Alternative Medicine's Rapid Spread? Nonsense
I don't want to provoke the ire of the pros or the antis (I managed to anger both after doing a story about alternative medicine in January), so please heed: This post is not about the clincial merits of herbals, acupuncture, homeopathy, and other forms of complementary and alternative medicine. It's about the intellectual dishonesty of the surveys that appear every few years purporting to show CAM use. Invariably, very, very large numbers of Americans say they use CAM, and this year's report is no exception. Released earlier this week by the National Center for Complementary and Alternative Medicine (part of the National Institutes of Health) and the National Center for Health Statistics, it shows that almost 40 percent of all American adults used some form of CAM in 2007.
Spin, folks. The kind that would do a political consultant proud. It started almost 20 years ago with the first large survey in 1990. That one found 34 percent of U.S. adults used alternative medicine (as it was then called). "Used" was defined so generously, however, that it's hard to understand how almost every person surveyed didn't qualify. You were a user if one time in the previous year you used one of the 16 listed therapies, which included such marginal entries as "self-help group," "commercial diet," and "lifestyle diet." The 1997 survey was the same except more so; usage was up to 42 percent.
In 2002, the hype really kicked in. The first figure cited in the report showed that adult CAM users had jumped to 62 percent. But read a little further and you see why—"prayer for health reasons" had been added. When that was removed, CAM usage dropped to 36 percent, a decline from 1997. And that was even though six more types of CAM therapies had been tacked onto the 1997 list.
Now we're up to the report released earlier this week. Prayer was gone, but four more therapies were added, bringing the total number of categories to 25. Yet the percentage of users was about 38 percent, or what it was in 2002. This year's hype is kids—almost 12 percent of children used CAM in 2007, we are told. Let's look. Hmm, a large number of those kids did "deep breathing exercises." Another big chunk had seen a chiropractor or osteopath. And the largest number of CAM children were taking (or had taken even once, remember) some kind of natural product, including fish oil.
That brings me to the final criticism, that the number of people using therapies that a reasonable person would consider CAM, such as Far Eastern medicine, homeopathy, and energy healing, is tiny. The percentage of ayurvedic medicine users is so low, 0.1 percent or less, that it is statistically invalid. Homeopathy: 1.8 percent. Energy healing: 0.5 percent. Naturopathy: 0.3 percent. I can go on, but you should read the report and judge for yourself. My point is that by and large, we are not a nation that buys into CAM. No amount of statistical twisting will change that. And that's what the message should be—-not an artificial conclusion that tens of millions of people are into CAM.
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Reader Comments
the trend is the point
I have no doubt that trying to account for - or count - the use of alternative therapies presents consumers with a confusion of claims and counterclaims. Is "prayer" a therapy? Hmmm. But research shows that accommodating a person's personal spiritual realm can be important in the process of healing.
The un-spun story of CAM can be found in simple experiences that are increasing, by any measure, in communities across the country. I would like a dollar for each time I've talked to someone who had good results by trying some alternative therapy. These are people who two years ago would never have considered such options.
41 of the nation's premier medical schools are members of a consortium with integrative medicine centers. The American Academy of Pediatrics earlier this year started a Section on "Complementary, Alternative and Integrative Medicine." NIH's NCCAM has been researching alternative options for 16 years, to the tune of $1.5 billion-plus.
This is not the result of hyper-spin and overselling, or the credulousness of scores of millions of Americans. It is due primarily to the word of mouth that has circulated through the population for the last 35 years. This is not unlike how common knowledge among aboriginal peoples is created through trial and error and passed on in those cultures. Unlike those times, we have the tools, technologies and curiosity now to understand the properties and attributes of natural substances that have only recently started to be evaluated in anything resembling a scientific examination. And of the whole human, down to the atom.
It is still very early.
Usage Timeline
As far as the use of vitamin/mineral-type therapies, this year's survey asked about usage of specific products within the last 30 days, not 12 months like previous surveys. This was one reason they gave why the Echinacea numbers were so dramatically different - the survey was during the spring, not typical cold/flu season when folks are using those products.
Economics of Medicine
I assume the survey was based on United States. This is become most of the world still uses alternate medicine. This is because most of the world simply can not afford the rich medicine practised in the United States.
We could reduce our health care costs if we were more flaxiable. It presently takes 800 million dollars to develop a drug based on the lastest claims by drugs companies and get the drug approved by the FDA.
The process is very expensive. If we want to at least modify this system we could be saving billions of dollars.
You can take the case of traditional Chinese medicine (TCM) which has been praticed 3,000 years without using FDA approval and call this alternative medicine. But it is showing via conventional research to prove out in many cases.
But still not accepted as this would require billions of dollars to get FDA approval. So what is accepted is big business created by our capitalist system. We may one day call our medicine practised in the United States as capitalist medicine and not conventional medicine as you can not separate culture from medicine.
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U.S. News's Avery Comarow has been editor of the America's Best Hospitals annual rankings since they first appeared in 1990. His reporting on clinical medicine, from the latest cholesterol guidelines to robotic surgery, has been driven by the question: What does this mean to patients? And that is the perspective he brings to his observations and commentaries on the increasing number of programs by hospitals and other healthcare providers to improve care and patient safety.
