Alternative Medicine: More Hype Than Hope?

Article excerpt

In 1992, Congress established The Office of Alternative Medicine to facilitate the scientific evaluation of therapies that could improve health and well being, but was usually not included in the educational curriculum or training of physicians. Implicit in its mandate was the need to serve as a clearinghouse for all such approaches, rather than investigating or endorsing a select few. But how can "Alternative" Medicine be defined? What would be included under this vague heading? What criteria could be utilized to determine where the limited funds available should be spent to get the greatest return?

Nobody seemed to have the answer to these questions. "Alternative" suggests something that is being substituted for conventional treatment. But "Complementary" and "Integrative" Medicine had become increasingly popular synonyms, implying that such nontraditional approaches should be used together with FDA approved drugs and procedures. "Holistic" or "Wholistic" embraced both concepts, but placed more of an emphasis on the importance of mind/body relationships, and the need to address emotional and spiritual needs in treatment. "Questionable," "unorthodox," "natural," "New Age," "unconventional" and "unproven" were frequently used substitutes, but each has a different connotation.

"Alternative Medicine" was considered by some to be a meaningless term, if not an oxymoron. Critics pointed out there might be "alternatives" to medicine, but not alternative medicine, since once something has been proven efficacious, it simply becomes medicine. As one emphasized, "There is no alternative medicine. There is only medicine that works and medicine that doesn't work."

Is Supplementation Superior To Substitution?

In 1999, because of confusion and controversy over terminology, Congress changed the title from Office of Alternative Medicine (OAM) to National Center for Complementary and Alternative Medicine (NCCAM). CAM was defined as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." Complementary therapies supplemented or enhanced the benefits of traditional medicine whereas alternative therapies were more likely to be substitutes that replaced them. NCCAM classified all of these as falling under one or more for the following five domains:

Alternative Medical Systems: Includes 19th century homeopathy, osteopathy, chiropractic and naturopathy, as well as ancient Indian (Ayurvedic) medicine (yoga, meditation, massage, diet and herbs) and Oriental (Chinese) medicine (acupuncture, qigong, herbal medicine, exercise and breathing techniques). There are also other Asian, Pacific Island and Native American modalities that are still practiced.

Mind-Body Interventions: Examples include meditation, guided imagery prayer, dance, music and art therapy, hypnosis, prayer and mental healing, and other mind-body techniques and practices such as Hatha yoga, cognitive behavioral therapy and support groups.

Biologically Based Therapies: Herbal therapies, macrobiotic and other special diets, megavitamin or orthomolecular therapy, procaine, EDTA and chelating compounds, shark cartilage, aromatherapy, apitherapy and other specific biological treatments such as immunoaugmentive therapy, antineoplastins and Coley's toxin for cancer.

Manipulative Body-Based Methods: Includes massage (Swedish, lymphatic, neuromuscular, reflexology), bodywork (Rolfing, polarity and cranio-sacral therapy), as well as postural programs that focus on relationships between the musculoskeletal system and body movement (Alexander Technique, Trager Approach and Feldenkrais Method)

Energy Therapies: Some energy medicine practitioners believe an invisible life force (Qi, ch'i, prana) flows through and surrounds the body in a biofield. Illness occurs when this force becomes blocked or imbalanced. The goal of therapy is to correct this blockage by applying pressure or manipulation. …