COMMENTARY

Patient Interest in CAM: A Rapidly Growing Trend

Hansa Bhargava, MD

Disclosures

August 16, 2016

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Complementary and alternative medicine (CAM). Why should you know what it is? Is it really useful for patients? Is it truly credible? Well, let's talk about it.

Over the past two decades, there's been a trend toward patients asking if there are natural or alternative therapies to treat their disease. Just the other day, a patient asked me if there were a herbal remedy for migraines. Her daughter had migraines for a while, and she didn't want her daughter to take medication that the neurologist had prescribed. She was worried about side effects and asked if she should take her daughter to see a chiropractor. It seems that as physicians, we're seeing this type of scenario more and more. Patients are asking for natural remedies for common illnesses such as allergies and asthma but also want to incorporate use of these alternative strategies for very serious conditions such as cancer. In fact, many academic centers over the past few years have opened up wellness centers as an adjunct to their major oncology centers to help patients have a more holistic plan for their illness.

Another interesting fact: Some experts have reported that more than 70% of patients with chronic or serious conditions are using some type of complementary medicine. And it seems that this number is rising. Do these patients talk to us about supplements or seeing another type of care provider? Apparently, not all the time: Importantly, patients may not be reporting this to you. In fact, a study conducted in 134 adolescents with juvenile arthritis found that 72% of these teens were using adjunct treatments, but only 43% told their doctors about them.[1]

And it's not just that patients are interested in these therapies; a whole line of products in marketing-based industries target these patients. Over-the-counter herbs and supplements, for example, are found not just in pharmacies or specialty stores anymore. You can find them in multiple grocery stores with a wellness agenda, such as Whole Foods, Trader Joe's, and a number of others.

In addition, there are many websites dedicated not only to promoting alternative medicine but to diminishing reliance on traditional health experts as well. Media and television have contributed to the interest in nontraditional medicine and, unfortunately, even the distrust in doctors. Diseases for which you may have patients ask you about alternatives include asthma, allergies, migraines, arthritis, and cancer. Illnesses that are chronic are frustrating people, and this is usually when they seek other solutions.

The first tip to understanding which of these therapies and professionals are good for your patient and which are not is to know what's out there. Some of the types of professionals that are out there include acupuncturists, chiropractors, integrated medicine specialists, functional medicine specialists, naturopaths, and massage therapists. And some of the integrated therapies that your patients may be talking about include biochemical agents such as vitamins and supplements and probiotics and dietary changes that include gluten-free, paleo, and vegan diets. And then there are physical therapies, such as Reiki, acupuncture, massage, magnets, yoga, and tai chi. And of course, don't forget mind-body therapy, meditation, biofeedback, hypnosis, and counseling.

With our upcoming Medscape series, we aim to give you some knowledge of these therapies and specialists. We hope to tell you what's out there, if there's good evidence to support it, if it's harmful, and how you may start incorporating it into your practice if you want to. As doctors, we need to know what's good for the patient and what is not. Acknowledging therapies in which our patients are interested and knowing about them will help us maintain a good relationship and good communication. It will help us be part of the conversation that's already happening. The good news is that many of these holistic therapies such as acupuncture, meditation, and tai chi, therapies for which we didn't have previous information, now have some good solid research. We look forward to investigating this new and growing area with you in the coming months.

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