Alternative Medicine - Growing Popularity Of Cam

Many people have turned to CAM approaches out of frustration that mainstream medicine cannot meet all their expectations and needs. Helping this movement along is information technology, enabling easy access to sources of CAM information on the Internet and in print and electronic media, and advertising and marketing of new CAM products and methods. As many as 42 percent of Americans are using CAM approaches to satisfy their health needs, according to the NCCAM.

A survey conducted in 1997 by Harvard Medical School researcher Dr. David Eisenberg and colleagues about the use of alternative medicine in the United States found that more than four in ten Americans had used at least one alternative therapy. The survey, published in the November 1998 Journal of the American Medical Association, revealed that approximately 42 percent of Americans used alternative medicine. Further, about $27 billion was spent out of pocket (not paid by insurance) for alternative medicine, a number that was comparable to what Americans paid out of pocket for conventional treatments from physicians in the same year. The researchers reported that the highest rates of CAM use were among college graduates living in the Western United States, ages thirty-five to forty-nine, with incomes greater than $50,000 per year.

Although the majority of CAM services are provided by alternative medical practitioners, CAM also is provided by some traditionally trained physicians. In the National Ambulatory Medical Care Survey: 2001 Summary, the Centers for Disease Control and Prevention (CDC) reported that "therapeutic and preventive services" (not including medication therapy) were ordered or provided at 41.4 percent of all office visits. Visits that included counseling or education related to diet or nutrition (11.6 percent) and exercise (8.2 percent) were made most frequently. (See Table 9.1.)

Americans' Use of Alternative Medicine Is Not Just a Fad

Researchers from the Harvard Medical School and Center for Alternative Medicine Research and Education studied long-term trends in the use of CAM therapies in the United States and published their findings in the August 21, 2001, issue of the Annals of Internal Medicine. The researchers conducted more than two thousand surveys and examined historical patterns of CAM utilization dating back to the 1960s. They questioned survey respondents about twenty different CAM practices, such as acupuncture, aromatherapy, biofeedback, energy healing, massage, and yoga.

TABLE 9.1
Number and percent of office visits, by counseling, education, or therapeutic services ordered or provided and patient's sex, 2001

			Patient's sex
			Female2	Male3
Counseling, education, or therapeutic services ordered or provided	Number of visits in thousands1	Percent of visits	Percent of visits	Percent of visits
All visits	880,487	…	…	…
None	480,457	54.6	55.2	53.7
Diet/nutrition	101,729	11.6	11.3	11.9
Exercise	72,073	8.2	7.8	8.7
Growth/development	34,757	3.9	3.3	4.9
Mental health/stress management	33,820	3.8	0.4	3.6
Weight reduction	23,402	2.7	2.4	3.0
Tobacco use/exposure	18,025	2.0	1.9	2.3
Psychotherapy	16,933	1.9	2.0	1.8
Physiotherapy	14,140	1.6	1.6	1.6
Asthma education	13,778	1.6	1.3	1.9
Other	164,140	18.6	19.1	17.9
Blank	35,281	4.0	3.9	4.2
… Category not applicable.
1Numbers may not add to totals because more than one type of therapeutic or preventive service may be reported per visit.
2Based on 520,110,000 visits made by females.
3Based on 360,377,000 visits made by males.
SOURCE: Adapted from "Table 17. Number and Percent of Office Visits with Corresponding Standard Errors, by Counseling, Education, or Therapeutic Services Ordered or Provided and Patient's Sex: United States, 2001," in "National Ambulatory Medical Care Survey: 2001 Summary," Advance Data,no. 337, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD, August 11, 2003

The study found that since the 1960s nearly all of the 20 CAM therapies had increased in popularity, although interest surged during the 1960s and 1970s. The researchers observed that specific CAM therapies gained acceptance during each decade. In the 1960s Americans embraced diet programs, vitamins, and self-help support groups, and in the 1970s they turned to herbal medicine, biofeedback, and energy healing. The 1980s saw growing popularity of massage and naturopathy, and during the 1990s the appeal of massage increased again along with interest in aromatherapy, energy healing, herbal medicine, and yoga.

In contrast with earlier studies, including Dr. Eisenberg's research, that found CAM users to be mostly educated adults living in Western states, the researchers found the use of alternative therapies was unrelated to education attained, gender, or ethnicity. They observed that the increases in both acceptance of CAM and its use during the past fifty years suggest that demand for CAM therapies will continue in the foreseeable future.

Why Do People Seek CAM?

People turn to CAM for many different reasons. One of the most attractive features of CAM is an emphasis on the "whole person," rather than simply the diseased organ or body part. CAM therapies and practitioners tend to consider patients as human beings rather than simply physical bodies, and nearly all emphasize the mind–body connection and pay attention to emotional wellness and spirituality.

Some patients seek alternative therapies when conventional medicine fails to relieve their symptoms or when traditional treatment produces unpleasant side effects. The 1998 study conducted by Dr. Eisenberg found that nearly half of CAM visits were to chiropractors and massage therapists for symptoms of pain associated with chronic conditions such as back and neck problems, headaches, and arthritis.

Other CAM users cite distrust of physicians, historically poor communication and interactions with physicians, the impersonality of traditional medical care, and the desire for practitioner–patient partnerships characterized by shared decision-making (rather than traditional physician–patient relationships in which physicians assume sole responsibility for decisions about patient care) for their interest in CAM.

Dr. Andrew Weil, a renowned physician and expert in CAM practices and director of the Program in Integrative Medicine at the University of Arizona School of Medicine, believes that one reason for the renewed popularity of CAM is that modern Western medicine has focused on technology and ignored simple, natural, and inexpensive ways to influence health and disease that were used by previous generations and are still used in other cultures. Dr. Weil contends:

People all over the world are increasingly concerned about the harm inflicted by modern, technological medicine, especially adverse reactions to pharmaceutical drugs that are now so common. In deciding what to put in their bodies, they are more inclined to pay attention to the wisdom of nature and be wary of all that is artificial.