Weighing the Alternatives: Lessons from the Paradoxes of Alternative Medicine
Authors: Frank Davidoff
Journal: Annals of Internal Medicine (1998)

Editorials15 December 1998Weighing the Alternatives: Lessons from the Paradoxes of Alternative MedicineFrank Davidoff, MD, EditorFrank Davidoff, MD, EditorEditorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-12-199812150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The realization that at least 25% to 50% of adults in industrialized nations, including the United States, consult alternative medicine practitioners [1, 2] has prompted serious exploration of what makes alternative practices so attractive to patients [3]. In this issue, Kaptchuk and Eisenberg [4] contribute importantly to our understanding of that attraction.Many conventional practitioners have responded to the emergence of alternative medicine by acquiring a new understanding of practices that they had previously considered to be "on the fringe" [5]. Others have incorporated "alternative" concepts and practices directly into their own daily patient care. Medical schools have opened their ...References1. Ernst E, Cassileth BR. The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer. 1998; 83:777-82. Google Scholar2. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med. 1993; 328:246-52. Google Scholar3. Astin JA. Why patients use alternative medicine: results of a national study. JAMA. 1998; 279:1548-53. Google Scholar4. Kaptchuk TJ, Eisenberg DM. The persuasive appeal of alternative medicine. Ann Intern Med. 1998; 129:1061-5. Google Scholar5. Eisenberg DM. Advising patients who seek alternative medical therapies. Ann Intern Med. 1997; 127:61-9. Google Scholar6. Wetzel MS, Eisenberg DM, Kaptchuk TJ. Courses involving complementary and alternative medicine at US medical schools. JAMA. 1998; 280:784-7. Google Scholar7. Weil A. Health and Healing: Understanding Conventional and Alternative Medicine. Boston: Houghton Mifflin; 1995. Google Scholar8. Chopra D. Perfect Health: The Complete Mind/Body Guide. New York: Harmony Books; 1991. Google Scholar9. Laine C, Davidoff F. Patient-centered medicine. A professional evolution. JAMA. 1996; 275:152-6. Google Scholar10. Davidoff F. Medicine and commerce. 1: is managed care a "monstrous hybrid"? [Editorial] Ann Intern Med. 1998; 128:496-9. Google Scholar11. Siegler M. Pascal's wager and the hanging of crepe. N Engl J Med. 1975; 293:853-7. Google Scholar12. Braitman LE, Davidoff F. Predicting clinical states in individual patients. Ann Intern Med. 1996; 125:406-12. Google Scholar13. Rangachari PK. Evidence-based medicine: old French wine with a new Canadian label? J R Soc Med. 1997; 90:280-4. Google Scholar14. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med. 1991; 324:370-6. Google Scholar15. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998; 279:1200-5. Google Scholar16. Millenson ML. Demanding Medical Excellence: Doctors and Accountability in the information Age. Chicago: Univ of Chicago Pr; 1997. Google Scholar17. Vandenbroucke JP. Homeopathy trials: going nowhere. Lancet. 1997; 350:824. Google Scholar18. Shekelle PG. What role for chiropractic in health care? [Editorial] N Engl J Med. 1998; 339:1074-5. Google Scholar19. Davidoff F. Time [Editorial]. Ann intern Med. 1997; 127:483-5. Google Scholar20. Laine C, Davidoff F, Lewis CE, Nelson EC, Nelson E, Kessler RC, et al. Important elements of outpatient care: a comparison of patients' and physicians' opinions. Ann Intern Med. 1996; 125:640-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Editor PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Persuasive Appeal of Alternative Medicine Ted J. Kaptchuk and David M. Eisenberg Metrics Cited ByReflexive Biomedicalization and Alternative Healing SystemsPushed and PulledThe diffusion and the reason for the use of complementary and alternative medicine among users of mental health services: a systematic review of literatureComplementry and Alternative MedicinePatient Initiation of Complementary and Alternative Medical Therapies (CAM) Following Cancer DiagnosisIntegrating Complementary Medicine Into Cardiovascular MedicineA Multicenter Study of Complementary and Alternative Medicine Usage among ED PatientsEthical and legal issues in antiaging medicineA survey of patients' out-of-pocket payments for complementary and alternative medicine therapiesUse of mind-body medical therapiesComplementary Alternative Medicine in Patients with Inflammatory Bowel Disease: Use and AttitudesSurviving Breast CancerPattern of use of complementary/alternative medicine (CAM) in epileptic patients in a tertiary care hospital in IndiaThe other medicine: complementary and alternative—why, why not?1,2 1We welcome your response to this commentary. Your letters in response to this and any other editorial may be published in an upcoming issue. The Editor reserves the right to shorten letters, delete objectionable comments, and make other changes to comply with the style of the journal. 2Edited by Stephen P. StoneComplementary and alternative medicine: The importance of doctor-patient communicationPerceptions about Complementary Therapies Relative to Conventional Therapies among Adults Who Use Both: Results from a National SurveyDavid M. Eisenberg, MD, Ronald C. Kessler, PhD, Maria I. Van Rompay, BA, Ted J. Kaptchuk, OMD, Sonja A. Wilkey, MD, Scott Appel, MS, and Roger B. Davis, ScDAlternative Medicine: More Than A Harmless OptionA physician's guide to talking about end-of-life careUse of complementary health practices by prostate carcinoma patients undergoing radiation therapyRecent advances in alternative therapiesUse of Complementary Therapies for Arthritis among Patients of RheumatologistsJaya K. Rao, MD, MHS, Kimberly Mihaliak, BS, Kurt Kroenke, MD, John Bradley, MD, William M. Tierney, MD, and Morris Weinberger, PhDEducational Needs Related to Complementary and AlternativeTherapiesAlternative Views on Alternative MedicineArunabha Ganguly, MDAlternative Views on Alternative MedicineEdzard Ernst, MD, PhD, FRCPWeighing the AlternativesKenneth D. Gardner Jr., MDMeditation and Chronic Pain 15 December 1998Volume 129, Issue 12Page: 1068-1070KeywordsClinical trial reportingEmotionsHealth careHealth economicsPatient advocacyPatientsPeer reviewQuality improvementToxicityWalking Issue Published: 15 December 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...