The role of complementary and alternative medicine

doi:10.1136/bmj.321.7269.1133

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E Ernst, director (E.Ernst@ex.ac.uk)

Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, Exeter EX2 4NT

Based on a presentation from the Millennium Festival of Medicine

Complementary and alternative medicine is defined as “diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine.”1 It comprises a confusingly large and heterogeneous array of techniques, with both therapeutic and diagnostic approaches (table 1).

Summary points

The one year prevalence for use of complementary and alternative medicine is around 20% and is predicted to rise

Some of the reasons for this popularity amount to a biting criticism of conventional medicine

At present much complementary and alternative medicine is still opinion based

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Table 1

Examples of techniques used in complementary and alternative medicine

Complementary and alternative medicine is popular

A recent telephone survey on the use of complementary and alternative medicine in the United Kingdom yielded a one year prevalence of 20%.14 Herbalism, aromatherapy, homoeopathy, acupuncture, massage, and reflexology were among the most popular. This level of use may seem impressive but, compared with other countries, it is low (figure). National differences are difficult to interpret. To some they indicate that in the United Kingdom complementary and alternative medicine will grow to match its popularity in Germany or France, where, contrary to the United Kingdom, it is mostly practised by medically trained doctors.

One year prevalence of complementary and alternative medicine in various countries. Data based on surveys of random or representative samples of population

Complex reasons for popularity

The exact reasons for the popularity of complementary and alternative medicine are complex; they change with time and space, they may vary from therapy to therapy, and they are different from one individual to another—for example, a patient with AIDS will have other motives than someone who is “worried well.” Reporting on complementary and alternative medicine in the British daily press is …