Complementary and Alternative Medicine

Results of a National Survey and Examination of Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

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SOURCE:   J Manipulative Physiol Ther. 2016 (Aug 14) [Epub]

Patricia M. Herman, ND, PhD, Ian D. Coulter, PhD

RAND Health,
Santa Monica, CA.
pherman@rand.org

OBJECTIVES:   The purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope.

METHODS:   This study used a 2-stage exploratory grounded approach. In stage 1, we identified how CAM is represented (if considered as professions vs modalities) across a purposely sampled diverse set of policy topic domains using exemplars to describe and summarize each. In stage 2 we convened 2 stakeholder panels (12 CAM practitioners and 9 health policymaker representatives), and using the results of stage 1 as a starting point and framing mechanism, we engaged panelists in a discussion of how they each see the dichotomy and its impacts. Our discussion focused on 4 licensed CAM professions: acupuncture and Oriental medicine, chiropractic, naturopathic medicine, and massage.

RESULTS:   Workforce policies affected where and how members of CAM professions could practice. Licensure affected whether a CAM profession was recognized in a state and which modalities were allowed. Complementary and alternative medicine research examined the effectiveness of procedures and modalities and only rarely the effectiveness of care from a particular profession. Treatment guidelines are based on research and also focus on procedures and modalities. Health plan reimbursement policies address which professions are covered and for which procedures/modalities and conditions.

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Efficacy of Selected Complementary and Alternative Medicine Interventions For Chronic Pain

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SOURCE:   J Rehabil Res Dev. 2007; 44 (2): 195–222

Gabriel Tan, PhD, ABPP, Michael H. Craine, PhD,
Matthew J. Bair, MD, MS,
M. Kay Garcia, DrPH, MSN, RN, LAc,
James Giordano, PhD, Mark P. Jensen, PhD,
Shelley M. McDonald, MD

Department of Anesthesiology,
Michael E. DeBakey Department of Veterans Affairs (VA) Medical Center (VAMC),
2002 Holcombe Blvd,
Houston, TX 77030, USA

Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as “whole or professionalized CAM practices.” Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners.

From the FULL TEXT Article:

INTRODUCTION

Definition of Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. They are not generally provided by U.S. hospitals and clinics or widely taught in medical schools [1].

Prevalence and Popularity of Complementary and Alternative Medicine Use

CAM modalities are widely used by the U.S. public. According to the Centers for Disease Control and Prevention (CDC), 62 percent of adults used some form of CAM during the past 12 months when the definition of CAM included prayer specifically for health reasons and 36 percent when prayer was excluded [2]. The most frequent conditions associated with CAM use included back pain, neck pain, joint pain, stiffness, anxiety, and depression (the latter two are commonly associated with chronic pain). CAM use increased substantially during the 1990s. The U.S. public spent an estimated $36 to $47 billion on CAM in 1997 alone [3]; between $12.2 and $19.6 billion were paid out-of-pocket for the services of CAM providers such as chiropractors, acupuncturists, and massage therapists. These fees are more than the U.S. public paid out-of-pocket for all hospitalizations in 1997 and half the amount of all out-of-pocket physician services for traditional care [4].

Purpose of This Article

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