Alternative, Complementary, and Integrative Medicine

July 1, 2011 | Health System Risk Management


While medical scientists were exploring the human genome, approximately 40% of the U.S. population was using approaches to healthcare that long predate modern medicine, according to a 2007 National Health Interview Survey conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention (Barnes et al.). Adults seek nonconventional healthcare to improve their health and well-being, relieve symptoms of chronic illness or adverse effects of conventional treatment, or treat a terminal illness. Concerns about the cost of conventional healthcare and lack of trust in conventional medicine among certain patient populations influences individuals’ decisions to use alternative healthcare approaches for themselves and their children. Many do not disclose their use of alternative medicine to conventional healthcare providers, who often remain unaware of their patients’ use of alternative medicine (Chao et al.).

A central question for risk managers, providers, and patients is whether alternative medical practices are safe and effective. To address this concern, Congress authorized the National Institutes of Health (NIH) to create the National Center for Complementary and Alternative Medicine (NCCAM) as one of numerous centers that make up NIH within the U.S. Department of Health and Human Services. NCCAM conducts and supports research and informs healthcare practitioners, researchers, and the public about alternative medicine and healthcare systems, practices, and products and about alternative therapies that have been shown to be effective in randomized clinical trials. The Office of Cancer Complementary and Alternative Medicine at the National Cancer Institute (NCI) is responsible for NCI’s complementary and alternative medicine research that may relate to cancer prevention, diagnosis, treatment, and symptom management.

Ideally, alternative therapies would receive the same scientific evaluation as standard healthcare approaches so that unconventional therapies proved to be safe and effective could become part of standard healthcare. Study results show that acupuncture, yoga, meditation, guided imagery, and massage therapy, for example, are increasingly integrated into the conventional treatment of heart disease, cancer, back pain, and other serious illnesses and conditions (Chou et al). However, most alternative medicine practices remain unstudied. The relative scarcity of credible information about the safety or efficacy of alternative practices coupled with patients’ reluctance to discuss their use of alternative therapy with their physicians creates challenges for conventional and alternative healthcare providers, patients, and healthcare organizations.

As alternative practices gain greater acceptance in the established medical community, the distinction between alternative and conventional medicine is blurring (Kemper et al.). Because of the increasing use of nonconventional therapy, the American Medical Association resolved in 2006 to "promote awareness among medical students and physicians of the wide use of complementary and alternative medicine, including its benefits, risks, and evidence of efficacy or lack thereof" (AMA).

Increasingly, hospitals, academic medical centers, hospices, home healthcare settings, and physician office practices are integrating alternative therapy with conventional medicine to meet the needs and desires of diverse patient populations (Van Meter and Sexton). Integrative medicine providers use a multitude of approaches to address licensure, credentialing, and malpractice liability risk and use various models...

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