Alternative, Complementary and Integrative Medicine – What Do They Mean?
Ravinder Mamtani, MD
Professor of Public Health
Weill Cornell Medical College in Qatar
Alternative (unconventional) medicine means different things to different people.
Many think of alternative medicine as a collection of unscientific practices, such as voodoo and witchcraft, which have no place in our highly technologically advanced health care system.
For these people, alternative medicine stands in stark contrast to conventional medical treatments that are based on the principles of natural sciences and a biomedical paradigm of health and disease that constitute the basis of our modern health care system.
Vague Concepts of Alternative Medicine
Then, there are those who are somewhat more open-minded but remain ambivalent about the effectiveness of alternative therapies. For them, alternative treatments are primarily based on elusive and abstract concepts that cannot be fully explained with our Western scientific model of disease causation and its treatment. Examples of such abstract concepts include Chi (a type of vital force) that forms the basis of traditional Chinese acupuncture, and doshas (energy factors that govern human life) and form the basis of Ayurveda, an ancient health care system widely practiced in India.
Evidence for Alternative Medicine
While most scientists acknowledge that the research data on alternative therapies remains incomplete, the evidence for and against some therapies is becoming apparent. There is sufficient evidence, for example, to support the use of a) acupuncture for
problems such as low back and neck pain, arthritis, and headache/migrain, b) massage therapy for anxiety, c) mind/body techniques such as meditation, hypnosis and and biofeedback for pain and anxiety disorders. Nutrition and herbal supplements are also helpful in many instances.
There are many alternative therapies, however, that have little to offer, or even be harmful to patients. Coffee enemas, ozone therapy, megadoses (large doses) of vitamins and shark cartilage are examples of such therapies.
Alternative or Complementary Medicine?
So what about complementary medicine? To some people the word ‘alternative’ might suggest that alternative treatments are being provided ‘in place’ of proven treatments. This, in my own clinical experience, is far from true.
Responsible practitioners including physicians who specialize in alternative approaches first perform or request a complete evaluation to arrive at a conventional diagnosis. Alternative treatments are then offered, if indicated, as an adjunct or in addition to conventional treatments that patients might receive from their physicians.
I feel it is prudent to offer unconventional treatments as complementary, rather than as an alternative. That is why many practitioners think of alternative medicine as complementary medicine, and rightly so.
New Integrative Medicine Approach
Alternative therapies, the origins of which are deep rooted in cultures of various nations, are here to stay. It is no longer an option for us to ignore them. Their growth is inevitable. While health policy planners and the health care industry grapple with their
growth, it is clear that a new integrative medical approach to disease and health management is beginning to emerge. This approach, which is based on scientific evidence, will make available to patients proven conventional and unconventional
treatments that best serve their interest.
Such an approach views the human body as an integrated system with a close relationship between the body and the mind. It pays attention to the patient’s religious, spiritual, socio-cultural beliefs and values.
Integrative medicine uses a patient-centered approach in which patients are active rather than passive participants. Patient empowerment, education, and self-care are important components of this approach.
In my opinion, this integrative approach to patient and disease management will allow us to focus on preventive medicine, health promotion and optimum health so individuals can lead a balanced and a healthy life. It will allow patients to become informed
consumers and make intelligent choices about their own health.
The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. If you have or suspect that you have a medical problem or condition, please contact your physician.