The Term Complementary and Alternative Medicine - Essay Example

Report on Complementary and Alternative Therapies Available to People in My Community The term Complementary and Alternative Medicine (CAM)refers to therapies and health-practices which do not form part of mainstream medical care. (House of Lords Report ch1) What constitutes 'mainstream' medical care would, of course, depend on the time and the place. In the current context it refers to Allopathic Medicine or 'Western' medicine, not including Homeopathy. In this essay we propose to look at the availability and role of CAM at the local level, principally in the health care system of the UK. The National Health Service (NHS) since 1948 acquired hospitals from local authorities. This hospital network was expanded, reworked and merged with the intention of providing a single District Hospital supporting local GP's and in turn being supported by teaching and specialist hospitals. These District Hospitals have 500 to 800 beds and operate at 90% capacity. (nhshistory.com). The availability of CAM in the organised NHS is very little. In fact CAM is hardly reimbursed under the NHS network. Most CAM services were provided by private practitioners - the majority were in the home counties and the Midlands; Northern Ireland, Wales, Scotland and East Anglia had the least. (Dixon et al 2003) Several studies and enquiries show that the use of CAM in the UK has been on the increase. But comparisons should be made with caution, because of the differences in the definition of the term. (House of Lords Report ch1) A telephonic random survey of 1204 persons conducted by the BBC in 1999, revealed that 20% of the respondents had used CAM in the preceding 12 months. Of these the favoured therapies in their order of importance were herbal remedies (34%), Aromatherapy (21%), Homeopathy (17%) and Acupressure/ Acupuncture (14%) (House of Lords Report ch1) A Report prepared by the Royal Pharmaceutical Society in 1999 found that retail sales of complementary medicine preparations came to 93m in 1998. (House of Lords Report ch 1) In Europe, both UK and Germany are countries, which are seen as 'CAM-tolerant'. "Germany has been considered to have a high level of (special) regulation and legal-political protection of CAM compared with other European countries (Guillod, 1999)."(Dixon et al 2003) This is in contrast with France, Spain and Belgium, "where the medical profession has maintained its monopoly over medical practice and where the activities of non-medically qualified CAM practitioners are illegal." (Dixon et al 2003) In the US too, a telephonic survey indicated that from 1900 to 1997, there was a noticeable increase in the already existing use of CAM. Out-of-pocket expenditure (paid for by patients, and not reimbursed) on this was estimated at $27.0 billion in 1997. (House of Lords Report ch1) What are the reasons for people shifting to CAM The possible reasons for using CAM is the need for people to have control over their own health, a philosophical and spiritual orientation, and a belief in the mind-body connection. It was found (in the US) that people of higher educational status tended to CAM. (House of Lords Report ch 1) This could probably be that those who had access to literature on the subject, and had an enquiring mind would use this to a greater extent. Another reason could be that conventional medicine is reimbursed, and not CAM. Presuming that better educated people had higher incomes, this would explain why CAM was (is) favoured by higher income groups as opposed to the lower. Apart from this, sufferers from chronic health problems such as anxiety, back problems, urinary tract problems and chronic pain used CAM. From this it may be deduced that conventional medicine had not provided a complete 'cure' for these problems. Another reason cited for the increased use of CAM is that it had become fashionable, and also due to the increasing interest in the paranormal (astrology and the like). More social mixing (immigrants from Asian and African countries) resulting in interest in other systems of medicine indigenous to Asia and Africa has also had an influence on the use of CAM. For instance, US based Indian doctor-writer, Deepak Chopra's books on alternate therapies have become quite the rage across the world, and have influenced many not only in the West, but also in his home country to adopt/ revert to the use of CAM. Another reason for the increasing popularity of CAM could be the "flight from science" (House of Lords Report, ch 1), fuelled by reports in the media of the views of environmental groups who warn against the results of too much technology and 'progress'. Regarding the evidence available for the efficacy of CAM it has been found that rigorous scientific research on the results of alternate medicine is not easily available as compared with that available in conventional medicine. Apart from this, practitioners of CAM have not shown much inclination to scientifically test the validity of treatment. (House of Lords Report ch 4) However, patient satisfaction, if considered as an index of efficacy then the increasing use of CAM would only signify its efficacy. On the other hand, CAM has been accused of not healing through its efficacy, but only achieving wellness through the placebo effect (PE). However, whether PE is itself something discreditable is a matter on which there can be two opinions. If PE is seen as healing being achieved through a powerful mental process, and if the mind-body connection in healing is recognised, then the placebo effect itself is elevated to the position of a 'respectable' cause for achieving healing. Let us look at the extent and methods by which CAM is regulated in the UK. The legal requirement for practice of medicine stipulates that anyone can treat a sick person without training in healthcare, provided the patient has given "informed consent." The person who dispenses such treatment cannot use any titles or claim to be a registered medical practitioner under the Medical Act or recommend prescription. There are several voluntary professional bodies in the UK, which regulate CAM practice, and which conduct themselves in a 'professional' manner. (e g for Acupressure, Aroma Therapy, Herbal Medicine, Shiastu and so on) (House of Lords Report ch 5) Apart from this there are general regulations like the Health and Safety at Work Act-1974, the Food Safety Act-1990 (this would govern prescribed medicines), the Trade Descriptions Act-1978, the Consumer Protection Act-1987, the London Local Authorities Act-1991 (requiring licensing of premises for dispensing CAM treatment), and also legislation preventing treatment of diseases like cancer or venereal disease except by qualified persons. (House of Lords Report ch 5) For a therapy to be safe and effective, there should be certain established professional standards, and only those who have obtained the stipulated level of qualification should be permitted to practise. On this issue, The House of Lords Report (Ch 6) has recommended that "CAM training courses should become more standardised and be accredited and validated by the appropriate professional bodies." The Report also notes that "continuing professional development" (ch 6) is lacking among practitioners of CAM. What are the sources of information for CAM in the UK The House of Lords Report (ch 8) mentions that the Foundation for Integrated Medicine (FIM - set up by the Prince of Wales in 1996) states that the sources of information for both patients and doctors pertaining to CAM, though useful, were disparate, since most of CAM came outside the purview of the NHS. Regarding research results and efficacy of treatment - these are published in journals, but not all of these journal articles are properly peer reviewed. The best source of CAM research references in the United Kingdom is with the Research Council for Complementary Medicine (RCCM). The report recommends that the NHS Centre for Reviews and Dissemination "be invited to work with the RCCM, the UK Cochrane Centre, and the British Library to develop a comprehensive information source with the help of the CISCOM database, in order to provide comprehensive and publicly available information sources on CAM research" (House of Lords Report ch 8) Media (journals and magazines) and the internet also provide information about CAM to the users. However, these are not sufficiently regulated, and therefore, the validity of such information is not established. This is not to say that these sources are not reliable; but merely that the user should treat the information available here with caution, and double-check. Many studies done in the UK have shown that CAM utilisation is higher among women. This could be accounted for by the fact that General Practitioners (GP's) tended to dispense CAM along with conventional therapies, and that women utilised health services provided by GP's more than the men did. As for non-registered CAM providers (the private market), the data on them is negligible. Such practitioners work either on a paid or voluntary basis. Some of them are also untrained, and they are also not registered with a voluntary or professional body. In conclusion, we may say that CAM has come to stay. And these are systems of healing that have gained respectability in recent times. Today, practitioners of conventional medicine take cognisance of alternate medicine, and recommend it to their patients. However, it is necessary that CAM is brought more into the mainstream and regulated in order to prevent its mis-utilisation. The very nature of these systems, though, makes standardisation and regulation hard to achieve. Works Cited - Dixon, Anna; Riesberg, Annette et al Complementary and Alternative Medicine in the UK and Germany- Research and Evidence on Supply and Demand, 2003 -House of Lords Science and Technology: Sixth Report 21st Nov 2000; retrieved 27th June 2007 -National Library for Health Complementary and Alternate Medicine Specialist Library, updated 11th June, 2007, retrieved 27th June 2007 < http://www.library.nhs.uk/cam/ > -Website nhshistory.com : Hospital Services retrieved 27th June 2007 Read More