“Complementary and integrative medicine” is often presented as an additional option alongside conventional therapy. It was known as “alternative medicine” until recently, with alternative therapy practitioners using “complementary” and “integrative” to make their practice seem more scientific.
Most alternative treatments lack significant evidence of efficacy, with therapies such as homeopathic remedies being little more than water (and perhaps alcohol, depending on the product). Patients may seek alternative treatments because of a perceived gap or failure in their conventional treatment (undesirable side effects, duration of treatment is too long, condition is chronic without a cure).
The renaming of alternative medicine to “complementary and integrative medicine” is a significant shift in that it has been recognized that alternative treatments should be used in addition to conventional treatment options (i.e. the treatments with scientifically-proven efficacy) if they are to be used at all. Practitioners of alternative therapies should not recommend that patients solely rely on the alternative treatment, because the alternative treatment often has no therapeutic benefit to the patient.
The problem arises when the alternative therapy practitioner recommends that the patient solely uses their alternative treatment (i.e. the patient discontinues conventional treatment). In addition to being an additional burden to that patient in terms of time and money, they are no longer receiving a treatment with scientifically-proven efficacy.
There’s an article at the Science-Based Medicine blog that looks at “Homeopathic Vaccines,” which is a great example of this problem. Link: http://www.sciencebasedmedicine.org/index.php/homeopathic-vaccines-revisited/
“…it has been recognized that alternative treatments should be used in addition to conventional treatment options”
I can’t tell whether I disagree with you or your phrasing of this sentence. Either way, it sounds like you are telling people they should be using unscientific, unproven alternative treatments when they otherwise might not.
Good point, I added “if they are to be used at all” to the end of that sentence. I do not generally recommend alternative treatments; they have low or no efficacy and they cannot stand in for conventional treatment options.
To add on to my reply, some patients want to use alternative treatments because they falsely believe that the efficacy is better, that it will treat their untreatable disease, or that there will be no side effects or complications. Helping these patients understand how the conventional therapy works and giving them the knowledge to make an informed decision would probably be enough to have them discontinue the alternative treatment and adhere the conventional therapy.
Maybe their healthcare provider didn’t provide the patient with the enough knowledge to be confident in the conventional therapy, so they sought alternative treatment. In that case, it might be helpful for them to have a chance to have a second talk with a healthcare provider about their concerns and receive reassurance that the conventional therapy is the best option.
Other patients are looking for something else. Perhaps they strongly believe in vitalistic or spiritual healing. The alternative treatments they seek may have no therapeutic benefit at all, but they soothe a different type of need: comfort and reassurance. If they make the informed decision to not discontinue the alternative treatment, then the best option is for them to use that treatment alongside the conventional therapy assuming there are no interactions or contraindications. If there are interactions or reasons not to use the two therapies together, then it’d be best to stress the need to stick to the conventional therapy.
Patients have the right to make informed decisions regarding the course of their treatment. I can’t very well shake them upside down until their belief in alternative medicine falls out — the best option is to get them to use the two together.
Does that sort of make sense? I’m still trying to put this together properly in my head, to be honest.