Bringing complementary and alternative medicine (CAM) into mainstream is not integration

EDITOR—Vickers's review is another example of how complementary and alternative medicine (CAM) is being brought into the mainstream rather than integrated.1 Times are indeed changing, but what to?

The dictionary defines integration as “the incorporation of equals into society.”2 Let's be honest: there is no equality in medicine; there never was and probably never will be. The recent approval of acupuncture by the BMA is by no means an overarching endorsement of Chinese medicine as a legitimate alternative system.3 It is simply an acknowledgement of the accumulation over time of good enough evidence that shows the effectiveness of acupuncture in some conditions. This is, to borrow a metaphor from the word processing world, a cut and paste approach. It results in the assimilation, and not creation, of a new emergent property. Combination medicine is not integrated medicine.

Two other important aspects related to the future of CAM deserve discussion.

Health services research—Currently, much of the research effort in CAM is in the form of treatment x for disease y. Almost no systematic research is taking place on the delivery, organisation, and financing of different integrative healthcare models or on the appropriateness, quality, availability, and cost of CAM modalities in the current healthcare system. At a time when there is much interest …