Complementary and alternative medicine (CAM) has grown rapidly over the last two decades and is now used by around six million people a year.
Britons spend £130m a year on complementary treatments and it is estimated this will exceed more than £200m over the next four years according to The Prince’s Foundation for Integrated Health.
The term complementary and alternative medicine refers to any therapy that is not provided by orthodox health professionals like doctors, nurses and dentists.
However, some techniques, for example massage therapy, are now being included in nurses’ training.
The Cochrane Collaboration defines complementary and alternative medicine (CAM) as a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health systems of a particular society or culture in a given historical period.
A survey conducted by the Centre for Complementary and Alternative Medicine at the University of Exeter in 2000 suggested that there are around 50,000 practitioners of Complementary and Alternative Medicine in the United Kingdom (House of Lords, 2000).
Alternative medicine is understood to mean therapies that are presented as an option to conventional or Western medical treatments. For example, when cancer patients choose not to have chemotherapy or radiotherapy and instead follow special dietary regimes.
On the other hand, complementary medicine or therapy describes treatments that can be used alongside conventional treatment, for example, osteopathy, Reiki healing, chiropractic and massage therapy.
Where complementary therapies are used within a conventional medical setting as part of a prescribed treatment, this is known as integrated medicine. Integrated health may be seen as a response to the changing patterns of disease in the early 21st century.
Most therapies have a holistic approach which believes that health flows from the harmonious balance of our physical, psychological and spiritual states. A disruption in any of these spheres can impact on one or both of the others.
In order to uncover the root cause of a symptom, a CAM practitioner will ask questions not only about your medical history but also about your diet, lifestyle habits, sleeping patterns, relationships etc. While this helps the therapist build up a picture, patients also find it helpful to have the opportunity to talk at length about themselves, something they are unable to do in an orthodox medical setting.
In terms of finding a fit within conventional medicine, complementary medicine or therapy is an adjunct or complementary to conventional medicine. For example, osteopathy can often relieve back pain more effectively than medication. It can also enhance conventional treatment. Massage therapy or Reiki healing may help relieve anxiety in cancer patients allowing insertion of a cannula more easily.
Increasingly, health professionals regard integrated medicine as the healthcare of the future. The idea being that when you consult your GP, he or she might prescribe medication or send you to a specialist and may also refer you to a complementary therapist attached to the practice.
The CAM sector conducts itself within a weak regulatory regime. The UK Government does not require CAM practitioners to be licensed to operate a business, enabling almost anyone to set up a practice.
However acupuncture, homeopathy, herbalism, massage, naturopathy and nutritional therapy do have well-established training standards and professional protocols.
Therapists in these fields are encouraged to complete rigorous training programmes, belong to therapy associations, and adhere to professional standards of conduct and best practice. Osteopathy and chiropractic have achieved statutory self-regulation.
A process is currently underway, following recommendations made by the House of Lords Select Committee on Science and Technology in 2000 to organise statutory regulation of acupuncture and herbal medicine in England.
Due to the increased popularity of complementary medicine in this country, the House of Lords Select Committee on Science and Technology undertook a 15-month study of CAM and their report was published in November 2000.
The report concluded that most therapies are relatively safe, with the exception of acupuncture, chiropractic and herbal medicine which could cause harm in the wrong hands. The report divided CAM into three groups:
Group One: acupuncture, chiropractic, osteopathy, herbal medicine and homeopathy – all of which had the best professional organisations and training standards. Chiropractic and osteopathy are now regulated which means it is illegal for anyone to practise without being registered with a professional body.
Group Two: These included therapies that were harmless enough to complement conventional medicine even though supporting evidence was lacking. Among these are Alexander techniques, aromatherapy, Bach flower remedies, massage therapy, hypnotherapy, meditation, reflexology, shiatsu, healing, nutritional medicine and yoga.
Group Three: This group consists of those therapies that the Committee considered scientifically unproven and unregulated. These include: ayurveda, traditional Chinese medicine, naturopathy, crystal therapy, iridology, and kinesiology.
Major steps towards regulation have been taken by the Foundation for Integrated Health which has been involved in helping many complementary healthcare professions move towards voluntary regulation.
It is widely accepted that CAM is still under-researched and there are also problems with funding and infrastructure. All of these elements lag behind the current popularity of CAM and this needs to be addressed. Commercial interests in CAM are scarce, so support has to rely heavily on government and charitable funding.
Many feel that all good medicine is evidence-based and, therefore the CAM community needs to embrace the need for evidence-based work in order raise its acceptance, not only amongst clients but also medical practitioners.
House of Lords Select Committee on Science and Technology Report November 2000.
This article was provided by the Institute for Complementary and Natural Medicine (ICNM). The ICNM was formed in 1982 to provide the public with information on all aspects of the safe and best practice of CAM. The ICNM also administers the British Register of Complementary Practitioners (BRCP. Established in 1989, this is the longest-running register of CAM practitioners in the UK. It is a multi-disciplinary Register of Practitioners in England, Wales, Scotland, Northern Ireland, and countries outside the UK, who have provided evidence of their individual competence to practice.