Personal Use of Complementary and Alternative Medicine (CAM) by U.S. Health Care Workers

The prevalence of complementary and alternative medicine (CAM) therapies, defined as therapies that are “not generally considered part of conventional medicine” (National Center for Complementary and Alternative Medicine 2007) is substantial and has grown since the early 1990s in the United States (Goldstein 2002). Eisenberg et al. examined 1990 national survey data about CAM use and found that 34 percent of U.S. adults “reported using at least one unconventional therapy in the past year, and a third of these saw providers for unconventional therapy” (Eisenberg et al. 1993). Data from a 1997 follow-up survey revealed an 8 percent increase in those who reported using at least one unconventional therapy in the past year and a 10 percent increase in those who reported seeing a provider for unconventional therapy (Eisenberg et al. 1998; Wolsko et al. 2002). More recent studies indicate that the prevalence of CAM use, although substantial, has increased for only a few therapies since 1997 (Tindle et al. 2005; Barnes, Bloom, and Nahin 2008). For example, a study using data from the 2007 National Health Interview Survey (NHIS) found that approximately 40 percent of adults used CAM therapies in the past year. However, when compared with 2002 NHIS data, only the prevalence of “acupuncture, deep breathing exercises, massage therapy, meditation, naturopathy, and yoga showed significant increases” (Barnes, Bloom, and Nahin 2008). Increasingly, CAM therapies are being integrated with conventional medicine. According to the American Hospital Association's Annual Survey of Hospitals, the percentage of hospitals offering CAM has increased from 7.9 percent in 1998 to 19.8 percent in 2006 (Ananth 2009; Henkel 2010). The widespread and growing consumer demand for CAM in the U.S. led Wyatt and Post-White (2005) to write that conventional “health care must now catch up with consumer practices to provide guidance in the safe and effective use” of CAM. Cornman, Carr, and Heitkemper (2006) worried about missed benefits of unused CAM and possible adverse reactions of CAM when misused, contending that all health care workers should “possess knowledge regarding the assessment of CAM use”. Thus, it is not surprising that, over the past two decades, inclusion of CAM education has increased in medical schools (Wetzel, Eisenberg, and Kaptchuk 1998; Wetzel et al. 2003) and nursing schools (Fenton and Morris 2003; Helms 2006). Although researchers have documented the knowledge and attitudes of health professionals about CAM (Astin et al. 1998; Brown et al. 2007; Sewitch et al. 2008; Rojas-Cooley and Grant 2009), few studies have investigated personal CAM use among those working in health care, and the existing studies focus on small, specialized practitioner populations. To date, no study has taken a population approach to CAM use among health care workers. Given the prevalence of CAM use in the general population, evolving research that supports the effectiveness of specific CAM therapies (Astin 2004; Furlan et al. 2008; Linde et al. 2009), the need for health care workers to provide safe and effective treatments to patients, and the importance of having a healthy health care workforce, this lacuna in research is not acceptable. Accordingly, the present study uses nationally representative survey data to examine the types of CAM therapies health care workers in the United States personally use, their reasons for using CAM, and the differences in CAM use across health care occupations. To provide context, we also compare CAM use among health care workers to CAM use in the rest of the employed population.