Complementary and Alternative Medicine (CAM). Why should you know what it is? Is it really useful for patients? Is it really credible? Well, let’s talk about it.
Over the past two decades, there has been a tendency for patients to ask if there are natural or alternative therapies to treat their condition. The other day a patient asked me if there was an herbal remedy for migraines. Her daughter had migraines for a while and she didn’t want her daughter to take the medication the neurologist prescribed. She was worried about side effects and asked if she should take her daughter to see a chiropractor. It seems that as doctors we are seeing more and more of this type of scenario. Patients are asking for natural remedies for common illnesses such as allergies and asthma, but also want to incorporate the use of these alternative strategies for very serious conditions such as cancer. In fact, many academic centers in recent years have opened wellness centers in addition to their main cancer centers to help patients have a more holistic plan for their disease.
Another interesting fact: Some experts have reported that over 70% of patients with chronic or severe illnesses use some type of complementary medicine. And it seems that number is increasing. Are these patients talking to us about supplements or seeing another type of provider? Apparently not all the time: it’s important to note that patients may not report this to you. In fact, a study of 134 teens with juvenile arthritis found that 72% of those teens were using adjunct treatments, but only 43% told their doctor.
And it’s not just that patients are interested in these therapies; a whole range of products in industries focused on marketing target these patients. Over-the-counter herbs and supplements, for example, are no longer just found in pharmacies or specialty stores. You can find them in several grocery stores with a wellness program, like Whole Foods, Trader Joe’s, and a number of others.
In addition, there are many websites dedicated not only to promoting alternative medicine, but also decreasing the reliance on traditional health experts. The media and television have contributed to the interest in non-traditional medicine and, unfortunately, even to the mistrust of doctors. Illnesses for which patients may ask you about alternatives include asthma, allergies, migraines, arthritis, and cancer. Chronic illnesses frustrate people, and that’s usually when they look for other solutions.
The first tip for understanding which of these therapies and professionals are good for your patient and which are not is to know what is out there. Some of the types of professionals that exist include acupuncturists, chiropractors, integrated medicine specialists, functional medicine specialists, naturopaths, and massage therapists. And some of the integrated therapies your patients can talk about include biochemicals like vitamins and supplements and probiotics and dietary changes that include gluten-free, paleo, and vegan diets. And then there are physical therapies, like Reiki, acupuncture, massage, magnets, yoga, and tai chi. And of course, don’t forget about mind-body therapy, meditation, biofeedback, hypnosis, and counseling.
With our upcoming Medscape series, we aim to give you some knowledge of these therapies and specialists. We hope to tell you what is out there, if there is good evidence to support it, if it is harmful, and how you can start incorporating it into your practice if you wish. As physicians we need to know what is good for the patient and what is not. Recognizing the therapies that interest our patients and knowing them will help us maintain a good relationship and good communication. This will help us to be part of the conversation that is already taking place. The good news is that many of these holistic therapies such as acupuncture, meditation, and tai chi, which we had no previous information about, now have good, solid research. We look forward to exploring this new and growing area with you in the months to come.