Complementary and Alternative Medicine

Defining CAM

Although the terms complementary medicine and alternative medicine are often used interchangeably, they have unique meanings. Alternative medicine suggests methods used in place of conventional Western medicine, while complementary medicine implies methods used in combination with conventional health care. As the field of unconventional medicine has grown, the combined term (complementary and alternative medicine or CAM) has become the acceptable nomenclature to depict the field. The National Institutes of Health Center for Complementary and Alternative Medicine (NCCAM) defines CAM as a group of diverse medical and health care systems, practices, and products that are not presently considered a part of conventional medicine. It includes medical or preventive practices that are not routinely taught in medical schools nor underwritten by thirdparty payers. These definitions, however, are exclusionary. More inclusive definitions suggest that CAM is a heterogeneous set of health systems and practices from cultures around the world that share characteristics differentiating them from conventional medicine. Most share a holistic approach that emphasizes wellness and health maintenance; acknowledges and integrates body, mind, and energy/spirit as the core and coequal elements of the human system; appreciates the role of environmental factors in health; and affirms the centrality of personal attitudes and choices in the creation of health and illness. According to the Cochrane Collaboration, an international nonprofit group that maintains a database of health care information, CAM is defined as a broad domain of healing resources that encompasses all health systems, [Page 222]modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. For example, Western medicine (also referred to as allopathic or conventional medicine), which is practiced by medical doctors (MDs) and is dominant in the United States, understands and treats illness from a biologic perspective. Acupuncture, which is neither taught in medical school nor has a recognized biologic basis for its effects, is therefore considered CAM.

CAM can be classified into three broad types: (1) Western alternative medical therapies, for example, homeopathy, naturopathy, herbal medicine, aromatherapy; (2) traditional medical systems, for example, Chinese medicine, Indian Ayurveda, Tibetan medicine, Native American healing, Latin American curanderismo; and (3) complementary approaches, for example, mind-body interventions, psychoneuroimmunology (the study of the relationship between social and psychological factors and biologic processes), energetic healing. Western alternative medical therapies are relatively newer systems of health and healing developed in Europe or America. Some stem from or are related to conventional Western medicine, while others are unique. Traditional medical systems stem from cultural perspectives and form a complete approach to health care. Complementary approaches rely on the mind-body connection or energy as the primary mode of cure and may be used in conjunction with biomedical approaches.

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