Alternative medicine
Alternative medicine broadly describes diagnosis, treatment or therapy used in place of conventional medical treatments. See medicine for the general definition of what medicine is, as well as a list of "conventional" fields of medicine.Complementary medicine refers to using alternative treatments alongside conventional medical treatment. Integrative medicine essentially means the same thing as complementary medicine. Collectively, these variations on alternative medicine are often referred to as complementary and alternative medicine (or simply as CAM).
Some kinds of alternative medicine can be practiced by the individual without the need for working with an alternative medicine practitioner. Others need to be carried out though alternative medicine clinics, GPs or businesses which advertise such services. When the service is performed by a conventional physician it is called complementary or integrative medicine.
Legal jurisdictions differ as to which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a state health service. Some practitioners and branches of alternative medicine have been investigated by state or national agencies for health-related fraud (commonly known as quackery), and in a few cases criminal charges have been brought.
Regulation does not, however, say anything about the efficacy of the methods used.
The most often used branches of alternative medicine in the United States are (Eisenberg et al., 1998):
Diagnostic specialties of alternative medicine include:
Overview
Branches of alternative medicine
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Other branches of alternative/complementary medicine include:
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Many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been shown through double-blind randomized controlled trials. Where alternative methods provide temporary symptomatic relief, compared to no treatment, this is often ascribed to the placebo effect.
Criticisms of alternative medicine are complicated by the wide variety of alternative medical practices. Critics often dismiss the entire field of alternative medicine based on the failure of one particular method. This however also works the other way around - proponents of alternative medicine sometimes cite a single example of success with one technique attempting to prove that all alternative medicine is effective.
There is no strict definition as to what constitutes "conventional" or "mainstream" medicines. One possible definition is that "conventional medicine" is what is recognized as valid medicine by the majority of the scientific and the health community in the Western world, with standards of proof of efficiency based on double-blind studies and explanations as to the workings of drugs based on biology and biochemistry.
Some doctors have called for alternative therapies, particularly herbal medicines, to be regulated in the same way as conventional medicine. This would require these treatments to be proven safe and effective in scientific trials, a hurdle that these critics strongly believe would not be met; some herbal preparations, like ephedra, have been proven to be dangerous. Herbal preparations also vary in potency and may be contaminated.
It should also be noted that many if not most scientists feel that the very term "alternative medicine" is misleading, on the grounds that these treatments are not a true alternative to conventional medicine, which is tested thoroughly before sale. Practices terming themselves "alternative medicine" have caused deaths indirectly when patients have used it in attempts to treat such conditions as appendicitis and failed. Proponents of alternative medicine say that people should be free to choose whatever method of healthcare they want. Critics agree that people should be free to choose, but when choosing people must be certain that whatever method they choose will be safe and effective. People who choose alternative medicine think they are choosing a safe, effective medicine, while they may only be getting quack remedies.
Alternative medicine chafes at the restrictions of government agencies which approve medical treatments (such as the American Food and Drug Administration), and their adherence to these experimental evaluation methods, seeking to bring new ideas and methods to the public more rapidly. The mainstream medical community maintains that official oversight is needed to help prevent quackery (which unregulated medical practices will be more prone to, and is the reason for the heavy regulation of conventional medical practice). Some advocates of alternative medicine strongly protest that their contributions and discoveries are being unfairly dismissed, overlooked or suppressed. The alternative medicine industry argues that health fraud, when it comes up, should be dealt with appropriately.
The scientific community argues that many studies carried out by alternative medicine promoters are flawed, as they often use testimonials and hearsay as evidence, leaving the results open to observer bias. They argue that the only way to counter observer bias is to run a double blind experiment, where neither the patient nor the practitioner knows whether the real treatment is being given or if a placebo has been administered. This research should then be reviewed by peers to determine the validity of the research methodology. Testimonials are especially useless in this procedure, because by chance alone some people will get cured and will be able to testify that the method really helped them. Furthermore, if the majority of people using a method do not notice any benefit or even get worse, there will still be a minority that can testify that the method really helped for them.
Nonetheless, mainstream doctors and scientists are open to revising their views of any specific new treatment, if new peer-reviewed evidence comes available. A review of the effectiveness of certain alternative medicine techniques for cancer treatment (Vickers 2004), notes that several studies have found evidence that the psychosocial treatment of patients by psychologists is linked to survival advantages, but comments that these results are not consistently replicated. The same review also cites studies indicating that several complementary therapies can provide health benefits by affecting cancer-related symptoms, for example, by reducing pain and improving the mood of patients.
Some argue that less research is carried out on alternative medicine because some alternative medicine techniques cannot be patented, and hence there is less of a financial incentive to study them. Drug research, by contrast, can be very lucrative, which has resulted in funding of trials by pharmaceutical companies. Many people, including conventional and alternative medical practitioners, point out that this funding has led to corruption of the scientific process for approval of drug usage, and that ghostwritten work has appeared in major peer-reviewed medical journals. (Flanagin et al. 1998, Larkin 1999).
Edzard Ernst wrote in the Medical Journal of Australia that "about half the general population in developed countries [use] complementary and alternative medicine (CAM)" (Ernst 2003), and it is certainly true that physicians that are subject to disciplinary actions of state licensing boards do offer alternative medicine services to their patients.
Increasing numbers of medical colleges have begun offering training courses in alternative medicine. For example, the University of Arizona College of Medicine offers a program in Integrative Medicine under the leadership of Dr. Andrew Weil which trains physicians in various branches of alternative medicine which "neither rejects conventional medicine, nor embraces alternative practices uncritically."
There is a concern among conventional medical practitioners that patients may delay seeking conventional medicine that could be more effective, whilst they undergo alternative therapies, potentially resulting in harm.
Alternative medicine may provide some health benefits through patient empowerment, by offering more choices to the public, including treatments that are simply not available in conventional medicine. Any positive effects that such alternative medicine treatments offer, even if they are only based on placebo effects, still provide benefits to overall patient health that traditional medicine might not have provided.
Criticism and Support and for alternative medicine
Criticisms
Regulation
Testing and studies
Support
Advocates of alternative medicine point to a number of different general arguments that tend to support the validity of using alternative methods of treatment to treat specific medical conditions.
Additionally, some who have no trust in the validity of certain alternative medicines with no side effects support their use for benign illnesses; the argument is that patients would otherwise seek treatments with actual effects, including side effects.Contemporary use of alternative medicine
Issues of regulation
In countries where healthcare is state-funded or funded by medical insurance, alternative therapies are often not covered, and must be paid for by the patient. Further, in some countries, some branches of alternative medicine are not properly regulated. So there is no governmental control on who practices, and no real way of knowing what training or expertise they possess in these countries.Other issues related to alternative medicine
A point often overlooked by some critics of alternative medicine is that their criticisms need not apply to all the different branches -- it is not valid to lump them all together. When exploring the individual branches of alternative medicine six questions need to be answered. The answers to these question will reveal whether or not each branch of alternative medicine is mostly quackery or something that the public should seriously consider using.
Several health research authors have voiced criticisms of evidence-based medicine (Tonelli 2001, Downing 2003), in effect supporting the value of eclectic branches of alternative medicine which place great value upon the clinical experience of the practitioner.References
Dictionary definitions
Journals dedicated to alternative medicine research
Research articles cited in the text
Other works that discuss alternative medicine
External links
General information about alternative medicine
Advocacy of alternative medicine
Critiques of alternative medicine