treatment options to include “alternative” meth-
ods. One day, during my second year of residency,
the chairman of medicine asked me what I planned
to do when I finished training. I told him that I was
interested in alternative medicine, to which he
responded, “Show me the evidence,” and quickly
changed the subject.
Although I was somewhat disappointed by this
reaction, his statement ultimately turned out to be
one of those seemingly innocent comments that
unintentionally have a profound effect. I began
pondering the challenge of integrating alternative
medicine into conventional medicine and the con-
ventional medical establishment. I began to appre-
ciate more fully the need for additional research on
alternative medicine. Only through that research
can conventional medical providers know which
therapies to recommend to their patients. Only
through that research can the public truly know
which treatments are safe and effective.
Ultimately I decided to pursue a two-year
research fellowship and a master’s degree in public
health with the goal of obtaining the skills neces-
sary to do research and further the integration of
nonconventional and conventional medicine.
Unfortunately I soon realized that it was not quite
that easy. Good research takes years and costs sig-
nificant amounts of money. Clearly, multiple agen-
cies are funding research on alternative medicine.
Congress has established the National Center for
the Study of Complementary and Alternative Med-
icine under the National Institutes of Health, and
the amount and quality of research on alternative
treatments are increasing exponentially. However,
the various types of alternative treatments avail-
able are also increasing. No matter how much
research is conducted, there will always be numer-
ous treatment options available that have little or
no data beyond anecdotal evidence to support their
use. There will always be treatments being utilized
that will ultimately be shown to be safe and effec-
tive as well as ones that will be harmful and futile.
Many treatments are from healing traditions
that have developed over hundreds, if not thou-
sands, of years through a process of trial and error
on thousands of patients. Acupuncture, a tradi-
tional Chinese medicine utilized for thousands of
years, is an example of an alternative medicine that
is just now being researched and shown to be effec-
tive for many ailments, such as nausea caused by
chemotherapy or pregnancy. Other treatments
such as ma huang(or ephedra) to assist with weight
loss maybe efficacious but when used improperly
are potentially dangerous (there have been more
than 50 reported deaths). Other treatments are
newly invented or conceived. Although some of
these treatments will ultimately be shown to be of
value, individuals who seek to take advantage of a
vulnerable public are often marketing fraudulent
products or interventions. The Internet has led to
increased empowerment of the public through
access to an endless amount of medical informa-
tion. Unfortunately it has also led to access to a
seemingly endless amount of inaccurate or poten-
tially misleading health information.
Traditionally the public has turned to physicians
and other health care providers for reliable infor-
mation on health-related matters. But multiple
studies have shown that the majority of people
who use alternative medicine do so without telling
their physicians or other health care providers. This
occurs for many reasons. Most health care
providers do not ask about alternative medicine
use, perhaps because of a lack of knowledge about
the subject matter and a desire not to appear unin-
formed. This omission often gives the impression
that the subject is not important or they simply do
not wish to know. At times physicians may be dis-
missive of such therapies because of a perception
that there is a lack of credible and authoritative evi-
dence of their effectiveness.
Patients, on the other hand, tend to believe that
it is unimportant for health care providers to know
about their use of alternative treatments. They
often believe that the alternative therapy is irrele-
vant to the biomedical treatment course. They may
think that a decision to pursue an alternative treat-
ment does not require input from the conventional
medical establishment, since they believe these
therapies are not truly harmful. Still others hesitate
to speak openly about their use of or desire to use
alternative medicine because of concern that their
questions may be dismissed or they may be viewed
as ungrateful, unrealistic, or gullible.
Regardless of the reason, lack of communication
about alternative medicine is yet another obstaclex The Encyclopedia of Complementary and Alternative Medicine