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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 p ...
despite lacking 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 logica ...
,
repeatability Repeatability or test–retest reliability is the closeness of the agreement between the results of successive measurements of the same measure, when carried out under the same conditions of measurement. In other words, the measurements are taken ...
, 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, dieta ...
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 claim ...
. 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 Supernatural refers to phenomena or entities that are beyond the laws of nature. The term is derived from Medieval Latin , from Latin (above, beyond, or outside of) + (nature) Though the corollary term "nature", has had multiple meanings si ...
or
superstitious A superstition is any belief or practice considered by non-practitioners to be irrational or supernatural, attributed to fate or magic, perceived supernatural influence, or fear of that which is unknown. It is commonly applied to beliefs and p ...
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 me ...
to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable
evidence Evidence for a proposition is what supports this proposition. It is usually understood as an indication that the supported proposition is true. What role evidence plays and how it is conceived varies from field to field. In epistemology, evidenc ...
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 aff ...
- 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 bl ...
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, slow ...
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 c ...
, 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 Onl ...
", 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 pr ...
. 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 ...
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". 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 pr ...
, 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 Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients". The aim of EBM is to integrate the experience of the clinician, the values of t ...
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 p ...
, 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 me ...
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 Scientific evidence is evidence that serves to either support or counter a scientific theory or hypothesis, although scientists also use evidence in other ways, such as when applying theories to practical problems. "Discussions about empirica ...
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 ...
,
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 chemica ...
,
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 phys ...
,
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 population ...
, and other
natural science Natural science is one of the branches of science concerned with the description, understanding and prediction of natural phenomena, based on empirical evidence from observation and experimentation. Mechanisms such as peer review and repeata ...
s 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 prac ...
, 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 inadmi ...
,
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 A superstition is any belief or practice considered by non-practitioners to be irrational or supernatural, attributed to fate or magic, perceived supernatural influence, or fear of that which is unknown. It is commonly applied to beliefs and ...
, belief in
supernatural Supernatural refers to phenomena or entities that are beyond the laws of nature. The term is derived from Medieval Latin , from Latin (above, beyond, or outside of) + (nature) Though the corollary term "nature", has had multiple meanings si ...
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 claim ...
, errors in reasoning,
propaganda Propaganda is communication that is primarily used to influence or persuade an audience to further an agenda, which may not be objective and may be selectively presenting facts to encourage a particular synthesis or perception, or using loaded ...
,
fraud In law, fraud is intentional deception to secure unfair or unlawful gain, or to deprive a victim of a legal right. Fraud can violate civil law (e.g., a fraud victim may sue the fraud perpetrator to avoid the fraud or recover monetary compen ...
, 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 tak ...
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 ble ...
. 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 ...
, leading to the pejorative term " quackademic medicine". Due to its many names, the field has been criticized for intense
rebranding Rebranding is a marketing strategy in which a new name, term, symbol, design, concept or combination thereof is created for an established brand with the intention of developing a new, differentiated identity in the minds of consumers, investors ...
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 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 actio ...
,
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 repo ...
, Indigenous Medical Systems, Homeopathic Medicine,
Naturopathic Medicine 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 naturop ...
,
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 pseudosc ...
, 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 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 aff ...
. 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 Vaccinol ...
: "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 naturop ...
or
homeopathy Homeopathy or homoeopathy is a pseudoscientific system of alternative medicine. It was conceived in 1796 by the German physician Samuel Hahnemann. Its practitioners, called homeopaths, believe that a substance that causes symptoms of a dis ...
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 actio ...
(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 body ...
,
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 che ...
,
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 mo ...
,
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 ope ...
, 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 an ...
.
Herbal medicine 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 remedi ...
, 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 h ...
medicine: ''veritable'' which involves scientifically observable energy (including
magnet therapy Magnetic therapy is a pseudoscientific alternative medicine practice involving the weak static magnetic field produced by a permanent magnet which is placed on the body. It is similar to the alternative medicine practice of electromagnetic th ...
, 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 circadi ...
) 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 Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (su ...
. # "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 ...
, 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 cut, l ...
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 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 alt ...
. 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 In the fields of sociology and political science, authority is the legitimate power of a person or group over other people. In a civil state, ''authority'' is practiced in ways such a judicial branch or an executive branch of government.''The ...
of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (
cultural relativism Cultural relativism is the idea that a person's beliefs and practices should be understood based on that person's own culture. Proponents of cultural relativism also tend to argue that the norms and values of one culture should not be evaluated ...
), 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 ''The BMJ'' is a weekly peer-reviewed medical trade journal, published by the trade union the British Medical Association (BMA). ''The BMJ'' has editorial freedom from the BMA. It is one of the world's oldest general medical journals. Orig ...
(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 The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("m ...
, 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 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, MB ...
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 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, allege ...
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 t ...
(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 m ...
. According to a 2005 book by a US
Institute of Medicine The National Academy of Medicine (NAM), formerly called the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, En ...
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 systema ...
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 drug A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The r ...
s 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 ...
. 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, dieta ...
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 In statistics, a confounder (also confounding variable, confounding factor, extraneous determinant or lurking variable) is a variable that influences both the dependent variable and independent variable, causing a spurious association. Con ...
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 isolat ...
. 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 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 surgery. He is an ...
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 In statistics, regression toward the mean (also called reversion to the mean, and reversion to mediocrity) is the fact that if one sample of a random variable is extreme, the next sampling of the same random variable is likely to be closer to ...
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 Observer bias is one of the types of detection bias and is defined as any kind of systematic divergence from accurate facts during observation and the recording of data and information in studies. The definition can be further expanded upon to inclu ...
, 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 Ev ...
and Peter C. Gøtzsche 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 bias A cognitive bias is a systematic pattern of deviation from norm or rationality in judgment. Individuals create their own "subjective reality" from their perception of the input. An individual's construction of reality, not the objective input, ...
es 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 u ...
. 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 empha ...
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 Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among m ...
, 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 bl ...
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 immu ...
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 ...
can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative 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 agree ...
, access to essential medicines is severely restricted by lack of resources and
poverty Poverty is the state of having few material possessions or little . 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 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 (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to
child neglect A form of child abuse, child neglect is an act of caregivers (e.g., parents) that results in depriving a child of their basic needs, such as the failure to provide adequate supervision, health care, clothing, or housing, as well as other physica ...
and
abuse Abuse is the improper usage or treatment of a thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, crimes, or other t ...
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 ...
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" 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 remedi ...
(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-conscio ...
(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 visualiz ...
(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 Hypnotherapy is a type of mind–body intervention in which hypnosis is used to create a state of focused attention and increased suggestibility in the treatment of a medical or psychological disorder or concern. Popularized by 17th and 18th ce ...
,
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, Shiatsu,
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 repor ...
, 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-conscio ...
. 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 National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after ...
, 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 illness, termi ...
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 (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 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 ...
, 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 (unstat ...
'' 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 In microeconomic theory, the opportunity cost of a particular activity is the value or benefit given up by engaging in that activity, relative to engaging in an alternative activity. More effective it means if you chose one activity (for example ...
. 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. 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 Scientific evidence is evidence that serves to either support or counter a scientific theory or hypothesis, although scientists also use evidence in other ways, such as when applying theories to practical problems. "Discussions about empirica ...
, 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 ''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 bi ...
'' (''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 powe ...
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 a ...
, 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 (biology), function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medica ...
, and had shown little or no effect. Writers such as
Carl Sagan Carl Edward Sagan (; ; November 9, 1934December 20, 1996) was an American astronomer, planetary scientist, cosmologist, astrophysicist, astrobiologist, author, and science communicator. His best known scientific contribution is research on e ...
, 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' Moveme ...
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 Bu ...
founders of Scientific Review of Alternative Medicine 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 fra ...
, 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 A superstition is any belief or practice considered by non-practitioners to be irrational or supernatural, attributed to fate or magic, perceived supernatural influence, or fear of that which is unknown. It is commonly applied to beliefs and ...
, belief in
supernatural Supernatural refers to phenomena or entities that are beyond the laws of nature. The term is derived from Medieval Latin , from Latin (above, beyond, or outside of) + (nature) Though the corollary term "nature", has had multiple meanings si ...
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 claim ...
, 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, 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 p ...
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 Richard Dawkins (born 26 March 1941) is a British evolutionary biologist and author. He is an emeritus fellow of New College, Oxford and was Professor for Public Understanding of Science in the University of Oxford from 1995 to 2008. An ...
, 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 cov ...
'', 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 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 interests, financial or otherwise, and serving one interest could involve working against another. Typically, this relates to situations ...
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 Th ...
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 Allopathic medicine, or allopathy, is an archaic term used to define science-based modern medicine. Citing: ''Gale Encyclopedia of Medicine'' (2008) and ''Mosby's Medical Dictionary'', 8th ed. (2009). There are regional variations in usage of t ...
* 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 env ...
*
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. T ...
* 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 the ...
*
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

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HowStuffWorks 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, termino ...
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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 ...
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National Science Foundation The National Science Foundation (NSF) is an independent agency of the United States government that supports fundamental research and education in all the non-medical fields of science and engineering. Its medical counterpart is the National ...
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US Government The federal government of the United States (U.S. federal government or U.S. government) is the national government of the United States, a federal republic located primarily in North America, composed of 50 states, a city within a fed ...
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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 ...
, date= 2004-02-10 , access-date = 2008-03-03 , archive-url= https://web.archive.org/web/20080509100851/http://www.quackwatch.org/01QuackeryRelatedTopics/altwary.html , archive-date= 2008-05-09 , url-status= live
{{cite book , last= Saks, first= M. , editor-last= Saks , editor-first= M. , title= Alternative Medicine in Britain , year= 1992 , publisher= Clarendon Press , location= Oxford , isbn=978-0198272786 , pages=1–21 , chapter= Introduction {{cite journal , title= Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet , last1= Saper , first1= R.B. , last2= Phillips , first2= R.S. , last3= Sehgal , first3= A. , last4= Khouri , first4= N. , last5= Davis , first5= R.B. , last6= Paquin , first6= J. , last7= Thuppil , first7= V. , last8= Kales , first8= S.N. , journal= JAMA , year= 2008 , volume= 300 , issue= 8 , pages= 915–923 , doi= 10.1001/jama.300.8.915 , pmc= 2755247 , pmid= 18728265 , display-authors= 1 {{cite journal , last=Sarris , first= J. , title= Current challenges in appraising complementary medicine evidence , journal=
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 ...
, volume= 196 , issue= 5 , pages=310–311 , year= 2012 , pmid= 22432660 , doi= 10.5694/mja11.10751 , s2cid= 31044567 , url= https://www.mja.com.au/system/files/issues/sar10751_fm_0.pdf , archive-url=https://ghostarchive.org/archive/20221009/https://www.mja.com.au/system/files/issues/sar10751_fm_0.pdf , archive-date=2022-10-09 , url-status=live , doi-access= free
{{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 Stanford University School of Medicine is the medical school of Stanford University and is located in Stanford, California. It traces its roots to the Medical Department of the University of the Pacific, founded in San Francisco in 1858. Th ...
, 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 Cit ...
, 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 CBS News is the news division of the American television and radio service CBS. CBS News television programs include the ''CBS Evening News'', '' CBS Mornings'', news magazine programs '' CBS News Sunday Morning'', '' 60 Minutes'', and '' 48 ...
, 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 f ...
, 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 t ...
, 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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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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