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Kicking Complementary Medicine Out of the Closet


Medically Reviewed On: November 24, 2003

By Christine Haran

These days, telling a coworker or friend that you're off to your acupuncture appointment is unlikely to generate a suspicious look. In 1998, a survey published in the Journal of the American Medical Association found that 42 percent of the population was using some sort of alternative and complementary medicine, and it's probable that these therapies are even more popular today.

Despite the widespread use of non-traditional therapies such as acupuncture, herbal remedies, prayer, guided imagery and magnet therapy, few people are sharing their use of these therapies with their conventional healthcare providers. Patients tend not to volunteer the information, and doctors don't ask. This lapse in communication may not only prevent patients from getting the best care possible though the integration of different approaches, it can sometimes threaten a patient's health.

Adam Perlman, MD, MPH, is the medical director for the Siegler Center for Integrative Medicine at the St. Barnabas Ambulatory Care Center in Livingston, New Jersey and executive director for the Institute for Complementary and Alternative Medicine at the University of Medicine and Dentistry of New Jersey. Below, Dr. Perlman discusses why doctors and patients need to have an open dialogue about complementary medicinešand offers ways to bridge the communication gap.

How would you define the terms "alternative medicine," "complementary medicine" and "integrative medicine"?
Different people define these words somewhat differently, but the way that I think about it is that "alternative medicine" implies you're either going to use conventional medicine or you're going to abandon conventional medicine and use some sort of alternative. That's not what I, nor what most of us involved in this field would advocate.

"Complementary medicine" gets a little closer to describing the way that the sorts of modalities are used most commonly in this country. For example, if you happen to have cancer and you had nausea from the chemotherapy, you would hopefully get medication for the nausea, but it often doesn't work 100 percent, or you might not want to take another medication. So you might use acupuncture to complement the conventional care you're receiving because acupuncture is supported by the National Institutes of Health (NIH) as being indicated for chemotherapy-induced nausea. So really the non-conventional, if you will, is complementing the conventional.

"Integrative" describes an approach to the care of the patient. It's trying to care for a patient by combining the best of conventional and select non-conventional modalities. It's looking beyond just the particular symptom or complaint or even disease process that someone may have and trying to look at the whole person. It's certainly a lot more than trying to replace Prozac with St. John's wort.

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