Complementary and alternative healthcare and medical practices (CAM) encompass a diverse range of systems, practices, and products that are not currently considered part of conventional medicine1. The debate surrounding the efficacy of CAM is ongoing and complex, with proponents arguing for the holistic care and individualized treatment offered by these practices, and skeptics pointing to the lack of rigorous scientific evidence supporting their use. This article aims to explore this debate in depth, drawing on the evidence presented in the article “Complementary and Alternative Healthcare: Is it Evidence-based?”
CAM practices can be grouped into five major domains: alternative medical systems, mind-body interventions, biologically-based treatments, manipulative and body-based methods, and energy therapies. These practices range from traditional systems like Ayurveda and Traditional Chinese Medicine to more contemporary practices like naturopathy and integrative medicine.
The philosophy of CAM is rooted in holistic care, focusing on treating the individual as a whole rather than just addressing specific symptoms. This approach often involves a combination of techniques that engage the mind, body, and spirit, with treatment plans being highly individualized based on the presenting symptoms.
The Efficacy Debate
The central debate surrounding CAM revolves around its efficacy. Conventional medicine relies on methods that have been proven safe and effective through carefully designed trials and research. Many CAM treatments, however, lack this solid research foundation, leaving their potential benefits and dangers largely unproven.
Despite this, the use of alternative medicine appears to be increasing. A 1998 study showed that the use of alternative medicine in the USA had risen from 33.8% in 1990 to 42.1% in 1997. This increase has been accompanied by a growing acceptance of CAM within the medical community, with many medical colleges now offering courses in alternative medicine.
The Role of Evidence-Based Medicine
Evidence-based medicine (EBM) applies the scientific method to medical practice, aiming to ensure that healthcare professionals make “conscientious, explicit, and judicious use of current best evidence” in their everyday practice. Critics of CAM argue that many alternative treatments fail to meet the standards of EBM, with their efficacy not demonstrated through double-blind randomized controlled trials.
However, advocates of CAM argue that the placebo effect, which may play a role in the benefits some receive from alternative therapies, does not diminish their validity. They contend that CAM provides health benefits through patient empowerment, offering more choices to the public.
CAM therapies are characterized by their holistic approach, often requiring active participation from the patient in their own treatment, such as through lifestyle changes like diet, exercise, and meditation. These therapies are diverse in nature and origin, with many based on the idea of enabling the body’s ability to heal itself.
In contrast, conventional medicine primarily focuses on understanding and correcting the underlying problems causing symptoms. Critics argue that conventional medicine often treats the condition rather than the person, expecting patients to accept the diagnosis and treatment. However, the influence of CAM approaches has led to an increasing recognition of the importance of patient involvement and choice in treatment within conventional medicine.
Why People Use CAM
People turn to CAM for a variety of reasons. Some are drawn to the more natural treatments that make them feel more in control. Others may have persistent pain, concerns about the side-effects of medication, or find that their symptoms are not fully controlled by conventional medicine.
The efficacy of CAM is difficult to generalize due to the wide variety of treatments available. Effectiveness might be judged by whether the patient feels better, but it may also relate to measurable improvement in the condition or general well-being.
Safety of CAM
Generally speaking, CAM is relatively safe, but it is always advisable to consult with a doctor before starting treatment. Some therapies, particularly herbal ones, may have significant side-effects or may interact with prescribed medication. The risks associated with CAM are often more related to the therapist than the therapy itself, highlighting the importance of consulting with a legally registered or ethically bound and insured therapist.
CAM on the NHS
The availability of CAM on the NHS varies, with some organizations employing chiropractors and osteopaths, and some physiotherapists using acupuncture. The Royal London Hospital for Integrated Medicine is an NHS center for integrated and complementary medicine, but a referral from a GP is required.
The Future of CAM
As research into CAM continues, the answers about whether these treatments are safe or effective will become clearer. There is a growing consensus that all treatments, whether “mainstream” or “alternative”, should be held to the standards of the scientific method.
In conclusion, the debate on the efficacy of CAM is complex and multifaceted. While there is a growing acceptance of these practices, more rigorous scientific research is needed to establish their safety and effectiveness. As the field of CAM continues to evolve, it is crucial to maintain a focus on patient safety and evidence-based practice.
About the author
Sarah B Brien, a distinguished scholar and clinician, holds a prominent position in the Academic Unit of Primary Care and Population Science at the University of Southampton. Sarah completed her undergraduate studies with a BSc, followed by a Master’s degree (MSc), and eventually attained her Doctorate (PhD). She further broadened her qualifications by obtaining an ATT and a Diploma in Hypnotherapy.
Her academic career has been marked by an unwavering commitment to exploring the potential of complementary medicine. With a commendable track record of 64 published clinical studies to her credit, Sarah is a leading voice in her field. Her contributions have significantly advanced understanding and informed best practices in complementary medicine.
Sarah’s multi-disciplinary training provides her with a uniquely integrative perspective, which she applies in her research and teaching. Her interests extend across a broad spectrum of complementary medicine, and she is known for her meticulous, evidence-based approach.
Sarah’s work is characterized by rigorous methodology, a deep commitment to improving patient care, and an earnest pursuit of scientific knowledge. Through her research, Sarah B Brien continues to challenge conventional paradigms and bring fresh insights into the practice and potential of complementary medicine.