernst (born 30 January 1948) is a retired British-German academic physician and researcher specializing in the study of complementary and alternative medicine. He was Professor of Complementary Medicine at the University of Exeter, alleged ...
characterized the evidence for many alternative techniques as weak, nonexistent, or negative and in 2011 published his estimate that about 7.4% were based on "sound evidence", although he believes that may be an overestimate. Ernst has concluded that 95% of the alternative therapies 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.
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
A randomized controlled trial (or randomized control trial; RCT) is a form of scientific experiment used to control factors not under direct experimental control. Examples of RCTs are clinical trials that compare the effects of drugs, surgical te ...
(RCT), and 23% had been assessed with a meta-analysis
A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
. According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.
, the Cochrane Library
The Cochrane Library (named after Archie Cochrane) is a collection of databases in medicine and other healthcare specialties provided by Cochrane and other organizations. At its core is the collection of Cochrane Reviews, a database of system ...
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, 0.7% 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.
Alternative therapies do not "complement" (improve the effect of, or mitigate the side effects of) functional medical treatment.[ Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment by making prescription drugs less effective, such as interference by herbal preparations with ]warfarin
Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent st ...
.
In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, diet ...
s. 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.
Cancer researcher Andrew J. Vickers has stated:
Perceived mechanism of effect
Anything classified as alternative medicine by definition does not have a proven healing or medical effect. However, there are different mechanisms through which it can be perceived to "work". The common denominator of these mechanisms is that effects are mis-attributed to the alternative treatment.
Placebo effect
A placebo is a treatment with no intended therapeutic value. An example of a placebo is an inert pill, but it can include more dramatic interventions like sham surgery
Sham surgery (placebo surgery) is a faked surgical intervention that omits the step thought to be therapeutically necessary.
In clinical trials of surgical interventions, sham surgery is an important scientific control. This is because it isolate ...
. The ''placebo effect'' is the concept that patients will perceive an improvement after being treated with an inert treatment. The opposite of the placebo effect is the ''nocebo effect'', when patients who expect a treatment to be harmful will perceive harmful effects after taking it.
Placebos do not have a physical effect on diseases or improve overall outcomes, but patients may report improvements in subjective outcomes such as pain and nausea. A 1955 study suggested that a substantial part of a medicine's impact was due to the placebo effect.[ However, reassessments found the study to have flawed methodology.] This and other modern reviews suggest that other factors like natural recovery and reporting bias
In epidemiology, reporting bias is defined as "selective revealing or suppression of information" by subjects (for example about past medical history, smoking, sexual experiences). In artificial intelligence research, the term reporting bias is u ...
should also be considered.
All of these are reasons why alternative therapies may be credited for improving a patient's condition even though the objective effect is non-existent, or even harmful.[ ]David Gorski
David Henry Gorski is an American Surgical oncology, surgical oncologist, professor of surgery at Wayne State University School of Medicine, and a surgical oncologist at the Barbara Ann Karmanos Cancer Institute, specializing in Breast cancer#Sur ...
argues that alternative treatments should be treated as a placebo, rather than as medicine.[ Almost none have performed significantly better than a placebo in clinical trials.][ Furthermore, distrust of conventional medicine may lead to patients experiencing the nocebo effect when taking effective medication.]
Regression to the mean
A patient who receives an inert treatment may report improvements afterwards that it did not cause. Assuming it was the cause without evidence is an example of the regression fallacy. This may be due to a natural recovery from the illness, or a fluctuation in the symptoms of a long-term condition. The concept of regression toward the mean implies that an extreme result is more likely to be followed by a less extreme result.
Other factors
There are also reasons why a placebo treatment group may outperform a "no-treatment" group in a test which are not related to a patient's experience. These include patients reporting more favourable results than they really felt due to politeness or "experimental subordination", observer bias, and misleading wording of questions. In their 2010 systematic review of studies into placebos, Asbjørn Hróbjartsson
Asbjørn Hróbjartsson is a Danish medical researcher. He is Professor of Evidence-Based Medicine and Clinical Research Methodology at the University of Southern Denmark, as well as head of research at Odense University Hospital's Center for Evide ...
and Peter C. Gøtzsche
Peter Christian Gøtzsche (born 26 November 1949) is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark.
He is a co-founder of the Cochrane Collaboration and has writ ...
write that "even if there were no true effect of placebo, one would expect to record differences between placebo and no-treatment groups due to bias associated with lack of blinding."[ Alternative therapies may also be credited for perceived improvement through decreased use or effect of medical treatment, and therefore either decreased ]side effects
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
or nocebo effects towards standard treatment.
Use and regulation
Appeal
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.
In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe, cognitive biases that help maintain self-esteem and promote harmonious social functioning, and the '' post hoc, ergo propter hoc'' fallacy.
Marketing
Alternative medicine is a profitable industry with large media advertising expenditures. Accordingly, alternative practices are often portrayed positively and compared favorably to "big pharma".
The popularity of complementary & alternative medicine (CAM) may be related to other factors that Edzard Ernst mentioned in an interview in ''The Independent
''The Independent'' is a British online newspaper. It was established in 1986 as a national morning printed paper. Nicknamed the ''Indy'', it began as a broadsheet and changed to tabloid format in 2003. The last printed edition was publish ...
'':
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."[ Promoting alternative medicine has been called dangerous and ]unethical
Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong behavior".''Internet Encyclopedia of Philosophy'' The field of ethics, along with aesthetics, concerns ma ...
.
Social factors
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
Scientific literacy or science literacy encompasses written, numerical, and digital literacy as they pertain to understanding science, its methodology, observations, and theories. Scientific literacy is chiefly concerned with an understanding ...
among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism
Mysticism is popularly known as becoming one with God or the Absolute, but may refer to any kind of ecstasy or altered state of consciousness which is given a religious or spiritual meaning. It may also refer to the attainment of insight in ...
. Related to this are vigorous marketing
Marketing is the process of exploring, creating, and delivering value to meet the needs of a target market in terms of goods and services; potentially including selection of a target audience; selection of certain attributes or themes to emph ...
of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics. Alternative medicine is criticized for taking advantage of the least fortunate members of society.
There is also an increase in conspiracy theories
A conspiracy theory is an explanation for an event or situation that invokes a conspiracy by sinister and powerful groups, often political in motivation, when other explanations are more probable.Additional sources:
*
*
*
* The term has a nega ...
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. 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. Medical doctors are also aggressively marketing alternative medicine to profit from this market.
Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects
In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequence ...
of biomedical treatments. Treatments for severe diseases such as cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
and HIV
The human immunodeficiency viruses (HIV) are two species of ''Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the immune ...
infection have well-known, significant side-effects. Even low-risk medications such as antibiotics
An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...
can have potential to cause life-threatening anaphylactic
Anaphylaxis is a serious, potentially fatal allergic reaction and medical emergency that is rapid in onset and requires immediate medical attention regardless of use of emergency medication on site. It typically causes more than one of the follo ...
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 therapies to avoid the adverse effects of conventional treatments.
Prevalence of use
According to recent research, the increasing popularity of the CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.
In developing nations
A developing country is a sovereign state with a lesser developed industrial base and a lower Human Development Index (HDI) relative to other countries. However, this definition is not universally agreed upon. There is also no clear agreeme ...
, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.
In Latin America, inequities against BIPOC communities keep them tied to their traditional practices and therefore, it is often these communities that constitute the majority of users of alternative medicine. Racist attitudes towards certain communities disable them from accessing more urbanized modes of care. In a study that assessed access to care in rural communities of Latin America, it was found that discrimination is a huge barrier to the ability of citizens to access care; more specifically, women of Indigenous and African descent, and lower-income families were especially hurt. Such exclusion exacerbates the inequities that minorities in Latin America already face. Consistently excluded from many systems of westernized care for socioeconomic and other reasons, low-income communities of color often turn to traditional medicine for care as it has proved reliable to them across generations.
Some have proposed adopting a prize
A prize is an award to be given to a person or a group of people (such as sporting teams and organizations) to recognize and reward their actions and achievements. system to reward medical research. However, public funding for research exists. In the US increasing the funding for research on alternative medicine is the purpose of the US National Center for Complementary and Alternative Medicine
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
(NCCAM). NCCAM has spent more than US$2.5 billion on such research since 1992 and this research has not demonstrated the efficacy of alternative therapies. The NCCAM's sister organization in the NIC Office of Cancer Complementary and Alternative Medicine
The Office of Cancer Complementary and Alternative Medicine (OCCAM) is an office of the National Cancer Institute (NCI) in the Division of Cancer Treatment and Diagnosis. OCCAM was founded in 1998 and is responsible for NCI's research agenda in ...
gives grants of around $105 million every year. Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources.
That alternative medicine has been on the rise "in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and 'evidence-based' practice is the dominant paradigm" was described as an "enigma" in the ''Medical Journal of Australia
The ''Medical Journal of Australia'' is a peer-reviewed medical journal published 22 times a year. It is the official journal of the Australian Medical Association, published by Wiley on behalf of the Australasian Medical Publishing Company.
The ...
''. A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%.
In the United States
In the United States, the 1974 Child Abuse Prevention and Treatment Act The Child Abuse Prevention and Treatment Act (Public Law 93–247) of 1988 provides financial assistance for demonstration programs for the prevention, identification, and treatment of child abuse and neglect and to establish a National Center on Ch ...
(CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices. Thirty-one states have child-abuse religious exemptions.
The use of alternative medicine in the US has increased, with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America. According to a national survey conducted in 2002, "36 percent of U.S. adults aged 18 years and over use some form of complementary and alternative medicine." Americans spend many billions on the therapies annually. Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain. In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons". In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004. More than 70% of the hospitals offering CAM were in urban areas.
A survey of Americans found that 88 percent thought that "there are some good ways of treating sickness that medical science does not recognize". Use of magnets was the most common tool in energy medicine
Energy medicine is a branch of alternative medicine based on a pseudo-scientific belief that healers can channel "healing energy" into a patient and effect positive results. Practitioners use a number of names including various synonyms for m ...
in America, and among users of it, 58 percent described it as at least "sort of scientific", when it is not at all scientific. In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies. "Therapeutic touch
Therapeutic touch (commonly shortened to "TT"), known by some as "non-contact therapeutic touch" (NCTT), is a pseudoscientific energy therapy which practitioners claim promotes healing and reduces pain and anxiety. "Therapeutic Touch" is a regi ...
" was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.
Prevalence of use of specific therapies
The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism
Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern reme ...
(19%), breathing meditation (12%), meditation
Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
(8%), chiropractic medicine (8%), yoga
Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consci ...
(5–6%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and Visualization
Visualization or visualisation may refer to:
* Visualization (graphics), the physical or imagining creation of images, diagrams, or animations to communicate a message
* Data visualization, the graphic representation of data
* Information visuali ...
(2%)
In Britain, the most often used alternative therapies were Alexander technique, aromatherapy
Aromatherapy is based on the usage of aromatic materials including essential oils and other aroma compounds, with claims for improving psychological and physical well-being. It is offered as a complementary therapy or as a form of alternative ...
, Bach and other flower remedies, body work therapies including massage, Counseling stress therapies, hypnotherapy, meditation
Meditation is a practice in which an individual uses a technique – such as mindfulness, or focusing the mind on a particular object, thought, or activity – to train attention and awareness, and achieve a mentally clear and emotionally calm ...
, reflexology
Reflexology, also known as zone therapy, is an alternative medical practice involving the application of pressure to specific points on the feet, ears, and hands. This is done using thumb, finger, and hand massage techniques without the use of ...
, Shiatsu
''Shiatsu'' ( ; ) is a form of Japanese bodywork based on concepts in traditional Chinese medicine such as qi meridians. Having been popularized in the twentieth century by Tokujiro Namikoshi (1905–2000), ''shiatsu'' derives from the older ...
, Ayurvedic medicine
Ayurveda () is an alternative medicine system with historical roots in the Indian subcontinent. The theory and practice of Ayurveda is pseudoscientific. Ayurveda is heavily practiced in India and Nepal, where around 80% of the population rep ...
, nutritional medicine, and Yoga
Yoga (; sa, योग, lit=yoke' or 'union ) is a group of physical, mental, and spiritual practices or disciplines which originated in ancient India and aim to control (yoke) and still the mind, recognizing a detached witness-consci ...
. Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.
According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.
In palliative care
Complementary therapies are often used in palliative care
Palliative care (derived from the Latin root , or 'to cloak') is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Wit ...
or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. "From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable." The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to "reduce pain and concomitant mood disturbance and increase quality of life."
Regulation
The alternative medicine lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine. Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. In some cases, promotion of alternative therapies is allowed when there is demonstrably no effect, only a tradition of use. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them.
Regulation and licensing of alternative medicine ranges widely from country to country, and state to state. In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs,[ and half or more of the American alternative practitioners are licensed MDs.] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.
Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The U.S. Food and Drug Administration
The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
(FDA), has issued online warnings for consumers about medication health fraud. This includes a section on Alternative Medicine Fraud, such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.
Risks and problems
Negative outcomes
According to the Institute of Medicine, use of alternative medical techniques may result in several types of harm:
* "Economic harm, which results in monetary loss but presents no health hazard;"
* "Indirect harm, which results in a delay of appropriate treatment, or in unreasonable expectations that discourage patients and their families from accepting and dealing effectively with their medical conditions;"
* "Direct harm, which results in adverse patient outcome."
Interactions with conventional pharmaceuticals
Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems. An example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking "natural" potions to "build up her strength" before the operation, including a powerful anticoagulant that nearly caused her death.
To ''ABC Online'', MacLennan also gives another possible mechanism:
Side-effects
Conventional treatments are subjected to testing for undesired side-effects, whereas alternative therapies, in general, are not subjected to such testing at all. Any treatment – whether conventional or alternative – that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative therapies sometimes use the ''appeal to nature
An appeal to nature is an argument or rhetorical tactic in which it is proposed that "a thing is good ''because'' it is 'natural', or bad ''because'' it is 'unnatural. It is generally considered to be a bad argument because the implicit (unstate ...
'' fallacy, i.e., "That which is natural cannot be harmful." Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.
An exception to the normal thinking regarding side-effects is homeopathy. Since 1938, the FDA has regulated homeopathic products in "several significantly different ways from other drugs."[ Homeopathic preparations, termed "remedies", are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but "their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength", and their alcohol concentration may be much higher than allowed in conventional drugs.][
]
Treatment delay
Alternative medicine may discourage people from getting the best possible treatment.[ Those having experienced or perceived 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, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld
Scott O. Lilienfeld (December 23, 1960 – September 30, 2020) was a professor of psychology at Emory University and advocate for evidence-based treatments and methods within the field. He is known for his books '' 50 Great Myths of Popular Psy ...
in 2002, "unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments" and refers to this as opportunity cost. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative outcomes.[ Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.][
]
Unconventional cancer "cures"
There have always been "many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine
Biomedicine (also referred to as Western medicine, mainstream medicine or conventional medicine) . These alternative cancer cures have often been described as 'unproven,' suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown." However, "many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective.... The label 'unproven' is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been 'disproven'."[
Edzard Ernst has stated:
]
Rejection of science
Complementary and alternative medicine (CAM) is not as well researched as conventional medicine, which undergoes intense research before release to the public. Practitioners of science-based medicine also discard practices and treatments when they are shown ineffective, while alternative practitioners do not. Funding for research is also sparse making it difficult to do further research for effectiveness of CAM. Most funding for CAM is funded by government agencies. Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable. The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet. Even with the little research done on it, CAM has not been proven to be effective. Studies that have been done will be cited by CAM practitioners in an attempt to claim a basis in science. These studies tend to have a variety of problems, such as small samples, various biases, poor research design, lack of controls, negative results, etc. Even those with positive results can be better explained as resulting in false positives due to bias and noisy data
Noisy data are data that is corrupted, distorted, or has a low signal-to-noise ratio. Improper procedures (or improperly-documented procedures) to subtract out the noise in data can lead to a false sense of accuracy or false conclusions.
Noisy ...
.
Alternative medicine may lead to a false understanding of the body and of the process of science. Steven Novella
Steven Paul Novella (born July 29, 1964) is an American clinical neurologist and associate professor at Yale University School of Medicine. Novella is best known for his involvement in the skeptical movement as a host of '' The Skeptics' Guide ...
, 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." Marcia Angell
Marcia Angell (; born April 20, 1939) is an American physician, author, and the first woman to serve as editor-in-chief of the ''New England Journal of Medicine''. She is currently a Senior Lecturer in the Department of Global Health and Social M ...
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. It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position are George D. Lundberg, former editor of the '' Journal of the American Medical Association'' (''JAMA'') and the journal's interim editor-in-chief
An editor-in-chief (EIC), also known as lead editor or chief editor, is a publication's editorial leader who has final responsibility for its operations and policies.
The highest-ranking editor of a publication may also be titled editor, managing ...
Phil Fontanarosa.
Writing in 1999 in ''CA: A Cancer Journal for Clinicians'' Barrie R. Cassileth mentioned a 1997 letter to the US Senate
The United States Senate is the upper chamber of the United States Congress, with the House of Representatives being the lower chamber. Together they compose the national bicameral legislature of the United States.
The composition and po ...
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
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
(NIH).)
In March 2009, a staff writer for ''the Washington Post
''The Washington Post'' (also known as the ''Post'' and, informally, ''WaPo'') is an American daily newspaper published in Washington, D.C. It is the most widely circulated newspaper within the Washington metropolitan area and has a large nati ...
'' 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
Steven Lloyd Salzberg (born 1960) is an American computational biologist and computer scientist who is a Bloomberg Distinguished Professor of Biomedical Engineering, Computer Science, and Biostatistics at Johns Hopkins University, where he is als ...
, 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
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
, and had shown little or no effect.
Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism
Scientific skepticism or rational skepticism (also spelled scepticism), sometimes referred to as skeptical inquiry, is a position in which one questions the veracity of claims lacking empirical evidence. In practice, the term most commonly refe ...
and the author of '' The Demon-Haunted 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. Barrett has pointed out that there is a policy at the NIH of never saying something does not work, only that a different version or dose might give different results. 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.
Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson
Wallace Sampson (March 29, 1930 – May 25, 2015), also known as Wally, was an American medical doctor and consumer advocate against alternative medicine and other fraud schemes.Antiscience Trends in the Rise of the 'Alternative Medicine' Movem ...
and Paul Kurtz
Paul Kurtz (December 21, 1925 – October 20, 2012) was an American scientific skeptic and secular humanist. He has been called "the father of secular humanism". He was Professor Emeritus of Philosophy at the State University of New York at B ...
founders of Scientific Review of Alternative Medicine
The ''Scientific Review of Alternative Medicine'' is a discontinued peer-reviewed medical journal published by the Commission for Scientific Medicine and Mental Health. It was established by Wallace Sampson (Stanford University) and Paul Kurtz (Co ...
and Stephen Barrett
Stephen Joel Barrett (; born 1933) is an American retired psychiatrist, author, co-founder of the National Council Against Health Fraud (NCAHF), and the webmaster of Quackwatch. He runs a number of websites dealing with quackery and health frau ...
, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch
Quackwatch is a United States-based website, self-described as a "network of people" founded by Stephen Barrett, which aims to "combat health-related frauds, myths, fads, fallacies, and misconduct" and to focus on "quackery-related information th ...
. Grounds for opposing alternative medicine include that:
* It is usually based on religion
Religion is usually defined as a social- cultural system of designated behaviors and practices, morals, beliefs, worldviews, texts, sanctified places, prophecies, ethics, or organizations, that generally relates humanity to supernatural, ...
, tradition, superstition, belief in supernatural energies, pseudoscience
Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characterized by contradictory, exaggerated or unfalsifiable clai ...
, errors in reasoning, propaganda, or fraud.
* Alternative therapies typically lack any scientific validation, and their effectiveness is either unproved or disproved.
* Treatments are not part of the conventional, science-based healthcare system.
* Research on alternative medicine is frequently of low quality and methodologically flawed.
* Where alternative therapies have replaced conventional science-based medicine, even with the safest alternative medicines, failure to use or delay in using conventional science-based medicine has caused deaths.
* Methods may incorporate or base themselves on traditional medicine
Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
, folk knowledge
Traditional knowledge (TK), indigenous knowledge (IK) and local knowledge generally refer to knowledge systems embedded in the cultural traditions of regional, indigenous, or local communities. According to the World Intellectual Property Orga ...
, spiritual beliefs, ignorance or misunderstanding of scientific principles, errors in reasoning, or newly conceived approaches claiming to heal.
Many alternative medical treatments are not patent
A patent is a type of intellectual property that gives its owner the legal right to exclude others from making, using, or selling an invention for a limited period of time in exchange for publishing an enabling disclosure of the invention."A ...
able, which may lead to less research funding from the private sector. In addition, in most countries, alternative therapies (in contrast to pharmaceuticals) can be marketed without any proof of efficacy – also a disincentive for manufacturers to fund scientific research.
English evolutionary biologist Richard Dawkins, in his 2003 book ''A Devil's Chaplain
''A Devil's Chaplain: Reflections on Hope, Lies, Science, and Love'' is a 2003 book of selected essays and other writings by Richard Dawkins. Published five years after Dawkins's previous book ''Unweaving the Rainbow'', it contains essays cove ...
'', defined alternative medicine as a "set of practices that cannot be tested, refuse to be tested, or consistently fail tests." Dawkins argued that if a technique is demonstrated effective in properly performed trials then it ceases to be alternative and simply becomes medicine.
CAM is also often less regulated than conventional medicine. There are ethical concerns about whether people who perform CAM have the proper knowledge to treat patients. CAM is often done by non-physicians who do not operate with the same medical licensing laws which govern conventional medicine, and it is often described as an issue of non-maleficence.
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
Adolf Hitler (; 20 April 188930 April 1945) was an Austrian-born German politician who was dictator of Nazi Germany, Germany from 1933 until Death of Adolf Hitler, his death in 1945. Adolf Hitler's rise to power, He rose to power as the le ...
and Goebels
Paul Joseph Goebbels (; 29 October 1897 – 1 May 1945) was a German Nazi politician who was the ''Gauleiter'' (district leader) of Berlin, chief propagandist for the Nazi Party, and then Reich Minister of Propaganda from 1933 to 19 ...
in their promotion of pseudoscience in medicine.
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."
Conflicts of interest
Some commentators have said that special consideration must be given to the issue of conflicts of interest
A conflict of interest (COI) is a situation in which a person or organization is involved in multiple wikt:interest#Noun, interests, finance, financial or otherwise, and serving one interest could involve working against another. Typically, t ...
in alternative medicine. Edzard Ernst has said that most researchers into alternative medicine are at risk of "unidirectional bias" because of a generally uncritical belief in their chosen subject. Ernst cites as evidence the phenomenon whereby 100% of a sample of acupuncture trials originating in China had positive conclusions. David Gorski contrasts evidence-based medicine, in which researchers try to disprove hyphotheses, with what he says is the frequent practice in pseudoscience-based research, of striving to confirm pre-existing notions. Harriet Hall
Harriet A. Hall (born July 2, 1945) is a U.S. retired family physician, former U.S. Air Force flight surgeon and skeptic who writes about alternative medicine and quackery for ''Skeptic'' and ''Skeptical Inquirer''. She writes under the name T ...
writes that there is a contrast between the circumstances of alternative medicine practitioners and disinterested scientists: in the case of acupuncture, for example, an acupuncturist would have "a great deal to lose" if acupuncture were rejected by research; but the disinterested skeptic would not lose anything if its effects were confirmed; rather their change of mind would enhance their skeptical credentials.
Use of health and research resources
Research into alternative therapies has been criticized for "diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology." Research methods expert and author of ''Snake Oil Science'', R. Barker Bausell, has stated that "it's become politically correct to investigate nonsense." A commonly cited statistic is that the US National Institute of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
had spent $2.5 billion on investigating alternative therapies prior to 2009, with none being found to be effective.
See also
* Allopathic medicine
* Alternative therapies for developmental and learning disabilities
* Conservation medicine
Conservation medicine is an emerging, interdisciplinary field that studies the relationship between human and animal health and environmental conditions. It is also known as ecological medicine, environmental medicine, or medical geology.
The envi ...
* Ethnomedicine
Ethnomedicine is a study or comparison of the traditional medicine based on bioactive compounds in plants and animals and practiced by various ethnic groups, especially those with little access to western medicines, e.g., indigenous peoples. The ...
* Gallbladder flush
* Psychic surgery
An alleged psychic surgeon at work
Psychic surgery is a pseudoscientific medical fraud in which practitioners create the illusion of performing surgery with their bare hands and use sleight of hand, fake blood, and animal parts to convince t ...
* Siddha medicine
Siddha medicine is a form of traditional medicine originating in southern India. It is one of the oldest systems of medicine in India.
In rural India, have learned methods traditionally through master-disciple relationships to become loca ...
Notes
References
{{Reflist, 30em, refs=
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''Skeptical Inquirer'' is a bimonthly American general-audience magazine published by the Committee for Skeptical Inquiry (CSI) with the subtitle: ''The Magazine for Science and Reason''.
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HowStuffWorks is an American commercial infotainment website founded by professor and author Marshall Brain, to provide its target audience an insight into the way many things work. The site uses various media to explain complex concepts, termin ...
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The ''American Journal of Public Health'' is a monthly peer-reviewed public health journal published by the American Public Health Association that covers health policy and public health. The journal was established in 1911 and its stated miss ...
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The ''Journal of the Royal Society of Medicine'' is a peer-reviewed medical journal. It is the flagship journal of the Royal Society of Medicine with full editorial independence. Its continuous publication history dates back to 1809. Since July 20 ...
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The ''Journal of Medical Ethics'' is a monthly peer-reviewed academic journal covering the field of bioethics that was established in 1975. According to the ''Journal Citation Reports'', the journal has a 2019 impact factor of 2.021, ranking it fou ...
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''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers ''The Observer'' and ''The Guardian Weekly'', ''The Guardian'' is part of the Gu ...
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''The Journal of the American Medical Association'' (''JAMA'') is a peer-reviewed medical journal published 48 times a year by the American Medical Association. It publishes original research, reviews, and editorials covering all aspects of biom ...
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The ''Canadian Medical Association Journal'' (French ''Journal de l'Association Médicale Canadienne'') is a peer-reviewed general medical journal published by the Canadian Medical Association (CMA). It publishes original clinical research, anal ...
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[{{cite web , url=https://nccih.nih.gov/research/statistics/2007/camsurvey_fs1.htm , title=The Use of Complementary and Alternative Medicine in the United States , publisher=]National Center for Complementary and Integrative Health
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
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The ''Medical Journal of Australia'' is a peer-reviewed medical journal published 22 times a year. It is the official journal of the Australian Medical Association, published by Wiley on behalf of the Australasian Medical Publishing Company.
The ...
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[{{cite book , last1= Sarris , first1= J. , last2= Wardle , first2= J. , title= Clinical Naturopathy: An Evidence-based Guide to Practice , year= 2010 , publisher= Elsevier Health Sciences , isbn= 978-0729579261, display-authors= 1 ]
[{{Citation , last1=Shang , first1=Aijing , last2=Huwiler-Müntener , first2=Karin , last3=Nartey , first3=Linda , last4=Jüni , first4=Peter , last5=Dörig , first5=Stephan , last6=Sterne , first6=Jonathan AC , last7=Pewsner , first7=Daniel , last8=Egger , first8=Matthias , title=Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy , journal=The Lancet , volume=366 , pages=726–732 , year=2005 , doi=10.1016/S0140-6736(05)67177-2 , pmid=16125589 , issue=9487, s2cid=17939264 ]
[{{cite journal, title=Complementary and Alternative Healthcare in Israel, first1=Judith T., last1=Shuval, first2=Emma, last2=Averbuch, journal=Israel Journal of Health Policy Research, date=2012, volume=1, issue=7 , page=7, pmc=3424827, doi=10.1186/2045-4015-1-7, pmid=22913721]
[{{cite book , title= The Skeptics Dictionary , last= Carroll , first= R.T. , author-link= Robert Todd Carroll , chapter= complementary medicine , chapter-url= http://www.skepdic.com/compmed.html , date= 2011-05-14 , edition= Online , archive-url= https://web.archive.org/web/20130927214632/http://www.skepdic.com/compmed.html , archive-date= 2013-09-27 , title-link= The Skeptics Dictionary 2013-09-27.]
[{{cite journal , title= Integrative medicine: Bringing medicine back to its roots , last1= Snyderman , first1= R. , last2= Weil , first2= A.T. , s2cid= 46177131 , author-link= Ralph Snyderman , journal= JAMA Internal Medicine , volume= 162 , issue= 4 , pages= 395–397 , year= 2002 , pmid= 11863470 , doi= 10.1001/archinte.162.4.395 , display-authors= 1 ]
[{{cite book , last= Sobel , first= D.S. , chapter= Chapter 28: The Cost-effectiveness of Mind-body Medicine Interventions , volume= 122 , pages= 393–412 , year= 2000 , pmid= 10737073 , doi=10.1016/S0079-6123(08)62153-6 , isbn= 978-0444500496 , editor1-last= Mayer , editor1-first= E.A. , editor2-last= Saper , editor2-first= C.B. , title= The Biological Basis for Mind Body Interactions , series= Progress in Brain Research ]
[{{cite web , title= Stanford's medical curriculum , url= http://med.stanford.edu/md/curriculum/ , publisher= Stanford University School of Medicine , work= Stanford University website , archive-url= https://web.archive.org/web/20130509161924/http://med.stanford.edu/md/curriculum/ , archive-date= 2013-05-09 , url-status= dead , access-date= 2013-01-26 ]
[{{cite journal , first= I. , last= Stehlin , archive-url= https://web.archive.org/web/20071012070120/https://www.fda.gov/fdac/features/096_home.html , url= https://www.fda.gov/fdac/features/096_home.html , title= Homeopathy: Real medicine or empty promises? , journal= FDA Consumer Magazine , date=December 1996 , archive-date= 2007-10-12 ]
[{{cite episode , first= N. , last= Swan , title= Alternative Medicine – Part Three , date= 2000-10-02 , network= ]Australian Broadcasting Corporation
The Australian Broadcasting Corporation (ABC) is the national broadcaster of Australia. It is principally funded by direct grants from the Australian Government and is administered by a government-appointed board. The ABC is a publicly-own ...
, station= Radio National
Radio National, known on-air as RN, is an Australia-wide public service broadcasting radio network run by the Australian Broadcasting Corporation (ABC). From 1947 until 1985, the network was known as ABC Radio 2.
History
1937: Predecessors a ...
, url= http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s195441.htm , series =The Health Report , access-date = 2008-03-06 , archive-url= https://web.archive.org/web/20080306230537/http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s195441.htm, archive-date= 2008-03-06 , url-status= dead
[{{cite web , title= Cochrane CAM Field , publisher= Center for Integrative Medicine, School of Medicine, University of Maryland , work= University of Maryland website , url= http://www.compmed.umm.edu/cochrane.asp , archive-url= https://web.archive.org/web/20130928113542/http://www.compmed.umm.edu/cochrane.asp , archive-date= 2013-09-28 , url-status= dead ]
[{{cite web , title= Center for Integrative Medicine , url= http://www.compmed.umm.edu , work= University of Maryland website , publisher= University of Maryland School of Medicine , archive-url= https://web.archive.org/web/20100323121138/http://www.compmed.umm.edu/ , archive-date= 2010-03-23 , url-status= dead ]
[{{cite journal , url=http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf , archive-url=https://ghostarchive.org/archive/20221009/http://www.currentscience.ac.in/Downloads/article_id_090_01_0005_0006_0.pdf , archive-date=2022-10-09 , url-status=live , title=Ayurveda: Putting the house in order , department= Guest Editorial , last= Valiathan , first= M.S. , journal= ]Current Science
''Current Science'' is an English-language peer-reviewed multidisciplinary scientific journal. It was established in 1932 and is published by the Current Science Association along with the Indian Academy of Sciences. According to the ''Journal C ...
, year= 2006 , volume= 90 , issue= 1 , pages= 5–6
[{{cite journal , last1= Vickers , first1= A. , title= Alternative cancer cures: 'Unproven' or 'disproven'? , journal= CA – A Cancer Journal for Clinicians , volume= 54 , issue= 2 , pages= 110–118 , year= 2004 , pmid= 15061600 , doi= 10.3322/canjclin.54.2.110 , citeseerx= 10.1.1.521.2180 , s2cid= 35124492 ]
[{{cite web , last= Warner , first= J., url= http://www.cbsnews.com/stories/2006/07/20/health/webmd/main1823747.shtml , title= Alternative Medicine Goes Mainstream , publisher= CBS News , work= ]WebMD
WebMD is an American corporation known primarily as an online publisher of news and information pertaining to human health and well-being. The site includes information pertaining to drugs. It is one of the top healthcare websites.
It was fou ...
, date= 2006-07-20 , access-date= 2013-03-11 , archive-url= https://web.archive.org/web/20130928001238/http://www.cbsnews.com/stories/2006/07/20/health/webmd/main1823747.shtml , archive-date= 2013-09-28 , url-status= live
[{{cite journal , last= Weber , first= D.O. , title= Complementary and alternative medicine considering the alternatives , journal= Physician Executive , volume= 24 , issue= 6 , pages= 6–14 , year= 1998 , pmid= 10351720 ]
[{{cite web, url=http://www.webmd.com/balance/tc/complementary-medicine-alternative-medical-systems, website=WebMD, title=Complementary Medicine – Alternative Medical Systems, archive-url=https://web.archive.org/web/20150601195452/http://www.webmd.com/balance/tc/complementary-medicine-alternative-medical-systems, access-date=2015-06-04, archive-date=2015-06-01, date=2014-01-14, url-status=live]
[{{cite web , url=http://nccam.nih.gov/health/whatiscam/ , title=What is Complementary and Alternative Medicine (CAM)? , access-date=2006-07-11 , publisher=]National Center for Complementary and Alternative Medicine
The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine (CAM). It was initially created in 1991 as the Office of Alternative Medicine (OAM), ...
, archive-url=https://web.archive.org/web/20051208040402/http://nccam.nih.gov/health/whatiscam/ , archive-date=2005-12-08 , url-status=dead
[{{cite report , title=White House Commission on Complementary and Alternative Medicine Policy Final Report , author1=((White House Commission on Complementary and Alternative Medicine Policy Staff)) , author2=((Dept. of Health and Human Services Staff United States)) , chapter=Overview of CAM in the United States: Recent History, Current Status, And Prospects for the Future , isbn=978-0160514760 , publisher=US Government Printing Office , url=http://whccamp.hhs.gov/finalreport.html , date=March 2002 , chapter-url=http://whccamp.hhs.gov/fr2.html , url-status=dead , archive-url=https://web.archive.org/web/20130215040532/http://www.whccamp.hhs.gov/finalreport.html , archive-date=2013-02-15 Chapter ]
archived
2011-08-25.
[{{cite web, url=https://www.who.int/mediacentre/factsheets/fs134/en/ , title=Traditional medicine , access-date=2008-03-06 , year=2003 , issue=Fact sheet 134 , publisher=WHO , archive-url=https://web.archive.org/web/20080727053337/http://www.who.int/mediacentre/factsheets/fs134/en/ , archive-date=2008-07-27 , url-status=dead ]
[{{Cite journal , title= Traditional Medicines: Definitions , url=https://www.who.int/medicines/areas/traditional/definitions/en/index.html , journal= WHO Website , series= Medicines , access-date= 2012-11-11 , archive-url= https://web.archive.org/web/20130927045217/http://www.who.int/medicines/areas/traditional/definitions/en/index.html , archive-date= 2013-09-27 , url-status= live , author1= Xiaorui Zhang Extracted from {{harvnb, WHO, 2000.]
[{{cite journal, last1=Li , first1=B , last2=Forbes , first2=T. , last3=Byrne , first3=J. , title=Integrative medicine or infiltrative pseudoscience? , journal=The Surgeon , year= 2018 , volume= 16 , issue= 5 , pages= 271–277 , pmid=29305045 , doi=10.1016/j.surge.2017.12.002 , s2cid=19580427 , url=https://www.sciencedirect.com/science/article/abs/pii/S1479666X17301695?via%3Dihub , url-access=subscription]
[{{Cite journal , doi= 10.1525/sp.2005.52.1.38 , volume= 52 , issue= 1 , pages= 38–61 , last = Winnick, first = T.A., title = From quackery to "complementary" medicine: The American medical profession confronts alternative therapies , journal= ]Social Problems
A social issue is a problem that affects many people within a society. It is a group of common problems in present-day society and ones that many people strive to solve. It is often the consequence of factors extending beyond an individual's cont ...
, year= 2005 , jstor= 10.1525/sp.2005.52.1.38
{{cite book , first= T.A. , last= Winnick , year= 2009 , chapter= From Quackery to "Complementary" Medicine: The American Medical Profession Confronts Alternative Therapies , title= The Sociology of Health and Illness , edition= 8th , editor-first= P. , editor-last= Conrad , location= New York , publisher= Worth , pages= 261–277 , isbn= 978-1429205580
[{{cite web , title= Medical Student Education Program: Curriculum Overview , url= http://medicine.yale.edu/education/curriculum/curriculum/overview/index.aspx , work= Yale University website , publisher= ]Yale School of Medicine
The Yale School of Medicine is the graduate medical school at Yale University, a private research university in New Haven, Connecticut. It was founded in 1810 as the Medical Institution of Yale College and formally opened in 1813.
The primary te ...
, archive-url= https://web.archive.org/web/20131004214032/http://medicine.yale.edu/education/curriculum/curriculum/overview/index.aspx , archive-date= 2013-10-04 , url-status= dead
[{{cite journal , last1= Zollman , first1= C. , last2= Vickers , first2= A. , title= What is complementary medicine? , department= ABC of complementary medicine , doi= 10.1136/bmj.319.7211.693 , pmid= 10480829 , pmc= 1116545 , journal= BMJ , volume= 319 , issue= 7211 , pages= 693–696 , year= 1999 , ref= {{harvid, Zollman et al., 1999, display-authors= 1 ]
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Penguin Books is a British publishing house. It was co-founded in 1935 by Allen Lane with his brothers Richard and John, as a line of the publishers The Bodley Head, only becoming a separate company the following year.[Diamond
Diamond is a solid form of the element carbon with its atoms arranged in a crystal structure called diamond cubic. Another solid form of carbon known as graphite is the chemically stable form of carbon at room temperature and pressure, ...]
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* {{cite journal , author = Eisenberg DM , title = Advising patients who seek alternative medical therapies , journal = Annals of Internal Medicine , volume = 127 , issue = 1 , pages = 61–69 , date = July 1997 , pmid = 9214254 , doi = 10.7326/0003-4819-127-1-199707010-00010 , s2cid = 23351104
* {{cite journal , author = Gunn IP , title = A critique of Michael L. Millenson's book, ''Demanding Medical Excellence: Doctors and Accountability in the Information Age, and its Relevance to CRNAs and Nursing'' , journal = AANA Journal , issn=0094-6354 , volume = 66 , issue = 6 , pages = 575–582 , date = December 1998 , pmid = 10488264
* {{cite book , last=Hand , first= W.D. , year=1980 , chapter=Folk Magical Medicine and Symbolism in the West , title=Magical Medicine , location=Berkeley , publisher=University of California Press , pages=305–319 , isbn= 978-0520041295 , oclc=6420468
* {{cite book , author-link= Ivan Illich , last= Illich , first= I. , title= Limits to Medicine: Medical Nemesis: The Expropriation of Health , publisher= Penguin , year= 1976 , isbn= 978-0140220094 , oclc= 4134656 , url= https://archive.org/details/limitstomedicine00illi
* {{cite book , author= Mayo Clinic , title= Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine , location= Parsippany, New Jersey , publisher= Time
Time is the continued sequence of existence and events that occurs in an apparently irreversible succession from the past, through the present, into the future. It is a component quantity of various measurements used to sequence events, ...
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''Skeptical Inquirer'' is a bimonthly American general-audience magazine published by the Committee for Skeptical Inquiry (CSI) with the subtitle: ''The Magazine for Science and Reason''.
Mission statement and goals
Daniel Loxton, writing in 2 ...
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* {{cite book , last= Planer , first= F.E. , year= 1988 , title= Superstition , edition= Rev. , location= Buffalo, New York , publisher= Prometheus Books , isbn= 978-0879754945 , oclc= 18616238 , url-access= registration , url= https://archive.org/details/superstition0000plan
* {{cite web , url= http://www.cwru.edu/med/epidbio/mphp439/Sources_of_Healthcare.htm , last= Rosenfeld , first= A. , title= Where Do Americans Go for Healthcare? , publisher= Case Western Reserve University , location= Cleveland, Ohio , year= c. 2000 , access-date= 2010-09-23 , archive-url= https://web.archive.org/web/20060509074143/http://www.cwru.edu/med/epidbio/mphp439/Sources_of_Healthcare.htm , archive-date= 2006-05-09 , url-status= dead
* {{cite journal, last1=Snyder, first1=Mariah, last2=Lindquist, first2=Ruth, title=Issues in Complementary Therapies: How We Got to Where We Are, journal=Online Journal of Issues in Nursing, date=May 2001, volume=6, issue=2, page=1, url=http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No2May01/ComplementaryTherapiesIssues.aspx, pmid=11469921, access-date=2017-01-18, archive-url=https://web.archive.org/web/20170203005253/http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume62001/No2May01/ComplementaryTherapiesIssues.aspx, archive-date=2017-02-03, url-status=dead
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* {{cite book , last= Trivieri , first= L. Jr. , editor-last= Anderson , editor-first= J.W. , title= Alternative Medicine: The Definitive Guide , location= Berkeley , publisher= Ten Speed Press , year= 2002 , isbn= 978-1587611414 , url-access= registration , url= https://archive.org/details/isbn_9781587611414_0
* {{cite book , last1= Wisneski , first1= L.A. , last2= Anderson , first2= L. , title= The scientific basis of integrative medicine , publisher= CRC Press , year= 2005 , isbn= 978-0849320811 , display-authors= 1
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World Health Organization
* {{cite book , title= General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine , url= http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf , archive-url=https://ghostarchive.org/archive/20221009/http://whqlibdoc.who.int/hq/2000/WHO_EDM_TRM_2000.1.pdf , archive-date=2022-10-09 , url-status=live , volume= WHO/EDM/TRM/2001.1 , author= World Health Organization , author-mask=0 , year= 2000 , location= Geneva , publisher= World Health Organization (WHO) , quote= This document is not a formal publication of the WHO. The views expressed in documents by named authors are solely the responsibility of those authors. , ref= {{harvid, WHO, 2000
* {{cite book , title= WHO Guidelines on Basic Training and Safety in Chiropractic , url=https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf , archive-url=https://ghostarchive.org/archive/20221009/https://www.who.int/medicines/areas/traditional/Chiro-Guidelines.pdf , archive-date=2022-10-09 , url-status=live , author= World Health Organization , author-mask=0 , year= 2005 , location= Geneva , publisher= WHO , isbn= 978-9241593717 , ref= {{harvid, WHO, 2005
* {{cite book , title= WHO Global Atlas of Traditional, Complementary and Alternative Medicine , last1= WHO Kobe Centre , last2= Bodeker , first2= G. , last3= Ong , first3= C.K. , last4= Grundy , first4= C. , last5= Burford , first5= G. , last6= Shein , first6= K. , year= 2005 , publisher= WHO , isbn= 978-9241562867, display-authors=2 }
Summary.
Benchmarks for training in traditional / complementary and alternative medicine
Journals
* Alternative Therapies in Health and Medicine. Aliso Viejo, California : InnoVision Communications, c1995- NLM ID
9502013
{{Webarchive, url=https://web.archive.org/web/20180612163050/https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9502013&Search_Code=0359&CNT=20&SID=1 , date=2018-06-12
Alternative Medicine Review: A Journal of Clinical Therapeutics
Sandpoint, Idaho : Thorne Research, c. 1996 NLM ID
9705340
{{Webarchive, url=https://web.archive.org/web/20180612162326/https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9705340&Search_Code=0359&CNT=20&SID=1 , date=2018-06-12
BMC Complementary and Alternative Medicine
{{Webarchive, url=https://web.archive.org/web/20150924012324/http://www.biomedcentral.com/1472-6882 , date=2015-09-24 . London: BioMed Central, 2001 NLM ID
101088661
{{Webarchive, url=https://web.archive.org/web/20180612162549/https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=101088661&Search_Code=0359&CNT=20&SID=1 , date=2018-06-12
* Complementary Therapies in Medicine. Edinburgh; New York : Churchill Livingstone, c. 1993 NLM ID
9308777
{{Webarchive, url=https://web.archive.org/web/20180612162156/https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?DB=local&v2=1&ti=1,1&Search_Arg=9308777&Search_Code=0359&CNT=20&SID=1 , date=2018-06-12
Evidence Based Complementary and Alternative Medicine: eCAM
New York: Hindawi, c. 2004 NLM ID
101215021
{{Webarchive, url=https://web.archive.org/web/20180914013658/https://locatorplus.gov/cgi-bin/Pwebrecon.cgi?v1=1&ti=1,1&Search_Arg=Evidence%20Based%20Complementary%20and%20Alternative%20Medicine&Search_Code=TKEY&CNT=10&PID=fpUDGDBAnYWR-hE7tDjwdrxtvHm&SEQ=20130926044311&SID=2 , date=2018-09-14
Forschende Komplementärmedizin / Research in Complementary Medicine
Journal for Alternative and Complementary Medicine
New York : Mary Ann Liebert, c. 1995
{{Webarchive, url=https://web.archive.org/web/20100822070458/http://www.sram.org/index.html , date=2010-08-22
External links
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