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Alternative medicine broadly describes methods and practices used in place of conventional medical treatments. It may also be described as "diagnosis, treatment, or therapy which can be provided legally by persons who are not licensed to diagnose and treat illness" — although practitioners are frequently so licensed.
Medical doctors and scientists define alternative medicine as any treatment that has not been verified through peer-reviewed, controlled studies.
Complementary medicine uses both alternative medicine methods and practices alongside conventional medical treatment. Integrative medicine, as defined by the National Center for Complementary and Alternative Medicine, combines conventional medical treatments and alternative treatments for which there is some peer-reviewed evidence of their safety and efficacy. Collectively, these variations on alternative medicine are often referred to as complementary and alternative medicine (or simply as CAM).
Legal jurisdictions differ as to which branches of alternative medicine are legal, which are regulated, and which (if any) are provided by a government-controlled health service. Regulation does not, however, reflect the effectiveness of the methods used. Some practitioners and branches of alternative medicine have been investigated by governmental agencies for health fraud, and in a few cases criminal charges have been brought.
Most doctors and scientists feel that the term "alternative medicine" is misleading, as these treatments have not been proven to be an effective alternative to regulated conventional medicine.
"Conventional medicine" refers to medical techniques accepted as valid by the majority of the scientific and the health community; it is based on standards of proof of efficacy based on double-blind studies. Such techniques are usually based on known, observed biochemical mechanisms, and their known relation to biology.
Richard Dawkins, professor of the Public Understanding of Science at Oxford University, defines alternative medicine as "that set of practices that cannot be tested, refuse to be tested or consistently fail tests" (See Diamond 2003).
There is a concern that patients may delay seeking conventional medicine that could be more effective, whilst they undergo alternative therapies, potentially resulting in harm.
Many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been shown through double-blind randomized controlled trials. Where alternative methods provide temporary symptomatic relief, this has been explained as being due to the placebo effect, or to natural healing, or to the cyclic nature of some illnesses.
Medical doctors hold that alternative medical practitioners sometimes fail to correctly diagnose illnesses, and therefore do not provide safe therapies every time. William T. Jarvis, Ph.D contends in the web article "How Quackery Harms Cancer Patients" that "Dubious therapies can cause death, serious injury, unnecessary suffering, and disfigurement" and gives an example of how an unlicenced naturopath caused a severe disfigurement of a patient.
Due to the wide range of types of alternative medicine few criticisms apply across the board. Criticisms directed at specific branches of alternative medicine range from the fairly minor (conventional treament is believed to be more effective in a particular area) to potential violations of the laws of physics (for example, in homeopathy).
Practices termed as "alternative medicine" have caused deaths indirectly when patients have used alternatives in attempts to treat such conditions as appendicitis and failed. Proponents of alternative medicine say that people should be free to choose whatever method of healthcare they want. Critics agree that people should be free to choose, but when choosing people must be certain that whatever method they choose will be safe and effective. People who choose alternative medicine may think they are choosing a safe, effective medicine, while they may only be getting quack remedies. This can be a particular issue in the treatment of children and individuals whose capacity to evaluate the treatment is impaired, and of animals.
The scientific community argues that many studies carried out by alternative medicine promoters are flawed, as they often use testimonials and hearsay as evidence, leaving the results open to observer bias. They argue that the only way to counter observer bias is to run a double blind experiment, where neither the patient nor the practitioner knows whether the real treatment is being given or if a placebo has been administered. This research should then be reviewed by peers to determine the validity of the research methodology.
Testimonials are especially useless in this procedure, because by chance alone some people will get cured and will be able to testify that the method really helped them. Furthermore, if the majority of people using a method do not notice any benefit or even get worse, there will still be a minority that can testify that the method really helped for them.
A review of the effectiveness of certain alternative medicine techniques for cancer treatment (Vickers 2004), while finding that most of these treatments are not merely "unproven" but are proven not to work, notes that several studies have found evidence that the psychosocial treatment of patients by psychologists is linked to survival advantages (although it comments that these results are not consistently replicated). The same review, while specifically noting that "complementary therapies for cancer-related symptoms were not part of this review", cites studies indicating that several complementary therapies can provide benefits by, for example, reducing pain and improving the mood of patients.
Some argue that less research is carried out on alternative medicine because many alternative medicine techniques cannot be patented, and hence there is little financial incentive to study them. Drug research, by contrast, can be very lucrative, which has resulted in funding of trials by pharmaceutical companies. Many people, including conventional and alternative medical practitioners, point out that this funding has led to corruption of the scientific process for approval of drug usage, and that ghostwritten work has appeared in major peer-reviewed medical journals. (Flanagin et al. 1998, Larkin 1999).
Nearly all mainstream doctors and scientists are open to revising their views of any specific new treatment, if new peer-reviewed evidence comes available.
As such, the boundaries of alternative medicine have changed over time. A number of techniques once considered to be alternative medicine have reached the status of conventional medicine.
Advocates of alternative medicine hold that alternative medicine may provide health benefits through patient empowerment, by offering more choices to the public, including treatments that are simply not available in conventional medicine.
Any positive effects that such alternative medicine treatments offer, even if they are only based on placebo effects, still provide benefits to overall patient health that traditional medicine might not have provided.
Some physicians are willing to embrace some aspects of alternative medicine. Dr. Russell Greenfield states "I tell them 'I'm one of you' and that we have the data - we have the studies, we're not making this up," when talking to other physicians. Greenfield was referring to published studies on the beneficial effect of saw palmetto on enlarged prostates, and how body work, or massage therapy, is effective for treating lower back pain.
Dr. Karen Koffler states: "I've learned how to balance the intellectual processes of medicine with an intuitive understanding of what this person, this patient really needs to gain strength for healing. That is never taught in medical school and is lost entirely from medicine now." (McClain 2004).
A major objection to alternative medicine is that it is done in place of conventional medical treatments. As long as alternative treatments are used alongside standard conventional medical treatments, most physicians find most forms of complementary medicine acceptable (Vickers 2004).
Those physicians that practice complementary medicine believe there is some value in alternative forms of treatments.
The boundary lines between alternative and mainstream medicine have changed over time. Some methods once considered alternative have later been adopted by conventional medicine, when confirmed by controlled studies. Many very old conventional medical practices are now seen as alternative medicine, as modern controlled studies have shown that certain treatments were not actually effective. Supporters of alternative methods suggest that much of what is currently called alternative medicine will be similarly assimilated by the mainstream in the future.
A search on PubMed reveals that there are over 370,000 research papers classified as alternative medicine published in Medline-recognized journals since 1966 in the National Library of Medicine database (such as Kleijnen 1991, Linde 1997, Michalsen 2003, Gonsalkorale 2003, and Berga 2003). There are no statistics on exactly how many of these studies were controlled, double-blind peer-reviewed experiments or how many produced results supporting alternative medicine or parts thereof.
Some alternative treatment methods have been shown to be effective for specific medical conditions in recently published research (such as Michalsen 2003, Gonsalkorale 2003, and Berga 2003).
Alternative medicine provide the public with services not available from conventional medicine. This argument covers a range of areas, such as patient empowerment, alternative methods of pain management, treatment methods that support the biopsychosocial model of health, cures for specific health concerns, stress reduction services, other preventative health services that are not typically a part of conventional medicine, and of course complementary medicine's palliative care which is practiced by such world renown cancer centers such as Memorial Sloan-Kettering (see Vickers 2004).
The placebo effect is a persistent problem when conducting research, because it makes it harder to determine the intrinsic effect of whatever is being studied. For a patient being treated, however, the placebo effect is always beneficial (Benedetti et al. 2003). Alternative medicine tries to capitalize on the positive value of the placebo effect.
Edzard Ernst wrote in the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health in the United States, found that in 2002, more than one-third of Americans used some form of alternative therapy — a category that included yoga, meditation, herbal treatments and the Atkins diet. If prayer was counted as an alternative therapy, the figure rose to almost two-thirds. Consistent with previous studies, this study found that the majority of individuals (i.e., 54.9%) used CAM in conjunction with conventional medicine ( page 6).
Increasing numbers of medical colleges have begun offering courses in alternative medicine. For example, the University of Arizona College of Medicine offers a program in Integrative Medicine under the leadership of homeopathy and acupuncture.
In countries where healthcare is state-funded or funded by medical insurance, alternative therapies are often not covered, and must be paid for by the patient. Further, in some countries, some branches of alternative medicine are not properly regulated. So there is no governmental control on who practices, and no real way of knowing what training or expertise they possess in these countries.
Many alternative medicine advocates chafe at the restrictions of government agencies which approve medical treatments (such as the American Food and Drug Administration) and the agencies' adherence to experimental evaluation methods. They claim that this impedes those seeking to bring new ideas and methods to the public more rapidly, and protest that their contributions and discoveries are unfairly dismissed, overlooked or suppressed. The alternative medicine industry argues that health fraud, when it occurs, should be dealt with appropriately.
List of alternative medicine techniques.
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