In 1993, Eisenberg et al.22 utilized a working definition of alternative medical therapies as interventions neither taught widely in medical schools nor generally available in US hospitals. As we have seen, these alternative therapies are becoming more available in conventional medical settings and are being taught in medical schools.18,20 A broader definition of complementary and alternative medicine is those medical systems, practices, interventions, applications, theories, or claims that are currently not part of the dominant or conventional medical system in that society.23 Under this definition, the list of practices that are considered complementary or alternative medicine will continually change as society changes and as those practices supported by research become incorporated into mainstream medicine. Eskinazi24 proposed a refined definition of alternative medicine as a broad set of healthcare practices that are not readily integrated into the dominant healthcare model because they pose challenges to diverse societal beliefs and practices. The idea of a challenge to conventional practice is important. It highlights the difference between what is called "alternative" and what is called "complementary."
The terminology used to describe the broad scope of practices that are considered "complementary" or "alternative" to mainstream medical practice is diverse and often confusing. Alternative medicine, complementary medicine, holistic medicine, integrative therapies, natural medicine and traditional medicine are all terms that have been used nearly synonymously to represent an approach to health that is different from the biomedical system that is so entrenched in the western industrialized world. Each of the adjectives, alternative, holistic, complementary integrative, etc., have slightly different connotations which define a relationship with mainstream medicine. The term alternative implies "instead of'' or "apart from'' conventional medicine, whereas complementary connotes "in addition to'' as a way of completing an approach to healing. Integrative medicine suggests multiple approaches that are applied "together" or "in concert'' with one another. Holistic is an older term which was used to emphasize an "all-encompassing'' approach to the person rather than the disease, illness, or symptom. Traditional medicines usually refer to a culturally based system such as traditional Chinese medicine, traditional Native American healing practices, and Ayurvedic medicine. In industrialized western societies, the term traditional medicine is sometimes used misleadingly to refer to the allopathic or biomedical model. Perhaps a more suitable term for those systems of healing that arise from one of the world's cultures is world medicine.
Even more problematic is the term natural as in natural healing, natural medicine, or naturopathy. The term generally implies techniques that rely only on botanicals and substances that are used in their natural form, i.e. are not modified by chemical or physical processes. The scope of what natural healing means has expanded to include techniques such as massage and acupuncture and other approaches that purport to promote the body's own power to heal itself by correcting mechanical or energy imbalances.25
Currently, the term complementary and alternative medicine (CAM) is the most commonly used term to describe the wide variety of complementary and alternative therapies offered in western culture.
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