Download The Benefits Of Alternative Medicine Over

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
2
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
3
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 Medicine
By 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.
4
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 comparison
Two 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.
5
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
6
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 Medicine
Alternative 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
7
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.
8
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:
9








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.
10
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.
11
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.
12
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.
13
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.
(Cowan, 288)
14
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
in microbes that could thwart them, too. Meanwhile, cures for arthritis, allergies,
15
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.
16
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,
17
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
18
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?
19

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
20
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 medicopharmaceutical-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.
21
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 evidencebased 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.
22
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 nonconventional 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
23
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 medicine
Much 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/InhospitalDeathsPatientSafetyPressRelease07270
4.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 procedures
7,000 deaths in hospitals due to prescription medicine errors
24
20,000 deaths in hospitals due to other errors
80,000 deaths due to infections picked up while hospitalized
106,000 deaths due to negative effects of drugs administered while hospitalized
These 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 Alternative
Many 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.
25
Integrative Medicine
This 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 medicine
Abstract
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.
26
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],
27
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.
28
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, noninstitutionalized 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
29
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
30
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 chisquare 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
31
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)
32
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, Biologicallybased 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.
33
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).
34
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
35
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
36
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).
37
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 noncost 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],
38
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 [4345], 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.
39
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
40
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.
41
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?
42
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.
43