COMPLEMENTARY ALTERNATIVE

MEDICINE(CAM)

ALTERNATIVE MEDICINE VERSUS CONVENTIONAL

SUMMARY :

Conventional vs. Alternative Medicine........................................................................................................4

Alternative medicine : A comparison...........................................................................................................5

The Benefits Of Alternative Medicine Over Conventional Medicine...........................................................7

Alternative vs Conventional Medicine: Which Is Better?.............................................................................9

Conventional Vs Alternative Medicine Explained......................................................................................10

What Is the Difference Between Conventional and Alternative Medicine?..............................................12

Is Alternative Medication Better Than Conventional Medicine?...............................................................12

Conventional or alternative medicine? That is the question: whether in poor health to live or whole body radiance to achieve...................................................................................................................................13

Getting the Treatment Right: Conventional and Alternative Medicine.................................................22

Deaths caused by conventional medicine.................................................................................................24

Complementary Versus Alternative.......................................................................................................25

Integrative Medicine.............................................................................................................................25

Health need and the use of alternative medicine among adults who do not use conventional medicine.26

Abstract.............................................................................................................................................26

Background....................................................................................................................................26

Methods........................................................................................................................................27

Results...........................................................................................................................................27

Conclusions....................................................................................................................................27

Background........................................................................................................................................27

Methods............................................................................................................................................29

Study Population...........................................................................................................................29

Dependent Variable.......................................................................................................................30

Independent Variables...................................................................................................................30

Statistical Analyses.........................................................................................................................31

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Results...............................................................................................................................................34

Characteristics of Those Who Did Not Report the Use of Conventional Care................................34

Characteristics of Those Who Did Not Report the Use of Conventional Care But Did Use Some Form of Alternative Medicine........................................................................................................34

External Environment....................................................................................................................34

Predisposing Factors......................................................................................................................35

Enabling Factors.............................................................................................................................35

Barriers to Conventional Care........................................................................................................35

Health Need Factors......................................................................................................................35

Personal Health Practices..............................................................................................................35

Health Need Measures and the Use of Alternative Medicine........................................................35

Barriers to Using Conventional Care in Those Who Used Only Alternative Medicine....................36

Reasons People Use Alternative Medicine....................................................................................37

Types of Alternative Medicine Therapies Used.............................................................................37

Discussion..........................................................................................................................................38

Conclusion.........................................................................................................................................41

What are the main differences between complementary and alternative medicine and conventional medicine?..................................................................................................................................................42

Complementary and alternative medicine:...........................................................................................43

Conventional medicine:.........................................................................................................................43

What’s similar?......................................................................................................................................43

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Conventional Medicine Better With Complementary Alternative Medicine?

“Complementary and alternative medicine,” “complementary medicine,” “alternative medicine,” “integrative medicine”—we have all seen these terms on the Internet and in marketing, but what do they really mean? While the terms are often used to mean the array of health care approaches with a history of use or origins outside of mainstream medicine, they are actually hard to define and may mean different things to different people. This fact sheet looks into these terms to help you understand them better, and gives you a brief picture of NCCAM’s mission and role in this area of research.

Conventional vs. Alternative MedicineBy Dr. Jon Cat

Conventional Western medicine is organized around the Theory of Diseases, which believes that a person becomes sick because he or she contracts a disease. In this model, each disease is seen as an independent entity which can be fully understood without regard to the person it afflicts or the environment in which it occurs. Conventional treatments are treatments of diseases, not of people. Most of the drugs employed in conventional medicine are designed to act as chemical strait jackets, preventing the cells of the body from performing some function that has become hyperactive. The side effects of these drugs are a direct extension of their actions and may be fatal. A Harvard research team concluded that 180,000 Americans are killed in hospitals by their doctors every year.(1) Most of these deaths occur because doctors prescribe drugs without paying attention to the special characteristics of the person for whom the drugs are prescribed.

Alternative Medical Systems, Ancient and Modern

Alternative systems of healing supply a perspective that can help to reverse the "one size fits all" philosophy of conventional medical practice. All alternative systems of healing, ancient or modern, share one common characteristic which separates them from conventional Western medicine. They all approach sickness as a dynamic event in the life of an individual, a problem of balance and relationship, the result of disharmony between the sick person and his or her environment. This approach to understanding illness is called biographical.

In the biographical concept of illness, the "disease" itself has no independent reality. The healer's job is not to identify and treat the disease entity, but to characterize the disharmony of each particular case, so that they can be corrected. These disharmonies are described differently in different cultures.

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The language which describes them may be magical or naturalistic, but the diagnostic and therapeutic focus is always on the person who is ill and the context in which the illness occurs, rather than on the disease itself.

Integrated Medicine perceives illness biographically and at the same time uses the powerful database of modern biological and behavioral science to help describe the varied disharmonies which undermine the health of each individual.

These disturbances originate, almost entirely, with dietary, environmental or social conditions. Although the media are full of stories about "cancer genes", for example, the scientific evidence is that greater than 90% of cancers are environmentally induced. When identical twins are reared in separate environments, the rate at which each twin develops cancer is comparable to the cancer rate in the adoptive family, not the biological family. The publicity accorded to "cancer genes" serves to cripple individual initiatives at cancer prevention and to displace scrutiny from cancer's environmental and dietary triggers. Integrated Medicine exists to empower you to improve your health by improving your four pillars of healing: interpersonal relationships, diet, environment, and your innate system of detoxification and repair.

Alternative medicine : A comparisonTwo systems of medicine are available in the USA: Conventional Western (Allopathic) Medicine and Alternative or Complementary Medicine. Conventional medicine is comprised of drugs that suppress the body's natural immune responses. It is the world of the American Medical Association (AMA) which is aligned with the multibillion dollar pharmaceutical industry. There is no better medicine when it comes to surgery, emergency and trauma.

But there is no question that Alternative Medicine, which is more cost effective over the long term, works better for just about everything else, especially for diseases like cancer, heart disease, rheumatoid arthritis, asthma, gastrointestinal disorders, headaches, sinusitis, etc. Alternative methods work by assisting your body to heal itself instead of introducing strong drugs. They emphasize prevention and attack causes rather than symptoms. The Chinese have a saying about the wisdom of "walking on both feet," which means using the best of both Eastern and Western procedures. Many alternative doctors do just that.

Experience shows that you're likely to get the best results with a practitioner who has trained in a number of different modalities. There may be many underlying factors influencing your health -- poor digestion, nutritional deficiency, toxicity, emotional stress, etc. You want someone who is capable of determining exactly what must be done to help you regain your health. Many alternative practitioners use high-tech, scientific diagnostic tools to pinpoint imbalances or underlying problems in major organs. Through a thorough line of questioning, they determine the probable cause and work with you toward a cure.

You also want someone who listens and is open-minded and who treats you as an individual. What's good for Dave is not necessarily good for Marie. You are biochemically unique and you deserve to be treated as such. Your health--your very life--depends on it.

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For example, the conventional doctor who has 20 patients with asthma will often provide each of them with the same protocol, thus treating the condition and not the patients themselves. An alternative practitioner realizes that asthma has many causes. Perhaps the cause is an allergic reaction or a viral infection or diminished nerve supply due to a misaligned spine. The practitioner will try to find the cause for each patient's condition and treat each differently. This difference between approaches is the cornerstone of alternative medicine.

The purpose of AltMedAngel is to help you educate yourself about alternative health care. The success of a treatment or protocol depends on an informed patient as well as a knowledgeable practitioner. Learn to use health practitioners as educators in an ongoing process and be aware that your doctor may also learn something from you. Remember, almost everything is reversible. You only need to find the right therapies.

Why Don't More Doctors Use Alternative Medicine?You may wonder why these methods are not being used by more doctors. Although they are being used by many, too many mainstream doctors today become so specialized that they treat the body parts and forget they are treating the whole body. This is fine for surgery, emergency or trauma but not for perpetuating good health.

1. One reason for this specialization is that medical schools are organized into organ-specific departments with no common link between them. Although disease usually appears as a local symptom, it is always related to the entire system. So you must treat the whole person to cure the disease, otherwise you are just treating the symptom. The medical school department heads ignore or deride this idea to defend their own orthodox concepts.

2. It takes time for new ideas to be accepted. In the 1800s, a Viennese doctor suggested that his colleagues wash their hands after they finish working on cadavers, instead of using their unwashed hands to deliver babies. After 30 years of ridicule and debate this idea finally caught on. How many babies died waiting for this idea to be accepted? How many cancer, heart and AIDS patients are dying today for the same reason?

Many doctors today are refusing to accept the common sense truths that have existed for centuries. The "cut, burn and poison" mentality of fighting the war on disease that exists today, completely ignores the importance of the immune system. In fact, it often weakens an immune system that is already under assault.

The important truth that is ignored is--it is not the doctors job to fight the war on disease. It is the patient's own immune system that must win that war. The doctor's job is to help the immune system and provide the tools with which it can fight. Since this is not being done in the U.S., American doctors are winning many battles but losing many wars. The majority of cancer patients who are given a "clean bill of health" die within five years. No attention is being paid to the immune system because this area is out of the realm of drugs and modern medicine.

3. Also one of the most powerful industries in America, the pharmaceutical industry, provides a huge amount of funding for the medical schools with the intent of marketing their medicines. There is a great deal of pressure from this industry to keep alternative methods from being

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taught. However, due to popular demand, some alternatives are now offered as electives. It's a small step--but it's a step in the right direction. Perhaps, 30 years from now, we may be living in a new era when we look back with great disgust at the many lives unnecessarily lost at the hands of conventional medicine.

4. Why don't we hear more about natural medicine from the news media? We are hearing more and more from the news media every day. But have you ever counted the pharmaceutical advertisements during a typical one hour program --especially if it's a movie where one of the characters has a specific health problem? How many drug ads do you think you would see during an expose of the drug industry or a show on the benefits of alternative medicine? The news media, like everyone else, is in the business of making money. Much of those revenues come in the form of advertising dollars. The pharmaceutical giants spend dearly on advertising.

5. Young doctors leaving medical school find themselves in a system that rewards "rescue medicine." That is what they are taught. There is no reward, and there may well be scorn from fellow doctors, for those who take the time to prevent illness or correct the deficiencies that may cause it. To do so would hurt the pocketbook of the medical establishment. Medical insurance supports this view. Financial rewards follow only from sticking to the model of ill-health and treatment. As educated consumers, we need to be keenly aware of the politics of conventional medical care.

6. Malpractice is another great fear for doctors. The definition of malpractice is not whether the treatment is good or bad for the patient, but rather if the practice in question is what other doctors in the given locality normally do or prescribe. Did you ever wonder why some therapies are only available in certain localities or why you may have to travel to a big city for a particular treatment?

7. We, the public, need to change our attitudes toward the "practice" of medicine. It's not about "medicine" or treating bad health. It's about producing good health. Drugs won't get you there and most of the time they will set you back by suppressing a symptom that is pointing to the real problem.  Instead of treating the symptom, treat the cause. The symptom will then disappear. Only then will you experience a true cure.

The Benefits Of Alternative Medicine Over Conventional MedicineAlternative medicines are becoming very popular these days as they provide for more benefits over the conventional medicines. Basically these alternative medicines have no side effects on the body and hence they are considered to be great choices for treating various kinds of ailments. The alternative medicines and information related to the same is easily available these days. Through this information and new researches you can get to learn more about the new medicines developed.

Most of the times, people using these alternative medicines have been able to get treatment for

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some of the worst diseases, but in a non conventional manner. There are plenty of new institutes which are offering course for studying these alternative medicines. Hence there is an emergence of a new set of physicians and doctors who use these alternative medicines to treat various kinds of health problems. The alternative medicines are considered to be safer options in many instances for curing problems of the mind and the body.

The term alternative medicines have also been used to define complementary and Alternative Medicine or CAM, which are ideal for getting rid of a lot of conventional health problems. These medicines use the alternate or substitute of the conventional medicines and thus treat various kinds of health problems. It should be remembered that these alternative medicines are not the substitutes for regular medicines. Most of the times, they work out to be a great form of treatment for curing diseases of the body and mind.

It has been seen that these complimentary alternative medicines are very different from the substitute medicines. These alternative medicines have no side effects and as per the medicine statistics, they don't contain chemicals and drugs at all. These are followed by many registered medical practitioners like doctors, nurses and therapists. They can be used alone or in combination with conventional practices. Most therapists prescribe alternate medicines, which deviate from the regular modes of practicing.

These alternative medicines are given in accordance with the system of medical education they have gone through. The alternate medicine practices and products are used with the sole intention of treating a patient, especially for those patients who had been unable to gain from the conventional treatments provided to them. The regular practices and products of alternative medicines deviate from the regular methods of standard care.

The commonly used forms of alternative medicinal therapies include aromatherapy, acupuncture or herbal medicines, which are safe and effective and have been practiced for ages in the ancient systems. These alternative or complimentary medicines are used as alternatives in place of the regular norms of medicines. These also include the options of both homeopathic or ayurvedic medicines as they are a great alternative to the conventional medicines.

Most of these alternative medicines can be consumed along with the regular medicines and they are also being considered as a replacement for conventional medicines. There are many institutes and doctors who keep a track of all these medicines and prescribe the medicines that have been successful in treating various kinds of health problems and diseases. These alternative medicines are clearly getting an upper edge over the conventional forms of medicine.

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Alternative vs Conventional Medicine: Which Is Better? Alternative Medicine:

Why don't people use alternative medicine more often (e.g., herbal, acupuncture, meditation, energy healing)?

As a Founding Member of the American Holistic Medical Association, which started in the 1970's, I have long been interested in Alternative medical treatments. We tried everything from Acupuncture to Biofeedback, and found certain success with many alternative treatments. We even tried doing a Cesarian Section with acupuncture. Unfortunately, we had to supplement with general anesthesia. While it is true certain hospitals in China use acupuncture for anesthesia, 99% of surgeries there are done with conventional methods.

Several years ago there was a company who was advertising a product for relief of hot flashes using natural ingredients in an Australian Medical Journal. The editor of the journal advised them that to be able to continue to advertise there, they would have to prove that their product worked.

They had it scientifically tested and it did not even work as well as a placebo, so the ad was pulled.

The company then advertised their product in a major medical publication in the US with the caveat, "This is the only natural product for hot flashes THAT HAS BEEN SCIENTIFICALLY TESTED."

While claims that your aunt Tilly lost weight during pregnancy by spitting might have worked for Tilly, it cannot be duplicated. (By the way, I actually heard this while getting my hair cut). That is what a double blind study is for - to assess the scientific validity that the results can be duplicated without bias. Many people exaggerate their claims; just because someone says it does not make it true.

But today more medical schools are teaching Integrative Medicine, realizing there is a definite place for alternative therapies.

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

The principles of integrative medicine:

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A partnership between patient and practitioner in the healing process - (this is important and often overlooked by physicians - that is, what does the patient want? And for the patient, awareness that he/she is responsible for health also).

Appropriate use of conventional and alternative methods to facilitate the body's innate healing response - as I have said before, the body is a tremendous machine.

Consideration of all factors that influence health, wellness and disease, including mind, spirit and community as well as body.

A philosophy that neither rejects conventional medicine nor accepts alternative therapies uncritically.

Recognition that good medicine should be based in good science, be inquiry driven, and be open to new paradigms.

Use of natural, effective, less-invasive interventions whenever possible. Use of the broader concepts of promotion of health and the prevention of illness as well

as the treatment of disease. Training of practitioners to be models of health and healing, committed to the process of

self-exploration and self-development.

But while considering alternative therapies, don't forget that conventional medicine does work in most instances. And in the typical American way, it is usually better and faster. One may take valerian root for anxiety, but Valium works better. As I tell my patients, if you have a headache you can do an hour of yoga and probably get rid of it - or you can take two aspirins and get on with your life.

Conventional Vs Alternative Medicine Explained

Our culture has allowed the health care industry to become so powerful and disproportionately lucrative that it is now in the business of illness rather than health. In one disconcerting example, a cancer physician, returning from an extended vacation, found an empty waiting room. His colleague had been treating his patients nutritionally. The physician wailed, “This is terrible. It took me years to build a long-term, regular patient clientele!” People everywhere are realizing that our doctors receive no reward for health, only for treating illness.

Most medical schools don’t teach disease prevention, proper diet or exercise as a part of health. Objective measures are emphasized – white blood cell counts, blood pressure readings, etc., instead of how the patient feels. Pain is treated as a powerful enemy, its symptoms assaulted with prescription drugs that mask it or drive it underground- a practice that usually means it will resurface later with increased intensity.

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The twenty-first century finds many people using more natural, less drug-oriented therapies, sometimes as an alternative to conventional medicine, sometimes in a team approach along with it. As orthodox medicine becomes more invasive, and less in touch with the person who is ill, informed people are becoming more willing to take a measure of responsibility for their own health.

Health is a lifestyle process. It is based in wellness care, instead of just illness treatment. The best news is that natural remedies work – often better than prescription drugs for many health conditions.

Orthodox medicine focuses on crisis intervention and is less successful in treating chronic illness. Many modern medical techniques were developed during war time, for emergency care. However, respected studies show that most illnesses don’t just drop out of the sky and hit us over the head. Arthritis, osteoporosis, lower back pain, high blood pressure, coronary-artery disease and hormone imbalances are related to aging and lifestyle. The emergency measures tend to overkill, and even suppress the body’s own immune response. Mental anxiety is brought on by needless testing, medication, or treatment, and a brusque or rushed doctor. You can literally worry yourself sick when there is nothing seriously wrong.

The human body is a beautifully designed healing system that can meet most problems without outside intervention. Even when outside help is needed, healing is enhanced if the patient can be free of emotional devastation, depression and panic. Emotional trauma impairs immune function and panic constricts blood vessels, putting additional burden on the heart.

Alternative healers recognize that pain is also the body’s way of informing us that we are doing something wrong, not necessarily that something is wrong. Pain can tell us that we are smoking too much, eating too much, or eating the wrong things. It can notify us when there is too much emotional congestion in our lives, or too much daily stress. Pain can be a friend with useful information about our health, so that we can effectively address the cause of the problem.

Not every problem requires costly, major medical attention. Healthy food, regular moderate exercise and restful sleep is still the best medicine for many health conditions. The principle of nature governing health and illness are ageless; they apply equally everywhere at all times. There is no down time with the laws of nature, and they do not play favorites.

We need to be re-educated about our health – to be less intimidated by doctors and disease. I believe that the greatest ally of alternative medicine will be science itself – not the restricted view of science that assumes its basic concepts are complete, but the open-ended science that sets preconceived notions aside. Today’s consumers are not only more aware of alternative health care choices, and more confident in their own healing strength, but also want to do something for themselves to get better. The time has clearly come for a partnership between health care professionals and patients, so that the healing resources from both sides can be optimally employed. No prescription is more valuable than knowledge.

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What Is the Difference Between Conventional and Alternative Medicine?There are three main differences between the fields of conventional and alternative medicine. Conventional medicine relies primarily on studies of efficacy to base treatments on, compared to alternative treatments which tend not to require a high standard of scientific proof. Alternative practitioners typically look at the health of a patient as a whole as a basis for treatments, whereas conventional medical professionals often look only at the problem area of the body. Educational qualifications and licensing standards can also be of a higher rigor for conventional medical practitioners compared to alternative practitioners.

Conventional medicine is also called scientific medicine, because of the ways in which doctors choose the appropriate treatments for a patient. Clinical studies, which look at people with a certain problem and how a particular treatment benefits them, is the basis of conventional medicine. This method of checking if a treatment does work, and how well it does work, allows doctors to discard treatments that are not effective and put in place treatments that are more beneficial to the patient. Conventional and alternative medicine differ in that while alternative practitioners may put their treatments through the clinical study process, it is not an essential part of the process for choosing a treatment.

Is Alternative Medication Better Than Conventional Medicine?

It is not surprising that these days people are losing confidence in established health care. This is because it is no longer the cure-all individuals once made it out to be. This is a matter of serious worry within the medical fraternity, as individuals have shifted their focus in protecting their family's health as well as their own. The trend is now leaning towards alternative medicine. More and more people prefer to choose this method to cure their health problems. You could say it is now a hallmark of total healthcare as conventional healthcare fails to produce satisfactory results.

TV and other media hold the view that medications can effectively ease symptoms and prevent various conditions. The sad news is that the modest public is taken for a ride when an unknown person promotes the success rates of a drug during its promotion. The same happens when adverts in magazines gives careless mention or incorrect explanations about the after effects of a drug. Such irresponsible handling of drug advancement often misleads individuals who then turn to trust complementary medications instead. Let us take a close look at some of the aftereffects of a popular drug called Premarin, used as a hormone replacement therapy. While it is possible to get headaches, the user may also experience chest pain. Other side effects include a confused mental state with memory lapses and possible swelling of the legs and feet.

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If you consult a herbalist, they will recommend a combination of black cohosh and dong quai to relieve the effects of menopause. It is a safe treatment for those undergoing this period of their life. The public is trained to use orthodox allopathic, also known as Western health care, which concentrates on the ailment and drug prescription. On the other hand, alternative health care targets the root of the problem, thus curing the entire body. As a result, people are cautious and do added research on a prescribed healthcare as it may present worse conditions than the occurring illness. These side effects have prompted individuals to try safer, natural and better options in overseeing their health.

Alternative healthcare is getting to be one of the mainstream answers for better health. Most allopathic doctorsand now prescribe it to cure sickness and diseases. The health care profession is beginning to grow aware of the beneficial contributions made to good health by herbs, yoga, acupuncture, massage therapy, and holistic living. It is sincerely hoped that over the years, alternative medications will offer even safer and more capable medical alternatives for health care.

Conventional or alternative medicine? That is the question: whether in poor health to live or whole body radiance to achieve New drugs present greater hazards as well as greater potential benefits than ever before for they ‐are widely used, they are often very potent, and they are promoted by aggressive sales campaigns that may tend to overstate their merits and fail to indicate the risks involved in their use… There is no way of measuring the needless suffering, the money innocently squandered, and the protraction of illnesses resulting from the use of ineffective drugs. John F. Kennedy, Consumers’ Protection Message of March 15, 1962 (qtd. in Wise Traditions, 17)

Although both conventional and alternative medicine aim at preventing and curing disease, they differ in their philosophy, treatments, effectiveness and cost, making it difficult for uninformed patients to choose between the two. Like the calomel of the old, today’s conventional treatments are expensive and, for the most part, ineffective in curing chronic illnesses. In America today degenerative diseases like heart disease, cancer, arthritis, multiple sclerosis, digestive disorders, diabetes, osteoporosis, Alzheimer’s, epilepsy, chronic fatigue, and other chronic conditions afflict half of our population and “cause three out of four deaths in the United States.” (Fallon, 1) Empirical research has shown that holistic approaches to chronic disease are very effective, while the advanced technologies of conventional medicine more effectively cure acute illness. However, the holistic approaches are virtually unknown to the general public, as they are not included in any official validation studies; unsuspecting patients are unable to make an educated decision regarding the best care for their specific illness.

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Medicine is the art and science dealing with maintenance of health and prevention, alleviation, or cure of disease. (“Medicine”) As a result the distinction between conventional and alternative medicine comes from their philosophy, treatments, effectiveness and cost.

Conventional medicine, or biomedicine (Cook, 22) also called traditional Western medicine, or mainstream medicine, is a style of medical practice in which practitioners hold either a medical doctor degree or a doctor of osteopathy degree, is practiced in hospitals and taught in the U.S. medical schools.(Cook, 22)

Other terms, like allopathy, mainstream, and conventional have been used by different authors with the same meaning. Allopathy comes from Greek “allos” means other; “pathos” means disease or suffering, implying methods of treatment that attempt to cure disease and its cause directly. (Burton Goldberg Group, 6)

Conversely, alternative medicine, consists of “any method, technique, or practice for healing” (Navarra, 6) not encompassed by biomedicine, that has at its core the belief that”there is a mind‐body connection that has an important impact on one’s ability to prevent illness, regain health, and create biopsychosocial balance.”(Navarra, 6) Alternative medicine is also defined in terms of holistic or integrative medicine.

Philosophy:

The philosophy behind mainstream medicine is doctor‐centered (Cook, 10) where the doctor is the active, all‐knowing participant in the health maintenance process, and the patient is the passive, submissive participant to the doctor’s advice. This medicine relies on advanced technology and medications to treat the symptoms, and not the cause of the disease. Biomedicine views the body as a machine (Marti, xi) without taking into account the relationship and conditioning of body, mind, emotions, social, and the environmental factors in the health maintenance process.

The philosophical underpinnings of the alternative medicine consists of the belief in the healing power of Nature (that men have the build‐in power to heal), the Hipocratic principle to “First, do no harm,” and identifies and treats the cause of the illness, not merely its symptoms. (Marti, xii)

This is a patient‐centered (Cook, 16) model of medicine, where not only the patient’s body is examined, but also the social, economic, and psychological conditions that refer to him/her. The physician, not only prescribes medication and treatment, but he/she also teaches the patient to maintain his/her health, as Adam Pelman, M.D. M.P.H. remarked:” (…) teaching patients to improve or maintain their health was part of medicine that often got lost in trying to provide patients with the latest advancements in order to diagnose, treat or cure disease.”(Navarra, ix)

Treatments/remedies:

Conventional medicine depends on a set of broadly defined symptomatic categories (Cook, 10) for which the doctor applies the standardized and often, the approved insurance treatment, addressing the symptoms, not the underplaying cause of disease. For instance: a patient with depression symptoms, without a previous history of depression, will be given the standardized treatment, usually a “serotonin reuptake inhibitor” Prozac, Paxil or Zoloft.

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(Cowan, 288) The standard treatment is based on the premise that depression is a chemical imbalance, without giving any blood or hormone tests to the patient to discover the imbalance, as there are no such physical tests to diagnose depression. For as Elio J. Frattarolli, M.D. puts it:” PMS, depression, agrophobia, and other so‐called psychiatric disorders, are not physical illnesses. (…) they are symptoms of a deeper mental illness that is both chemical and emotional. Like the physical symptoms of fever, cough, and pain, they are part of a healing process.” (www.eliofrattaroli.com) Therefore, in cases like these alternative treatment would be a more effective healing approach.

Similarly, fever is treated with either an over‐the‐counter drug, like ibuprofen to reduce it, and perhaps with an antibiotic, if there is an infection. In this case the antibiotic will most likely destroy the necessary gut flora, leading the patient to a Candida infection.

Alternative medicine, on the other hand, sees every patient as a unique set of body, mind, economic, and social organism, which needs an individual treatment. Disease is viewed as one or more imbalances in the patient, bacteria not being the necessary cause of all disease.

Going back to the previous depression example: alternative medicine would start from the premise that the causes of depression are not necessarily physical, maybe the cause is situational, and this in turn affects the emotions of the patient. In this case the patient is encouraged to focus on his/her inner life, and activities that “encourage more flow in (…) emotions like taking walks, writing in a journal, listening to music, eating foods that the patient particularly enjoys, or cooking a special dish.” (Cowan, 291) The alternative practitioner might also recommend an integrative approach to depression: the use of St. John’s Wort to correct the chemical imbalance, and probably will counsel the patient to reflect on his sadness, and take appropriate action. (Moore, 150-152)

One of the many classifications of alternative medical practices includes: Diet, Nutrition and Lifestyle changes, Mind/body control, Manual healing, and Herbal medicine. (Cook, 3) The typical alternative medicine practitioner would use some or all of the above methods that fit the particular patient, to treat depression. A fever patient will be encouraged to stay in bed and increase the fever to kill bacteria naturally. In case of infection, the doctor will likely prescribe a homeopathic medicine, “A substance that cause similar effects as the symptoms of the disease.” (“Homeopathy and Allopathy”)

Another important aspect distinguishing conventional from alternative medicine is the length of a doctor visit: a visit to a conventional medical office lasts at most 10 minutes, which is not enough time for the patient’s examination, let alone to properly diagnose and treat a condition. In contrast, a visit to an alternative doctor lasts between one and two hours, and the doctor‐patient relationship is one of cooperation and exchange of information to cure the disease. The antechamber waiting time is half an hour to one hour for the conventional doctor and 5‐10 minutes to see the alternative doctor.

Effectiveness

Several decades ago, however, consumer confidence in conventional medicine began to show some signs of waning. Reports emerged on the side effects and inadequacies of widely used drugs, and new strains of bacteria suddenly appeared that were resistant to the first “magic bullet” antibiotics. The use of new, more powerful antibiotics eventually resulted

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in microbes that could thwart them, too. Meanwhile, cures for arthritis, allergies, hypertension, cancer depression, cardiovascular disease, digestive problems, and other chronic conditions (…) eluded the best minds of biomedicine. (Cook, 9)

As public confidence in conventional medicine faltered, in 1997 there was a 20% increase since 1990 in visits to alternative practitioners; more visits than to the U.S. primary care physicians. (Navarra, xi) Also in 1997 in the U.S. 27 billion dollars was spent annually on alternative medicine. (Navarra, xi) A 1998 Stanford study found that 69% of Americans use some form of unconventional medical therapies, 67% of HMOs cover a few forms of alternative medicine, 60% of physicians refer their patients to alternative therapy, and 70% of family doctors desire training in alternative medical practices. (Navarra, xix) In 2002 Complementary Alternative Medicine (CAM) was used by 149 million people, with 123 million using it for the first time in the past 12 months. (U.S. national Center for Health Statistics, no. 343) Furthermore, the health services and supplies per capita for alternative medicine in 1990 were 71 million dollars, and raised in 2004 to 273 million dollars. (U.S. Census Bureau, Health Expenditure Data) These statistics clearly show that alternative medicine practices are more effective than mainstream medicine, as the consumers will not choose them if they were not happy with the results.

However, there is no formal research available as to the effectiveness of alternative medicine practices, as most of its practitioners are clinicians, not researchers, and they can only report from their experience with their patients. Their data is empirical, not validated by use of generally accepted methods of effectiveness of a treatment. (Navarra, xvii) For instance, one alternative doctor reported that the same treatment for re‐occurring ear infections in infants, yielded different results: the infant with a calm mother cleared the infection, while the one with an anxious mother kept getting them. (Cowan, 1) Although the formal research showing the effectiveness of alternative medicine is missing, the rise in patients seeking alternative medicine practices shows clearly first that the patients are not basing their decisions on validated effectiveness statistics, but they experience themselves what treatment best works for them, and secondly, that patients see the alternative medicine more effective than the conventional, as they keep returning to it, especially if suffering of a chronic disease.

In our depression example above, the treatment with Paxil, Prozac or Zoloft will temporarily alleviate the symptoms, but the patient will still experience a sad and swinging mood, and the side effects of Prozac, Paxil, or Zoloft: dependence, blurry mind, lack of libido, gastrointestinal disturbance, somnolence, headache, insomnia, sexual dysfunction and suicidal tendencies, all in effect decreasing patient’s quality of life. (www.drugs.com) St. John’s Wort also has some side effects, like restlessness, insomnia, anxiety, dizziness and headache, but it can be used as a herbal tea, or as a spice, with no side effects. (St_John’s_Wort#use_as_spice) In Germany it is used to treat major depression with very good results. (Wikipedia)

Cost

As far as cost is concerned, a visit to either a conventional or alternative doctor costs the same: about $200. Some visits to alternative doctors are not covered by medical insurances, and they might seem more expensive. Laboratory tests for diagnosis and treatment have the same price, but sometimes, if prescribed by an alternative doctor, the insurance might deny coverage, motivating that the test is not medically necessary.

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A number of alternative treatments like PT, craniosacral, acupuncture, and chiropractic, are covered by insurance by mandate in 11 American states. (Navarra, xix)

The medications are regulated by the U.S. Food and Drug Administration (FDA). FDA oversees distribution, development and marketing of new medicines, foods and vitamins that make a therapeutic claim. (Cook, 17‐18) This process is very expensive. “It can take up to 10 years and cost hundreds of millions of dollars to obtain FDA approval for a new drug. These astronomical costs are beyond the reach of all but a few corporations and can be recouped only by exercising the legal 17‐year monopolies conferred by the U.S. patent laws. With a patent, drug companies can and do charge whatever the market will bear.” (Cook, 18)

In contrast, there is no incentive for pharmaceutical companies to research and develop alternative therapies/medicines, since a natural substance cannot be patented, and consequently alternative medications fall prey to this formal validation process. (Cook, 18‐19) For instance, Zoloft costs $98 (Burton Goldberg Group, 19) and is not covered by all insurances. The price of Paxil ranges from $54 to $102 (www.coreynahman.com) and Prozac ranges from $89 to $179. (www.coreynahman.com) St. John Wort cost ranges between $10.66 and $19.95. (www.wholehealth.com) The quince/lemon anti‐allergy spray costs $15, while the Fluticasone Roxan costs $55 (generic), and both are similarly effective against hay fever; additionally, the lemon‐quince spray does not have the side effects of the steroids in Fluticasone.

It is obvious that alternative medicines are less expensive than the conventional ones, partly because they do not have to go through the expensive FDA approval process, and they do not fall under any company’s patent monopoly. As seen above, at least as far as alternative depression medications are concerned, they are more effective and don’t seem to create dependence or have suicidal side effects. Furthermore, transcendental meditation, breathing exercises, yoga and other emotion‐control practices can be learned and be practiced at home at a fraction of the regular marriage therapy costs. (www.skepdic.com)

In light of these economic and policy considerations, a question still remains: “How much is it costing us to make symptoms like this (PMS, depression, agrophobia, and other so‐called psychiatric disorders) go away while pretending they are not about anything? What price are we paying to have a chemically liberated nation of happy shoppers and successful compliant children? In monetary terms the price of Prozac is going down. In human terms it has never been higher.” (Fratternolli, web comment)

Although conventional medicine is costly and ineffective with chronic disease, its advanced technology and treatments are most effective in cases of acute illness like trauma, extremely high fever, and trouble breathing. (Wise Traditions, 36)

New studies to validate alternative treatments for chronic diseases and their use by the conventional doctors would better inform and benefit the patients suffering from chronic illnesses. Patient welfare depends heavily on whether there is freely available medical information, as Keats said: “Knowledge enormous makes a god of me.” (qtd. in Cowan, 287) Informed patients would choose a holistic practitioner that uses a combination of biomedicine with certain validated alternative treatments, in an office where the patient is examined by a conventional doctor; however, the treatment, depending on the condition,

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combines acupuncture, nutrition, a clinical herbalist, and a mind‐body practitioner. (Navarra, xi)

Conventional or alternative medicine? The answer could be the marriage between modern medical inventions and the holistic medical ways: the partnership will transform our era into a Golden Age, “divorce hastens the physical degeneration of the human race.” (Fallon, xii)

Alternative Medicine: Why so popular?by Hans R. Larsen, MSc ChE

In 1997 Americans made 627 million visits to practitioners of alternative medicine and spent $27 billion of their own money to pay for alternative therapies. In contrast, Americans made only 386 million visits to their family doctor. It is estimated, by none other than the Harvard Medical School, that one out of every two persons in the United States between the ages of 35 and 49 years used at least one alternative therapy in 1997. That is a growth of 47.3 per cent since 1990. This is spectacular by any means and of great concern to conventional (allopathic) medicine especially since the people using alternative medicine are primarily well-educated, affluent baby boomers(1). The trend to alternative medicine is repeated throughout Western society. In Australia 57 percent of the population now use some form of alternative medicine, in Germany 46 percent do, and in France 49 percent do. The growth of some types of alternative medicine is indeed astounding. Between 1991 and 1997 the use of herbal medicines in the United States grew by 380 per cent and the use of vitamin therapy by 130 per cent. These are impressive numbers by anyone's standard(1-3).

What it is and isn't

So why do people increasingly prefer alternative to conventional medicine? The reasons are pretty simple - it is safe and it works! While there is little doubt that allopathic medicine works well in the case of trauma and emergency (you don't call your herbalist if you get hit by a car), it is much less effective when it comes to prevention, chronic disease, and in addressing the mental, emotional, and spiritual needs of an individual. These are precisely the areas where alternative medicine excels. To most of the world's population, over 80 per cent to be precise, alternative medicine is not "alternative" at all, but rather the basis of the health care system. To Western-trained physicians alternative medicine is "something not taught in medical schools" and something that allopathic doctors don't do and, one could add, generally know nothing about. Alternative medicine actually encompasses a very large array of different systems and therapies ranging from ayurvedic medicine to vitamin therapy.

Ayurvedic medicine has been practiced in India for the past five thousand years and has recently undergone a renaissance in the West due, in no small measure, to the work and lectures of Dr. Deepak Chopra, MD. Ayurvedic medicine is a very comprehensive system that places equal emphasis on body, mind, and spirit and uses a highly personalized approach to return an individual to a state where he or she is again in harmony with their environment. Ayurvedic medicine uses diet, exercise, yoga, meditation, massage, herbs, and medication and, despite its

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long lineage, is as applicable today as it was 5000 years ago. For example, the seeds of the Mucuna pruriens plant have long been used to treat Parkinson's disease in India; it is now receiving attention in conventional circles as it is more effective than l-dopa and has fewer side effects(4).

Traditional Chinese medicine has been practiced for over 3000 years and over one quarter of the world's population now uses one or more of its component therapies. TCM combines the use of medicinal herbs, acupuncture, and the use of therapeutic exercises such as Qi Gong. It has proven to be effective in the treatment of many chronic diseases including cancer, allergies, heart disease and AIDS. As does Ayurvedic medicine, TCM also focuses on the individual and looks for and corrects the underlying causes of imbalance and patterns of disharmony.

Homeopathy was developed in the early 1800s by the German physician Samuel Hahnemann. It is a low-cost, non-toxic health care system now used by hundreds of millions of people around the world. It is particularly popular in South America and the British Royal Family has had a homeopathic physician for the last four generations. Homeopathy is an excellent first-aid system and is also superb in the treatment of minor ailments such as earaches, the common cold, and flu. Homeopathy is again based on the treatment of the individual and when used by a knowledgeable practitioner can also be very effective in the cure of conditions such as hay fever, digestive problems, rheumatoid arthritis, and respiratory infections.

Chiropracty primarily involves the adjustment of spine and joints to alleviate pain and improve general health. It was practiced by the early Egyptians and was developed into its present form by the American Daniel David Palmer in 1895. It is now the most common form of alternative medicine in the United States. Chiropractors not only manipulate spine and joints, but also advise their patients on lifestyle and diet matters. They believe that humans possess an innate healing potential and that all disease can be overcome by properly activating this potential.

Naturopathic medicine also strongly believes in the body's inherent ability to heal itself. Naturopathy emphasizes the need for seeking and treating the causes of a disease rather than simply suppressing its symptoms. Naturopaths use dietary modifications, herbal medicines, homeopathy, acupuncture, hydrotherapy, massage, and lifestyle counseling to achieve healing.

Vitamin therapy or orthomolecular medicine uses vitamins, minerals, and amino acids to return a diseased body to wellness in the belief that the average diet today is often woefully inadequate in providing needed nutrients and that the need for specific nutrients is highly individual. Conditions as varied as hypertension, depression, cancer, and schizophrenia can all benefit enormously from vitamin therapy.

Biofeedback, body work, massage therapy, reflexology, hydrotherapy, aromatherapy, and various other forms of energy medicine round out the vast spectrum of alternative medicine modalities.

How is it different?

So what sets alternative medicine apart from allopathic medicine?

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Conventional medicine is preferred in the treatment of trauma and emergencies while alternative medicine excels in the treatment of chronic disease, although homeopathy can also be very effective as a first-aid.  

Conventional medicine focuses on the relief of symptoms and rarely places emphasis on prevention or the treatment of the cause of a disorder. All alternative systems, on the other hand, strive to find and treat the cause of a disorder and frown on covering up the symptoms. Alternative therapies are also much more focused on prevention.  

Conventional medicine is organ specific, hence ophthalmologists, cardiologists, nephrologists, neurologists, etc. Alternative medicine, without exception, considers each person as a unique individual and uses a holistic approach in treatment.  

Conventional medicine believes in aggressive intervention to treat disease. It revels in terms such as "magic bullet" and "war" ("the war on cancer"), and prefers quick fixes (as do many patients). Alternative medicine believes in gentle, long-term support to enable the body's own innate powers to do the healing.  

Conventional medicine's main "arsenal" consists of surgery, chemotherapy, radiation, and powerful pharmaceutical drugs. Alternative medicine uses time-tested, natural remedies and gentle, hands-on treatments.  

Conventional medicine practitioners are guided in their treatment by strict rules set out by the Colleges of Physicians and Surgeons. This often leads to a "one size fits all" approach. Practitioners of alternative medicine, on the other hand, treat each patient as an individual and do what, in their opinion, is best rather than what is specified in a "rule book".  

Conventional medicine sees the body as a mechanical system (the heart is a pump and the kidneys are a filter) and believes most disorders can be traced to chemical imbalances and therefore are best treated with powerful chemicals (drugs). Alternative medicine systems, almost without exception, accept that the body is suffused by a network of channels (meridians) that carry a subtle form of life energy. Imbalances or blockages of this energy are what lead to disease and clearing of the blockages and strengthening of the energy is the ultimate goal of alternative medicine.  

Conventional medicine prefers patients to be passive and accept their treatment without too many questions. Alternative medicine, in contrast, prefers and indeed, in many cases, requires the patient to take a highly active part in both prevention and treatment.  

Both conventional and alternative medicine ascribe to the principle "Do no harm". However, while alternative medicine is essentially achieving this goal, conventional medicine seems to have almost totally lost sight of it. Hospitals are now the third largest killer in Australia and over one million people are seriously injured in American hospitals every year. Blood infections acquired in American hospitals cause 62,000 fatalities every year and bypass surgery results in 25,000 strokes a year. Two million patients experience

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adverse drug reactions in hospitals in the United States every year; of these, over 100,000 die making hospital-induced adverse drug reactions the fourth leading cause of death after heart disease, cancer, and stroke(5-11).  

The practice of conventional medicine is intimately tied in with the whole medico-pharmaceutical-industrial complex whose first priority is to make a profit. Although most conventional physicians have "healing the patient" as their first priority, they find it increasingly difficult to do so while operating within the system with its pharmaceutical salesmen, its rule books, its fear of malpractice suits, its endless paperwork to satisfy bureaucrats and insurance companies, and its time pressures. Most alternative medicine practitioners have no such constraints and pressures and can give the patient their undivided attention.  

Conventional medicine generally resists the use of natural remedies long after their efficacy has been scientifically proven (Germany is an exception to this). Most alternative medicine practitioners eagerly embrace new remedies and, in many cases, can point to years of safe use. Ginkgo biloba is now the most prescribed drug in Germany and has been found effective in the prevention and treatment of Alzheimer's disease(12). Also in Germany the herb saw palmetto is now prescribed in 90 per cent of all cases of enlarged prostate; in the United States 300,000 prostate operations are performed each year to solve this problem. More profitable for sure, but dangerous and unpleasant for the patient(13).  

The major source of funds for medical research is pharmaceutical companies who, not surprisingly, are very reluctant to support investigations into lifestyle modifications, vitamins, and other unpatentable products. Nevertheless, a growing number of medical researchers are focusing their attention on natural supplements and remedies and are publishing their work in mainstream journals. The benefits of antioxidants have now been thoroughly documented by researchers at the Harvard Medical School and similar prestigious institutions. Folic acid, a simple B vitamin, has also been extensively studied in university laboratories and has been found to be effective in preventing or ameliorating heart attacks, strokes, angina, intermittent claudication, atherosclerosis, kidney disease, colon cancer, hearing loss, and Alzheimer's disease(14-18). Although alternative practitioners and a small group of conventional physicians do embrace the use of natural therapies and products the vast majority of "establishment" physicians are still dragging their heels and even denigrating and ridiculing alternative medicine. This fact, perhaps more than anything else, is what is driving the rapid and massive switch from conventional to alternative medicine.

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Getting the Treatment Right: Conventional and Alternative Medicine

What makes a medical procedure scientific? What makes it quackery?

Unlike many of my friends, I’m a conventional medicine guy. I don’t have any patience for

homeopathy and reflexology and the like because they have no scientific backing. And as a

writer about science, I’m convinced that the scientific method—which in the case of medicine

centers on random controlled testing of therapies, drugs, and procedures—is the best tool we

have for determining what treatments are effective and what are not. There’s really no rational

argument you can make that would lead to any other conclusion.

In a randomized controlled clinical trial, a drug or treatment is tested by administering it, and a

placebo (an inactive agent), to a sample group of subjects on a random basis. That is, the choice

of whether a given subject receives the drug or the placebo is done on a random basis.

Furthermore, neither the researchers nor the subjects know which subjects have received the drug

and which the placebo. In this way, the efficacy of the drug or procedure can be measured

statistically against what would have happened to the subjects had they not received the

treatment.

Conventional medicine’s claim to superiority over alternative medicine—acupuncture, shiatsu,

healing, and other such systems—is that its protocols are backed up by just such scientific trials.

Now, if I were to take this to the extreme, I would be an uncompromising advocate of evidence-

based medicine (for a rundown of this approach’s advantages, see Ivan Oransky’s article in the

current issue of The New Republic ). But, frankly, like most people, I want a human being for a

doctor, not a computer. Evidence-based medicine is based on the assumption that if you punch

all the data on the patient into a computer, it will produce the proven best treatment. The human

doctor becomes nearly superfluous. Yet we all sense that part of what makes a doctor good is his

(or her) acquaintance with patients, and the intuitions that come from that acquaintance,

combined with experience.

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So I’m an advocate of scientific method, but I don’t discount the personal and non-scientific side

of medicine. That’s why, at yesterday’s conference of the Israel Society for the History and

Philosophy of Science, I chose to attend a session on “Boundaries and Categories in the

Alternative Medicine Discourse.”

In the session’s first talk, Dr. Dani Filc of Ben-Gurion University (presenting work he has done

with Dr. Nadav Davidovitch of Tel Aviv University), said that this boundary is a relatively new

one. Prior to World War II, he explained, conventional medicine was based on the individual

case study, not on the large statistical samples we today equate with scientific medicine. In fact,

the earliest forms of the controlled trial of treatments were used by homeopaths in their efforts to

provide solid grounding for their theories. Then, Filc said, homeopathy and other non-

conventional theories were considered non-scientific precisely because they sought to base

themselves on impersonal measures rather than on the intimate knowledge of the individual

patient that the well-trained and experienced medical practitioner saw as the sine qua non of

modern medicine.

In other words, there has been a change in the standard of what science is. This in turn has

affected the way both conventional and non-conventional practitioners see their work. Statistical

methods are nearly all that is important to advocates of the new school of evidence-based

medicine, which seeks to make health care more effective and efficient by nearly eliminating the

physician’s intuitions and prejudices from his work. Many alternative therapists have recast their

fields from being alternatives to conventional methods to being supplements to it. At the same

time, some conventional practitioners are resisting the pure empiricism of evidence-based

medicine, and many alternative therapists claim that the worth of their treatments cannot be

measured randomized controlled trials precisely because they are tailored to the individual

patient.

As I understood Filc’s talk, the point here is not that we have no objective way of distinguishing

between effective and non-effective treatments. Scientific procedure does in fact provide us with

important tools for doing so. However, following the development of scientific practice keeps us

humble. The scientific gold standard of today would have been foreign to researchers a century

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ago, and we can assume that a century from now scientific procedures will be different from

what they are now.

In other words, as we retain rigorous standards of what counts as knowledge and what is merely

wishful thinking, we need to remain humble about our certainties. Not everything goes, and we

must examine our hypotheses carefully using the best means at our disposal. But we should not

assume that we have, unlike our predecessors, reached the end of history and the end of science.

The best ways we have of getting at the facts today may be superseded tomorrow.

Deaths caused by conventional medicineMuch has been said in various news stories lately concerning the alleged ineffectiveness of alternative medicine. Both privately and publicly, conventional doctors and others have referred to natural healing methods and those involved in that field by such terms as "quackery", "voodoo", "witch doctors" and "charlatans", among others. While those who have actual knowledge of holistic healing by either profession or treatment certainly disagree, what the allopathic medical world has not mentioned in all of this is their own track record. No doubt it can be agreed on either side of the argument that there is no such thing as an all-perfect, infallible mode of healing all health problems in all circumstances. However, the conventional medical field is by no means able to claim to be flawless. If that were the case, malpractice lawyers would be starving.

In an article from Medical News Today (August 9, 2004), from 2000 to 2002 inclusive, an average of 195,000 Americans died annually due to preventable, in-hospital errors. This information came from a study of 37 million patients' records by a healthcare quality firm, HealthGrades. The study, "HealthGrades Patient Safety in American Hospitals" (see http://www.healthgrades.com/media/DMS/pdf/InhospitalDeathsPatientSafetyPressRelease072704.pdf), only took into account patients covered by Medicare. It also did not examine the files of those whose deaths were reported as by another cause but incorrectly diagnosed. Nor did the study consider cases of patients dying elsewhere other than in hospitals such as at home or in hospices. Many are those who die shortly after being released from a hospital for reasons such as incorrect treatment or too-early release. Adding these factors to the whole picture, the statistics could be higher.

Similarly, in the Journal of the American Medical Association's article (2003) concerning a research study by Dr. Chunliu Zhan and Dr. Marlene R. Miller, the medical profession was named as the third leading cause of death in this country. The article broke down the statistics as follows:12,000 deaths annually due to unnecessary surgical procedures7,000 deaths in hospitals due to prescription medicine errors

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20,000 deaths in hospitals due to other errors80,000 deaths due to infections picked up while hospitalized106,000 deaths due to negative effects of drugs administered while hospitalizedThese statistics add up to 225,000 patient deaths per year as the result of medical errors. This figure conflicts with the estimated number of overall preventable in-hospital Medicare patient deaths given by HealthGrades.

In yet another JAMA article, "Is US health really the best in the world?", in July, 2000, by Dr. Barbara Starfield of Johns Hopkins School of Hygiene and Public Health, the above figure of 225,000 is backed up. Dr. Starfield pointed out that in other industrialized nations such as Japan, the percentage of iatrogenic deaths (those caused by medical treatment by all medical personnel, not only doctors) is lower. Comparing these causes of death to others such as heart disease, cancer, lifestyle choices and violence, the article's statistics demonstrated that medically induced death is more prevalent in our population than in those of other countries.

Given the above grim facts, which certainly many will choose to dispute no matter what, it can be concluded that, to quote an old saying, "those who live in glass houses should never throw rocks." Better still, allow all people to decide for themselves if they wish to seek assistance from certified, fully-trained practitioners of natural healing, using methods known to have worked for thousand of years in cultures all over the world, or to stick with the current medical and pharmaceutical establishment. Patients are consumers as well, and have the right to make their own informed decisions as to their preferred treatment.

Complementary Versus AlternativeMany Americans, nearly 40 percent, use health care approaches developed outside of mainstream Western, or conventional, medicine for specific conditions or overall well-being. When describing health approaches with non-mainstream roots, people often use the words “alternative” and “complementary” interchangeably, but the two terms refer to different concepts:

“Complementary” generally refers to using a non-mainstream approach together with conventional medicine.

“Alternative” refers to using a non-mainstream approach in place of conventional medicine.

True alternative medicine is not common. Most people use non-mainstream approaches along with conventional treatments. And the boundaries between complementary and conventional medicine overlap and change with time. For example, guided imagery and massage, both once considered complementary or alternative, are used regularly in some hospitals to help with pain management.

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Integrative MedicineThis array of non-mainstream health care approaches may also be considered part of integrative medicine or integrative health care.

For example, cancer treatment centers with integrative health care programs may offer services such as acupuncture and meditation to help manage symptoms and side effects for patients who are receiving conventional cancer treatments such as chemotherapy.

There are various definitions for “integrative health care,” but several facts about this growing health trend are clear:

It’s happening now. Many individuals, health care providers, and health care systems are integrating various practices with origins outside of mainstream medicine into treatment and health promotion.

The integrative trend is growing among providers and health care systems. Driving factors include marketing of integrative care by health care providers to consumers who perceive benefits to health or well-being, and emerging evidence that some of the perceived benefits are real or meaningful.

The scientific evidence is limited. In many instances, a lack of reliable data makes it difficult for people to make informed decisions about using integrative health care.

Health need and the use of alternative medicine among adults who do not use conventional medicineAbstract

Background

We hypothesize that a substantial portion of individuals who forgo conventional care in a given

year turn to some form of alternative medicine. This study also examines whether individuals

who use only alternative medicine will differ substantially in health and sociodemographic status

from individuals using neither alternative medicine nor conventional care in a given year. To

identify those factors that predict alternative medicine use in those not using conventional care,

we employed the socio-behavioral model of healthcare utilization.

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Methods

The current study is a cross-sectional regression analysis using data from the 2002 National

Health Interview Survey. Data were collected in-person from 31,044 adults throughout the 50

states and the District of Columbia.

Results

19.3% of adults (38.3 million) did not use conventional care in a 12 month period, although

39.5% of these individuals (14.7 million) reported having one or more problems with their

health. Of those not using conventional care, 24.8% (9.5 million) used alternative medicine.

Users of alternative medicine had more health needs and were more likely to delay conventional

care because of both cost and non-cost factors compared to those not using alternative medicine.

While individual predisposing factors (gender, education) were positively associated with

alternative medicine use, enabling factors (poverty status, insurance coverage) were not.

Conclusions

We found that a quarter of individuals who forgo conventional care in a given year turn towards

alternative medicine. Our study suggests that the potential determinants of using only alternative

medicine are multifactorial. Future research is needed to examine the decision process behind an

individual's choice to use alternative medicine but not conventional medicine and the clinical

outcomes of this choice.

Background

Despite national surveys suggesting that approximately 40% of the U.S. adult population use

complementary medicine or alternative medicine [1-3], prior studies examining health needs and

healthcare utilization in the U.S. adult population have not controlled for or considered the use of

complementary medicine or alternative medicine in their calculations. It has been estimated that

16-26% of the adult population does not receive conventional care in a given year [4-9]. It has

also been estimated that while most individuals who use complementary medicine or alternative

medicine use it as complementary to conventional medicine (complementary medicine) [10,11],

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about 4% of the adult population may be using it as an alternative to conventional medicine

(alternative medicine) [10,11]. Thus, up to 20-25% of the adult population not receiving

conventional care in a given year might, in fact, be using alternative medicine instead.

It may be that individuals using only alternative medicine differ substantially from individuals

using neither complementary medicine nor conventional care. If that is true, then prior studies

investigating access to care in those not receiving conventional care may not fully reflect all

relevant characteristics of this population (in that they did not distinguish alternative medicine

only users). Thus, this project begins to address an Institute of Medicine observation that [12]

"one of the shortcomings in the [access to care] literature is a lack of information about the

experience of those adults who do not seek care, whether insured or uninsured."

This study examines whether individuals who use only alternative medicine will differ

substantially in health and sociodemographic status from individuals using neither alternative

medicine nor conventional care in a given year. To identify those factors that predict alternative

medicine use in those not using conventional care, we employed the socio-behavioral model of

healthcare utilization [13-15]. In current formulations of this framework, six sets of variables are

posited to interact and influence one's use of health services: elements of the healthcare system,

the external environment, predisposing factors, enabling factors, health need measures, and

personal health practices. The model predicts that health needs are the most direct cause of health

service use followed by enabling and predisposing factors [16]. Therefore, we hypothesize that

those individuals using only alternative medicine will be less healthy and have more health needs

than individuals using neither alternative medicine nor conventional care after controlling for

other variables in the socio-behavioral model. We will also explore the relative contribution of

predisposing (e.g., age, gender, race and ethnicity), and enabling (e.g., poverty status, marital

status, health insurance coverage) factors in an individual's choice to use alternative medicine but

not conventional care. These data will reveal what factors most strongly predict when an

individual decides to use alternative medicine instead of conventional medicine and may help

guide outreach approaches to optimize an individual's health care plans.

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Methods

To address our research questions we utilized data from the 2002 National Health Interview

Survey (NHIS). The NHIS is an annual survey of the health of the U.S. civilian, non-

institutionalized population conducted by the National Center for Health Statistics, Centers for

Disease Control and Prevention (CDC). The 2002 survey used a multi-stage clustered sample

design, and oversampled non-Hispanic black and Hispanic persons to allow for more accurate

national estimates of health for these increasing minority populations.

The survey contains four main modules: Household, Family, Sample Child, and Sample Adult.

The first two modules collect health and sociodemographic information on each member of all

families residing within a sampled household. Within each family, additional information is

collected from one randomly selected adult (the "sample adult") aged 18 years or older. For the

2002 interviewed sample, there were 36,161 households consisting of 93,386 persons in 36,831

families. The total household response rate was 89.6%. From the households interviewed, 31,044

sample adults completed interviews, resulting in an overall sample adult response rate of 74.3%.

The 2002 NHIS was approved by the National Center for Health Statistics Research Ethics

Review Board on November 13, 2001. Verbal or written consent was obtained from all survey

respondents (for more information on the NHIS, go to http://www.cdc.gov/nchs/nhis.htm

webcite).

Study Population

From the pool of sample adults in the 2002 NHIS, we identified those individuals who did not

report using conventional care in the previous 12 months. To be included in this group,

individuals had to report not seeing any of the following medical professionals: a mental health

professional such as a psychiatrist, psychologist, psychiatric nurse, or clinical social worker; a

foot doctor; a nurse practitioner, physician assistant, or midwife; a doctor who specializes in

women's health, such as an obstetrician or gynecologist; a medical doctor who specializes in a

particular medical disease or problem; and a general doctor who treats a variety of illnesses, such

as a doctor in general practice, family medicine, or internal medicine. In addition, the sample

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adult had to report zero trips to a hospital emergency room, not receiving care at home from a

nurse or other healthcare professional, and not having surgery or other surgical procedures as an

inpatient or outpatient in the past 12 months. The sociodemographics and health status of this

population are presented in Table 1.

Table 1. Descriptive Characteristics of Sample Adults Not Using Conventional Care in the Past 12 Months1

Dependent Variable

In 2002, a 10-minute supplement on complementary medicine and alternative medicine was

added to the NHIS. The supplement was administered to sample adults who were asked a

number of questions about the use of complementary medicine and alternative medicine

therapies within the past 12 months. Alternative medicine use, the dependent variable for this

study, was defined as use of any of the following in the past 12 months in those not using

conventional medicine (defined above): acupuncture, Ayurveda, biofeedback, chelation therapy,

chiropractic care, energy healing therapy/Reiki, folk medicine, hypnosis, massage, naturopathy,

natural herbs, homeopathic treatment, diet-based therapies (specifically, Vegetarian diet,

Macrobiotic diet, Atkins diet, Pritikin diet, Ornish diet and Zone diet), high dose or megavitamin

therapy, yoga, tai chi, qi gong, and meditation and other relaxation techniques.

Independent Variables

Using the socio-behavioral model of healthcare utilization [13-15], we identified several

measures to be employed as independent variables in our analysis. Two measures of the external

environment were included: region of residence [17], and urban/rural location or population

density [18,19]. Measures of predisposing factors included age [20,21], sex [20,22], race and

ethnicity [21,23], education [22,24], occupational status or class of worker [17], and immigrant

status [23]. Four measures of enabling characteristics were included: poverty status [23], a

source for regular healthcare [19], marital status [24], and health insurance coverage [21,22]. In

the socio-behavioral model of healthcare utilization "health need" refers to an individual's level

of illness, which is the most immediate cause of health service use. Therefore, we examined five

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measures of health needs: reported health status [25], reported changes in health status, the

presence of pre-existing chronic medical conditions other than back pain [19,26], the presence of

a functional limitation [27] and the presence of back pain or problems. The presence of back pain

was broken out from other pre-existing medical conditions because national surveys consistently

find that back pain is, by far, the most prevalent condition for which complementary medicine or

alternative medicine are used [1-3,11]. In addition, a dichotomous composite measure of health

need was created based on the five health need measures. More specifically, adults with one or

more health needs were defined as those who had one or more of the following: poor or fair

health; health is worse than it was 12 months ago; one or more serious chronic or acute

conditions; a functional limitation; and/or back problems. Measures of personal health practices

included the following: tobacco use [26], alcohol consumption [28,29] and level of physical

activity. Finally, a dichotomous measure of barriers to conventional care was included: did the

individual delay conventional care due to cost and/or non cost barriers [30].

Statistical Analyses

Chi-square analysis was used to identify statistically significant bivariate associations (p < .05)

between the independent/control variables and alternative medicine use for adults not using

conventional care.

Multiple logistic regression was used to assess the relationships between the dichotomous

measure of health need and use of alternative medicine in the past 12 months, after controlling

for sets of external environment, predisposing factors, enabling factors and barriers to

conventional care, and personal health practice controls. The models are nested in that the first

regression controls for the external environment measures, the second controls for the external

environment and predisposing measures and barriers to conventional care, and so on (Table 2).

Variables significantly associated with the dependent variable at the .05 level in the Table 1 chi-

square analysis were retained as control variables in the regressions. For each model, global

Wald chi-square values were calculated, a significant value of which indicates a good-fitting

model. To assess the improvement in the fit of a model with the addition of variables, we

calculated the improvement chi-square. This was done by subtracting the global Wald chi-square

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and degrees of freedom of the previous model from the global Wald chi-square and degrees of

freedom of the current model. A table of critical chi-square values was used to determine if the

improvement chi-square represented a significant improvement in model fit. We also calculated

adjusted odds ratios for the composite health needs measure and all other control variables

included in the full model, model 4 (Table 3).

Table 2. Respondent Health Need and Association with Alternative Medicine Use (Versus Use of Neither Alternative Medicine nor Conventional Care

Table 3. Logistic Regression Results for Socio-Behavioral Model Predicting. Alternative Medicine Use among Adults Not Using Conventional Care in the Past 12 Months

Next we determined if barriers to conventional care are present for those adults who use

alternative medicine. Odds ratios were calculated using multiple logistic regression to assess the

relationships between two measures of barriers to conventional care and the use of alternative

medicine in the past 12 months (versus not using alternative medicine). The analysis is limited to

adults with one or more health needs who reported not using conventional care in the past 12

months. All external environment, predisposing, enabling, and personal health practice measures

significantly associated (p < .05) with the dependent variable via chi-square analysis (see Table

1) were entered as controls in the regression.

We conclude these analyses by presenting the reasons for using alternative medicine for

treatment purposes among adults who use alternative medicine, and the types of alternative

medicine therapies they used. Table 4 presents the percentage of adults reporting negative and

positive reasons for using alternative medicine. Positive reasons for using alternative medicine

included that alternative medicine was suggested by a conventional medical professional or that

the participant thought alternative medicine would be interesting to try. Negative reasons for

using alternative medicine included participants reporting that conventional medical treatments

would not help or were too expensive.

Table 4. Reasons Persons Who Use Only Alternative Medicine for Their Healthcare Used CAM for Treatment Purposes: NHIS, 2002 (weighted)

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Eisenberg and colleagues [10] first proposed that therapies used for both complementary

medicine and alternative medicine could be dichotomized into those that typically involve a

practitioner (e.g., acupuncture, chiropractic care), and those that do not (e.g., diet-based

therapies). Subsequently, the National Center for Complementary Medicine and the CDC have

expanded on this concept and termed these two groups of therapies as practitioner-based

therapies (i,e., acupuncture, Ayurveda; biofeedback; chelation therapy; chiropractic care; energy

healing therapy/Reiki; folk medicine; hypnosis; massage; and naturopathy), and self-care

therapies (defined as therapies that a person can perform alone, even if some training is required,

i.e., nonvitamin, nonmineral, natural products; homeopathic treatment; diet-based therapies; high

dose/megavitamin therapy; yoga; tai chi; qi gong; meditation; guided imagery; progressive

relaxation; and deep breathing exercises), and examined differences in the use of these two

groups of therapies [31]. We therefore present prevalence estimates for practitioner-based and

self-care alternative medicine therapies in Table 5. We also presents prevalence estimates for

each of four different alternative medicine domains (Alternative Medical Systems, Biologically-

based Therapies, Mind-body Therapies, and Manipulative and Body-based Therapies) previously

examined in analyses of the 2002 and 2007 NHIS [2,3]. The therapies within each of these four

domains are as follows: Alternative medical systems include acupuncture; Ayurveda;

homeopathic treatment; and naturopathy. Biologically-based therapies include chelation therapy;

folk medicine; nonvitamin, nonmineral, natural products; high dose/megavitamin therapy; and

diet-based therapies. Mind-body therapies include biofeedback; meditation; guided imagery;

progressive relaxation; deep breathing exercises; hypnosis; yoga; tai chi; and qi gong.

Manipulative and body-based therapies include chiropractic care and massage. While the

therapies within the four alternative medicine domains are unique to a single domain (e.g.,

meditation is counted only with the Mind-body Therapy domain), the therapies are also coded, as

appropriate, to either Practitioner-based Therapies, or Self-care Therapies (e.g., meditation was

also coded as a self-care therapy). P-values from a chi-square analysis assessing the bivariate

relationships between use of each of the alternative medicine domains and having or not having a

health need are also presented.

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Table 5. Types of CAM Therapies Used by Individuals Using Only Alternative Medicine in the Past 12 Months: NHIS, 2002 (weighted)

All estimates were generated using SUDAAN software (version 9.0, Research Triangle Institute,

Inc., Research Triangle Park, NC) to account for the complex sample design of the NHIS. To

represent the U.S., civilian, non-institutionalized population age 18 years and over, all estimates

were weighted using the NHIS sample adult record weight.

Results

Characteristics of Those Who Did Not Report the Use of Conventional Care

It was found that 19.3% of adults did not use conventional care within the last 12 months. This

equates to roughly 38.3 million adults. Of these, 38.4% (approximately 14.7 million) had some

health need, with 23.8% having a serious acute or chronic condition. Almost one-quarter (24.8%;

approximately 9.5 million adults) of those not using conventional care used some form of

alternative medicine, with 12.0% (approximately 4.6 million) reporting one or more health needs

and using alternative medicine.

The majority of individuals not using conventional care were male, younger than 45 years old,

non-Hispanic white, without a college education, married, working in the private sector, born in

the U.S., were not poor, had private health insurance, had a usual place of care, had not delayed

care because of cost or non-cost issues, currently drank alcohol, or were involved in some type of

leisure-time physical activities (Table 1).

Characteristics of Those Who Did Not Report the Use of Conventional Care But Did Use Some Form of Alternative Medicine

External Environment

Region of residence but not population density (metropolitan statistical area - MSA - status) was

associated with alternative medicine use (Table 1).

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Predisposing Factors

Sex (female), age, race and ethnicity, education, class of worker and born in the U.S. (U.S. born)

were all associated with alternative medicine use (Table 1).

Enabling Factors

While poverty status and health insurance coverage were associated with alternative medicine

use (Table 1), marital status and having a usual place of care were not.

Barriers to Conventional Care

Delaying care due to cost and/or non-cost barriers was associated with the use of alternative

medicine.

Health Need Factors

For all adults not using conventional care, individuals reporting a functional limitation, a serious

chronic or acute condition, back problems, or one or more health needs were more likely to use

alternative medicine (Table 1). Reported changes in health status compared to 12 months ago

were also associated with alternative medicine use. A greater percentage of individuals reporting

improvements or declines in their health used alternative medicine than did individuals who

reported their health to be about the same. However, current health status was not associated

with alternative medicine use.

Personal Health Practices

Leisure-time physical activity, alcohol drinking status and smoking status were all associated

with alternative medicine use.

Health Need Measures and the Use of Alternative Medicine

Table 2 shows the results from a series of logistic regression models fitted for having one or

more health needs in which external environment measures (Model 1), predisposing factors

(Model 2), enabling factors and barriers to conventional care (Model 3), and personal health

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practice measures (Model 4) are added sequentially to the regression models as controlling

factors.

The positive association seen between having one or more health needs and alternative medicine

use in the unadjusted analysis is maintained after sequentially adjusting for the external

environment, predisposing factors, enabling factors and barriers to conventional care, and

personal health practice controls (models 1-4). All effects were in a similar direction, though

somewhat attenuated when the personal health practice measures were added (model 4). While

each model is a better fit of the data than the preceding model, the addition of predisposing

factors (model 2), and personal health practices (model 4) produced the largest changes in the

improvement chi-square. The addition of enabling factors and barriers to conventional care to the

model (model 3) produced a moderate improvement in chi-square, along with a small attenuation

of the health needs measure.

To explore the model in more detail, Table 3 presents adjusted odds ratios for the composite

health needs measure and all other control variables included in the model. In general, observed

associations seen in bivariate analyses (chi square) were maintained after adjusting for other

independent variables with the exception of age, born in the U.S., poverty status and smoking

status for which no associations were seen in the fully adjusted model. Consistent with the model

building presented in Table 2, the odds ratios associated with two predisposing variables

(education level and gender) were among the largest seen. Large odds ratios were also seen for

personal health practices (leisure-time physical activity and alcohol drinking status) and for

delaying conventional care because of either cost and/or non-cost barriers. As might be predicted

from the model building presented in Table 2, individual enabling factors were either not

associated with alternative medicine use (poverty status) or inversely associated with alternative

medicine use (health insurance coverage).

Barriers to Using Conventional Care in Those Who Used Only Alternative Medicine

Given the strong association between alternative medicine use and delaying conventional care,

we examined the impact of cost and non-cost barriers to conventional care separately. After

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adjusting for external environment measures, predisposing factors, enabling factors, and personal

health practices, we found that the association between alternative medicine use and non-cost

barriers (AOR = 2.04; 95% CI = 1.28-3.25) was slightly stronger than that seen for cost barriers

(AOR = 1.67; 95% CI = 1.22-2.30).

Reasons People Use Alternative Medicine

Of those who used alternative medicine for treatment purposes, 59.9% had positive reasons for

this use, and 33.7% had negative reasons relative to conventional care (Table 4). The most

prevalent reason for alternative medicine use was that respondents "thought it would be

interesting to try." For this response, there were no differences when looking at only those adults

with one or more health needs.

About 20% of individuals used alternative medicine because they believed conventional

treatments would not work or because conventional medical treatments were too expensive.

Those with one or more health needs were significantly more likely to use alternative medicine

for these two reasons than those in good health.

Types of Alternative Medicine Therapies Used

We examined the prevalence of use of six categories of alternative medicine therapies (Table 5).

For the overall sample of individuals using only alternative medicine, self-care therapies were

more popular than practitioner-based therapies (90.0% vs. 23.6%).

Of the six categories, only practitioner-based therapies and manipulative and body-based

therapies showed a significant difference between healthy individuals and those with one or

more health needs. While 27.0% of those with one or more health needs used practitioner-based

therapies, only 20.1% of healthy individuals used these therapies (p < .01). Similarly, while

24.2% of those with one or more health needs used manipulative and body-based therapies, only

19.2% of healthy individuals used these therapies (p < .05).

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Discussion

We found that 19.3% of adults (38.3 million) did not use conventional healthcare in the last 12

months despite that fact that 38.4% of these individuals had one or more health needs, with

almost one-quarter having a serious chronic or acute medical condition. Instead of conventional

care, 24.8% of these individuals used alternative medicine. Several striking differences were

seen when comparing the characteristics of those who used alternative medicine to those who

used neither alternative medicine nor conventional medicine. First, users of alternative medicine

had poorer health. Second, users of alternative medicine were more likely to have more barriers

to care as exemplified by their having to delay conventional care because of both cost and non-

cost factors, with 1 in 5 having used alternative medicine because conventional care was too

expensive. Finally, those who used only alternative medicine and those who used neither

alternative medicine nor conventional medicine displayed distinctly different patterns of

predisposing factors, as well as different patterns of personal health practices.

While the present data do not allow us to directly answer the question as to why the predisposing

factors and personal health practices of alternative medicine users differed from non-users, they

are consistent with the hypothesis that complementary medicine and alternative medicine users

are more likely to have a wellness lifestyle than non-users [32]. For instance, it has been

proposed that higher education, a predisposing factor strongly associated with alternative

medicine use in the present study, increases an individual's exposure to various types of

complementary medicine and alternative medicine therapies [11], perhaps through increased

medical literacy and health information seeking activity [33]. This seems especially true for the

use of modern technologies like the internet [34], which are increasingly used to access

information on complementary medicine and alternative medicine [35]. It may be that positive

health behaviors associated with a wellness lifestyle [32] cluster in alternative medicine users

just as they do in females and those with higher education in the general population [36].

Supporting this contention, it has been found that complementary medicine and alternative

medicine are associated with a number of positive health behaviors that would be part of a

wellness lifestyle [32] including regular levels of exercise [37], nonuse of tobacco [37-39],

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nonuse or moderation in use of alcohol [37,40], healthy diet choices [40] and preventive

screening [41]. While the 2002 NHIS did not specifically ask participants if they used

complementary medicine or alternative medicine for wellness, the 2007 NHIS did incorporate

such a question. Future planned analysis of the 2007 dataset will allow direct assessment of

whether those using only alternative medicine, do so for their overall wellness, as well as to treat

specific diseases or conditions.

Our analyses are consistent with other national surveys [10,11,42] showing that a relatively small

proportion (1.7%-4.4%) of the population use alternative medicine but not conventional

medicine. While predisposing factors (age, education, race and sex) were not predictors of

relying primarily on alternative medicine in Astin's study [11], education, race and sex were

associated with the use of alternative medicine among those not using conventional care in the

present study. Astin cautioned that his small sample size may have missed important predictors

of using only alternative medicine. While, to our knowledge, no other studies besides Astin [11]

have specifically examined predictors of alternative medicine use, several studies have examined

the predictors of complementary medicine and alternative medicine combined [11,37,43,44].

Consistent with the present results, these earlier studies identify education, race and sex as

predictors of use.

Contrary to earlier studies on complementary medicine and alternative medicine combined [43-

45], enabling factors appear to have little impact on the use of alternative medicine. Yet, cost

issues seem to play some role in whether an individual uses alternative medicine versus neither

complementary medicine nor conventional medicine in that even after accounting for insurance

coverage and poverty status, those who delayed conventional care because of cost were more

likely to use alternative medicine. It is, therefore, not surprising that individuals who used only

alternative medicine predominately used lower cost self-care therapies such as dietary

supplements and mind-body therapies. However, when faced with one or more health needs,

individuals who used only alternative medicine were more likely to use practitioner-based

therapies, especially manipulative and body based therapies.

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While cost and other barriers to conventional care may be motivators of alternative medicine use,

there also is an indication that some users of only alternative medicine do not find conventional

medicine helpful (Table 5). These data are consistent with observations suggesting that

individuals who use only alternative medicine distrust the conventional care system and are

generally dissatisfied with conventional care [11,46,47]. In a similar vein, skepticism toward

medical care is strongly associated with reduced use of conventional healthcare, even after

controlling for predisposing, enabling and need factors [48]. For these individuals, the value of

conventional care for their health needs may not be appreciated.

Some users of only alternative medicine used alternative medicine because they felt conventional

care was too expensive. It is possible this group would use conventional care if they could.

Future research might assess whether this population is aware of public health insurance options

and other failsafe measures to pay for conventional care. Finally, a substantial proportion of

respondents who used only alternative medicine did so because they thought it would be

interesting to try. Some of these individuals may be encountering non-cost barriers to

conventional care, while, as mentioned earlier, others appear to be using alternative medicine as

part of a healthy lifestyle choice [11,32].

Our study has several limitations. First, the cross sectional nature of the study does not allow us

to assess clinical outcomes in our two identified populations, those who use neither alternative

medicine nor conventional healthcare and those who use only alternative medicine. Thus we

cannot comment on the potential safety or efficacy of using only alternative medicine. Given that

substantial numbers of both groups have one or more health needs, future prospective studies of

these populations should investigate a number of possible outcomes such as avoidable

hospitalization or premature death. Second, our measures were based on self-reported data that

were not independently verified. Third, many other factors that may enable or impede healthcare

utilization are not measured in this report but need to be considered. These factors include health

beliefs, cultural practices, language barriers, social networks and contacts, and the availability of

care in the community [15]. Fourth, we limited our population for analysis to those individuals

who did not report seeing a conventional provider in the preceding 12 months. There is always

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the potential for recall error in these types of questions. Finally, because our primary focus was

to identify factors associated with the use, versus nonuse, of alternative medicine, a dichotomous

dependent variable was utilized. By doing so, information on the number and type of alternative

medicine therapies used and frequency of their use was lost. It may be that substantial

differences exist between heavy and light users of alternative medicine or between the various,

heterogeneous alternative medicine modalities.

Conclusion

We found that a quarter of individuals who forgo conventional care in a given year instead turn

towards alternative medicine. Overall, our study suggests that while the potential determinants of

using alternative medicine but not conventional care are multifactorial, healthcare needs

followed by predisposing factors are prime drivers of use. Since the 2007 NHIS also contained

an extensive set of supplemental questions asking about alternative medicine use, we plan

longitudinal assessments comparing the 2002 and 2007 NHIS to identify any cohort or secular

trends in the associations that are not evident in the cross-sectional analysis. Future research is

also needed to examine the decision process behind an individual's choice to use alternative

medicine but not conventional medicine and the clinical outcomes of this choice.

FACTS AND STATISTICS According to CNN one-half of all medical schools now offer courses in alternative medicine. The World Health Organization estimates that between 65 to 80 percent of the world's population (about 3 billion people) rely on traditional (alternative) medicine as their primary form of health care.     In 1993, American consumers spent almost $1.5 billion dollars on herbal remedies-ten times more than was spent on over-the-counter sleeping pills from grocery stores and drug stores.     Worldwide, only 10 to 30 percent of people use conventional medicine, 70 to 90 percent use alternative medicine.    

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Approximately $22 million of U.S. government money has already been spent on alternative medical research since 1992 at the National Institutes of Health and Public Health Services.     The American Medical Association (AMA), in Resolution #514, "is encouraging its members to become better in-formed regarding alternative (complementary) medicine and to participate in appropriate studies of it.   Almost one-third of American medical schools-among them Harvard, Yale, John's Hopkins, and Georgetown Universitities-now offer coursework in alternative methods.   Mutual of Omaha says it saves about $6.50 in covering non-standard (alternative) treatments.   74 percent of the American population desire a more natural approach to health care.   Of the one out of three Americans who say they have used alternative medicine techniques, 84 percent said they would use it again.   Traditional chinese medicine has been chosen by the World Health Organization for worldwide propagation to meet the heath care needs of the twenty-first century.   The U.S. government sponsors the use of acupuncture in drug rehabilitation programs.   There are five homeopathic hospitals in Great Britain run by the British National Service.   One out of three drugs prescribed in Germany is an herb.   One out of every ten Americans is under the care of a chiropractor.   In 1991, Americans made more visits to unconventional healh care providers (425 million) than to conventional doctors (388 million).   One out of three Americans were using unconventional medicine in 1991.   Americans spent almost $13.7 billion on unconventional health care in 1991.   75 percent of that $13.7 billion (above) was out of pocket. 12 percent of Fortune 500 companies offer alternative medicine as part of their health care compensation packages.  That percentage was expected to increase to 18 percent by the end of 1996.

What are the main differences between complementary and alternative medicine and conventional medicine?

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Complementary and alternative medicine:

tends to be holistic and includes therapies from various historical and cultural backgrounds often needs you to actively join in with the treatment with lifestyle changes (e.g. diet, exercise

and positive thinking) features therapies that are diverse in nature and origins. The ways in which these therapies are

thought to work are also diverse, although many are based on the idea of enabling your body’s ability to heal itself.

Conventional medicine:

mainly focuses on understanding and correcting the underlying problems that are causing your symptoms. In many instances these aren’t fully understood, although there have been major advances in recent years, especially in rheumatoid arthritis, with much of the research being funded by Arthritis Research UK

is often criticised for treating your condition and not you as a person, needing you to accept the diagnosis and treatment

is increasingly recognising the importance of your involvement and choice in your treatment, and many argue this is due to the influence of complementary and alternative medicine approaches.

What’s similar?

Both styles of treatment emphasise the quality of the relationship between you and the practitioner. A good relationship is important for a successful outcome. Often, both conventional and complementary and alternative medicine approaches are used and may help you if you have arthritis or chronic pain.

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