Although many Americans use complementary alternative medicine (CAM), nevertheless the boundaries between CAM and conventional medicine are not absolute because there is a lack of evidence in its safety and effectiveness. While some doctors and patients embrace alternative medicine and use them by integrating them with conventional therapies, other professionals and patients believe they may be dangerous or simply just don’t work. Most conventional medicine is proven to work with evidence obtained through clinical trials and other research. The majority of this research has been done on conventional therapies, like pharmaceutical drugs.
With there being little evidence that proves alternative medicine or therapies work many think they don’t work. This is not necessarily true and is the result of the lack of research put into CAM. Most research is supported by for-profit organizations like pharmaceutical and medical device manufacturers to prove that their drug or device works. With this proof, they can get FDA approval to sell their drug or device. Even research done in nonprofit organizations like universities and academic medical centers are mostly being conducted through grants and foundations developed by for-profit companies.
There isn’t as much money to be made if the evidence for CAM therapies is shown to exist. Further, no research needs to be done to achieve FDA approval. Therefore, except for government research projects through the National Center for Complementary and Alternative Therapy, research simply does not exist. If the research doesn’t exist, then efficacy of CAM therapy can’t be proved one way or the other. We just don’t know if it works or not. That means we mostly rely on anecdotal evidence. Some medical professionals and patients just need anecdotal evidence to decide a CAM therapy is useful.
For example, natural supplements are a multi-billion dollar business in the United States, and there those supplements have no proof to show they work. Some even have proof that shows they don’t. But people still buy them. Meanwhile there are skeptics that say spending money on CAM supplements and therapies is a waste of money and may even be dangerous. Choosing a CAM therapy may cause a conflict with a current, conventional therapy which can result in additional medical problems when they are used together. Using a CAM therapy in place of a conventional therapy may mean improvement in health, or it may cause death.
However, even these reports are anecdotal. The evidence of the conflicts and deaths is not based on studies or clinical trials either. Another caution about anecdotal evidence is quackery: the illegal and dangerous practice of selling therapies to sick, debilitated and dying patients who spend their money on products and procedures that don’t work. CAM therapies take a different approach. Most are founded in Chinese medicine, also called Eastern medicine (emanating from the Eastern hemisphere). They rely on herbs and other “natural” substances the human mind or physical manipulation to achieve health and wellness.
Often the term “alternative” and “complementary” are used interchangeably. However, there is a difference. Alternative therapies are used in place of a conventional medical approach. Complementary therapies are used together with conventional therapies. The U. S. government, on its website devoted to Complementary and Alternative Medicine, breaks down these therapies into five categories: •Biologically-Based, such as herbal supplements, botanicals, animal-derived products, vitamins, proteins, probiotics and other organic approaches.
•Energy Medicine, such as veritable energy like sound, electromagnetic forces, biofields which work to identify a body’s own energy field, also called “chi. ” Alternative medicine professionals believe that when these biofields are disturbed, it causes illness in the body. Examples of energy medicine are acupuncture, reiki, Qi gong, homeopathy, healing touch and intercessory prayer in which the prayers of one person help improve the health of another. These particular therapies are among the most controversial of the CAM therapies. •Manipulative and Body-Based, such as chiropractic, osteopathic, reflexology, and therapeutic massage.
These therapies rely on the structures and systems of the body, making adjustments to them to heal symptoms and medical problems. •Mind-Body Medicine, which focuses on the interactions among the brain, behavior and physical health, such as meditation, yoga, biofeedback, tai chi, even spirituality. Conventional medicine has also long understood the relationship between the mind and the body. Mental health and physical health are intertwined, and this idea is being used more and more for pain control, cancer control, and is being explored to learn more about its immunity response.
Is there, then, anything such as “alternative medicine” per se? There is one standard modern medicine by comparison with which everything else becomes alternative (Harold). There is a lack of evidence and effectiveness found with CAM because there is a lack of communication between providers and patients about alternative techniques. Why is this so? It could be because some patients believe that conventional providers will be uninterested or have a negative response to CAM experimentation; others patients may believe that CAM use is irrelevant to conventional treatment.
Greater use of such techniques and their reports of effectiveness may lead to even greater acceptance and use of CAM—because of physician recommendations or as part of conventional medical practice, further expanding CAM use. CAM requires further study, if for no other reason than it is likely to in? uence how we come to de? ne and conceptualize health, disease, wellness, and treatment (Hildreth). Researchers estimated that in 1997, Americans paid $27 billion out of pocket for alternative therapies, a figure comparable to the amount estimated to have been spent out of pocket on all U.
S. physician services. When chiropractic treatments covered by insurers are excluded, the proportion paying for alternative treatments increases significantly. A nationwide survey of ten thousand adults conducted in 1997 and 1998 found that 72 percent of those visits to practitioners of CAM were paid for out of pocket. In recent years, a number of insurance companies and health maintenance organizations (HMOs) have responded to increased consumer interest by creating programs that provide coverage for various forms of CAM treatments.
Despite these efforts, both successful and unsuccessful, to integrate alternative medicine into the mainstream health care system, the majority of health insurance plans do not cover CAM treatments. Health insurance industry representatives as well as members of the medical establishment argue that conventional medicine has achieved its legitimacy by passing the rigors of scientific testing, central to which is research based on clinical trials that has been scrutinized through the peer-review process that leads to publication in medical journals.
By contrast, most CAM have not been subjected to those tests. The National Center for Complementary and Alternative Medicine of the National Institutes for Health has begun funding clinical trials of alternative medical treatments, but the accumulated evidence on the effectiveness of those treatments remains small (Tillman). The editors of the New England Journal of Medicine argued in the introduction to a special edition of the journal on alternative medicine, “There cannot be two kinds of medicine-conventional and alternative.
There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work”. This evidence above shows that alternative medicine has not been well integrated into most health insurance plans, which means that consumers who utilize the services of CAM practitioners will most often continue to pay for those services themselves. There are, although, significant differences across the different forms of alternative medicine in the extent to which they have been recognized by health insurers as legitimate providers of medical services.
The most successful, by far, has been chiropractic. In fact, with mandated benefits as well as licensing standards in place in most states, chiropractic medicine is in the process of being “accepted” as part of mainstream medicine (Tillman). Alternative medicine has been proven to work and accepted in some countries. Zimbabwe continues to have one of the most serious AIDS epidemics in the world. Epidemics like AIDS have the power to dramatically transform cultures, and those working at the intersection of health and society, such as traditional healers, are important agents of social change.
70 percent of all Zimbabweans live in rural communities where there is limited access to biomedicine, making Uganda the country’s de facto primary system of health and healing. With the increase in use of complementary alternative medicine (CAM) the boundaries between CAM and conventional medicine can be diminished if evidence in its safety and effectiveness is proven. This can only be done through acceptance that it may work and putting in the research to see if it actually does. It will work when people who currently use CAM will be more open about it and help refer it to those in need.
If Zimbabwe was able to accept CAM as a better mean to providing good health to its sick, it is possible for us to be able to diminish that boundary between CAM and conventional medicine.
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