1. Complementary and Alternative Medicine – an overview
Dr Kevin Hickey
Shipley Health Centre

2. Complementary and Alternative Medicine
“A broad domain of healing resources that encompasses all health systems, modalities and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health systems of a particular society or culture in a given historical period”!!

3. Complementary and Alternative Medicine
Perceptions: Positive
Treat anything
More time given to patients
Growing body of evidence
More holistic approach
Can succeed where conventional methods fail
Hope for the hopeless

4. Complementary and Alternative Medicine
Perceptions: Negative
Strange smelling herbs and needles
Strange words: chakras / meridians/ energies/ chi
Unnecessary pain
Limited evidence
Unknown mechanisms of action
Placebo effect
Unregulated
Private sector

5. Complementary and Alternative Medicine
Evidence improving
Mechanisms more understood
More regulation
Full explanations before treatment
Significant numbers of therapists working within the NHS
Primary and secondary care
Private, voluntary and NHS funding

6. House of Lords Report November 2000
CAM therapies grouped by organisational characteristics, diagnostic capabilities, apparent effectiveness and training

7. Group 1 Acupuncture Chiropractic Herbal medicine Homeopathy Osteopathy
Professionally organised disciplines, with their own diagnostic approach. They have some scientific evidence of effectiveness and recognised systems of training for practitioners

8. Group 2 Aromatherapy Bach flower remedies
Bodywork therapies including massage
Counselling stress therapy
Healing
Hypnotherapy
Maharishi ayurvedic medicine
Meditation
Nutritional medicines
Reflexology
Shiatsu
Yoga
Complementary therapies which lack a firm scientific basis and are not regulated to protect the public, but which give help and comfort to many people

9. Group 3a Anthroposophical medicine Ayurvedic medicine
Chinese herbal medicine
Eastern medicine (tibb)
Naturopathy
Traditional chinese medicine
Alternative disciplines which offer diagnostic information as well as treatment but for which the Committee did not find convincing evidence of efficacy. 3a are long established and traditional disciplines with very specific philosophies

10. Group 3b Crystal therapy Dowsing Iridology Kinesiology Radionics
As 3a but classed as “Other alternative disciplines”.

11. CAM As Last Resort?
Mainly provided in the private sector for people with poorly met needs:
Chronic painful and stress related conditions, frequent consulters
Specific conditions e.g. Irritable bowel syndrome, migraine, back and neck pain, eczema, rhinitis, hay fever, insomnia
Side effects from conventional therapies

12. CAM As First Resort? Improve patient choice
Improve practitioner choice
Improvement of public well being
Improvement of public health
Freely available on NHS?

13. What about the Placebo Effect?
20-40% improvement accounted for by placebo effect
People feel better
Symptoms resolve
Long tradition of using placebos in primary care
Less use of resources
(Mostly) harmless
Better than doing nothing?