CAM Therapies; who uses them-when and why

A recent study published in the Journal of Family Practice1 reads like a report card for the so-called “alternative health” or “complementary and alternative medicine” (CAM) professions. And as chiropractic is still the leading provider, this study tells us much about the effect chiropractic has had, particularly in the minds of medical patients.

The study looked at when and why (medical) family practice patients included various forms of CAM for their health complaints. The study found that 21 percent of family practice patients (34.5 percent of which were chiropractic patients) “reported using one or more forms of CAM therapy in conjunction with the most important health problem.”

Don’t misinterpret that 21 percent. That is not the percentage of the public that uses alternative care, merely the percentage of medical family practice patients that do. Dr. Eisenberg’s determination that 42 percent of the U.S. population uses alternative care over the course of a year is still reliable, 2 with a later study putting the lifetime use at 66 percent.3

The Journal of Family Practice study1 revealed two important findings:

1. CAM Users Begin Using Alternative Care First:

Of that 21 percent who also used CAM for their health problems, 33 percent began using one or more forms of alternative care before visiting their family physicians. Another 37 percent began using alternative care concurrent with their initial medical office visits, with 19 percent using alternative care after visiting their MDs. These findings should bring to your minds a number of thoughts. Here are a few thoughts that quickly came to me:

v These patients aren’t waiting for “permission” to use chiropractic or any other form of alternative care.

v Patients believe they are sufficiently informed to make decisions about their health.

v Alternative care and medical care are seen as compatible, at least by these 21 percent.

2. Dissatisfaction/Failure of Medicine is the Leading Reason for Using CAM

The Journal of Family Practice study (1) found numerous reasons why medical patients used alternative care:

v To avoid medical side effects - 25.9 percent

v Friend/co-worker recommended it - 25.9 percent

v Failure of medical treatment - 24.1 percent

v Prefer to deal with own problems -14.7 percent

v Philosophical reasons - 12.9 percent

v Parents/relatives use CAM for problem - 12.9 percent

v Failure of MD to correctly diagnose - 12.1 percent

v Heard about treatment in the news - 9.5 percent

v Unhappy with the attitudes of MDs - 6.0 percent

v Taught to treat problem this way as a child - 5.2 percent

v Serious illness with poor chance of recovery - 2.6 percent

v No medical treatment for problem - 2.6 percent

If we group these reasons, we see that over two-thirds (68.1 percent) of the patients sought alternative care for these reasons:

Ø To avoid unwanted side effects, because of the failure of medicine

Ø Because they didn’t like the attitudes of the MDs.

These reasons are a serious indictment of the medical model.

So what have we taught these 21 percent?

v They can address their own health needs.

v Alternative forms of care are generally very safe.

v They can avoid dangerous medical side effects.

v They don’t have to accept substandard care (or attitude) from medicine.

v Their personal health philosophy does matter.

Understanding these concepts/options provides patients with the ability to take charge of their own health care and regulate their exposure to potentially inappropriate/harmful medical care. And while there are many people who only see a medical provider for extreme situations, these patients apparently comfortable in mixing alternative and medical resources in deciding how best to maintain their own health.

Just think about what could happen if we could teach the other 79 percent (who represent approximately 320 million visits per year) the same concepts. Also, consider that almost 10 percent of these alternative care users went to alternative providers because they “heard about this treatment in the news.” This continues to underscore our need to get our information into mainstream media.

References:

Palinkas LA, Kabongo ML, et al. The use of complementary and alternative medicine by primary care patients. J Fam Pract 2000; 49:1121-1130.

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. JAMA 1998; 280:1569-1575.

Most American find alternative remedies effective. InterSurvey/Knowledge Networks, May 12, 2000.