· By Michael Goldberg
Complementary And Alternative Medicine (CAM)
The first Medicare bankruptcy
Alternative medicine refers to medical approaches to diagnosis and treatment that lie outside the province of conventional medicine and are practiced instead of, rather than alongside, conventional medicine. Complementary medicine, which may consist of the same treatments as alternative medicine, is practiced in conjunction with conventional medicine, as a supplement.
CAM includes not only Acupuncture, Homeopathy, Chiropractic Therapy, and Herbal Medicine, but many other approaches to diagnosis and treatment, including (in alphabetical order) Alexander Technique, Alternative Diets, Alternative Exercise Therapies, Anthroposophic Medicine, Aromatherapy, Ayurvedic Medicine, Bach Flower Remedies, Cellular Therapy, Chelation Therapy, Colonic Irrigation, Craniosacral Therapy, Crystal Therapy, Cupping, Detoxification, Ear Candles, Feldenkrais Method, Feng Shui, Food Supplements, Hypnotherapy, Leech Therapy, Magnet Therapy, Massage Therapy, Meditation, Naturopathy, Neural Therapy, Orthomolecular Medicine, Oxygen Therapy, Reflexology, Reiki, Relaxation Therapies, Shiatsu, Spiritual Healing, and Traditional Chinese Medicine.
There is some difference in opinion as to what should or should be not classified as CAM. In a semantic sense, there really is no CAM that has been shown to work, since once a CAM treatment has been found effective it becomes adopted as a part of conventional medicine, so it is no longer “CAM.” Some CAM treatments have been shown to be ineffective, but for others there is insufficient evidence as yet to make the case one way or the other, and they might be useful.
While the same treatments can be used in alternative and complementary medicine, alternative medicine is more risky. By dismissing conventional medicine (e.g. many alternative practitioners advise patients not to immunize their children or use antibiotics), alternative medicine runs the risk of neglecting treatment for conditions that are highly treatable by the conventional approach. One plays Russian roulette with a child’s health by relying only on alternative medicine. Administering an ineffective remedy for a high fever in a child will be successful when the treater is lucky and there is a spontaneous cure, which usually occurs. But in the less common situation where there is a more serious illness, such as a meningitis or septicemia, the results may be disastrous. Hence, the importance of working together with the conventional system if one wants to try an unconventional approach.
You are taught conventional medicine in medical school rather than CAM. You will need to learn more about CAM on your own. You will be faced with patients who ask about or are using a variety of unconventional approaches. How do you sort through and evaluate all these options? The Internet is full of misleading information, as are many TV and radio shows, and tabloids that patients rely on from supermarket check-out counters. I suggest the following sites for trustworthy information:
Science-Based Medicine blog
Quackwatch, by Stephen Barrett
The SkepDoc by Harriet Hall, MD
New York’s Memorial Sloan Kettering Cancer Center’s herbal/botanical database
The Cochrane Summaries
There are also the following books:
Trick or Treatment: The Undeniable Facts about Alternative Medicine, by Edzard Ernst and Simon Singh
Snake Oil Science: The Truth about Complementary and Alternative Medicine, by R. Barker Bausell
Bad Science: Quacks, Hacks, and Big Pharma Flack, by Ben Goldacre
Do You Believe in Magic?: Vitamins, Supplements, and All Things Natural: A Look Behind the Curtain, by Paul A. Offit