Difference between revisions of "Alternative medicine"

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'''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''). 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>
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'''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 not used by science based medicine (or ''evidence based medicine, EBM''). Its supporters in particular also apply terms like ''complementary medicine'', ''experience based medicine'', and ''integrative medicine''. Complementary and alternative medicine are often abbreviateded as ''CAM''. Richard Dawkins 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>
  
Edzard Ernst, Professor of Complementary Medicine at the University of Exeter, England, argues that the term "Complementary and Alternative Medicine" ("CAM") is an almost nonsensical umbrella term, and that distinctions between its modalities must be made. All treatments, whether "mainstream" or "alternative", ought to be held to standards of the scientific method. The evidence-based medicine is an ideal state which has not yet been achieved by either current mainstream or alternative medicine. Ernst characterizes the evidence for many alternative techniques as weak, nonexistent, or negative, but states that some evidence exists for about 20 treatments, particularly certain herbs and acupuncture – although this evidence does not mean these treatments are mainstream, especially not worldwide.<ref>[http://www.cosmolearning.com/topics/alternative-medicine/ Cosmo Learning: Alternative medicine], accessed June, 4 2011</ref><ref name="GWUP2">[http://www.scienceblogs.de/astrodicticum-simplex/2011/06/gwuptagung-in-wien-zweiter-tag-homoopathie-und-der-mozarteffekt.php GWUP-Tagung in Wien, zweiter Tag: Homöopathie und der Mozart-Effekt], Florian Freistetter, ScienceBlogs, accessed June, 4 2011</ref>
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Edzard Ernst, retired Professor of Complementary Medicine at the University of Exeter, England, argues that the term "Complementary and Alternative Medicine" ("CAM") is an almost nonsensical umbrella term, and distinctions between its modalities must be made. All treatments, whether "mainstream" or "alternative", ought to be held to standards of the scientific method. The evidence-based medicine is an ideal state which has not yet been achieved by either current mainstream or alternative medicine. Ernst characterizes the evidence for many alternative techniques as weak, nonexistent, or negative, but states that some evidence exists for about 20 treatments, particularly certain herbs and acupuncture – although this evidence does not mean these treatments are mainstream, especially not worldwide.<ref>[http://www.cosmolearning.com/topics/alternative-medicine/ Cosmo Learning: Alternative medicine], accessed June, 4 2011</ref><ref name="GWUP2">[http://www.scienceblogs.de/astrodicticum-simplex/2011/06/gwuptagung-in-wien-zweiter-tag-homoopathie-und-der-mozarteffekt.php GWUP-Tagung in Wien, zweiter Tag: Homöopathie und der Mozart-Effekt], Florian Freistetter, ScienceBlogs, 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>
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A ''National Center for Complementary and Alternative Medicine NCCAM'' in USA defines complementary and alternative therapies as treatments which are used in place of ("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 its clinical efficacy has been demonstrated in prospective, randomized trials or a biological rationale establishes the treatment as reasonable. In 2009, an Anglo-Australian group of researchers demonstrated with a computional model that for some odd reason those methods with little or no effect at all show a tendency to spread quickly.<ref name="Tanaka">Tanaka MM, Kendal JR, Laland KN (2009) [http://www.plosone.org/article/fetchObjectAttachment.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0005192&representation=PDF From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious]. PLoS ONE 4(4): e5192. doi:10.1371/journal.pone.0005192</ref><ref>[http://www.newscientist.com/article/dn17064-quack-remedies-spread-by-virtue-of-being-useless.html Quack remedies spread by virtue of being useless], New Scientist, May 01, 2009</ref>
  
 
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> Almost all alternative treatments belong into the realm of [[pseudomedicine]].
 
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> Almost all alternative treatments belong into the realm of [[pseudomedicine]].
  
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><ref>axiom. Dictionary.com. Dictionary.com Unabridged. Random House, Inc. http://dictionary.reference.com/browse/axiom (accessed: June 03, 2011).</ref>
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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/downloads/praesentationen/adhs081217trott
 
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So genannte „alternative“ Behandlungen der ADHS], Götz-Erik Trott, December 17, 2008 page 10</ref><ref>axiom. Dictionary.com. Dictionary.com Unabridged. Random House, Inc. http://dictionary.reference.com/browse/axiom (accessed: June 03, 2011).</ref>
CAM has turned into a big business, the worldwide turnover is estimated at more than 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>
 
  
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CAM has turned into a big business, the worldwide turnover is estimated at more than 60&nbsp;billion U.S. Dollars.<ref name="Tanaka" />
  
 
==The typical patient==
 
==The typical patient==
The typical patient or customer can, according to studies, be characterized by the following attributes:<ref name="Astin">Astin JA (May 1998). [http://jama.ama-assn.org/content/279/19/1548 "Why patients use alternative medicine: results of a national study"]. JAMA 279 (19): 1548–53.</ref>
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The typical patient or customer, according to studies, can be characterized by the following attributes:<ref name="Astin">Astin JA (May 1998). [http://jama.ama-assn.org/content/279/19/1548 "Why patients use alternative medicine: results of a national study"]. JAMA 279 (19): 1548–53.</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>
 
* 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>
 
* higher education
 
* higher education
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* female
 
* female
 
* a [[holistic]] orientation to health
 
* a [[holistic]] orientation to health
* suffers from anxiety, back problems, chronic pain, urinary tract problems
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* suffers from anxiety, back problems, chronic pain or urinary tract problems
 
 
  
 
==Appeal==
 
==Appeal==
 
For the popularity of offers outside of science-based medicine a variety of factors were identified.  
 
For the popularity of offers outside of science-based medicine a variety of factors were identified.  
  
People seeking alternative treatments were found to have had had a transformational experience that changed the person's worldview and showed often commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology. One study found that dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies. It concluded, that people find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.<ref name="Astin" /> Still, arguments like "[[healing practitioners]] commit more time to patients than doctors" are frequently heard.  
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People seeking alternative treatments were found to have had had a transformational experience that changed the person's worldview and often showed commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology. One study found that dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies. It concluded that people find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations towards health and life.<ref name="Astin" /> Still, arguments like "alternative practitioners devote more time to patients than doctors" are frequently heard.  
  
Disappointments and distrust for conventional therapies plays 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. Often, anti-scientific attitude is meshed with [[New Age]] mysticism.  Vigorous marketing and extravagant claims create false hope. 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>
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Other studies found that disappointments with and distrust of conventional therapies play a role. Many patients and clients find pleasure in the more or less explicit criticism of [[mainstream medicine]]" or "the pharmaceutical industry" which is not uncommon in alternative medicine circles. Often, an anti-scientific attitude is mixed with [[New Age]] mysticism.  Vigorous marketing and extravagant claims create false hope. When people become sick, any promise of a cure is appealing.<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>
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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. In a study, Edzard Ernst showed 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>
  
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:
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In an interview with "The Independent", Ernst blames providers, clients, and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped:
 
:"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>
 
:"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>
  
 
==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> 65% of population and nearly all cancer patients use the services provided by CAM at least once a year.<ref name="GWUP2" />
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The number of CAM providers in Germany is rising. Between 1993 and 2000, the number of alternative practitioners as the most important non-medical CAM-profession increased by &nbsp;90% (from 11/100.000 to 21/100.000&nbsp;persons). During the same period, the CAM supply of doctors increased 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> 65% of population and nearly all cancer patients use the services provided by CAM at least once a year.<ref name="GWUP2" />
  
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 health care. 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>  
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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 health insurances. 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 valued the total turnover at about 20% of the whole [[Wellness]] industry in Germany, which has an annual volume of 50&nbsp;billion Euro.<ref>Horst Klinkmann, Third National Conference for Health Economics (Rostock), 2007</ref>  
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Another estimate valued the total turnover at about 20% of the entire so-called [[Wellness]] industry in Germany, which has an annual volume of 50&nbsp;billion Euro.<ref>Horst Klinkmann, Third National Conference for Health Economics (Rostock), 2007</ref>  
  
 
==Business in USA==
 
==Business in USA==
A 2008 survey of US hospitals by Health Forum, a subsidiary of the American Hospital Association, found that more than 37 percent of responding hospitals indicated they offer one or more alternative medicine therapies, up from 26.5 percent in 2005. More than 70% of the hospitals offering CAM were in urban areas.<ref>[http://www.aha.org/aha/press-release/2008/080915-pr-cam.html Latest Survey Shows More Hospitals Offering Complementary and Alternative Medicine Services], Press Release, American Hospital Association, accessed June 4, 2011</ref>
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A 2008 survey of US hospitals by Health Forum, a subsidiary of the American Hospital Association, found that more than 37% of responding hospitals indicated they offer one or more alternative medicine therapies, up from 26.5% in 2005. More than 70% of the hospitals offering CAM were in urban areas.<ref>[http://www.aha.org/aha/press-release/2008/080915-pr-cam.html Latest Survey Shows More Hospitals Offering Complementary and Alternative Medicine Services], Press Release, American Hospital Association, accessed June 4, 2011</ref>
  
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 were 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.
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The National Health Statistic Report in an article dated July 30, 2009<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> states that U.S patients have spent 33.9&nbsp;billion Dollars on CAM services and products in 2007. Homoeopathy accounted for 3&nbsp;billions, [[Qigong]] for 4&nbsp;billions. Expenditure for food supplements like vitamins and minerals were not included in this amount.<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 by patients 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 amount spent by patients on medical services.
  
A study found that 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> A further study found that 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.  
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A study found that 27&nbsp;billion dollars were spent on complementary and alternative medical treatments by consumers in 2002.<ref>Curt G.A.: Introduction: Complementary and Alternative Medicine in Cancer Treatment. Sem Oncol 2002; 29: 529-530</ref> A further study found that, in 1987, four times as much money was spent in the USA on complementary medicine than on 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.  
  
 
==Research==
 
==Research==
Funding for research in the field of alternative medicine comes usually from private foundations in Germany, such as:
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In Germany, funding for research in the field of alternative medicine usually comes from private foundations, 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]].
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* 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.
* Krupp-Foundation
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* Krupp Foundation
* Kneipp-Foundation
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* Kneipp Foundation
 
* Gerhard Kienle Foundation
 
* Gerhard Kienle Foundation
 
* Erich Rothenfußer Foundation
 
* Erich Rothenfußer Foundation
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The manufacturers of alternative medical products are also funding research in this field. German companies Bionorica and Schwabe have research budgets of 17&nbsp;and 25&nbsp;million Euro. While it is not possible to patent substances that occur in nature (such as plants), special techniques for preparation can be patented.
 
The manufacturers of alternative medical products are also funding research in this field. German companies Bionorica and Schwabe have research budgets of 17&nbsp;and 25&nbsp;million Euro. While it is not possible to patent substances that occur in nature (such as plants), special techniques for preparation can be patented.
  
Since 1999 the ''National Center for Complementary and Alternative Medicine'' (NCCAM) has funded research on alternative medicine with 2,5&nbsp;billion U.S. dollar.
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Since 1999, the ''National Center for Complementary and Alternative Medicine'' (NCCAM) has funded research on alternative medicine with 2,5&nbsp;billion U.S. Dollars.
 
 
The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122&nbsp;million dollars, financed by the state and has spent $2.5 billion on studies of CAM therapies.<ref>[http://scienceblogs.com/insolence/2009/06/the_ap_shoots_and_scores_again.php The AP shoots and scores again], scienceblogs.com</ref><ref>[http://nccam.nih.gov/research/results/ Research Results NCCAM]</ref>The NCCAM budget has been criticized because despite the duration and intensity of studies, there have been exactly zero effective CAM treatments supported by scientific evidence to date.<ref>[http://www.washingtonpost.com/wp-dyn/content/article/2009/03/16/AR2009031602139.html Scientists Speak Out Against Federal Funds for Research on Alternative Medicine], David Brown, Washington Post, March 17, 2009</ref><ref>[http://www.quackwatch.org/01QuackeryRelatedTopics/nccam.html Why the National Center for Complementary and Alternative Medicine (NCCAM) Should Be Defunded], Wallace I. Sampson M.D., Quackwatch, December 2002</ref> R. Barker Bausell, a research methods expert and author of "Snake Oil Science" states that "it's become politically correct to investigate nonsense."<ref>[http://www.msnbc.msn.com/id/31190909/ $2.5 billion spent, no alternative cures found], msnbc.com</ref>
 
  
Wallace Sampson, an editor of Scientific Review of Alternative Medicine and a Stanford University professor of medicine write that CAM is the "propagation of the absurd" based on the example that alternative and complementary have been substituted for quackery, dubious and implausible and concerns that CAM tolerates contradiction without through reason and experiment.
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The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122&nbsp;million dollars, financed by the government, and spent $2.5 billion on studies of CAM therapies.<ref>[http://scienceblogs.com/insolence/2009/06/the_ap_shoots_and_scores_again.php The AP shoots and scores again], scienceblogs.com</ref><ref>[http://nccam.nih.gov/research/results/ Research Results NCCAM]</ref> The NCCAM budget has been criticized because despite the duration and intensity of studies, there have been exactly zero effective CAM treatments supported by scientific evidence to date.<ref>[http://www.washingtonpost.com/wp-dyn/content/article/2009/03/16/AR2009031602139.html Scientists Speak Out Against Federal Funds for Research on Alternative Medicine], David Brown, Washington Post, March 17, 2009</ref><ref>[http://www.quackwatch.org/01QuackeryRelatedTopics/nccam.html Why the National Center for Complementary and Alternative Medicine (NCCAM) Should Be Defunded], Wallace I. Sampson M.D., Quackwatch, December 2002</ref> R. Barker Bausell, a research methods expert and author of "Snake Oil Science" states that "it's become politically correct to investigate nonsense."<ref>[http://www.msnbc.msn.com/id/31190909/ $2.5 billion spent, no alternative cures found], msnbc.com</ref>
  
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Wallace Sampson, an editor of Scientific Review of Alternative Medicine and a Stanford University professor of medicine, comments CAM is the "propagation of the absurd" based on the example that alternative and complementary have been substituted for dubious and implausible quackery.
  
 
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Currently (2010), the "National Center for Complementary and Alternative Medicine" (NCCAM) and the "Office of Cancer Complementary and Alternative Medicine" (OCCAM) spend a combined 240 million U.S. Dollars 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>
 
  
 
==Criticism==
 
==Criticism==
Users of alternative medical methods refer in the question of effectiveness often only to their own experiences, which are based on a selective perception of the past. Such retrospective observations are not evident by nature. The occasional argument, [[Who heals is right]] is not sensible because causality and correlation are often confused in anecdotal experiences and reports. In other words, an illness treated with [[globules]] might just as well have gone away by itself.
+
As far as effectiveness is concerned, users of alternative medical methods often only refer to their own experience which is based on a selective perception of the past. Such retrospective observations are not evident by nature. The argument used occasionally, "He who heals is right", is not sensible because causality and correlation are often confused in anecdotal experience and reports. In other words, an illness treated with globules might just as well have gone away by itself.
  
The notion of a postulated and fuzzy formulated "holistic approach" (usually associated with "of body, mind and soul") remains a pure promise within alternative medicine that would be difficult to implement because of time and financial constraints (see [[holistic]] after Issels).
+
The notion of a postulated and fuzzy phrased "holistic approach" (usually associated with "of body, mind and soul") remains a mere promise within alternative medicine and would be difficult to implement because of time and financial constraints.
  
 
==Potential danger==
 
==Potential danger==
 
Alternative medicine involves several dangers and risks<ref>Markman M (2002): Safety issues in using complementary and alternative medicine. J Clin Oncol 20: 39-41</ref><ref>http://sekten-info-nrw.de/index.php?option=com_content&task=view&id=59&Itemid=36</ref><ref>http://www.eurekalert.org/pub_releases/2010-12/bmj-cmc122210.php (engl.)</ref>:
 
Alternative medicine involves several dangers and risks<ref>Markman M (2002): Safety issues in using complementary and alternative medicine. J Clin Oncol 20: 39-41</ref><ref>http://sekten-info-nrw.de/index.php?option=com_content&task=view&id=59&Itemid=36</ref><ref>http://www.eurekalert.org/pub_releases/2010-12/bmj-cmc122210.php (engl.)</ref>:
* rejection of effective diagnostic and therapy in favor of [[pseudomedicine]] methods without proof of effectiveness leading to protraction of the illness or appearance of avoidable symptoms
+
* rejection of effective diagnostics and therapies in favour of [[pseudomedicine|pseudo-medical]] methods without proof of effectiveness leading to protraction of the illness or appearance of avoidable symptoms
* misdiagnoses because of inadequate medical training of alternative medicine practitioners
+
* misdiagnoses because of inadequate medical training of alternative practitioners
 
* deterioration of therapeutic prospects due to futile pseudomedical efforts
 
* deterioration of therapeutic prospects due to futile pseudomedical efforts
* development of guilty feelings at failure, towards oneself or towards family members
+
* development of guilt feelings at failure, towards oneself or family members
* psychological and financial abuse through the healing supply, which often shows [[sect|sect-like]] structure
+
* psychological and financial exploitation by a CAM method displaying cult-like structures
* development of psychological dependency an [[New Age addiction|addiction to the treatment]]
+
* development of psychological dependency or addiction
* deaths and lasting damage due to inappropriate procedures
+
* deaths or permanent damage due to inappropriate procedures
  
A study by the Royal Children's Hospital in Melbourne published in December 2010 investigated 39 cases where children were hurt due to alternative medical treatments. In 30 cases a correlation between damage to the patients and the use of alternative medical therapies or the denial of prescribed medicines could be found. Four of the children died because the parents refused medical treatment. An eight-month-old malnourished infant died of septic shock because he had been set on a diet of "naturopathic" rice milk because of an alleged obstruction since his third month of life. A 10-month-old baby died also of septic shock because he was set on a restrictive diet against chronic dermatitis. A further child died after multiple epileptic seizures after the parents hat stopped the anti-epileptic drug treatment for fear of side effects and treated it with an alternative medical remedy. A fourth child suffered fatal bleeding because the parents refused treatment with clotting factors in favour of a complimentary medical treatment<ref>http://www.aerzteblatt.de/nachrichten/44039/Paediatrie--Tod-nach-Alternativmedizin.htm</ref><ref>http://adc.bmj.com/content/early/2010/11/24/adc.2010.183152.short?q=w_adc_ahead_tab</ref>
+
A study by the Royal Children's Hospital in Melbourne published in December 2010 investigated 39 cases in which children suffered damage fpllowing alternative medical treatments. In 30 cases, a correlation between damage to the patients and use of alternative medical therapies or denial of prescribed medicines was established. Four of the children died because their parents refused medical treatment. An malnourished infant of eight months died of septic shock because he had been put on a diet of "naturopathic" rice milk due to an alleged constipation since his third month of life. A baby of ten months also died of septic shock because he was put on a restrictive diet against a chronic eczema. Another child died from multiple epileptic seizures after parents had stopped the anti-epileptic drug medication for fear of side effects, using an alternative remedy instead. A fourth child suffered fatal bleeding because the parents refused a therapy with anticoagulants in favour of a complementary medical treatment.<ref>http://www.aerzteblatt.de/nachrichten/44039/Paediatrie--Tod-nach-Alternativmedizin.htm</ref><ref>http://adc.bmj.com/content/early/2010/11/24/adc.2010.183152.short?q=w_adc_ahead_tab</ref>
  
 
==Intimidation and actions against critics==
 
==Intimidation and actions against critics==
Individuals or institutions that have a critical view of alternative medicine and indicate its [[pseudomedicine]]character must expect personal attacks. Two women who asked critical questions at an event [[Helmut Pilhar]] about [[Germanic New Medicine]] in Frankfurt, Germany. were "accompanied home" by "bald gentlemen". The two women had to call police. A cellular therapist tried to stop a critic with a court order and from giving his assessment of [[cellular therapy]].<ref>LG Stuttgart AZ&nbsp;17&nbsp;0&nbsp;289/76 Claims 500,000&nbsp;German Mark</ref> A further example are civil actions against the project Paralexx which led to a temporary shutdown.
+
Individuals or institutions with a critical view of alternative medicine pointing out its [[pseudomedicine|pseudo-medical]]character must expect personal attacks. Two women who asked critical questions of the lecturer at an event on [[Germanic New Medicine]] in Frankfurt, Germany were "accompanied home" by "bald-headed gentlemen". The two women had to call the police. A cellular therapist tried to stop a critic with a court order and from giving his assessment of [[cellular therapy]].<ref>LG Stuttgart AZ&nbsp;17&nbsp;0&nbsp;289/76 Claims 500,000&nbsp;German Mark</ref> A further example are civil actions against the former project Paralexx which led to a temporary shutdown.
  
The German consumer protection foundation "Stiftung Warentest" wanted to publish a book with a critical analysis and evaluation of natural and alternative medicine. The magazine "Stern" seized the opportunity to do a prior publication: Krista Federspiel, one of the two authors and her colleague Hans Weiss offered to do a undercover report on the scene and have ten natural healers give them a diagnosis. Stern offered generous payment for the report and requested a second part that should present victims of alternative methods by name. To prove that the journalists had indeed visited natural healers a photographer was documenting it. Each attended healer imputed the subject with several diseases: A total of 38&nbsp;different diseases and an myriad of ailments and allergies were diagnosed and more than 130&nbsp;drugs prescribed. When the report "Wunderheiler und Krankbeter" (miracle healers and patient prayers) was published in Stern&nbsp;49/1991, the raised criticism was met by outrage and massive protests by healing practitioners that the editors postponed and later cancelled the second part fearing the loss of readers. The rights were returned to the autors.<ref>http://kritischgedacht.wordpress.com/2007/12/25/sanfte-alternative/</ref>
+
The German consumer protection foundation "Stiftung Warentest" wanted to publish a book with a critical analysis and evaluation of natural and alternative medicine. The magazine "Stern" seized the opportunity to do a prior publication: Krista Federspiel, one of the two authors and her colleague Hans Weiss offered to do a undercover report visiting ten alternative practicians to obtain a diagnosis. "Stern" offered generous payment for the report and requested a second part presenting victims of alternative methods by name. To prove the journalists had indeed seen these alternative practicians, a photographer documented the visits. Each prcitioner attended imputed the subject with several diseases: A total of 38&nbsp;different diseases and a myriad of ailments and allergies were diagnosed, and more than 130&nbsp;drugs prescribed. When the report titled "Wunderheiler und Krankbeter" (Miracle Healers and Faith Un-Healers) was published in "Stern"&nbsp;49/1991, the criticism raised was met by outrage and massive protests by alternative practitioners to such an extent that editors postponed and later cancelled the second part, fearing the loss of readers. The rights were returned to the authors.<ref>http://kritischgedacht.wordpress.com/2007/12/25/sanfte-alternative/</ref>
  
In a TV-show of the German station ZDF on September 5, 2007 titled "Heilen mit dem Nichts?"(Healing with nothing?) the journalist Joachim Bublath reported about scientific findings on [[homoeopathy]] (including an analysis of the renowned journal ''The Lancet'' [http://www.dzvhae.com/portal/pics/abschnitte/011005042421_lancet_kopie.pdf]) that questioned a possible effectiveness of this controversial method beyond [[placebo]]s. This led to a call from advocates of homoeopathy to ''spam'' and ZDF shied away by deleting the websites citing the Lancet figures.<ref>http://www.promed-ev.de/modules/news/article.php?storyid=110</ref><ref>http://docs.google.com/gview?a=v&q=cache%3AyI15cEvKzLYJ%3Awww.bdhn-ev.de%2Fuploads%2Fmedia%2FDie_modernen_Wunderheiler.pdf+%22Die+modernen+Wunderheiler%22+Aufruf&hl=de&gl=de&sig=AFQjCNEeIW2yCgFsl__3f69O5E8oV-HJCQ&pli=1</ref>
+
In a show aired by German TV station ZDF on September 5, 2007 titled "Heilen mit dem Nichts?"(Healing with nothing?), journalist Joachim Bublath reported about scientific results on [[homoeopathy]] (including an analysis of the renowned journal ''The Lancet''<ref>[http://www.ncbi.nlm.nih.gov/pubmed/16125589 Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy], The Lancet, 2005</ref>) which questioned a possible effectiveness of this controversial method beyond [[placebo]]s. This led to a call from advocates of homoeopathy to ''spam'' the station's website and ZDF shied away by deleting the site citing the Lancet figures.<ref>http://www.promed-ev.de/modules/news/article.php?storyid=110</ref><ref>http://www.bdhn-ev.de/uploads/media/Die_modernen_Wunderheiler.pdf accessed June 13, 2011</ref>
 +
 
 +
{{OtherLang|en=Alternative medicine|ge=Alternativmedizin}}
  
 
==Literature==
 
==Literature==
(mostly German)
+
(German)
 
*Shermer M. und Lee Traynor: Heilungsversprechen - Alternativmedizin zwischen Versuch und Irrtum, Skeptisches Jahrbuch III, Alibri, 2004, ISBN 3-932710-86-X
 
*Shermer M. und Lee Traynor: Heilungsversprechen - Alternativmedizin zwischen Versuch und Irrtum, Skeptisches Jahrbuch III, Alibri, 2004, ISBN 3-932710-86-X
 
*Ullmann Christian: Fakten über die „andere Medizin“. Augsburg: Foitzick 2006
 
*Ullmann Christian: Fakten über die „andere Medizin“. Augsburg: Foitzick 2006
 
*Lambeck Martin, Irrt die Physik?: (2003) Über alternative Medizin und Esoterik, Beck Verlag
 
*Lambeck Martin, Irrt die Physik?: (2003) Über alternative Medizin und Esoterik, Beck Verlag
 
*Heyll Uwe, Wasser, Fasten, Luft und Licht: Die Geschichte der Naturheilkunde in Deutschland, (2006) Campus Verlag
 
*Heyll Uwe, Wasser, Fasten, Luft und Licht: Die Geschichte der Naturheilkunde in Deutschland, (2006) Campus Verlag
*Singh Simon, Ernst Edzard, Trick or Treatment: The Undeniable Facts about Alternative Medicine, (2008) Random House
 
 
*Goldner C: Alternative Diagnose- und Therapieverfahren: Eine kritische Bestandsaufnahme. Alibri 2008 ISBN-10: 3865690432
 
*Goldner C: Alternative Diagnose- und Therapieverfahren: Eine kritische Bestandsaufnahme. Alibri 2008 ISBN-10: 3865690432
 
*Federspiel K., I. Lackinger-Karger: Kursbuch Seele. Köln: Kiepenheuer & Witsch 1996 (544 S.)
 
*Federspiel K., I. Lackinger-Karger: Kursbuch Seele. Köln: Kiepenheuer & Witsch 1996 (544 S.)
Line 113: Line 111:
 
*Oepen I., Amardeo Sarma (Hrsg.)(1998): Paramedizin - Analysen und Kommentare, Muenster.
 
*Oepen I., Amardeo Sarma (Hrsg.)(1998): Paramedizin - Analysen und Kommentare, Muenster.
 
*Oepen I., R. Scheidt: Wunderheiler heute. Eine kritische Literaturstudie. München: Zuckschwerdt 1989
 
*Oepen I., R. Scheidt: Wunderheiler heute. Eine kritische Literaturstudie. München: Zuckschwerdt 1989
 +
*Siebert A.: Strafrechtliche Grenzen ärztlicher Therapiefreiheit. Berlin: Springer 1983
 +
*Weber Tobias: Christian Ullmanns „Fakten über die andere Medizin“. Skeptiker 19 (3/06) 103-106
 +
 +
(English)
 
*Randi J.: Flim-Flam! Buffalo: Prometheus 1982, chapter 9 (The medical humbugs)
 
*Randi J.: Flim-Flam! Buffalo: Prometheus 1982, chapter 9 (The medical humbugs)
*Siebert A.: Strafrechtliche Grenzen ärztlicher Therapiefreiheit. Berlin: Springer 1983
 
 
*Stalker D., C. Glymour (eds.): Examining holistic medicine. Buffalo: Prometheus 1985
 
*Stalker D., C. Glymour (eds.): Examining holistic medicine. Buffalo: Prometheus 1985
*Ernst E.: The Desktop Guide to Complementary and Alternative Medicine. An evidence-based approach. Mosby, Harcourt Publishers Limited 2001
 
 
*R. Barker Bausell: Snake Oil Science. The Truth about Complementary and Alternative Medicine, B&T, 2007
 
*R. Barker Bausell: Snake Oil Science. The Truth about Complementary and Alternative Medicine, B&T, 2007
*Weber Tobias: Christian Ullmanns „Fakten über die andere Medizin“. Skeptiker 19 (3/06) 103-106
 
 
*Margaret Thaler Singer und Janja Lalich: (1996) "Crazy" Therapies - What are they? Do They Work? San Francisco: Jossey-Bass Publishers, 1996
 
*Margaret Thaler Singer und Janja Lalich: (1996) "Crazy" Therapies - What are they? Do They Work? San Francisco: Jossey-Bass Publishers, 1996
 +
*Ernst E.: The Desktop Guide to Complementary and Alternative Medicine. An evidence-based approach. Mosby, Harcourt Publishers Limited 2001
 
*Ernst E. How to get rich quickly with 'alternative' medicine Skeptical Inquirer 2009, Mar-Apr S. 57
 
*Ernst E. How to get rich quickly with 'alternative' medicine Skeptical Inquirer 2009, Mar-Apr S. 57
 +
*Singh Simon, Ernst Edzard, Trick or Treatment: The Undeniable Facts about Alternative Medicine, (2008) Random House
 +
*Ben Goldacre, Bad Science: Quacks, Hacks, and Big Pharma Flacks, Faber & Faber; ISBN 978-0865479180
  
 
See also: [[Helsana-Study]]
 
See also: [[Helsana-Study]]
  
==Weblinks==
+
==Weblinks (mostly in German language)==
 
* http://www.faz.net/s/RubF3CE08B362D244869BE7984590CB6AC1/Doc~EFE6249A7501E4254B8EEA47E0CA266ED~ATpl~Ecommon~Scontent.html
 
* http://www.faz.net/s/RubF3CE08B362D244869BE7984590CB6AC1/Doc~EFE6249A7501E4254B8EEA47E0CA266ED~ATpl~Ecommon~Scontent.html
 
* http://www.hauszumdolder.ch/docs/03_01_Robert_Juette.pdf
 
* http://www.hauszumdolder.ch/docs/03_01_Robert_Juette.pdf
Line 134: Line 136:
 
* http://www.zm-online.de/zm/17_01/pages2/mediz1.htm
 
* http://www.zm-online.de/zm/17_01/pages2/mediz1.htm
 
*[http://wissen.spiegel.de/wissen/dokument/dokument.html?id=9219191&top=SPIEGEL Der Spiegel: Alternativmedizin und Artenschutz]
 
*[http://wissen.spiegel.de/wissen/dokument/dokument.html?id=9219191&top=SPIEGEL Der Spiegel: Alternativmedizin und Artenschutz]
*[http://blog.ebook-insel.de/2009/05/26/anthroposophie-homoopathie-co-wie-verhalten-sich-dazu-kassen-und-politiker-in-deutschland/ blog.ebook-insel: Anthroposophie-Homöopathie-co wie verhalten sich dazu Kassen und Politiker in Deutschland]
 
 
*Laborjournal: [http://www.laborjournal.de/wordpress/wp-content/uploads/2010/10/Alt-Med-Flowchart.png A flowchart of alternative medicine]
 
*Laborjournal: [http://www.laborjournal.de/wordpress/wp-content/uploads/2010/10/Alt-Med-Flowchart.png A flowchart of alternative medicine]
 
*Sekten-Info NRW: [http://sekten-info-nrw.de/index.php?option=com_content&task=view&id=59&Itemid=36 Kriterien zur Beurteilung alternativer/komplementärer Heilmethoden]
 
*Sekten-Info NRW: [http://sekten-info-nrw.de/index.php?option=com_content&task=view&id=59&Itemid=36 Kriterien zur Beurteilung alternativer/komplementärer Heilmethoden]

Latest revision as of 08:06, 17 December 2014

Alternativmedizin.jpg

Alternative Medicine (for etymological meaning see: [1]) refers to methods and treatments not used by science based medicine (or evidence based medicine, EBM). Its supporters in particular also apply terms like complementary medicine, experience based medicine, and integrative medicine. Complementary and alternative medicine are often abbreviateded as CAM. Richard Dawkins stated that "there is no alternative medicine. There is only medicine that works and medicine that doesn't work."[2], a view that is also shared by Tim Minchin in his animated poem "Storm"[3]

Edzard Ernst, retired Professor of Complementary Medicine at the University of Exeter, England, argues that the term "Complementary and Alternative Medicine" ("CAM") is an almost nonsensical umbrella term, and distinctions between its modalities must be made. All treatments, whether "mainstream" or "alternative", ought to be held to standards of the scientific method. The evidence-based medicine is an ideal state which has not yet been achieved by either current mainstream or alternative medicine. Ernst characterizes the evidence for many alternative techniques as weak, nonexistent, or negative, but states that some evidence exists for about 20 treatments, particularly certain herbs and acupuncture – although this evidence does not mean these treatments are mainstream, especially not worldwide.[4][5]

A National Center for Complementary and Alternative Medicine NCCAM in USA defines complementary and alternative therapies as treatments which are used in place of ("alternative") or together ("complementary") with conventional, established therapy.[6] A treatment is considered established when its clinical efficacy has been demonstrated in prospective, randomized trials or a biological rationale establishes the treatment as reasonable. In 2009, an Anglo-Australian group of researchers demonstrated with a computional model that for some odd reason those methods with little or no effect at all show a tendency to spread quickly.[7][8]

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.[9] Almost all alternative treatments belong into the realm of pseudomedicine.

The concepts of alternative and complementary medicine are usually based on an axiom (a self-evident truth that requires no proof).[10][11]

CAM has turned into a big business, the worldwide turnover is estimated at more than 60 billion U.S. Dollars.[7]

The typical patient

The typical patient or customer, according to studies, can be characterized by the following attributes:[12]

  • young (30-50 years)[13]
  • higher education
  • poorer health status
  • tends to be politically "left" or "green"[14]
  • relatively high income
  • female
  • a holistic orientation to health
  • suffers from anxiety, back problems, chronic pain or urinary tract problems

Appeal

For the popularity of offers outside of science-based medicine a variety of factors were identified.

People seeking alternative treatments were found to have had had a transformational experience that changed the person's worldview and often showed commitment to environmentalism, commitment to feminism, and interest in spirituality and personal growth psychology. One study found that dissatisfaction with conventional medicine did not predict use of alternative medicine. Only 4.4% of those surveyed reported relying primarily on alternative therapies. It concluded that people find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations towards health and life.[12] Still, arguments like "alternative practitioners devote more time to patients than doctors" are frequently heard.

Other studies found that disappointments with and distrust of conventional therapies play a role. Many patients and clients find pleasure in the more or less explicit criticism of mainstream medicine" or "the pharmaceutical industry" which is not uncommon in alternative medicine circles. Often, an anti-scientific attitude is mixed with New Age mysticism. Vigorous marketing and extravagant claims create false hope. When people become sick, any promise of a cure is appealing.[15]

An appeal may also result from the typical features of pseudomedical treatments, such as simple, clear explanations for the alleged therapeutic effect or lack of side effects. In a study, Edzard Ernst showed this notion is wrong and side effects may indeed occur.[16]

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

"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."[17]

Business in Germany

The number of CAM providers in Germany is rising. Between 1993 and 2000, the number of alternative practitioners as the most important non-medical CAM-profession increased by  90% (from 11/100.000 to 21/100.000 persons). During the same period, the CAM supply of doctors increased by 125% (from 19/100.000 to 43/100.000).[18] 65% of population and nearly all cancer patients use the services provided by CAM at least once a year.[5]

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).[19] Five billion Euros are paid by the patients themselves, four billions are refunded by health insurances. 40.000 doctors offer respective treatments.[20]

Another estimate valued the total turnover at about 20% of the entire so-called Wellness industry in Germany, which has an annual volume of 50 billion Euro.[21]

Business in USA

A 2008 survey of US hospitals by Health Forum, a subsidiary of the American Hospital Association, found that more than 37% of responding hospitals indicated they offer one or more alternative medicine therapies, up from 26.5% in 2005. More than 70% of the hospitals offering CAM were in urban areas.[22]

The National Health Statistic Report in an article dated July 30, 2009[23] states that U.S patients have spent 33.9 billion Dollars on CAM services and products in 2007. Homoeopathy accounted for 3 billions, Qigong for 4 billions. Expenditure for food supplements like vitamins and minerals were not included in this amount.[24] In 1997, between 36 and 47  billion U.S. Dollars were spent on complementary medicine. Of these, 12 to 20 billion USD were paid by patients for complementary therapists.[25] This is half of the amount spent by patients on medical services.

A study found that 27 billion dollars were spent on complementary and alternative medical treatments by consumers in 2002.[26] A further study found that, in 1987, four times as much money was spent in the USA on complementary medicine than on all cancer research.[27] In 1981 Laetrile, a then popular ineffective, alternative cancer drug made from apricot kernels had a turnover of 2 billion U.S. dollars. In the same period 0.2 billion dollars were spent on chemotherapy.

Research

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

  • Karl und Veronica Carstens-Foundation (27 million Euro). It sponsored 1.5 million Euro in May 2008 for an endowed chair of alternative medicine at the Berlin Charité.
  • Krupp Foundation
  • Kneipp Foundation
  • Gerhard Kienle Foundation
  • Erich Rothenfußer Foundation

The manufacturers of alternative medical products are also funding research in this field. German companies Bionorica and Schwabe have research budgets of 17 and 25 million Euro. While it is not possible to patent substances that occur in nature (such as plants), special techniques for preparation can be patented.

Since 1999, the National Center for Complementary and Alternative Medicine (NCCAM) has funded research on alternative medicine with 2,5 billion U.S. Dollars.

The National Center for Complementary and Alternative Medicine in USA has an annual budget of 122 million dollars, financed by the government, and spent $2.5 billion on studies of CAM therapies.[28][29] The NCCAM budget has been criticized because despite the duration and intensity of studies, there have been exactly zero effective CAM treatments supported by scientific evidence to date.[30][31] R. Barker Bausell, a research methods expert and author of "Snake Oil Science" states that "it's become politically correct to investigate nonsense."[32]

Wallace Sampson, an editor of Scientific Review of Alternative Medicine and a Stanford University professor of medicine, comments CAM is the "propagation of the absurd" based on the example that alternative and complementary have been substituted for dubious and implausible quackery.

Currently (2010), the "National Center for Complementary and Alternative Medicine" (NCCAM) and the "Office of Cancer Complementary and Alternative Medicine" (OCCAM) spend a combined 240 million U.S. Dollars of taxpayers' money from the NIH (National Institute of Health).[33]

Criticism

As far as effectiveness is concerned, users of alternative medical methods often only refer to their own experience which is based on a selective perception of the past. Such retrospective observations are not evident by nature. The argument used occasionally, "He who heals is right", is not sensible because causality and correlation are often confused in anecdotal experience and reports. In other words, an illness treated with globules might just as well have gone away by itself.

The notion of a postulated and fuzzy phrased "holistic approach" (usually associated with "of body, mind and soul") remains a mere promise within alternative medicine and would be difficult to implement because of time and financial constraints.

Potential danger

Alternative medicine involves several dangers and risks[34][35][36]:

  • rejection of effective diagnostics and therapies in favour of pseudo-medical methods without proof of effectiveness leading to protraction of the illness or appearance of avoidable symptoms
  • misdiagnoses because of inadequate medical training of alternative practitioners
  • deterioration of therapeutic prospects due to futile pseudomedical efforts
  • development of guilt feelings at failure, towards oneself or family members
  • psychological and financial exploitation by a CAM method displaying cult-like structures
  • development of psychological dependency or addiction
  • deaths or permanent damage due to inappropriate procedures

A study by the Royal Children's Hospital in Melbourne published in December 2010 investigated 39 cases in which children suffered damage fpllowing alternative medical treatments. In 30 cases, a correlation between damage to the patients and use of alternative medical therapies or denial of prescribed medicines was established. Four of the children died because their parents refused medical treatment. An malnourished infant of eight months died of septic shock because he had been put on a diet of "naturopathic" rice milk due to an alleged constipation since his third month of life. A baby of ten months also died of septic shock because he was put on a restrictive diet against a chronic eczema. Another child died from multiple epileptic seizures after parents had stopped the anti-epileptic drug medication for fear of side effects, using an alternative remedy instead. A fourth child suffered fatal bleeding because the parents refused a therapy with anticoagulants in favour of a complementary medical treatment.[37][38]

Intimidation and actions against critics

Individuals or institutions with a critical view of alternative medicine pointing out its pseudo-medicalcharacter must expect personal attacks. Two women who asked critical questions of the lecturer at an event on Germanic New Medicine in Frankfurt, Germany were "accompanied home" by "bald-headed gentlemen". The two women had to call the police. A cellular therapist tried to stop a critic with a court order and from giving his assessment of cellular therapy.[39] A further example are civil actions against the former project Paralexx which led to a temporary shutdown.

The German consumer protection foundation "Stiftung Warentest" wanted to publish a book with a critical analysis and evaluation of natural and alternative medicine. The magazine "Stern" seized the opportunity to do a prior publication: Krista Federspiel, one of the two authors and her colleague Hans Weiss offered to do a undercover report visiting ten alternative practicians to obtain a diagnosis. "Stern" offered generous payment for the report and requested a second part presenting victims of alternative methods by name. To prove the journalists had indeed seen these alternative practicians, a photographer documented the visits. Each prcitioner attended imputed the subject with several diseases: A total of 38 different diseases and a myriad of ailments and allergies were diagnosed, and more than 130 drugs prescribed. When the report titled "Wunderheiler und Krankbeter" (Miracle Healers and Faith Un-Healers) was published in "Stern" 49/1991, the criticism raised was met by outrage and massive protests by alternative practitioners to such an extent that editors postponed and later cancelled the second part, fearing the loss of readers. The rights were returned to the authors.[40]

In a show aired by German TV station ZDF on September 5, 2007 titled "Heilen mit dem Nichts?"(Healing with nothing?), journalist Joachim Bublath reported about scientific results on homoeopathy (including an analysis of the renowned journal The Lancet[41]) which questioned a possible effectiveness of this controversial method beyond placebos. This led to a call from advocates of homoeopathy to spam the station's website and ZDF shied away by deleting the site citing the Lancet figures.[42][43]

Versions of this article in other languages

Literature

(German)

  • Shermer M. und Lee Traynor: Heilungsversprechen - Alternativmedizin zwischen Versuch und Irrtum, Skeptisches Jahrbuch III, Alibri, 2004, ISBN 3-932710-86-X
  • Ullmann Christian: Fakten über die „andere Medizin“. Augsburg: Foitzick 2006
  • Lambeck Martin, Irrt die Physik?: (2003) Über alternative Medizin und Esoterik, Beck Verlag
  • Heyll Uwe, Wasser, Fasten, Luft und Licht: Die Geschichte der Naturheilkunde in Deutschland, (2006) Campus Verlag
  • Goldner C: Alternative Diagnose- und Therapieverfahren: Eine kritische Bestandsaufnahme. Alibri 2008 ISBN-10: 3865690432
  • Federspiel K., I. Lackinger-Karger: Kursbuch Seele. Köln: Kiepenheuer & Witsch 1996 (544 S.)
  • Beyerstein B.L.: Warum falsche Therapien zu wirken scheinen. In Shermer/Traynor (s. u.)
  • Harder Bernd: Stimmt es, dass Recht hat, wer heilt? Skeptiker 2/07, 74-75
  • Much Theodor: Der veräppelte Patient?: Alternativmedizin zwischen (Aber-)Glauben und Wissenschaft. Verlag: EDITION VA bENE, Klosterneuburg; 2003. ISBN-10: 3851671430
  • Oepen I.: An den Grenzen der Schulmedizin. Eine Analyse umstrittener Methoden. Köln: Dt. Ärzte-Verlag 1985
  • Oepen I., O. Prokop (Hrsg.): Außenseitermethoden in der Medizin. Ursprünge, Gefahren, Konsequenzen. WBG 1989
  • Oepen I. (1993): Unkonventionelle medizinische Verfahren, Stuttgart.
  • Oepen I., Amardeo Sarma (Hrsg.)(1998): Paramedizin - Analysen und Kommentare, Muenster.
  • Oepen I., R. Scheidt: Wunderheiler heute. Eine kritische Literaturstudie. München: Zuckschwerdt 1989
  • Siebert A.: Strafrechtliche Grenzen ärztlicher Therapiefreiheit. Berlin: Springer 1983
  • Weber Tobias: Christian Ullmanns „Fakten über die andere Medizin“. Skeptiker 19 (3/06) 103-106

(English)

  • Randi J.: Flim-Flam! Buffalo: Prometheus 1982, chapter 9 (The medical humbugs)
  • Stalker D., C. Glymour (eds.): Examining holistic medicine. Buffalo: Prometheus 1985
  • R. Barker Bausell: Snake Oil Science. The Truth about Complementary and Alternative Medicine, B&T, 2007
  • Margaret Thaler Singer und Janja Lalich: (1996) "Crazy" Therapies - What are they? Do They Work? San Francisco: Jossey-Bass Publishers, 1996
  • Ernst E.: The Desktop Guide to Complementary and Alternative Medicine. An evidence-based approach. Mosby, Harcourt Publishers Limited 2001
  • Ernst E. How to get rich quickly with 'alternative' medicine Skeptical Inquirer 2009, Mar-Apr S. 57
  • Singh Simon, Ernst Edzard, Trick or Treatment: The Undeniable Facts about Alternative Medicine, (2008) Random House
  • Ben Goldacre, Bad Science: Quacks, Hacks, and Big Pharma Flacks, Faber & Faber; ISBN 978-0865479180

See also: Helsana-Study

Weblinks (mostly in German language)

References

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