Talk:Complementary and alternative medicine

I am archiving this article and its talk page and starting us over

Here goes. For future reference only, here is:

• Complementary_and_alternative_medicine/article_archive
• Talk:Complementary_and_alternative_medicine/archive.

--Pat Palmer

What I've done

• I would recommend giving this article a simple name, maybe just "Alternative medicine"
• I would recommend moving debates to specific subtopics, such as representing, on an acupuncture article, the perceived arguments for and against, specifically, acupuncture
• I am moving Howard's comments to my talk page, for now, because he made them before I had finished this archiving action; he may choose to come back here if he wishes, I just want to give others a chance to think first

--Pat Palmer

Countersuggestion: could everyone look at integrative medicine and see if it already is moving in the right direction?

Also, while it's very early, look at phytomedicine and see if it has the flavor of specific argument. It may not yet have enough detail; there are, for example, a few plant-derived remedies that show evidence of efficacy. With the particular regulatory and economic structure in the U.S., there's no incentive to do full studies and standardization for indications and warnings. Germany, however, has a system that is much friendlier to a combination of scientific and traditional approaches. China has yet another. Howard C. Berkowitz 00:03, 27 December 2008 (UTC)

Howard, I will go look soon as I get time. THanks!Pat Palmer 00:07, 27 December 2008 (UTC)

Complementary

I find that I am bothered by the term "complementary". Sorry, it's an OPINION as to whether an unofficial health approach is complementary or not. It is not an opinion as to whether an approach is "alternative" (i.e., "unofficial" or "not necessarily approved"). Therefore, I strongly recommend renaming this article back to simply "alternative medicine".

This article should, in my opinion, describe the idea that there are regulating authorities, and that anything they do not "approve" is "alternative" (even if it is not banned, though some alternatives ARE banned). The issue of whether patients would be better off pursuing both official therapies and alternative therapies is up for dispute. I don't think any sensible person would rule out investigation, or at least considering the idea of, alternatives.

But, calling this article "Complementary" (as well as "alternative") implies that alternative therapies and approaches ARE always helpful, and that is open to question in every single case. Simply renaming this article makes it easier to keep it merely descriptive, and helps us keep separate the philosophical questions such as, 1) who gets to be the police of what's "official", 2) what should be "banned" or downright "illegal", 3) whether unblessed approaches have value or not. All these are really interesting and important questions, but no one has been able to produce a definitive answer for them in thousands of years, and we are not going to be able to agree on the answer in CZ either. We can only agree on the questions.

Sorry, no. In the U.S., it varies state-by-state, but there is a concept of "scope of practice". Within broad limits, anything within the discretion of a physician, and consistent with his or her training, is "official". There are exceptions where additional licensing may be required for the use of radioisotopes, certain drugs, etc., and a hospital isn't normally going to let an opthalmologist do high-risk obstetrics.

The usual definition of alternative medicine is that it is offered as a whole system of health care, to the full or partial exclusion of people with conventional medical licenses. Complementary medicine is seen as something that works jointly with conventional medicine. The combination, however, is a set of skills outside the scope of conventional medical training. Again, see the National Center for Complementary and Alternative Medicine; it may be surprising that music therapy is considered complementary. Spiritual healing is complementary when, for example, a hospital chaplain does a religious healing ritual in the ICU, while an alternative spiritual healer would not approve of anything except prayer.

No, there isn't any implication of efficacy for CAM. Calling something "medicine" doesn't mean it is effective; I can give you a long list of drugs and surgical procedures, performed by physicians, that turned out to be useless or actively dangerous. You may be thinking of evidence-based medicine.

For example, acupuncture is outside the scope of the U.S. National Board of Medical Examiners. Nevertheless, in Virginia, one must be a licensed physician to perform it, presumably with additional training. In other states, someone trained only in acupuncture might perform it only on physician orders, or, depending on the state, might be licensed to perform it on self-referred patients.

Nurse practitioners can prescribe all drugs in some states, or prescribe anything but there must be a responsible physician, or might be able to prescribe antibiotics but not "narcotics". Each state defines scope of practice, even though there often are national examinations. Howard C. Berkowitz 02:03, 27 December 2008 (UTC)