Academic journal article American Journal of Law & Medicine

Alternative Medicine's Roadmap to Mainstream

Academic journal article American Journal of Law & Medicine

Alternative Medicine's Roadmap to Mainstream

Article excerpt


Alternative medicine has been rapidly expanding as consumers drive the demand for more cost-effective, accessible and individualized healthcare.1 A commonly cited survey in the New England Journal of Medicine (NEJM) found that more Americans were consulting alternative care providers than allopathic/conventional physicians.2 In 1998, David Eisenberg published a follow up to this landmark survey, showing a marked increase in both the use of alternative care and the number of individuals seeking such care.3 The study revealed that 42.1% of Americans consulted at least 1 of 16 alternative therapies during 1997, an increase from 33.8% in 1990.4 Total visits to alternative practitioners soared from 427 million in 1990 to 629 million in 1997.5 This explosion of alternative care in the United States has begun to force prominent medical schools across the country to offer courses in alternative medical techniques.6 Over seventy-five major medical schools have begun to teach courses in alternative modalities.7 Moreover, the alternative care industry has established several journals to cover its expanding field.8

In an attempt to monitor the expanding field of medicine, Congress directed the National Institutes for Health to establish the Office of Alternative Medicine (OAM) in 1993.9 The OAM provides research grants to evaluate the safety and efficacy of alternative modalities.10 Since its inception, the OAM has funded over ninety research grants totaling over $13 million.11 Under the 1999 Omnibus appropriations bill, enacted on October 21, 1998, Congress established the National Center for Complementary and Alternative Medicine (NCCAM) in place of the OAM.12 Congress appropriated $50 million to establish NCCAM with the purpose of identifying and evaluating alternative modalities.13 For Fiscal Year 2000, Congress increased appropriations to $68.4 million to reflect growing interest in alternative care.14 "NCCAM has already begun a number of activities that will serve to facilitate the integration of validated CAM theories into conventional medical practice."15

Despite the dramatic surge in the promotion and use of alternative care, several obstacles still block alternative medicine's transition into the mainstream. Most notably, the American Medical Association (AMA) has impeded alternative providers access to its physicians' patients.16 An editorial in the NEJM lambasted alternative care, claiming that these therapies are insufficiently tested, "rely ... on anecdotes and theories", are possibly dangerous, and are "a reversion to irrational approaches to medical practice."17

In addition, the insurance industry has been slow to react to the rise in demand for alternative treatment and has only recently begun to experiment with coverage.19 The percentage of users paying entirely out-of-pocket for alternative therapies has improved only slightly between 1990 (64.0%) and 1997 (58.3%).19 These statistics demonstrate the difficulty still faced by consumers in obtaining coverage for alternative care. Consumer demand has created a market for alternative care; however, discrimination against these providers abounds.20

This Note focuses on the expanding field of alternative medicine and its struggle to find a place in the healthcare quagmire. Part II describes the five fields of practice that fall under the rubric of alternative medicine and their licensure status throughout the United States. Part III provides an overview of state medical practice statutes as they pertain to alternative care and their varying acceptance of non-conventional modalities. Part IV illustrates legislative and judicial reluctance to bring alternative medicine into the mainstream. Part V discusses both federal and state legislation to provide choice of care to consumers. Part VI enumerates reasons to provide consumers with freedom of choice as well as mechanisms for its regulation. Part VII concludes by arguing that federal and state government should enact legislation to bring conventional and alternative medicine together to accommodate the integrated care that consumers increasingly demand. …

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