Alternative and traditional medicine have a great deal to learn from each other and we all have a lot to learn in terms of bringing the two closer together. To begin, let's look at how alternative medicine and traditional medicine are defined, what constitutes some of the differences between the two approaches to medical care, and how these systems can work together.
Alternative medicine is referred to in many different waysalternative medicine, complementary medicine, complementary and alternative medicine (CAM), nontraditional medicine, nonconventional medicine, unorthodox medicine, and, I am sure, a whole host of others.
My preference is either alternative or complementary medicine. CAM is the term used by the National Institute of Health (NIH) and other mainstream medical establishments. The use of an acronym is a common practice in conventional medicine and, in my opinion, highlights one of the differences between the two disciplinesan attempt to objectify vs. an attempt to personalize medical practices and treatments.
Traditional medicine is also referred to in many different waysallopathic, traditional, conventional, orthodox and Western medicine, to name a few. The term "traditional," although used quite commonly, seems somewhat inaccurate, given that many alternative medical disciplines have been around for thousands of years, while many conventional practices have been around much less than a century. Most of these terms, actually, are only relevant in the context of Western culture.
A commonly used definition of alternative medicine is "practices that are not in conformity with the beliefs or standards of the dominant group of medical practitioners in a society." As one might imagine, therefore, in another society our so-called traditional approach would be considered alternative and a particular alternative approach would be considered traditional. The Role of the AMAHow Does It Affect Alternative Therapy Practices? In 1847 a body known as the American Medical Association (AMA) was established to try to regulate medical care. The initial goals of the organization included licensing physicians and setting standards for the delivery of medical education. Now, this governing body controls state medical boards, and determines whether doctors can receive or maintain hospital privileges, and whether they can keep their medical license. A medical license can be revoked for a reason secondary to incompetence, which is essentially defined as deviating from what is known as the "standard of care". As long as Western medical practices are considered "standard of care," it makes it very difficult for alternative medical practices to become recognized, accepted and respected; in fact, the implication is that, because they deviate from the "standard of care," the practices and practitioners are incompetent.
Past Studies on Alternative Therapy UseEven though the medical establishment has been reluctant to recognize alternative therapies, patients have been flocking to alternative practitioners in droves. Surveys conducted by David Eisenberg, MD and his colleagues reveal that the use of CAM increased from 33.8% to 42.1% in the United States between the years 1990 and 1997. The total number of visits to CAM practitioners between those two years increased from 427 million to 629 million, far exceeding the total number of visits to primary care physicians. And if money is a good yardstick of success, alternative health is thriving: people in the US spent an estimated $12.2 billion of their own money for alternative medicine practitioners in 1997 and $27.0 billion for alternative therapies.However, the caution, or sometimes outright disagreement, that many physicians harbor towards alternative health practitioners has not been lost on patients. The same studies which found a rise in CAM use also noted that less than 40% of these individuals have shared this information with their own medical doctors. This is a good example of the importance of bridging, at the very least, the communication gap in order to assure safety for individuals who combine the two types of medical approaches for themselves.
Why Is Alternative Medicine Popular?Reflection on the above statistics raises the questions: why is alternative medicine so popular? What is the appeal? Although the approach and focus of different types of alternative therapies may differ, they all seem to share the following characteristics:Empowerment of the individual to participate in and take responsibility for his or her own health.Recognition and emphasis on lifestyle issues such as proper nutrition, exercise, adequate rest, and emotional and spiritual balance.Treating the individual as a whole person, as opposed to a series of parts.An emphasis on preventing disease and maintaining health. Challenging Some Common CriticismsFrom Both SidesA common criticism of traditional medicine by alternative practitioners seems to be that medical doctors treat symptoms, such as pain or fever, without searching for the root cause and that they tend to give medications to try to mask these symptoms. This is not entirely true. Although it is true that we often give medications or use approaches to control symptoms, we do also search for causes of symptoms such as infection or inflammation in order to be able to treat them allopathically.Looking in the other direction, one frequent criticism of alternative medical practices made by conventional practitioners is the occasional sensationalism in reporting the merits of a particular approach. For example, there are books about certain dietary approaches that claim to cure a whole host of ailments; the same types of claims are sometimes made about particular supplements.
Logic makes it unlikely that one approach could be the answer for so many health problems. When one is trained to "think objectively," as medical training is supposed to teach, it makes it very difficult to accept this cure-all type of thought process. Medical doctors are trained to be skeptics.Another example of recounting information which some traditional practitioners may think of as sensationalist, is the method of case reportingin other words, telling a story, or what we refer to as an anecdote, of someone who did quite well with a particular approach. Any medical doctor can also tell you individual stories about someone who did either quite well or quite poorly with one or another method of treatment.The objective approach, the so-called evidence-based approach of Western medicine, however, is intended to look at how likely a particular treatment is to help a person with a certain problem. Evidence-based medicine is the application of a scientific process to distinguish outcomes due to chance from outcomes which are reproducible and, therefore, presumably more reliable. Bridging the GapIn order to help bridge the gap and bring the two disciplines together, integrative medicine was created. This how it has been defined by Victoria Maizes, a family physician with University of Arizona and one of the key people responsible for its success: Integrative medicine honors the innate ability of the body to heal, values the relationship between patient and physician, and integrates complementary and alternative medicine when appropriate to facilitate healing. Integrative medicine refocuses medicine on health and healing. It insists on patients being treated as whole personsminds and spirits, as well as physical bodies who participate actively in their own healthcare.Today, many medical schools in the US teach the principles and practice of integrative medicine. There are clinics and practices that embrace its philosophy. Also, integrative medicine research studies have been published in peer reviewed journals and recently an integrative medicine residency program was created at the University of Arizona. Naturally, there are many sceptics within both CAM and traditional medical community that blame integrative medicine for being either too scientific or not scientific enough, depending on ones point of view. For patients however who would like the best of the two worlds integrative medicine practice may be a very good choice. If finding an integrative medicine clinic in your area is difficult however, I wanted to offer some insight into how your doctor may be thinking and why you may be met with resistance when you try to discuss your desires for and experience with alternative medicine.
There is a very important role for the objectivity that a Western medical doctor learns. This objectivity should, in many ways, provide you with a certain degree of comfort and confidence. There is also an extremely important role for the personal and holistic approach of alternative medicine practices and practitioners. This warmth and individuality should provide a different type of comfort and confidence.Ideally, there is a way to bring aspects of the two together and have the best of both worlds. One word of advice I can give to the alternative medicine consumer is to try to not be intimidated or scared about discussing your practices with your medical doctor. We all have a great deal to learn in terms of integrating these important areas of health care, and communication is one of the best places to begin. RESOURCES: American Academy of Family Physicianshttp://www.aafp.org National Center for Complementary and Alternative Medicinehttp://altmed.od.nih.gov CANADIAN RESOURCES Canadian Family Physicianhttp://www.cfpc.ca/cfp/ Traditional Chinese Medicine and Acupuncture Health Information Organization http://tcm.health-info.org/ References Bell, I, Caspi O, Schwartz GER, Grant K, Gaudet T, Rychener D, Maizes V, Weil Integrative medicine and systematic outcomes research: issues in the emergence of a new model for primary health care. A. Arch Int Med 2002;162:133-140.
B Kligler, MD, MPH, V Maizes, MD, S Schachter, MD, CM Park, MD, PhD, T Gaudet, MD, R Benn, PhD, R Lee, MD, and RN Remen, MD. Core Competencies in Integrative Medicine for Medical School Curricula: A Proposal Academic Medicine. vol. 79, no. 6, June 2004. Eisenberg D. Alternative medicine: implications for clinical practice and state of the science symposia. Harvard Medical School Dept. of Continuing Education, Center for Alternative Medicine Research and Education. Department of Medicine, Beth Israel Deaconess Medical Center; 1999. Eisenberg D, et.al. Trends in alternative medicine uses in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998 Nov 11; 280(18):1596-75. Eisenberg D, et.al. Unconventional medicine in the United Statesprevalence, costs, and patterns of use. N Engl J Med. 1993 Jan 28;328:246-52. Maizes V & Caspi O. The principles and challenges of integrative medicine: More than a combination of conventional and alternative medicine. West J Med. Sept 1999;171(3):148-9. Milan FB, et. al. Teaching residents about complementary and alternative medicine in the United States. J Gen Intern Med. 1998 Aug;13:562-567.
Wetzel M. Teaching alternative medicine in US medical schools. Harvard Focus. 1998 Nov 27. Victoria Maizes, MD, Craig Schneider, MD, Iris Bell, MD, PhD, MD(H), and Andrew Weil, MD Integrative Medical Education: Development and Implementation of a Comprehensive Curriculum at the University of Arizona Academic Medicine 2002 Last reviewed February 2008 by Marcin Chwistek, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.