Is there a Yamalube alternative?

For knowledgeseeker-ga, Alternative Health

• Hi knowledge seeker, Sorry I vanished for a while. Life got very busy. First, some old business. Some time ago, I posted a question about hospital charges that you answered in a comment. That question has since expired. I left a comment on that question asking you to post your comment as an answer, so that I could pay you. Uncertain of the mechanics (can you post an answer to an expired question, etc.) Now, on to new business. I believe that alternative medicine has grown a great deal in the United States, and I hypothesize that one of the factors contributing to its growth has been the increase in the number of people who have no health insurance or inadequate health insurance. Here's what I am hoping you can find for me: 1. I am looking for a good working definition of alternative medicine (don't spend too much time on this, as this is not my main question). 2. I am looking for some evidence proving or disproving that alternative medicine has grown in the United States (again, this is not my main question). 3. Assuming that alternative medicine has indeed grown in the U.S., I am looking for information on the factors that have driven its growth (this is my main question). I would be interested in both qualitative and quantitative information. I have some intuitive beliefs about factors that may or may not prove out. For instance, I think that there is a growing level of unhappiness with "conventional" medicine and that there are some people who have very good health insurance who are turning to alternative medicine because they think it offers better or complementary care. I also think that people who do not have health insurance turn to alternative remedies because they are easier to access (i.e., people can self prescribe) and because practitioners of alternative medicine set their fees at a more affordable level than regular doctors. Finally, I think that many people pick and choose which approach to use depending on the underlying medical problem - i.e., people may use alternative medicine for well care, for quotidian aches and pains, and for chronic medical problems, but will still show up in the emergency room if they have a broken arm or need stitches. I'll be especially interested in any information you can find supporting (or disproving) the notion that the uninsured and under-insured turn from conventional to alternative medicine. Let me know if you need clarification. BTW, time frame is within the next two weeks.

• Answer:

  Hi Natalie, Before I start I have to tell you, I am blown away by what I’ve learned here. The psychology and sociology behind the public’s shift to alternative forms of treatment is much more complex than I ever imagined. Like many people, I have always chalked this alternative health movement up to being a recent fad. It turns out, it’s not. I also figured that many of the people jumping on the bandwagon were either uneducated, gullible, desperate, poor, or defiantly antiestablishment. Turns out they are not. And finally, I thought the orthodox medical establishment maintained an arms-crossed supercilious attitude towards alternative health options. It turns out, they do not. So I’ve been educated today. There’s a lot of information out there on this topic – hundreds of articles. What I tried to do in researching this, is first get a sense of the overall state of the alternative health movement. Then, once I got that nailed down, I selected representative articles and the major studies and reports to illustrate each of the different topics I’ve addressed. So, here we go. I’ll start with the Short Answer – basically a summary and then give you all the supporting explanation and documentation. ===================== THE SHORT ANSWER ===================== The use of ALTERNATIVE MEDICINE -- that is, treatment options that are not normally provided or accepted by the conventional Western medical community -– is, and has been on the rise since the 1950’s. Today the term that’s used is CAM: COMPLEMENTARY AND ALTERNATIVE MEDICINE The reason for the rise in CAM usage can be attributed on the one hand to what is possibly a single underlying human drive and at the same time can be attributed to cultural factors that open the door to CAM therapies and to individual circumstances that trigger patients to use them. In the end it seems to boil down to this: Patients seek medical treatments that mesh with their own personal value systems. They choose treatments and health-care providers that make them feel comfortable. To this end, they often have little regard to what has been proven to be effective or even safe. People’s value systems are shaped both internally and by their world around them. Their ultimate decision to step in the direction of alternative therapies is a reflection of their opinions of their current health and of how they perceive the medical establishment responding to their needs. For the past 50 years the scene has been set for a mismatch between the values of the baby boom and post-baby boom cohort groups and the traditional focus of conventional medicine. These cohorts are people who value empowerment and control. They have access to lots of information and want to have a hand in managing their own treatments (remember, these are the same people who want to manage their own stock portfolios) But, most importantly, they want to be considered by their doctors as a whole person, not just a disease. They want their mind and bodies treated as one. The 1960’s counter-culture helped to open the doors to new alternative therapies that fit these bills. However, it’s important to understand that using CAM is not a new phenomenon. Alternative or unaccepted medical therapies have drawn large audiences throughout US history, only falling to a low point during the 1940s and 1950 medical breakthrough boom. Hence, what we are seeing now may well be the norm – the only difference being that conventional physicians (probably because they are of the same cohort as their patients) are more accepting of concurrent use of alternative treatments than in past eras. And now, the Long Answer -------- ================================== DEFINING ALTERNATIVE MEDICINE ================================== This is probably more than you were expecting, but the specific definitions and classifications are important when it comes to understanding how and why people use alternative therapies and the trends that have occurred in the field of alternative medicine. It’s also helpful to understand just which therapies are considered alternative. In general, ALTERNATIVE MEDICINE is a catch-all phrase for treatments that have not been fully accepted by the mainstream Western medical establishment. However, since physicians are becoming more accepting of many formerly discounted “alternative” treatment options and since most patients use alternative therapies in conjunction with conventional therapies, the term now being used by professionals is COMPLEMENTARY AND ALTERNATIVE MEDICINE or CAM. In the United States, NIH has created an oversight body, The National Center for Complementary and Alternative Medicine (NCCAM), to support research on CAM treatments, train researchers in CAM, and disseminate information to the public and professionals on the effectiveness of CAM therapies. NCCAM uses the following definitions: CAM: a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. COMPLEMENTARY MEDICINE: Used together with conventional medicine. Eg: using aromatherapy to help lessen a patient's discomfort following surgery. ALTERNATIVE MEDICINE: Used in place of conventional medicine. Eg: using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy. CAM classifies CAM therapies into five categories, or domains: 1. Alternative Medical Systems – those built upon complete systems of theory and practice that usually have evolved apart from and earlier than the conventional medical approach. Eg: homeopathy, naturopathy, Ayurvedic medicine. 2. Mind-Body Interventions - using techniques designed to enhance the mind's capacity to affect bodily function and symptoms. Eg: prayer, meditation, art and music therapies. 3. Biologically Based Therapies - using substances found in nature, such as herbs, foods, and vitamins. Eg: dietary supplements, herbal products, shark cartilage. 4. Manipulative and Body-Based Methods - based on manipulation and/or movement of one or more parts of the body. Eg: chiropractic, osteopathic manipulation, massage. 5. Energy Therapies - involve the use of either of two types of energy fields: Biofield therapies (qui gong, Reiki) and Bioelectromagnetic-based therapies (pulsed fields, magnetic fields). DEFINITION RESOURCES ---------------------------- NCCAM - What Is Complementary and Alternative Medicine (CAM)? http://nccam.nih.gov/health/whatiscam/ MEDICAL DICTIONARY - ALTERNATIVE MEDICINE http://www.books.md/A/dic/alternativemedicine.php THE ALTERNATIVE MEDICINE HOME PAGE http://www.pitt.edu/~cbw/altm.html =============================== TRENDS IN THE USE OF CAM =============================== You are correct in your assumption that there has been an increase in the use of CAM in the US. According to NCCAM: Utilization of CAM Practices is pervasive, appealing and rapidly growing: 40% of Americans, over 2/3rds world-wide 30% increase in use and visits to CAM practitioners since 1990 $27 billion in out-of-pocket expenses [1] One team of researchers at Harvard Medical School and Center for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Center, in Boston (see Eisenberg [2] & [3] below) has conducted several large retrospective and cohort studies plotting the use and acceptance of CAM therapies. They found that between 1990 and 1997: “Use of at least 1 of 16 alternative therapies increased from 33.8% in 1990 to 42.1% in 1997. The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3%.” [2] However, this increased interest in alternative therapies is not new. What the team also found is that the lifetime prevalence of CAM therapy use in the United States has been increasing steadily since the 1950s. Even more interestingly, CAM therapies were used extensively in the 1850’s and in 1900 and are also documented in the 1920’s and 1930’s. From this the researchers postulate that their data may be demonstrating a resurgence in CAM use after a period of reduced use during the 1940s and 1950s – a time when conventional medical breakthroughs (antibiotics, vaccines) were at a peak. [3] * RESOURCES FOR TRENDS & STATISTICS ------------------- [1] Challenges and Opportunities for Collaboration with Industry National Center for Complementary and Alternative Medicine (NCCAM) Industry Colloquium - Washington, DC - May 14, 2001 http://nccam.nih.gov/news/pastmeetings/051401/straus/index.htm [2] Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey [PMID: 9820257] JAMA. 1998;280:1569-75 http://jama.ama-assn.org/cgi/content/abstract/280/18/1569 [3] David M. Eisenberg, MD; Ronald C. Kessler, PhD; David F. Foster, MD; Roger B. Davis, ScD; et al. Long-Term Trends in the Use of Complementary and Alternative Medical Therapies in the United States; 21 August 2001, Volume 135 Issue 4. Pages 262-268 http://www.annals.org/cgi/content/full/135/4/262 * *this is an in-depth prevalence study based on a retrospective survey of 2055 respondents. It includes many tables and graphs and discussions of the rise and fall of specific types of therapies, cohort group trends, aggregate statistics, and a long view of the history of CAM use. I will be referring to it throughout my answer. ========================================== FACTORS DRIVING THE GROWTH IN CAM USAGE ========================================= Ok, now the hard part -- WHY? Here we have to consider two things: the distal and the proximal causes for the rise in CAM. Identifying the distal causes will tell us the answer to the question: Why has CAM therapy grown to be such a large part of today’s medical arsenal? Identifying the proximal causes will give us the answer to the question: Why does an individual makes a decision to switch or add CAM to their medical treatment. DISTAL DRIVING FORCES ---------------------------------------------- The distal reasons are the things that are inherent “in the air” – what’s going on in the world around us culturally, scientifically, and even biologically. These are things that act on everyone. They are: ------------------ COHORT GROUP ------------------ Not to be confused with age, a patient’s cohort group, that is the group of people who were born around the same time as the patient and who travel through time with him/her is an important predictor of the likelihood of that patient trying and using a alternative therapy. Cohort groups move in a like-fashion due to shared underlying belief systems that stem from being born and coming of age in the same space/time in cultural history. Again citing Eisenberg et al. [3] : “… Lifetime use steadily increased with age across three age cohorts: Approximately 3 of every 10 respondents in the pre–baby boom cohort [pre-1945], 5 of 10 in the baby boom cohort [1945-1964], and 7 of 10 in the post–baby boom cohort [post 1964] reported using some type of CAM therapy by age 33 years…Of note are the dramatic differences in use among cohorts.. “…These consistent and pervasive results should dispel any suggestion that use has increased for only singular complementary or alternative modalities or that the use of CAM therapies is a passing fad associated with one particular generation or fringe segment of the population.” As you can see from that, the baby boom and post baby boom cohorts are a driving force in the overall use of CAM. The purchase power of these two groups comprises a large portion of the US market. Anything that appeals to them will certainly take market share. -------------------------------------------- SHIFT IN PHYSICIAN ATTITUDE TOWARDS CAM -------------------------------------------- There has been a shift towards acceptance of CAM by conventional practitioners. Of course this is a chicken-egg scenario; the market has had a role in driving the process of physician acceptance, and that acceptance has subsequently increased the growth of CAM usage. Kaptchuk and Eisenberg (below) sum it up thusly: “…the new biomedical discussion is probably substantially due to changes in the internal orientation of the biomedical community … “…Managed care, insurance carriers, hospital providers, major academic medical centers, and individual MDs are increasingly receptive to developing new "integrative" models of health care that would have been unthinkable just a short time ago … “…there is a widespread acknowledgment of the need for new dialogue and a new relationship between what were once regarded as opposing forces. “…Alternative medicine has also shifted. … Instead of provoking antagonism, complementary and integrative medicine have become the new politically correct buzzwords. Many alternative providers see themselves in a partnership with biomedicine. A cease-fire, if not a complete armistice, has been declared.” Varieties of Healing. 1: Medical Pluralism in the United States Ted J. Kaptchuk, OMD and David M. Eisenberg, MD 7 August 2001 | Volume 135 Issue 3 | Pages 189-195 http://www.annals.org/cgi/content/full/135/3/189 Berman BM, Singh BK, Lao L, Singh BB, Ferentz KS, Hartnoll SM. Physicians' attitudes toward complementary or alternative medicine: a regional survey. J Am Board Fam Pract. 1995 Sep-Oct;8(5):361-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7484223&dopt=Abstract Boucher TA, Lenz SK. An organizational survey of physicians' attitudes about and practice of complementary and alternative medicine. Altern Ther Health Med. 1998 Nov;4(6):59-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9810068&dopt=Abstract Astin, John A., et. A Review of the Incorporation of Complementary and Alternative Medicine by Mainstream Physicians Arch Intern Med 1998 158: 2303-2310 http://archinte.ama-assn.org/cgi/content/abstract/158/21/2303 ----------------------------------------------------- INCREASED INSURANCE COVERAGE FOR SOME TREATMENTS ----------------------------------------------------- Again, chicken-egg. Some CAM treatments such as chiropractic are now being at least partially covered by insurance. This opens the door to patients who could not previously afford alternative treatments. Pelletier KR, Marie A, Krasner M, Haskell WL. Current trends in the integration and reimbursement of complementary and alternative medicine by managed care, insurance carriers, and hospital providers. Am J Health Promot. 1997 Nov-Dec;12(2):112-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=10174663&dopt=Abstract Steyer TE, Freed GL, Lantz PM. Medicaid reimbursement for alternative therapies. Altern Ther Health Med. 2002 Nov-Dec;8(6):84-8 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12440844&dopt=Abstract --------------------------------- GENDER / EDUCATION / INCOME --------------------------------- I group these because many of the studies include all three variables. In general researchers agree that people who use CAM tend to be more educated and of slightly higher or similar income than non-CAM users, and most often female. Here are the major studies: “The 1994-95 National Population Health Survey shows Canadians who consult rejected alternative health care providers compared with those who consult accepted health care providers have similar incomes, more education, slightly fewer chronic diseases and slightly more good health habits. For both groups, alternative health care supplements orthodox health care rather than being an alternative to it. Two major differences emerge: women outnumber men more than two to one as opposed to being only a slight majority, and usage peaks in Quebec, not Western Canada.” Fries CJ, Menzies KS. Gullible fools or desperate pragmatists? A profile of people who use rejected alternative health care providers. Can J Public Health. 2000 May-Jun;91(3):217-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10927852&dopt=Abstract *Astin, JA. Why Patients Use Alternative Medicine: Results of a National Study JAMA.1998; 279: 1548- 1553. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9605899&dopt=Abstract * The above is an important study, cited by many other researchers. Unfortunately, it is not available for free online. However, the paper cited below does summarize at least a portion of the data. This paper is taken from a University student’s overview of the major studies surrounding CAM usage. No points for design, but good marks for compiling a single source of data and all of the pertinent bibliographies checked out. “In a national study in the US, Astin (1998) found education to be the #1 sociodemographic variable that predicted use of alternative medicine; individuals with higher educational attainment were more likely to use alternative forms of healthcare.” “Eisenberg et al. (1998) in their 1997 US-wide study found a similar difference between genders (48.9% of women were consumers of CAM vs. 37.8% of men) as well as other similar patterns to those found in the Canadian studies—e.g. higher rates of use among people aged 35-49, people with some college education and people earning higher incomes. As expected, however, rates of use ranged from 32% to 54% in the wide range of sociodemographic groups examined.” Patients' use of CAM http://sprojects.mmi.mcgill.ca/cam/patients.htm “[CAM] appears to be common in all socio-economic groups, although AT use is apparently slightly less among low-income persons than in the general population.” Use of alternative therapies by a low income population. Krastins M, Ristinen E, Cimino JA, Mamtani R. Preventive Medicine Residency Program, New York Medical College, USA http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9789588&dopt=Abstract --------------------------------------- MEDIA / ADVERTISING / WORD OF MOUTH --------------------------------------- The word is out. Everywhere you look alternative therapies are being preached and pushed. Even accepted pharmaceuticals are being advertised directly to consumers through magazines, television and online. The overall effect is that consumers are driving the market for certain drugs and treatment options in both the accepted and alternative realms of medicine. Driving the alternative therapies into the forefront is their proponent’s ability to profess blatant unfounded claims of medical success. Whereas orthodox pharmaceutical companies and medical professionals are bound by laws that restrict them to accurate claims of efficacy and safety, many alternative products and practitioners are not. This dichotomy makes alternative therapies look much more attractive than conventional ones. “To people who are unwell, any promise of a cure is especially beguiling. In this vulnerable state, false hope easily supplants common sense, and patients often accept sophisticated marketing as sufficient grounds to try new therapies. Another characteristic of decisions to consult a CAM practitioner seems to be that they are mediated by the opinions of friends, relatives or neighbors.” Patients' use of CAM http://sprojects.mmi.mcgill.ca/cam/patients.htm “Why would so many well-educated people continue to sell and purchase such a treatment? The answer, I believe, lies in a combination of vigorous marketing of unsubstantiated claims by "alternative" healers (Beyerstein and Sampson 1996), the poor level of scientific knowledge in the public at large (Kiernan 1995), and the "will to believe" so prevalent among seekers attracted to the New Age movement (Basil 1988; Gross and Levitt 1994).” SKEPTICAL INQUIRER - Why Bogus Therapies Seem to Work Barry L. Beyerstein, Ph.D http://www.csicop.org/si/9709/beyer.html PROXIMAL DRIVING FORCES ------------------------------------ Given that all of the above are out there in our environment acting on all of us – the media, our disposable income, the subtle expectations of our cohorts, our doctor’s open-mindedness – why don’t we all add CAM to our own treatment plans? One reason would be that many CAM therapies simply have not been proven to work. They are truly snake-oil. In fact, given what’s documented about most of these therapies, you would think that the more educated we are, the less likely we’d be to choose CAM. But now we know that’s not true. In fact our education makes us more likely to add CAM to our repertoire of treatments. So, there must be a difference between those who make the leap to from merely being susceptible to the draw of CAM therapies and those actually taking action. NCCAM describes the general “PUSHES” that drive us away from conventional treatment and the “PULLS” that draw us to CAM therapies. Some of these we’ve addressed above, but others are more personal in nature: Conventional Medicine - 'Push' Factors Failure to yield cures Adverse effects of orthodox regimens Lack of practitioner time Dissatisfaction with the technical approach Fragmentation of care by specialists CAM Therapies - 'Pull' Factors Media reports of dramatic results Belief that CAM treatments are natural Empowerment of patient Focus on spiritual and emotional well-being Provision by therapist of "touch, talk and time Challenges and Opportunities for Collaboration with Industry National Center for Complementary and Alternative Medicine (NCCAM) Industry Colloquium - Washington, DC - May 14, 2001 http://nccam.nih.gov/news/pastmeetings/051401/straus/index.htm Here are some studies that address a patient’s specific motivations for choosing a CAM therapy: ------------------------------------------------ EMPOWERMENT / PARTICIPATORY NATURE OF CAM ------------------------------------------------ Below Kaptchuk and Eisenberg give us an educated postulation based on observations of numerous research results. The authors’ points are good. They surmise that although there is no proof of efficacy for many CAM therapies, people seem to prefer the participatory nature of CAM therapies to conventional treatments and also the unbounded claims of CAM provide a more optimistic outlook than the realistic claims of orthodox treatments. “…It may be that independent of any … efficacy, the attraction of alternative medicine is related to … a participatory experience of empowerment, authenticity, and enlarged self-identity when illness threatens their sense of intactness and connection to the world. …. It may be that biomedicine, when it is honest, is less optimistic and more realistically accepts the limitations and finitude of the human condition.” The Persuasive Appeal of Alternative Medicine Ted J. Kaptchuk, OMD and David M. Eisenberg, MD 15 December 1998 | Volume 129 Issue 12 | Pages 1061-1065 http://www.annals.org/cgi/content/full/129/12/1061 ---------------------------------------------------- SEVERITY AND DURATION OF ILLNESS / PROGNOSIS ---------------------------------------------------- It is clear that the severity and real or perceived hopelessness of a patient’s illness has a direct bearing on their adoption of CAM. CAM is most frequently added by patients with medical conditions not easily treated by modern medicine. These include chronic pain, poor mental health, HIV infection, and cancer. Driving forces include the need to maintain personal control, the perception of having been abandoned by their physician, and the need to “do something” when other treatments have failed. “We concluded that cancer patients have a higher usage rate and expenditure for CAM, particularly while they are receiving medical therapy, and are more likely to discuss the use of alternative therapies with their physicians. CAM was perceived as helpful by patients despite the lack of scientific data about its effect. Von Gruenigen VE, White LJ, Kirven MS, Showalter AL, Hopkins MP, Jenison EL. A comparison of complementary and alternative medicine use by gynecology and gynecologic oncology patients. Int J Gynecol Cancer. 2001 May-Jun;11(3):205-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11437926&dopt=Abstract “Astin (1998) finds a significant negative correlation between health status and CAM use, with use increasing as health status declined. A number of specific health problems (i.e., back problems, chronic pain, anxiety, and urinary tract problems” Patients' use of CAM http://sprojects.mmi.mcgill.ca/cam/patients.htm For an in depth look at the use of alternative therapies by cancer patients, see this 12-chapter National Technical Information Service (NTIS) Report: NTIS - Unconventional Cancer Treatments OTA-H-405 / NTIS order #PB91-104893 http://www.wws.princeton.edu/~ota/disk2/1990/9044.html Some excerpts from Chapter 7: Patients Who Use Unconventional Cancer Treatments and How They Find Out About Them Patient Characteristics “The published literature on unconventional cancer treatments has often depicted users of these treatments as deviant, poor, marginal persons, hostile to mainstream medicine, mentally unstable, ignorant, gullible, “straw-graspers," or as uninformed “miracle-seekers” (see, e.g., (104)). These stereotypes generally reflect the opinions of the writers and society, and are not backed by systematic observation.” “… the majority of patients in the study who used unconventional treatments, either exclusively or in addition to conventional treatment, were well educated, and had accepted mainstream medical care before getting cancer…” Patient Attitudes and Motivations “The desire to mitigate feelings of helplessness and hopelessness may specifically motivate cancer patients to use unconventional treatments… exploring unconventional cancer treatments serves to both restore a degree of personal control and offer a perceived antidote to the cause of turmoil..” “Some cancer patients may be motivated to use unconventional treatments by their feelings of abandonment or rejection by mainstream physicians ..” “A cancer patient’s personal and financial resources, belief system, and personal style of seeking health care all help to determine which sources of information are used, how information is interpreted, and how treatment decisions are made.” -------------------------------------- PERSONAL VALUES AND BELIEF SYSTEMS -------------------------------------- “…. the majority of alternative medicine users appear to be doing so not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values, beliefs, and philosophical orientations toward health and life.” Astin, JA. Why Patients Use Alternative Medicine: Results of a National Study JAMA.1998; 279: 1548- 1553. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9605899&dopt=Abstract “The major difference between the two groups were the fact that the AP group were more critical and skeptical about the efficacy of modern medicine; they believed their health could be improved; they stayed loyal to their chosen practitioner; they had tried more alternative therapies and have more self- and ecologically aware lifestyles; and they believed that treatment should concentrate on the whole person and greater knowledge of the physiology of the body.” Furnham A, Forey J. The attitudes, behaviors and beliefs of patients of conventional vs. complementary (alternative) medicine. J Clin Psychol. 1994 May;50(3):458-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8071452&dopt=Abstract Finally, I’d like to address pinkfreud’s comment below because it illustrates a good point. Her observation that interest in alternative medicine parallels the increase in interest in Eastern religions is probably valid, but in the sense that it tells us not WHY people use CAM therapies but WHICH CAM therapies they embrace. The 1960’s counter-culture movement, backed by the baby boom, launched America’s interest in all-things Eastern; Buddhism, Taoism, meditation, yoga, enlightenment, karma were all buzzwords of the day. Our current interest in related therapies has clearly grown (but in many cases has diverged) from that root. However, as I said earlier, various different CAM therapies were prevalent in earlier decades. Kaptchuk and Eisenberg give examples of previous forms of alternative therapies that have been embraced by the American public. Between 1850 and 1931 they include: Indian doctors, clairvoyants, natural bone-setters, mesmerists [and practitioners of] galvanic, astrologic, magnetic, uriscope, 7th sons, Homeopaths, eclectic physicians, magnetic healers, drugless practitioners, osteopaths, chiropractors, midwives, faith healers, cults, Christian Scientists, naturopaths, and medicine show ‘cure-all’ frauds. Varieties of Healing. 1: Medical Pluralism in the United States Ted J. Kaptchuk, OMD and David M. Eisenberg, MD 7 August 2001 | Volume 135 Issue 3 | Pages 189-195 http://www.annals.org/cgi/content/full/135/3/189 I dwell on this point to reiterate that the current wave of CAM usage is clearly nothing new. It merely presents a different face today than it has in the past. It may well be that throughout history humans have sought alternatives to what they perceive as the limited scope and promise of orthodox medicine or a mismatch between their values and the prevalent medical practices. This has been a fascinating research topic Natalie. I’m truly glad to have had the opportunity to research it. Many of the behavioral mysteries surrounding the use of alternative therapies have been cleared up for me. Take your time going through what I’ve presented here. It’s a lot of information. If you come across anything that needs explanation or further bolstering with hard data, let me know. Or, if you just want to bounce some ideas or questions off me, I’m happy to discuss them with you. Let me know if you need anything – -K~ search strategy: Once I had the term CAM, it was a matter of wading through the numerous articles in PubMed until I figured out which studies carried the most weight. Once I had those, I followed bibliographical leads to other research.