Conventional medicine’s goal is to locate the physical source of a particular disease and remove it. For example, if a patient has an infection, a conventional doctor would probably prescribe a specific antibiotic to kill invading bacteria. Conventional medicine’s focus is on the symptoms, diseases and/or disorders.

On the other hand, CAM practitioners take a “holistic” approach to healthcare. They believe that health and disease involve a complex interaction of physical, spiritual, mental, emotional, genetic, environmental, and social factors. To treat a disease or promote good health, CAM practitioners treat the whole body by considering all of these factors.

In the United States, this holistic approach to health is termed “alternative” for a variety of reasons. It is difficult to scientifically test alternative practices, such as acupuncture, in the same way that conventional practices, such as medications, are tested. Although alternative therapies are often based on hundreds – in some cases thousands – of years of experience, the conventional medical community relies heavily on scientific evidence (rather than clinical experience) when evaluating the safety and effectiveness of a particular therapy. For this reason, many alternative practices that have not been or cannot be thoroughly tested are considered “unscientific” by modern Western standards. In addition, many non-Western healing practices are not taught in United States medical schools, not available to patients in U.S. hospitals and are not even covered by health insurance.

Although CAM therapies vary widely, the following themes can be traced throughout:

• Prevention of illness is a primary concern.
• Treatments are highly individualized.
• Treatments are aimed at the causes of illness rather than at its symptoms.
• Treatments are designed to support the natural healing processes of the body.
• The focus is on the whole person – physical, emotional, social, and spiritual.

Demand for CAM services continues to grow at a startling rate. A 2001 survey found that nearly 70 percent of Americans have used at least one form of CAM therapy in their lifetime, making this “unconventional” medical approach one of the fastest growing sectors of American healthcare. Although herbs and supplements are not regulated by the U.S. Food and Drug Administration (FDA), pharmacies across the country are experiencing a tremendous surge in the sales of these alternative remedies. From 1991 to 1996 alone, the demand for over-the-counter natural remedies (including herbs and supplements) doubled. In a 1996 survey by Landmark Healthcare, more than 70 percent of HMOs reported an increase in requests for CAM by their members. Most patients (56 percent), requested acupuncture, followed by chiropractic (45 percent), massage (25 percent), acupressure and biofeedback (21 percent each), hypnotherapy (eight percent), and reflexology (four percent).

U.S. medical schools are also becoming more receptive to CAM. As of 1998, 75 out of 117 (64 percent) U.S. medical schools offered at least one course in CAM. In a 1994 survey, 60 percent of doctors reported recommending CAM to their patients. Nearly half of the doctors who responded to the survey acknowledged that they used CAM themselves. More and more health insurance plans are also covering CAM, particularly treatments such as acupuncture and chiropractic, whose safety and effectiveness in the treatment of certain health problems has been well established. A number of health plans now cover the Ornish heart program, which has a basis in yoga and nutrition. All of these changes in American healthcare illustrate the movement toward an integrative medicine system that incorporates the most useful therapies from many of the world’s healing traditions.

• Alternative Medical Systems: built upon complete systems of theory and practice. Examples include Ayurveda, homeopathy, naturopathy, and traditional Chinese medicine (TCM).
• Biological Medicine: use of substances found in nature, such as foods, herbs, and vitamins to promote health.
• Energy Medicine: involves the use of energy fields to promote health. Some forms of energy medicine (known as biofield therapies) are designed to influence energy fields that are believed to surround and penetrate the human body. Examples of biofield therapies include qi gong, Reiki, and Therapeutic Touch. Other forms of energy medicine (known as bioelectromagnetic-based medicine) involve the use of electromagnetic fields such as electroacupuncture.
• Manual Medicine: based on manipulation and/or movement of one or more parts of the body. Examples include chiropractic, Feldenkrais, massage, osteopathy, physical therapy and reflexology.
• Mind-Body Medicine: uses a range of techniques that help boost the mind’s ability to influence bodily functions and symptoms. Examples include biofeedback, deep relaxation, guided imagery, hypnotherapy, meditation, prayer, support groups, and yoga.

In 1998 Congress established the National Center for Complementary and Alternative Medicine (NCCAM) to supersede the OAM. With an annual budget of more than $68 million, NCCAM’s mission is to support basic and applied CAM research and provide information to healthcare providers and the public. Among other efforts, NCCAM focuses on research that evaluates the safety and effectiveness of herbs and nutritional supplements and their potential for interaction with medications. It also evaluates other CAM treatments such as acupuncture and chiropractic. NCCAM funds several research centers outside of the NIH.

In July of 2000, the White House announced the establishment of a White House Commission on Alternative Medicine, designating the Chair of the first 10 members. The commission’s goal is to develop a set of legislative and administrative recommendations to maximize the benefits of CAM for the American public. Beyond the research goals of NCCAM, the Commission will set the agenda for the education and training of CAM practitioners as well as provide policy recommendations for insurance industry coverage of alternative therapies.