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For Dummies is a registered trademark of Wiley Publishing, Inc. in the United States and other countries. Used here by license.What do all the names mean?At one time, people often used the term alternative medicine because people tended to select this therapy as an alternative to mainstream medicine – that is, the medicine practiced by doctors and nurses and offered in GP surgeries, hospitals, and so on. Mainstream medicine is generally referred to as orthodox, allopathic, or conventional medicine. So, alternative medicine has also sometimes been called unconventional or unorthodox medicine.
Some practitioners liked the term alternative medicine, because they believed their approach did provide a real alternative to orthodox healthcare. However, others felt the term was too confrontational, creating a ‘them’ and ‘us’ situation between medics and alternative medicine practitioners. These people preferred the term complementary medicine, because they saw their work as complementary to orthodox medicine and believed the two were perfectly capable of working alongside one another.
Gradually, the term CAM – complementary and alternative medicine – evolved to reconcile these two perspectives and has been quite widely used. However, as CAM therapies become more incorporated into the mainstream, people are dropping the word ‘alternative’. Also, the term CAM is itself now making way for the buzz phrase integrated medicine, referring to what Prince Charles calls ‘the best of both worlds’. This incorporates the best of both orthodox and complementary approaches to provide the most appropriate form of healthcare for different health problems and individuals.
I use the terms complementary medicine and complementary therapies because these are currently two of the most widely used and recognized. However, I myself see complementary medicine as part of the wider whole of healthcare – drawing on the best of tried and tested ancient medical traditions, pioneering new and modern forms of healthcare, and integrating with existing medical practices. I also believe that rigorous training standards, research, and evaluation of the different therapies are essential to ensure that they’re safe and effective for public use.
What is complementary medicine?What actually comes under the complementary medicine umbrella? Ancient traditions provide the roots of complementary medicine: the medical systems of China, India, Tibet, and so on that also incorporate influences from the traditions of ancient Greece, Persia, and elsewhere. Some people believe that these traditions shouldn’t even really be classed as alternative or complementary because they’ve been practiced for thousands of years. However, their revitalization and popularity today puts them firmly in the frame of modern health approaches. Good examples of these are Ayurveda, Traditional Chinese Medicine (TCM), Tibetan medicine, and Kanpo (Japanese herbal medicine).
Some of the most popular complementary therapies today developed directly from these ancient roots – for example, acupuncture is a part of Traditional Chinese Medicine and has developed over thousands of years. Others have been developed more recently, such as osteopathy, which developed from the work of US Army doctor Andrew Taylor Still in the 19th century.
Five types of therapies are particularly well-established in the UK: Osteopathy, chiropractic, acupuncture, herbalism (Western and other forms such as Chinese, Tibetan, and Japanese herbal medicine), and homeopathy. In the US, Australia, and Germany naturopathy is also a predominant and well-regulated form of treatment. Other therapies, such as nutritional therapy, are growing in popularity too.
Some of these complementary therapies have become increasingly mainstream. Osteopathy and chiropractic, for example, are now regulated by law in the UK, included under many health insurance schemes, practiced on the National Health Service (NHS), and used for referral by GPs for health problems such as back and neck pain. In fact, for some people these therapies are no longer regarded as complementary at all but are considered as professions allied to medicine.
However, this situation doesn’t mean that all therapies are immune to controversy. A subtle form of osteopathy, known as cranial osteopathy, has been particularly under attack, and homeopathy, developed in the 18th century in Germany by Dr Samuel Hahnemann, excites major disagreement as to whether it is effective or ‘all in the mind’.
Other less well-established therapies are regarded by many as truly weird and wacky. These include crystal, color, and light therapy, chakra healing, and so on. Yet each of these therapies also has many serious and committed practitioners and research may yet confirm their effectiveness.
What’s the evidence?Complementary medicine can generate huge amounts of controversy, with the argument ranging between those who are convinced that it works to those who are dead set against it and determined that it’s all ‘quackery’. Probably a middle path is a more reasonable approach, where each therapy is considered in the clear light of evidence examining its effectiveness.
Critics often argue that little or no good research supports the use of complementary medicine, but this simply isn’t true. Many of the well-established therapies, such as acupuncture, herbal medicine, naturopathy, osteopathy and chiropractic, have quite a number of good quality scientific studies on their use. Research has been carried out around the world, including in Europe, the US, China, Japan, and India. However, researchers often find it difficult to get funding for this kind of research (only a tiny portion of public or private money is spent on complementary medicine research compared to medical research in most countries) and many early studies have design flaws. More good quality research is underway and much needed.
Other therapies, however, have little or no scientific research to back them up, although they may have lots of anecdotal evidence – that is, accounts of people who claim to have benefited from the therapy. However, this type of evidence is not enough to ‘prove’ that the therapy is effective and is rarely enough to convince skeptics. Lack of evidence may be a reason to approach the therapy with caution but it doesn’t necessarily mean that it is ineffective.
All in the mind?Some critics argue that complementary medicine is all placebo, that is, that the treatments work simply because the patients want them to work rather than through any value of their own and that benefits are ‘all in the mind’ or are due to the increased personal attention and time spent with patients in complementary consultations. The growing body of scientific evidence doesn’t really justify such a claim and yet all treatments involve placebo to some extent. For example, studies have shown that, even in orthodox medicine, patients do better if they have strong confidence in their doctor or the treatment/medicine that they’re receiving. So some researchers argue that placebo is a power to be harnessed rather than dismissed.
Prince Charles famously said, ‘The unorthodoxy of today may well become the orthodoxy of tomorrow’, and so it may prove that some of the therapies that are so maligned and ridiculed now prove to be accepted and commonplace in years to come.
Going carefully but breaking down barriersCarefully investigating what sort of evidence is available before deciding to undergo a particular therapy is certainly worthwhile. However, also remember that orthodox, or conventional, medicine is itself relatively new, and many of its treatments have also developed through trial and error and even accident (such as the discovery of penicillin!). Many of its medicines, such as aspirin, are based on old herbal remedies and even extensive medical research cannot always guarantee safety. In fact, certain orthodox treatments have triggered terrible side effects (consider thalidomide) and the British Medical Journal has concluded that many have only limited or unknown proven effectiveness.
So complementary medicine deserves the chance to be carefully considered and investigated, along with other forms of medicine, rather than being rejected simply because it is unconventional. Building barriers may in fact obstruct new learning that could be beneficial to health!
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For Dummies is a registered trademark of Wiley Publishing, Inc. in the United States and other countries. Used here by license.