ACADEMY PUBLIC POLICIES

Complementary and Alternative Medicine (CAM) has a objective: study and research of  a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Practices are often grouped into broad categories, such as natural products, mind and body medicine, and manipulative and body-based practices. 

Some  practices may fit into more than one category as "Natural Products" includes use of a variety of herbal medicines (also known as botanicals), vitamins, minerals, and other "natural products." Many are sold over the world as dietary supplements.

(Some uses of dietary supplements-e.g., taking a multivitamin to meet minimum daily nutritional requirements or taking calcium to promote bone health-are not thought of as CAM.)

"Natural Products" also include probiotics-live microorganisms (usually bacteria) that are similar to microorganisms normally found in the human digestive tract and that may have beneficial effects.

Probiotics are available in foods (e.g., yogurts) or as dietary supplements. They are not the same thing as prebiotics-nondigestible food ingredients that selectively stimulate the growth and/or activity of microorganisms already present in the body. 

Herbal or botanicalmedicines reflect some of the first attempts to improve the human condition. The personal effects of the mummified prehistoric "ice man" found in the Italian Alps in 1991 included medicinal herbs. By the Middle Ages, thousands of botanical products had been inventoried for their medicinal effects.

Mind and Body Medicine

Mind and body practices focus on the interactions among the brain, mind, body, and behavior, with the intent to use the mind to affect physical functioning and promote health. Many CAM practices embody this concept in different ways.

• Meditation techniques include specific postures, focused attention, or an open attitude toward distractions. People use meditation to increase calmness and relaxation, improve psychological balance, cope with illness, or enhance overall health and well-being.
• The various styles of yoga used for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. People use yoga as part of a general health regimen, and also for a variety of health conditions.
• Acupuncture is a family of procedures involving the stimulation of specific points on the body using a variety of techniques, such as penetrating the skin with needles that are then manipulated by hand or by electrical stimulation. It is one of the key components of traditional Chinese medicine, and is among the oldest healing practices in the world. Acupuncture is considered to be a part of mind and body medicine, but it is also a component of energy medicine, manipulative and body-based practices, and traditional Chinese medicine.

 Other examples of mind and body practices include deep-breathing exercises, guided imagery hypnotherapy, progressive relaxation, qi gong, and tai chi.

The concept that the mind is important in the treatment of illness is integral to the healing approaches of traditional Chinese medicine and Ayurvedic medicine, dating back more than 2000 years. Hippocrates also noted the moral and spiritual aspects of healing and believed that treatment could occur only with consideration of attitude, environmental influences, and natural remedies.

Manipulative and Body-Based Practices

Manipulative and body-based practices focus primarily on the structures and systems of the body, including the bones and joints, soft tissues, and circulatory and lymphatic systems. Two commonly used therapies fall within this category:

• Spinal manipulation is practiced by health care professionals such as chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. The amount of force applied depends on the form of manipulation used. The goal of the treatment is to relieve pain and improve physical functioning. Spinal manipulation is among the treatment options used by people with low-back pain - a very common condition that can be difficult to treat.
• The term Massage therapy encompasses many different techniques. In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. People use massage for a variety of health-related purposes, including to relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and depression, and aid general well-being.

 Spinal manipulation has been used since the time of the ancient Greeks and was incorporated into chiropractic and osteopathic medicine in the late 19th century. Massage therapy dates back thousands of years. References to massage appear in writings from ancient China, Japan, India, Arabic nations, Egypt, Greece (Hippocrates defined medicine as "the art of rubbing"), and Rome.

Other CAM Practices

CAM also encompasses movement therapies - a broad range of Eastern and Western movement-based approaches used to promote physical, mental, emotional, and spiritual well-being. Examples include Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration.

Practices of traditional healers can also be considered a form of CAM. Traditional healers use methods based on indigenous theories, beliefs, and experiences handed down from generation to generation.

Some CAM practices involve manipulation of various energy fields to affect health. Such fields may be characterized as veritable (measurable) or putative (yet to be measured). Practices based on veritable forms of energy include those involving electromagnetic fields (e.g., magnet therapy and light therapy). Practices based on putative energy fields (also called biofields) generally reflect the concept that human beings are infused with subtle forms of energy; qi gong, Reiki, and healing touch are examples of such practices.

Finally, whole medical systems, which are complete systems of theory and practice that have evolved over time in different cultures and apart from conventional or Western medicine, may be considered CAM. Examples of ancient whole medical systems include Ayurvedic medicine and traditional Chinese medicine. More modern systems that have developed in the past few centuries include homeopathy and naturopathy. 

1. According to a random survey conducted in 2010, 45% of Americans sought out and used one or more types of medical interventions that were not taught in medical schools and were not generally available in U.S. hospitals. This represented an eight percentage point increase over the 1990 results of the same survey. While the vast majority (96%) of these people was also seeking conventional treatment for their health problems, less than 40% of these people told their conventional doctors what they were doing. Clearly, something’s going on with alternative medicine. More than half of these Americans paid for the entire cost of treatment themselves, contributing to the estimated $ 36 billion spent on alternative medicine treatments in 2012 - almost equal to U.S. consumers’ out-of-pocket expenses for conventional physician’s services in the same time period. In total, Americans made 800 million visits to alternative healers in 2011, nearly 243 million more visits than to all U.S. primary care physicians. While no comparable survey results have been published since then, all indications are that Americans have continued to embrace alternative therapies, most likely at an accelerating rate. Clearly, alternative medicine is a big business.The mainstream medical community can no longer ignore alternative therapies. The public interest is extensive and growing. You have only to look at the proliferation of popular health books, health food stores, and clinics offering healing therapies to realize that this interest cannot be dismissed. In other words, Americans want something more than biomedicine, and they are willing to pay for it.

 2. Why Are People Turning to Alternative Medicine?

 Some people have the same goal for both conventional and alternative medicine, such as the use of both pain medications and acupuncture to control chronic pain. Others may have a different expectation for each approach: For example, seeing a conventional practitioner for antibiotics to eradicate an infection, and then using an alternative practitioner to improve natural immunity through a healthy lifestyle. Someone receiving chemotherapy may use meditation and visualization to control the side effects of the chemotherapeutic agents. People who combine conventional and alternative therapies are making therapeutic choices on their own and assuming responsibility for their own health.

 Thirteen Top Reasons People Seek Alternative Therapies

 Problem Percentage of Sufferers:

1. Neck problems 57
2. Back problems 48
3. Anxiety 43
4. Depression 41
5. Headaches 32
6. Arthritis 27
7. GI problems 27
8. Fatigue 27
9. Insomnia 26
10. Sprain/strains 24
11. Allergies 17
12. Lung problems 13
13. Hypertension 12

Because alternative therapists are rushing to meet the demand, it is increasingly difficult for consumers to figure out how and where to get the best health care. It may be difficult to find reliable information to help separate the healers from those who pretend to have medical knowledge. You should beware of healers who display these characteristics:

 ·         Say they have all the answers.

·         Maintain that their therapy is the only effective therapy.

·         Promise overnight success.

·         Refuse to include other practitioners as part of the healing team.

·         Seem more interested in money than in your well-being.

Some alternative specialties are more regulated and licensed than others, but none come with guarantees - any more than conventional medicine comes with guarantees. Many people locate alternative therapists through friends, family, an exercise instructor, health food stores, or referral lines at local hospitals. Most people don’t speak with their conventional medicine providers about their use of alternative therapies, out of fear of embarrassment, ridicule, or discouragement. These fears are unreasonable. If your physician is judgmental and not pleased to see you taking an active interest in your health, then you may want to consider finding another physician. On the other hand, there’s no doubt that your doctor knows more about medicine than you do (unless you’re a doctor too!). By having an open and frank discussion, you can find therapies that help address your concerns while steering clear of those that are dangerous or hoaxes.

 REASONS WHY PEOPLE CHOOSE ALTERNATIVE THERAPIES:

• To pursue therapeutic benefit.
• To seek a degree of wellness not supported in biomedicine.
• To attend to quality-of-life issues.
• They prefer high personal involvement in decision-making.
• They believe conventional medicine treats symptoms, not underlying cause.
• They find conventional medical treatments to be lacking or ineffective.
• To avoid toxicities and/or invasiveness of conventional interventions.
• To decrease use of prescribed or over-the-counter (OTC) medications.
• To identify with a particular healing system as a part of cultural background.

 Alternative medicine is an umbrella term for hundreds of therapies drawn from all over the world. Many forms are based on the medical systems of older cultures, including Egyptian, Chinese, Asian Indian, Greek, and Native American, and have been handed down over thousands of years, both orally and as written records. Other therapies, such as osteopathy and naturopathy, have evolved in the United States over the past two centuries. Still others, such as some of the mind-body and bioelectromagnetic approaches, are on the frontier of scientific knowledge and understanding. Although they represent diverse approaches, alternative therapies share certain attributes. They are based on the paradigm of whole systems, and the belief that people are more than physical bodies with fixable and replaceable parts. Mental, emotional, and spiritual components of well-being are considered to play a crucial and equal role in a person’s state of health. Since body, mind, and spirit are one unified reality, illness is considered to affect, and be affected by, both body and mind. Even Hippocrates, the father of Western medicine, espoused a holistic orientation when he taught doctors to observe their patients’ life circumstances and emotional states. Socrates agreed, declaring, “Curing the soul; that is the first thing.” In alternative medicine, symptoms are believed to be an expression of the body’s wisdom as it reacts to cure its own imbalance or disease. Other threads or concepts common to most forms of alternative medicine include the following:

• An internal self-healing process exists within each person.
• People are responsible for making their own decisions regarding their health care.
• Nature, time, and patience are the great healers.