What is CAM?
Complementary and alternative medicine (CAM) is a term used to describe a diverse group of healing systems that are not presently considered to be part of mainstream medicine. The goal of conventional medicine is to locate the physical source of a particular disease and then remove it. For example, if a patient has some sort of infection, a conventional doctor would probably prescribe a specific antibiotic to kill the invading bacteria. CAM practitioners, on the other hand, take a more “holistic” approach to healthcare. They believe that health and disease involve a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, and social factors. In order to treat a disease or simply promote good health, CAM practitioners treat the whole body by taking all of these factors into account.
In the United States, this holistic approach to health has been labeled “alternative” for a variety of scientific, cultural, and political reasons. In many cases it is very difficult to scientifically test alternative practices, such as acupuncture, in the same way that certain conventional practices, such as medications, are tested. Although alternative therapies are often based on hundreds — in some cases thousands — of years of experience, the conventional medical community relies heavily on scientific evidence (rather than clinical experience) when evaluating the safety and effectiveness of a particular therapy. For this reason, many alternative practices that have not been thoroughly tested (or cannot be thoroughly tested) are considered “unscientific” by modern Western standards. In addition, many non-Western healing practices are not taught in United States medical schools, available to patients in U.S. hospitals, or even covered by health insurance in the country.
What does complementary medicine and alternative medicine mean?
The terms “complementary medicine” and “alternative medicine,” although often used to mean the same thing, actually have quite different implications. Complementary medicine refers to medical practices used together with conventional medicine while alternative medicine is used in place of conventional medicine. An example of complementary medicine is the use of hypnotherapy together with pain medications to reduce anxiety and enhance relaxation in people recovering from severe burns. Following a special diet rather than taking medications to treat attention deficit/hyperactivity disorder (ADHD) is an example of alternative medicine.
What is integrative medicine?
The term “integrative medicine” is often used interchangeably with CAM, but it has a subtle and very important different meaning. Professionals who practice integrative medicine blend appropriate CAM therapies with mainstream medicine rather than simply adding one complementary therapy (such as herbs, for example) to a standard medical treatment. For example, an integrative treatment for Alzheimer’s disease may include a combination of the following: (1) medications that increase certain brain chemicals, (2) antioxidants (such as vitamin E and ginkgo biloba) that scavenge free radicals, (3) changes in lifestyle (such as walking programs and relaxation training) to reduce anxiety and improve behavior, and (4) music therapy to bolster the immune system. More and more Americans are becoming familiar with the term “integrative medicine,” and studies have found that this blended approach to healthcare is safe and effective for a growing number of medical conditions.
What are the basic principles of CAM?
Although CAM therapies vary widely, several themes can be traced through them all:
The focus is on the whole person — physical, emotional, social, and spiritual.
Prevention of illness is a primary concern.
Treatments are highly individualized.
Treatments are aimed at the causes of illness rather than at its symptoms.
Treatments are designed to support the natural healing processes of the body.
Who is using CAM?
The barriers to integrative medicine are beginning to fall — or, at least are becoming less difficult to overcome. Alternative healing practices are increasingly being tested for effectiveness and safety in well-designed research studies. The intermixing of diverse cultures in the West are bringing once distant healing practices to the forefront and more Americans are turning to integrative medical care than ever before.
The movement toward integrative medicine in the United States has been prompted by a growing consumer demand for CAM services. A landmark study published in 1993 found that more than one-third of Americans had sought CAM therapies, that in 1990 they had made more visits to CAM providers than to their primary care physicians, and that consumers had spent more than 13 billion dollars out-of-pocket for these CAM visits.
Studies suggest that demand for CAM services continues to grow at a startling rate. A 2001 survey found that nearly 70% of Americans have used at least one form of CAM therapy in their lifetime, making this “unconventional” medical approach one of the fastest growing sectors of American healthcare. Although herbs and supplements are not regulated by the U.S. Food and Drug Administration (FDA), pharmacies across the country are experiencing a tremendous surge in the demand for these alternative remedies. From 1991 to 1996 alone, the demand for over-the-counter natural remedies (including herbs and supplements) doubled. In a 1996 survey by Landmark Healthcare, more than 70% of HMOs reported an increase in requests for CAM by their members. Most patients (56%) requested acupuncture, followed by chiropractic (45%), massage (25%), acupressure and biofeedback (21% each), hypnotherapy (8%), and reflexology (4%).
Studies also suggest that U.S. medical schools may be warming up to CAM. As of 1998, 75 out of 117 (64%) U.S. medical schools offer at least one course in CAM. In a 1994 survey, 60 percent of doctors reported recommending CAM to their patients. Nearly half of the doctors who responded to the survey acknowledged that they used CAM themselves. More and more health insurance plans are also covering CAM, particularly treatments such as acupuncture and chiropractic, whose safety and effectiveness in the treatment of certain health problems has been fairly well researched. A number of health plans now cover the Ornish heart program, which has a basis in yoga and nutrition. All of these changes in American healthcare point to the careful movement—often with a healthy dose of skepticism—toward an integrative medicine system that incorporates the most useful therapies from the world’s many healing traditions.
What are the major types of CAM?
The National Center for Complementary and Alternative Medicine (NCCAM) classifies CAM therapies into five major groups:
Alternative Medical Systems: built upon complete systems of theory and practice. Examples include homeopathy, naturopathy, traditional Chinese medicine (TCM), and Ayurveda.
Biological Medicine: use of substances found in nature, such as herbs, foods, and vitamins to promote health.
Energy Medicine: involves the use of energy fields to promote health. Some forms of energy medicine (known as biofield therapies) are designed to influence energy fields that are believed to surround and penetrate the human body. Examples of biofield therapies include qi gong, Reiki, and Therapeutic Touch. Other forms of energy medicine (known as bioelectromagnetic-based medicine) involve the use of electromagnetic fields, such as electroacupuncture.
Manual Medicine: based on manipulation and/or movement of one or more parts of the body. Examples include osteopathy, physical therapy, massage, chiropractic, Feldeinkrais, and reflexology.
Mind-Body Medicine: uses a range of techniques that help boost the mind’s ability to influence bodily functions and symptoms. Examples include biofeedback, deep relaxation, guided imagery, hypnotherapy, meditation, prayer, support groups, and yoga.