Complementary and alternative medicine (CAM)is a group of diverse health care systems, practices, and products that are not presently considered to be part of conventional Western medicine (CWM). The interest in CAM has increased dramatically over the past decade. A national health survey in 2007 revealed that more than $34 billion is spent on CAM annually in the US.
Mind-body techniques considered as CAM are meditation, Yoga, Tai-chi, Qi-gong, and music therapy. Manual and manipulative methods in CAM include chiropractic, massage, acupuncture, and touch therapy.
In the current circumstances, the gap between CWM and CAM is very substantive. It pertains to methodology and rigorous applications of scientific standards of evidence as well as to the meaning and context of illness and health.
1.The lack of a common language between CAM and CWM;For most CWM physicians, a genuine understanding of the underlying concepts and practices of CAM, such as acupuncture and homeopathy, is almost beyond achievement. This lack of understanding is not because physicians do not have the ability or willingness to understand CAM. The reason is that CAM and CWM do not share the same language. The root of this discrepancy is directly related to the entire process of medical education of both CAM and CWM.
According to traditional Chinese medicine (TCM) concepts, the energy force, known as Qi(pronounced Chee), runs through the body. Qi energy enters the body through specific acupuncture points and flows to deeper organ structures, bringing life-giving nourishment of a subtle energetic nature. Meridians are classified on the basis of the direction in which Qi flows on the surface of the body. If the flow of Qi is insufficient, or interrupted, Yin and Yang become unbalanced and illness may occur . However, for most CWM physicians the words of Qi, meridians, and Yin and Yang cannot be understandable. There was no clear evidence to demonstrate the existence of acupuncture points or meridians (Acupuncture points and meridians 2008).
The concept of TCM has been established more than 3,000 years ago. The ancient “physicians” and “scientists” in China analyzed our health and illness based on their feeling and terminology. Do we weed to educate and explain the concept of Qi, meridians, and Yin/Yang to CWM students and physicians?
The ancient words in CAM should be translated into CWM terminology, if the concepts of TCM are making sense. According to TCM,“Acupuncture is believed to restore the balance of Yin and Yang.” This can be translated into the CWM terminology as “Acupuncture restores balance between the parasympathetic and sympathetic systems” (Acupuncture review 2011).
The medical training of CAM is basically possible, once we have succeeded in creating a common language. In the last decade, the mechanisms of various CAM procedures have widely been studied using our modern technique of anatomy, physiology, biochemistry, pharmacology, and molecular biology. Now, we are ready to build a concrete bridge between CAM practitioners and CWM physicians.
2. Poor evidence of efficacy and mechanism;It has been criticized that CAM are promoting unscientific ideas and unscientific therapies. This puts us in conflict with evidence-based medicine. Currently, there is a great deal of research and evidence supporting CAM therapies. The beneficial effects of CAM are mainly due to reduction of stress responses and pain pathways.
Once these CAM therapies are proven to be safe and effective, CAM will become adopted into conventional health care and as new approaches to health care emerge.