Alternative Medicine

Complementary and alternative medicine has been defined as “those practices that aren’t part of the politically dominant medical system”.  They aren’t taught in medical schools, they are unavailable in most clinics, and they are rarely reimbursed by health insurance.  Herbal medicine, mind-body interaction, past-lives regression therapy, art therapy, ethnic healing rituals, pet therapy, and aromatherapy are just a few examples.   In 1990 it was found that one-third of Americans regularly used alternative therapies and the vast majority of these patients, expecting disapproval, never tell their doctors.  Since 1990, use of these therapies has increased exponentially.  Although the National Institutes of Health has established an Office of Alternative Medicine, there remains only the weakest of links between practitioners of alternative medicine and physicians.    

Some therapies, like acupuncture for chronic pain and relaxation techniques for insomnia, have become part of physicians’ tools.  Their effectiveness and safety are supported by clinical evidence.  Other therapies, such as certain herbal medicines, are perceived to be safe by patients because they require no prescription and are marketed as ‘natural’, but have serious side effects.  Unless traditional health care providers become more familiar with these, we will remain unprepared to manage our patients’ health.  These authors also argue physicians need to begin to augment their patient management with complementary and alternative approaches.  There is a need for better interaction and understanding between these two medical worlds. 

Over 70 medical schools now introduce complementary and alternative medicine to their students.  But there are no pertinent content areas that must be covered.  The authors recommend that scientific efficacy of many therapies, legal and ethical considerations, and the role of spirituality in healing must become part of established medical school and residency curricula.

(Konefal J: Academic Medicine 2002; 77(9):847-850.)

Comment: Many schools have had to develop guidelines on whether nurses and other school staff should administer herbal medications, and if so, how to do this.  The more the medical profession understands about this, the better off we will all be.      – H.T.