CAM: Does an apple a day really keep the doctor away?
The National Center for Complementary and Integrative Health reported in 2012, 33.2 percent of adults in the United States used alternative health approaches (NIH). John Astin received his PhD in health psychology from the University of California. He researches the field of mind and body medicine. He claims that people seek out alternative medication because they are not satisfied with traditional treatment, they feel as if they have more control over their own health care conditions, or the alternative methods are more compatible with their values and beliefs. He conducted a study on alternative medication which consisted of a written survey that examined the actual use of alternative methods, status on health, as well as values and attitudes toward traditional medicine. He concluded that patients’ dissatisfaction with traditional medicine practices didn’t predict the use of alternative medication, because only 4.4 percent of the 1035 people who were surveyed said that they relied primarily on alternative treatments (Astin, 1998).
CAM is a group that consist of diverse medical systems and practices that aren’t usually seen in today’s conventional medicine (NIH). Complementary medical practices can be used alongside of traditional medicine, or in place of traditional medicine as a whole. These types of treatments consist of mind and body therapies such as acupuncture, art therapy, meditation, massage therapy, chiropractic therapies, natural remedies with essential oils and many, many more. Alternative treatments focus on prevention, encouraging patients to try and prevent disease and illness before it even occurs. Also, alternative medicines focus on whole body care and health, addressing the physical body, as well as patient’s emotions and spiritual health. Although the outcomes of alternative medicine sound body positive and natural, there is very limited scientific research behind its concept (UCSF Medical Center). So, the question is, how affective is alternative medication, and is it really benefiting its patients?
In order to get into the concept of alternative medication, it is important to know a brief history of medicine in general, and when alternative medication finally started to pop up on the history of medicine timeline. It was prior to the 19thcentury when medical practices included things such as prescribing herbal remedies. 19thcentury health care was something that became centered on the division of labors. For example, specialized doctors like surgeons. Also, scientist during the 19thcentury discovered ways to separate ingredients in plant based medicines, which was a contributor to the rise of the modern pharmaceutical industry. It was by the mid 20thcentury that advances in medicine incorporated CAM into western countries. It was roughly between the 1960’s and 70’s when the medical counterculture became popular in the west. Some people believed that conventional medicine was counterproductive due to medical tragedies. People also associated conventional medicine with depersonalization and disempowerment; people thought that being treated with conventional medication took away from being a human because it is not a natural way of healing (Saks). The transition from conventional medical practices to alternative medicine in the west sparked a counterculture movement that still exists today all over the world.
It is important to address scientific studies and their conclusions on the topic of alternative medicine to really address why people use this type of treatment and how it is affecting patients. The conclusion of John Astin’s study on why patients use alternative medicine was that the majority of alternative medicine users are simply not satisfied with conventional medical treatments and because they find alternative medicine to be more congruent with their values and beliefs toward health and life (Astin, 1998). Astin’s conclusion supports the fact that most alternative medicine treatments are not scientifically backed, and that patients turn to alternative medicine because they feel that is what is right for their bodies and lifestyle. Another factor that has been looked into is whether patients inform their doctors about their alternative medicine use. A study conducted by Patricia Thomson, Jenny Jones, Josie M. Evans, and Stephen J. Leslie done in the Complementary Therapies in Medicine Journal looked into whether patients tell their doctors about their alternative medicine uses and the factors that influence the use of alternative medicine. This study was conducted through a random sample survey of 1261 adults in Queensland Australia, asking questions about CAM use, how often CAM is used, the types of CAM that are used, reasons for use, and if patients discuss CAM use with their doctor. The main results were that 61.7 percent of the surveyed responders had used self- prescribed alternative medicine methods or visited an alternative medicine practitioner. They concluded that a significant amount of people don’t seek medical advice from their primary care doctor before using CAM (Thomson, Jones, Evans, Leslie 2011). What all this information shows is that patients turn to a specialized CAM doctor in order to use alternative treatments, not their primary medical doctor who would potentially prescribe traditional medicine rather than conventional medicine. The more important studies focus on the effects of alternative medicine uses. For example, The New England Journal of Medicine reported on the risks of untested and unregulated remedies. It stated that “what most sets alternative medicine apart, in our view, is that it has not been scientifically tested”, and “alternative medicine also distinguishes itself by an ideology that largely ignores biologic mechanisms (…) and relies on what are purported to be ancient practices and natural remedies” (The New England Journal of Medicine, 1998). Basically, people don’t believe in alternative medicine because there is no science to support it, and those who do believe in alternative medicine practices rely on history and things that haven’t been proven true. This journal states a case where a patient suffered from central nervous system depression after taking a substance sold in a health- foods store as well as another patient who experienced being poisoned after consuming an Indian herbal remedy for diabetes. What these cases put forward is that not only are these alternative medicines not supported with scientific evidence, but because they aren’t tested treatments, they have the potential to harm and kill patients. The Clinical Toxicology journal reported a study in Singapore on adverse events associated with peoples use of complementary medicine. The study stated that from 1998-2009, 627 cases of adverse events due to alternative medicine were reported. 22 fatalities were reported (Patel, Low, Tan, Tan, Zhang, Low, Chan & Koh 2012.) What all these studies show is that because CAM is not scientifically supported, it is not usual to see CAM prescribed by a primary care physician. Also, not only are alternative methods supported by science, but they have also been the cause of harm and death to patients who choose to use them.
The current outlook on alternative medicine is controversial, and largely depends on people’s views. Those in the scientific community see alternative medicines as inaccurate, and even harmful. Because alternative medicine still currently lacks scientific support and evidence of actually helping patient’s health, those who practice science will continue to reject the idea of CAM. As for those who willingly take part in the use of alternative medicine, they feel that alternative medicine methods are more congruent to their lifestyle, as well as their values and beliefs. Aside from how people feel about the topic, CAM still lacks scientific evidence and support, therefore making traditional medicine practices more effective and more reliable.
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