More and more people are paying for CAM services in supplementation to or in place of allopathic medicine. Many MDs hold strong critical opinions regarding CAM providers since much of what they practice does not meet the standards of evidence-based medicine. Evidence-based medicine are therapies (drugs and interventions) that have shown to have measurable, predictable benefits through controlled studies.
Although we may not understand how much of CAM works from a physiological or pharmacological level, I still think there is a valuable role for CAM in health care alongside Western medicine. For one, Western medicine does a poor job at prevention and treatments that integrate psychological/lifestyle aspects into care. Second, Western medicine often uses aggressive therapies which carry risks of complications (procedures) and side effects (drugs). CAM, on the other hand, approaches illness from a holistic perspective that places greater value on prevention, the mind-body connections, and typically uses very conservative, low-risk methods.
Controversy in Western medicine centers around the following questions
- When does an MD refer his patient to a CAM providers?
- What should be the scope of medical practice legally and ethically permitted by CAM providers?
- To what medical standard should CAM providers be held?
A hypothetical case
A CAM doctor treats a cough for 6 months with little resolution. The patient sees an allopathic doctor who immediately discovers a tumor that could have been diagnosed earlier, altering the treatment and outcome for the patient. In this case, the CAM doctor will probably not be sued and not be held professionally responsible as a primary care doctor might be.
At any rate it seems that in the future a multi-modal treatment approach will be the most successful for many common conditions. Ideally a patient seeking help for back pain would be treated by a team of allopathic and CAM doctors who work together and know each other's practice philosophy intimately. Treatment for cancer might fall primarily to the MD, with palliative pain therapy support from the acupucturist. Treatment for lower back pain may fall primarily on the chiropractor with support from the MD and Oriental medicine doctor.
Also, I hope that with better scientific understanding CAM therapies will become more accepted in Western medicine, and that CAM doctors will embrace a critical approach to their respective fields as scientific knowledge of CAM practices grows.
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