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'''Alternative Medicine''' (etymological meaning: <ref>"alternative": etymological meaning. Adj. "1580s, "offering one or the other of two," from M.L. alternativus, from L. alternatus, pp. of alternare (see alternate). Sense of "the other of two which may be chosen" is recorded from 1838. Adj. use, "purporting to be a superior choice to what is in general use" was current by 1970 (earliest ref. is to the media); e.g. alternative energy (1975).", Source: Dictionary.com. Online Etymology Dictionary. Douglas Harper, Historian. http://dictionary.reference.com/browse/alternative (accessed: June 03, 2011).</ref> refers to methods and treatments that are not used by science based medicine (or ''evidence based medicine, EBM''). Alternative treatments are almost always [[pseudomedicine]]. Especially it's supporters use also terms like ''complementary medicine'', ''experience based medicine'' and ''integrative medicine''. Complementary and alternative medicine are often called ''CAM''.

'''Alternative Medicine''' (for etymological meaning see: <ref>"alternative": etymological meaning. Adj. "1580s, "offering one or the other of two," from M.L. alternativus, from L. alternatus, pp. of alternare (see alternate). Sense of "the other of two which may be chosen" is recorded from 1838. Adj. use, "purporting to be a superior choice to what is in general use" was current by 1970 (earliest ref. is to the media); e.g. alternative energy (1975).", Source: Dictionary.com. Online Etymology Dictionary. Douglas Harper, Historian. http://dictionary.reference.com/browse/alternative (accessed: June 03, 2011).</ref>) refers to methods and treatments that are not used by science based medicine (or ''evidence based medicine, EBM''). Alternative treatments almost always fall into the realm of [[pseudomedicine]]. Especially it's supporters use also terms like ''complementary medicine'', ''experience based medicine'' and ''integrative medicine''. Complementary and alternative medicine are often called ''CAM''. Richard Dawkins has stated that "there is no alternative medicine. There is only medicine that works and medicine that doesn't work."<ref>Dawkins, Richard (2003). A Devil's Chaplain. United States: Houghton Mifflin. p. 58. ISBN 978-0-618-33540-4.</ref>, a view that is also shared by Tim Minchin in his animated poem "Storm"<ref>[http://www.timminchin.com/2011/04/08/storm/ Storm!!!!!!!!], by Tim Minchin, April 8, 2011, accessed June, 4 2011</ref>

 

A ''National Center for Complementary and Alternative Medicine NCCAM'' in USA defines complementary and alternative therapies as treatments which are used in place ("alternative") or together ("complementary") with conventional, established therapy.<ref>[http://nccam.nih.gov/health/whatiscam/ What Is Complementary and Alternative Medicine?], National Center for Complementary and Alternative Medicine NCCAM, accessed June 03, 2011</ref> A treatment is considered established, when it's clinical efficacy has been demonstrated in prospective, randomized trials or a biological rationale establishes the treatment as reasonable. An Anglo-Australian group of researchers demonstrated with a computional model in 2009 that for some odd reason the methods which have little or no effect at all show a tendency to spread quickly.<ref>Tanaka MM, Kendal JR, Laland KN (2009) From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious. PLoS ONE 4(4): e5192. doi:10.1371/journal.pone.0005192 [http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0005192&representation=PDF]</ref><ref>http://www.newscientist.com/article/dn17064-quack-remedies-spread-by-virtue-of-being-useless.html</ref>

A ''National Center for Complementary and Alternative Medicine NCCAM'' in USA defines complementary and alternative therapies as treatments which are used in place ("alternative") or together ("complementary") with conventional, established therapy.<ref>[http://nccam.nih.gov/health/whatiscam/ What Is Complementary and Alternative Medicine?], National Center for Complementary and Alternative Medicine NCCAM, accessed June 03, 2011</ref> A treatment is considered established, when it's clinical efficacy has been demonstrated in prospective, randomized trials or a biological rationale establishes the treatment as reasonable. An Anglo-Australian group of researchers demonstrated with a computional model in 2009 that for some odd reason the methods which have little or no effect at all show a tendency to spread quickly.<ref>Tanaka MM, Kendal JR, Laland KN (2009) From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious. PLoS ONE 4(4): e5192. doi:10.1371/journal.pone.0005192 [http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0005192&representation=PDF]</ref><ref>http://www.newscientist.com/article/dn17064-quack-remedies-spread-by-virtue-of-being-useless.html</ref>

The terms ''alternative medicine'' and ''complementary medicine'' are therefore euphemistic, as they do not offer a real alternative and are just ineffective or less effective pseudomedical methods. This also applies to the "experience based medicine" which tries to invoke anecdotal cures instead of solid proof as a positive quality.

The terms ''alternative medicine'' and ''complementary medicine'' are therefore euphemisms, as they do not offer a real alternative and are just ineffective or less effective pseudomedical methods. This also applies to the "experience based medicine" which tries to invoke anecdotal cures instead of solid proof as a positive quality.<ref>[http://www.skepdic.com/compmed.html complementary medicine] in the Skeptic Dictionary, accessed June, 4 2011</ref>

 

 

The concepts of alternative and complementary medicine are usually based on an axiom(a self-evident truth that requires no proof).<ref>http://www.uni-marburg.de/ivv/download/praesentationen/adhs081217trott page 10</ref>axiom. Dictionary.com. Dictionary.com Unabridged. Random House, Inc. http://dictionary.reference.com/browse/axiom (accessed: June 03, 2011).</ref>

In addition, arguments like "[[healing practitioners]] commit more time to patients than doctors" are frequently heard. Disappointments and distrust for conventional therapies play a role. Many patients and customers find pleasure in the more or less explicit criticism of [[mainstream medicine]]" or  "the pharmaceutical industry" which is not uncommon in alternative medicine circles. When people become sick, any promise of a cure is beguiling.<ref>Beyerstein BL (March 2001). [http://dx.doi.org/10.1097%2F00001888-200103000-00009 "Alternative medicine and common errors of reasoning"]. Academic Medicine 76 (3): 230–7.</ref> An appeal may also result from the [[Pseudomedicine#Typical_Features|typical features of pseudomedical treatments]], such as simple, clear explanations for the alleged therapeutic effect or lack of side effects. Edzard Ernst showed in a study that this notion is wrong and side effects may indeed occur.<ref>[http://www.nature.com/nature/journal/v381/n6581/pdf/381361a0.pdf Complimentary Medicine], N. C. Abbot, A. R. White & E. Ernst, Nature 381, 361 (30 May 1996), doi:10.1038/381361a0</ref>

==The appeal of alternative medicine==

In an interview with "The Independent" Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped:

For the popularity of offers outside of science-based medicine various factors can be assumed. In addition to the usual arguments like "[[healing practitioners]] commit more time to patients than doctors" disappointments and distrust for conventional therapies ma play a role. Many patients and customers find pleasure in the more or less explicit criticism of [[mainstream medicine]]" or  "the pharmaceutical industry" which is not uncommon in alternative medicine circles. An appeal may also result from the [[Pseudomedicine#Typical_Features|typical features of pseudomedical treatments]], such as simple, clear explanations for the alleged therapeutic effect or lack of side effects.

:"People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives. "At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn't make me popular with the public, but it's the truth."<ref>[http://www.independent.co.uk/life-style/health-and-families/features/complementary-therapies-the-big-con-813248.html Complementary therapies: The big con?], The Independent, April 22, 2008, accessed June 4, 2011</ref>

==Alternative medicine business in Germany==

==Business in Germany==

The number of CAM providers is rising in Germany. From 1993 to 2000 the number of healing practitioners rose as the most important non-medical CAM-profession by &nbsp;90% (from 11/100.000 to 21/100.000&nbsp;persons). The CAM-offerings of doctors rose in the same period by 125% (from 19/100.000 to 43/100.000).<ref>Susanne Weinbrenner, MPH&nbsp;FG Management in health care, Technical University of Berlin Berlin</ref>

The number of CAM providers is rising in Germany. From 1993 to 2000 the number of healing practitioners rose as the most important non-medical CAM-profession by &nbsp;90% (from 11/100.000 to 21/100.000&nbsp;persons). The CAM-offerings of doctors rose in the same period by 125% (from 19/100.000 to 43/100.000).<ref>Susanne Weinbrenner, MPH&nbsp;FG Management in health care, Technical University of Berlin Berlin</ref>

Every year herbal remedies for about two billion Euros are prescribed in Germany and about nine billion Euros are spent on complimentary and alternative medical procedures (2006).<ref>Anja Achenbach: Millionenmarkt Naturheilkunde. In: Financial Times, January 21, 2009</ref> Five billion Euros are paid by the patients themselves. Four billions are refunded by insurance companies. 40.000&nbsp;doctors offer respective treatments.<ref>http://www.aerzteblatt.de/v4/archiv/artikel.asp?src=heft&id=57593 Deutsches Ärzteblatt&nbsp;104, Issue&nbsp;46, November 16, 2007</ref> Another estimate estimates that the total turnover is about 20% of the whole [[Wellness]] industry in Germany which has an annual volume of 50&nbsp;billion Euro, and would therefore be about 10&nbsp;billion Euros per year.<ref>Horst Klinkmann, Third National Conference for Health Economics (Rostock)</ref> The worldwide turnover is estimated at 60&nbsp;billion U.S. dollar.<ref>Tanaka MM, Kendal JR, Laland KN (2009) From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious. PLoS ONE 4(4): e5192. doi:10.1371/journal.pone.0005192 [http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0005192&representation=PDF]</ref> According to figures by the economic research company "Global Insight" the annual turnover of the spa industry is now estimated at about 73 billion Euros.

Every year herbal remedies for about two billion Euros are prescribed in Germany and about nine billion Euros are spent on complimentary and alternative medical procedures (2006).<ref>Anja Achenbach: Millionenmarkt Naturheilkunde. In: Financial Times, January 21, 2009</ref> Five billion Euros are paid by the patients themselves. Four billions are refunded by insurance companies. 40.000&nbsp;doctors offer respective treatments.<ref>http://www.aerzteblatt.de/v4/archiv/artikel.asp?src=heft&id=57593 Deutsches Ärzteblatt&nbsp;104, Issue&nbsp;46, November 16, 2007</ref> Another estimate estimates that the total turnover is about 20% of the whole [[Spa]] industry in Germany which has an annual volume of 50&nbsp;billion Euro, and would therefore be about 10&nbsp;billion Euros per year.<ref>Horst Klinkmann, Third National Conference for Health Economics (Rostock)</ref> The worldwide turnover is estimated at 60&nbsp;billion U.S. dollar.<ref>Tanaka MM, Kendal JR, Laland KN (2009) From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious. PLoS ONE 4(4): e5192. doi:10.1371/journal.pone.0005192 [http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0005192&representation=PDF]</ref> According to figures by the economic research company "Global Insight" the annual turnover of the spa industry is now estimated at about 73 billion Euros.

 

Sales figures for alternative and complementary medicine in United States are also known. The National Health Statistic Report states in an article from July 30, 2009 for 2007<ref> Richard L. Nahin, Patricia M. Barnes, Barbara J. Stussman, Barbara Bloom. NHSR, Number 18 n July 30, 2009. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007</ref> that U.S- patients have spent 33.9&nbsp;billion dollar for CAM services and products. Homoeopathy accounted for 3&nbsp;billions, [[Qigong]] for 4&nbsp;billions. Expenditure for food supplements like vitamins and minerals are not included in this sum.<ref>http://www.quackometer.net/blog/2009/07/what-would-34-billion-of-quack-money.html</ref> In 1997 between 36&nbsp;and 47&nbsp; billion U.S. dollars were spent on complementary medicine. Of these, 12&nbsp;to 20&nbsp;billion USD were paid out of the one's own pocket for complementary therapists.<ref>Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998;280:1569–75</ref> This is half of the sum spent out of pocket for medical services.

Sales figures for alternative and complementary medicine are also known from United States. The National Health Statistic Report states in an article from July 30, 2009 for 2007<ref> Richard L. Nahin, Patricia M. Barnes, Barbara J. Stussman, Barbara Bloom. NHSR, Number 18 n July 30, 2009. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007</ref> that U.S- patients have spent 33.9&nbsp;billion dollar for CAM services and products. Homoeopathy accounted for 3&nbsp;billions, [[Qigong]] for 4&nbsp;billions. Expenditure for food supplements like vitamins and minerals are not included in this sum.<ref>http://www.quackometer.net/blog/2009/07/what-would-34-billion-of-quack-money.html</ref> In 1997 between 36&nbsp;and 47&nbsp; billion U.S. dollars were spent on complementary medicine. Of these, 12&nbsp;to 20&nbsp;billion USD were paid out of the one's own pocket for complementary therapists.<ref>Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC. Trends in alternative medicine use in the United States, 1990–1997: results of a follow-up national survey. JAMA 1998;280:1569–75</ref> This is half of the sum spent out of pocket for medical services.

According to a further source 27&nbsp;billion dollars were spent in 2002 for complementary and alternative medical treatments by the consumers.<ref>Curt G.A.: Introduction: Complementary and Alternative Medicine in Cancer Treatment. Sem Oncol 2002; 29: 529-530</ref> According to a study by author McGinnis four times as much money was spent in USA in 1987 on complementary medicine than for all cancer research.<ref>McGinnis L.S.: Alternative therapies, 1990. An overview. Cancer 1991; 67 (6 Suppl): 1788-1792</ref> In 1981 [[Amygdalin|Laetrile]], a then popular, ineffective, alternative cancer drug made from apricot kernels had a turnover of 2&nbsp;billion U.S. dollars. In the same period 0.2&nbsp;billion dollars were spent on chemotherapy. The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122&nbsp;million dollars, financed by the state.

According to a further source 27&nbsp;billion dollars were spent in 2002 for complementary and alternative medical treatments by the consumers.<ref>Curt G.A.: Introduction: Complementary and Alternative Medicine in Cancer Treatment. Sem Oncol 2002; 29: 529-530</ref> According to a study by author McGinnis four times as much money was spent in USA in 1987 on complementary medicine than for all cancer research.<ref>McGinnis L.S.: Alternative therapies, 1990. An overview. Cancer 1991; 67 (6 Suppl): 1788-1792</ref> In 1981 [[Amygdalin|Laetrile]], a then popular, ineffective, alternative cancer drug made from apricot kernels had a turnover of 2&nbsp;billion U.S. dollars. In the same period 0.2&nbsp;billion dollars were spent on chemotherapy. The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122&nbsp;million dollars, financed by the state.

==Research of Alternative medicine==

==Research==

Funding for research in the field of alternative medicine comes usually from private foundations in Germany, such as:

Funding for research in the field of alternative medicine comes usually from private foundations in Germany, such as:

* [[Karl und Veronica Carstens-Foundation]] (27&nbsp;million Euro). It sponsored 1.5&nbsp;million Euro in May 2008 for an endowed chair of alternative medicine at the Berlin [[Charité]].

* [[Karl und Veronica Carstens-Foundation]] (27&nbsp;million Euro). It sponsored 1.5&nbsp;million Euro in May 2008 for an endowed chair of alternative medicine at the Berlin [[Charité]].

Currently (2010), the "National Center for Complementary and Alternative Medicine" (NCCAM) and the "Office of Cancer Complementary and Alternative Medicine" (OCCAM) spend together 240 million U.S. dollar of taxpayers money from the NIH (National Institute of Health).<ref>Salzberg S. Save taxpayer $$$: Eliminate alternative medicine research. Forbes.com, 18. Juni 2010 [http://blogs.forbes.com/sciencebiz/2010/06/save-taxpayer-eliminate-alternative-medicine-research/]</ref>

Currently (2010), the "National Center for Complementary and Alternative Medicine" (NCCAM) and the "Office of Cancer Complementary and Alternative Medicine" (OCCAM) spend together 240 million U.S. dollar of taxpayers money from the NIH (National Institute of Health).<ref>Salzberg S. Save taxpayer $$$: Eliminate alternative medicine research. Forbes.com, 18. Juni 2010 [http://blogs.forbes.com/sciencebiz/2010/06/save-taxpayer-eliminate-alternative-medicine-research/]</ref>

==Patients of alternative medicine==

==The typical patient==

The typical patient or customer can be characterized by the following attributes:

The typical patient or customer can be characterized by the following attributes:

* young (30-50&nbsp;years)<ref>Richardson MA, Ramirez T, Palmer JL (2000): Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18: 2505-2514</ref>

* young (30-50&nbsp;years)<ref>Richardson MA, Ramirez T, Palmer JL (2000): Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. J Clin Oncol 18: 2505-2514</ref>