COMPLEMENTARY & ALTERNATIVE MEDICINE.

ELLEN F. HUGHES, MD, PhD.

KEVIN BARROWS, MD.   (ref. Current Medical Diagnosis.)

The use of complementary and alternative medicine (CAM) has become common in the United States. To maintain effective clinician patient communication and ensure responsible clinical practice, it is important that clinician learn the theory, practice, and scientific evidence associated with these therapies.

GENERAL CONSIDERATION.

CAM is defined by the National Institutes of Health (NIH) as a group of diverse health care systems, practices, and products that are not presently considered to be part of conventional medicine, CAM therapies may be used alone as an alternative to conventional therapies or in addition to conventional, mainstream medicine to treat conditions and promote well being.

CAM modalities have been classified by NIH into five major categories;

1. .Biology based practices use substances found in nature, such as herbs, special diets, or vitamins ( in doses outside those used in conventional medicine).
2. Energy medicine involves the use of energy fields, such as magnetic fields or biofields ( energy fields that some believe surround or penetrate the human body). Examples include Reiki, external qigong, and therapeutic touch.
3. Manipulative and body-based practices  use manipulation or movement. of one or more body parts (massage, chiropractic, Feldenkrais method and other ''body work'' systems).
4. MIND BODY MEDICINE use a variety of techniques designed to enhance the mind's ability to affect bodily function and symptoms, such as biofeedback, meditation, prayrer, art and music therapy, hypnosis, and guided imagery.

Whole medical system are built on complete systems of theory and practice that have evolved apart from--and often earlier than--the conventional medical approach used in United States. Systems such as traditional Oriental medicine, acupuncture, homeopathy, naturopathy, Ayurveda, and Tibetan medicine often use one or more of the methods listed above.

Most people who use CAM combine it with conventional medicine because they perceive the combination to be superior to either alone.

In January 2005, the Institute of Medicine of the National Academics released a report on the use of CAM in the United States. They recommend ''health profession schools incorporate sufficient information about complementary and alternative medicine (CAM) into the standard curriculum at all levels to enable licensed professionals to competently advise their patients about CAM.''

Funding for biomedical research in this field increased when the NIH established the Office of Alternative Medicine in 1992 with an annual budget of $2 million. In 1998, its role was expanded as the National Centre for Complementary and Alternative Medicine (NCCAM).  NCCAM's budget for fiscal year 2007 was $21 million.