Complementary and Alternative Therapies

Right Choice Index

Page Contents

Alternatives

Do your homework

Silence not golden

Skeptics

Communication

Children

Site Contents

Patients & visitors

Medical professionals

Yale-New Haven
Children's Hospital

Yale-New Haven
Psychiatric Hospital

General information

Calendar

Online resource

Press information

Phone Numbers

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(203) 688-3333

Admitting
(203) 688-2221

Children's admitting
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(203) 688-9907

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New Haven, CT 06510-3202

Speak Up about Complementary and Alternative Therapies

Americans try alternatives

Every year Americans spend millions of dollars out of pocket on a variety of therapies considered outside the mainstream of conventional medicine. Often collectively referred to as complementary and alternative medicine (CAM), a 1997 survey published in JAMA, the journal of the American Medical Association, revealed that over 42 percent of Americans used CAM during the previous year. CAM is not usually used as a replacement for conventional medicine, but in conjunction with it.

While the safety and effectiveness of CAM may be the subject of debate, two things are evident:

A decision to use alternative therapies, as with any therapy, should be made with a clear understanding of the potential risks and benefits.
Every action you take in regard to your health should be shared with your health care providers—both traditional and CAM—because CAM therapies can have an impact on therapies prescribed by your physicians. . .and vice versa.

Do your homework

Ask a qualified, licensed health care practitioner—whether a conventional physician or a CAM practitioner—about safety and effectiveness. In addition, you should explore with the CAM practitioner whether there is any new research that may support or not support its safety and effectiveness, about the advantages, disadvantages, risks, side effects, expected results and the length of treatment you can expect. Discuss any medications you are currently taking.
Do your own research. Thousands of articles on CAM are published in books, journals and magazines every year. This information can be found in most public libraries (consult your librarian for assistance). Scientific research literature is also available online through the National Library of Medicine and the National Center for Complementary and Alternative Medicine: CAM on PubMed.
Speak with others who have undergone the treatment, both recently and in the past. Look for people who have the same health condition you have. Remember, patient testimonials alone do not adequately assess the safety and effectiveness of a therapy and should not be the exclusive reason for its selection. Controlled scientific trials usually provide the best information about a therapy's effectiveness and should be sought whenever possible.
Talk with the practitioner in person. Prepare a list of questions you would like to discuss. Ask about his or her education, additional training, years of experience, continuing education, licenses and certifications—both conventional and unconventional. Talk with former patients to discuss experiences and practitioner competency. Contact a state or local regulatory agency with authority over those who practice the therapy or treatment you seek. Most types of complementary and alternative practices have national organizations of practitioners who may be able to direct you to the appropriate regulatory agencies and provide referrals and information.
Consider cost. Currently, only about one-quarter of complementary and alternative treatments are reimbursed by health insurance. You may be required to pay directly for these services. Ask your CAM practitioner and your health insurer which treatments or therapies are reimbursable.

Silence is not golden

While the range of therapies, approaches and systems that fall under the alternative or complementary label is quite diverse -- acupuncture, herbs, homeopathy, chiropractic, hypnosis, traditional oriental medicine to name a few -- the way patients choose to deal with them is remarkably similar: they rarely share the details with their physician.

Patients may elect to hide their use of alternative therapies for a variety of reasons:

Awareness their physician does not approve or subscribe to such therapies
Fear of ridicule or embarrassment
Underestimating the potential impact the alternative therapy may have
Inadequate opportunity/time to talk to a physician

Why your physician may be skeptical

Even a proven therapy may not be effective for everyone. What causes many physicians concern is that CAM therapies are only beginning to undergo the type of rigorous scientific examination that supports most of conventional Western medicine.

When using an unproven therapy as an alternative to routine therapy, you may trade off the benefits of a proven therapy and lose valuable time in the process. Or, you may spend your money on a therapy that ultimately does you no good. Even a proven CAM therapy can interact unfavorably with other therapies. One controversial drug, Ephedra (a.k.a. Ma Huang), has occasionally had major side effects (such as heart attacks and strokes). It is an ingredient in the popular weight loss drug Metabolife.

In addition to having an impact on conventional therapies, CAM may also affect the results of diagnostic tests and rehabilitation. We accept risks with any treatment, conventional or otherwise. The key is to be informed and discuss the benefits and risks with a care provider.

Keep lines of communication open

A collaborative relationship between you and your health care providers will generally produce better outcomes. While your physician may not agree with your decision to investigate or use complementary and alternative medicine, it's important you be completely honest with everyone who provides your health care. Even if your health care providers do not directly ask you for this information, in order to improve safety and effectiveness, it is important you tell them about any treatments or therapies you are receiving. Most health care providers will be pleased to know.

CAM and children

While more than 20 percent of parents say they have treated their children with alternative therapies in the past year, only a third have actually spoken with their child's pediatrician about it. By discussing CAM with your child's pediatrician, you can identify possible problems that are common among children using alternative medicines, or, depending upon the circumstances, your pediatrician may be able to recommend an alternative therapy to use in conjunction with your child's traditional therapy.

For further information about complementary and alternative medicine:
National Center for Complementary and Alternative Medicine Clearinghouse
P.O. Box 8218, Silver Spring, MD 20907-8218
Toll free & TTY/TDY: 888-644-6226 Fax: 301-495-4957
www.nccam.nih.gov

"Information about Common Herbals" YNHH Drug Information Service
Request a copy by calling (203) 688-2000, toll free 888-700-6543 or sending your name and address to prs@ynhh.org.

Call (203) 688-2000 or toll free (888) 700-6543 to speak with a health information coordinator or request an appointment. You can also get physician information or request an appointment on this web site.

Last revised: March 5, 2004 (cfs)