Alternative medicine comprises medical practices which are untested, untestable, or known to be ineffective. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), functional medicine, and holistic medicine are among many of its rebrandings.
Terms for alternative medicine
The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in most contexts.
There is concern that a lack of stabilized terminology for these practices may give the appearance of effectiveness. Loose terminology may also be used to suggest that a dichotomy exists when it does not, e.g., the use of the expressions "Western medicine" and "Eastern medicine" to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and other forms of treatment.
Some scholars adopt this "Western" and "Eastern" language. For example, in a study done on musculoskeletal pain acupuncture treatment, researchers use the term "Western Acupuncture", which is defined as the acupuncture practices that are evidence based. This term also removes the cultural connotations that are used in acupuncture such as "qi", or "primordial energy".
Complementary or integrative medicine Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with mainstream medical treatment, in a belief that it improves the effect of treatments. For example, acupuncture (piercing the body with needles to influence the flow of a supernatural energy) might be believed to increase the effectiveness or "complement" science-based medicine when used at the same time. Instead, significant drug interactions caused by alternative therapies may make treatments less effective, notably in cancer therapy. Integrative medicine has been described as an attempt to bring pseudoscience into academic science-based medicine. Due to its many names, the field has been criticized by writer Rose Shapiro for what she describes as intense rebranding of what are essentially the same practices.
CAM is an abbreviation of the phrase complementary and alternative medicine. The 2019 World Health Organization (WHO) Global Report on Traditional and Complementary Medicine states that the terms complementary and alternative medicine "refer to a broad set of health care practices that are not part of that country's own traditional or conventional medicine and are not fully integrated into the dominant health care system. They are used interchangeably with traditional medicine in some countries."
Other terms
Traditional medicine comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the era of modern medicine. The 2019 WHO study defines traditional medicine as "the sum total of the knowledge, skill and practices based on the theories, beliefs and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness."
Holistic medicine is another rebranding of alternative medicine. In this case, the words balance and holism are often used alongside complementary or integrative, claiming to take into account a "whole" person, in contrast to the supposed reductionism of medicine. The "whole" person idea is referring to the 'analysis of physical, nutritional, environmental, emotional, spiritual and lifestyle elements' as defined by the American Holistic Health Association. When specific ailments are diagnosed, or health is being analyzed, things like mental health are factors that are also taken into consideration alongside physical health. According to a random national survey in America of US osteopathic physicians, less than a third of the respondents agreed with the fact that holism is a concept in osteopathic medicine that is distinct from allopathic medicine. This study highlights that osteopathic physicians view that practitioners in the allopathic field also practice holism in their respective practices.
Functional medicine is a marketing term for alternative medicine created by Jeffrey Bland, who founded The Institute for Functional Medicine (IFM).
Definitions of alternative medicine
Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine, but whose effectiveness has not been established using scientific methods, or whose theory and practice is not part of biomedicine, or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine. "Biomedicine" or "medicine" is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine, an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.
Challenges in defining alternative medicine
Terminology has shifted over time, reflecting the preferred branding of practitioners."Integrative medicine": A brand, not a specialty. Science Based Medicine For example, the United States National Institutes of Health department studying alternative medicine, currently named the National Center for Complementary and Integrative Health (NCCIH), was established as the Office of Alternative Medicine (OAM) and was renamed the National Center for Complementary and Alternative Medicine (NCCAM) before obtaining its current name. Therapies are often framed as "natural" or "holistic", in apparent opposition to conventional medicine which is "artificial" and "narrow in scope", statements which are intentionally misleading.
Prominent members of the science and biomedical science community say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, because the expressions "conventional medicine", "alternative medicine", "complementary medicine", "integrative medicine", and "holistic medicine" do not refer to any medicine at all. Others say that alternative medicine cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between alternative and conventional medicine overlap, are porous, and change. The systems and practices it refers to are diffuse, and its boundaries poorly defined. Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Some alternative therapies, such as traditional Chinese medicine (TCM) and Ayurveda, have antique origins in East or South Asia and are entirely alternative medical systems;. others, such as homeopathy and chiropractic, have origins in Europe or the United States and emerged in the eighteenth and nineteenth centuries. Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions. Under a definition of alternative medicine as "non-mainstream", treatments considered alternative in one location may be considered conventional in another.
Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo. It has been said that "there is really no such thing as alternative medicine, just medicine that works and medicine that doesn't", and that the very idea of "alternative" treatments is paradoxical because any treatment proven to work is by definition "medicine."
Different types of definitions Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare. This can refer to the lack of support that alternative therapies receive from medical scientists regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum. In 1993, the British Medical Association (BMA) stated that it referred to "...those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses". In a US context, a definition coined in 1993 by the Harvard-based physician David M. Eisenberg described alternative medicine as "interventions neither taught widely in medical schools nor generally available in US hospitals".. . In a definition published in 2000 by the World Health Organization (WHO), CAM was defined as a broad set of health care practices that are not part of that country's own tradition and are not integrated into the dominant health care system. A widely used descriptive definition devised by the US NCCIH calls it "a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine". However, these descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and introductory courses or modules can be offered as part of standard undergraduate medical training; alternative medicine is taught in more than half of US medical schools and US health insurers are increasingly willing to provide reimbursement for alternative therapies. In 1999, 7.7% of US hospitals reported using some form of alternative therapy; this proportion had risen to 37.7% by 2008. A 15-year systematic review published in 2022 on the global acceptance and use of CAM among medical specialists found the overall acceptance of CAM at 52% and the overall use at 45%.