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Complementary and alternative medicine is defined as any medical system, product or practice that is not thought of as a standard of care. Complementary medicine usually refers to the use of these services and products in conjunction with mainstream medicine, whereas alternative medicine means using them instead of mainstream medicine.
Over 5 million Canadians have reported using some form of alternative or complementary health product in the past year.
These treatments are rooted in a different belief system than the one underlying mainstream medicine. Complementary and alternative medicine is based on tradition and belief, and doesn’t have a strong research tradition or infrastructure.
In spite of the lack of high quality evidence about the benefits and harms of many of these treatments, and the fact that Canadians usually pay for them out of pocket, over 76% of Canadians have purchased natural health products such as vitamins and herbal products, and about 70% of Canadians use these products at least once weekly. The growing use of complementary and alternative medicine has led to a broader regulatory focus on these products and professionals. Kirsten Smith, a Toronto-based naturopathic doctor sees regulation as an opportunity for naturopathic medicine to gain broader acceptance, saying that “it validates the profession.” However, Heather Boon, a researcher at the University of Toronto and one of the founding chairs of the Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research is concerned about the impact of regulating these groups. Boon notes that “the big issue is that regulation is supposed to protect the public, and it is still not clear how the colleges, in regulating these groups, will do that.” Boon questions who will bear the costs of setting up expensive, bureaucratic infrastructure for regulation. In spite of the costs, and the lack of information about effectiveness, many Canadians have embraced complementary and alternative medicine, mostly using it in addition to mainstream therapies.
Mainstream medicine, however, has been slower to accept many of these products and practitioners. Bill Evans, a medical oncologist and president of the Juravinski Cancer Center in Hamilton says that some “patients are afraid to tell their doctors” about the natural health products they are using, or practitioners they are seeing, for fear that “their doctor won’t approve, and at the least will scold them, and at the worst, withhold treatment.” However, it is crucial for doctors to know what treatments patients are using, because there is evidence that some natural products and prescription drugs can interact. There are efforts to provide further guidance to doctors on how to have these conversations, and to learn about their patients’ use of complementary and alternative medicine.
Many Ontarians use both the mainstream and complementary and alternative health care systems at the same time, despite the two systems’ different underlying philosophies and approaches to evidence. Ontarians avidly use the services of mainstream medicine and demand increasingly “high tech” tests and treatments. Despite their skepticism of some of the claims of mainstream medicine, patients are increasingly willing to use complementary and alternative medicines, many of which have little evidence to support their impact on health outcomes. What is the most important reason for the growing use of complementary and alternative medicine? Would have liked to see a more indepth discussion about the spectrum that is alternative medicine. The obvious bias towards conventional medicine, coupled with the lack of useful information about CAM therapies resulted in an article that came off as judgmental and dismissive of all those engaging in unconventional care – both the practitioners and patients.
Tara, please enlighten us as to what about CAM this article misrepresents through its supposed bias. As a practitioner, one of my major concerns is that due to a lack of regulation, often there is no way to verify what is actually in a bottle with a certain label. Ritika is quite right that there is indeed significant variability in the potency of natural products.
Interestingly, for anyone who has wondered what the difference is between Cold FX, generic knock offs, and Wild American Ginseng (from which Cold FX and knock offs are made), it is precisely this issue of dosing. Yes it does come down to the fact that it is a billion dollar industry and it is demanded by the consumers! Yes, after having voted in the poll system above, I do think that the main reason why so many patients continue to seek alternative medicine is because the holistic therapies, herbal remedies, acupuncture, etc have been around for centuries. Could you reference where you found the statistics on who uses CAM in Canada and how much they spend? To clarify as per my quote, Naturopathic Doctors are regulated, however we are currently in the process of transitioning to a different governing body (the RHPA) which would be an improvement for both the public and the profession.
I am glad this article was published as it has generated some good discussion and many questions; namely blowing open the clear necessity to do a series of articles addressing these topics as they are the source of a lot of confusion for both the public and health care professionals, and frankly, it would be of great value to everyone to shed some light on the facts. What role do alternatives approaches to health care play in terms of the various chronic diseases that are either epidemic or rapidly becoming so? I optimistic that this forum can address many of these topics with clarity, facts and lack of bias.


Imagine the outcry if this basic safety information was left off the labels of medications made by big pharma. This document is provided under the terms of a CreativeCommons Attribution Non-commercial Share Alike license. The conference target audiences were Healthcare Leaders, Policy Makers, and Executives; Healthcare Practitioners, and other Health Professionals.
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Have you ever wondered about the difference between various ALTERNATIVE MEDICINE providers and TRADITIONAL providers? For instance, what does an ALLOPATHIC doctor do versus an OSTEOPATHIC or NATUROPATHIC physician? INTEGRATIVE PHYSICIAN has been a generic term that providers use to specify that they try to integrate the whole person concept (mind, body, spirituality) when caring for patients. CHIROPRACTORS utilize adjustments of the spine and nervous system to treat a variety of ailments, primarily neck, back and joint pain.
The additional alternative methods mentioned above (massage, energy medicine, yoga, tai chi….) are fairly self-explanatory and many believe they can and should be incorporated into a balanced and healthy lifestyle. So in conclusion, when you are seeking a healthcare provider, it’s critically important to understand what YOUR philosophy is on health and what level of involvement you would like in your own care. Drawing together some of the country's leading physicians, scientists, researchers, community educators, and other health experts, the Center for Complementary and Integrative Medicine emphasizes the synergies between research and practice in complementary and integrative medicine.
There are many complementary and alternative providers and products in Canada, including homeopaths, naturopathic doctors and traditional Chinese medicine practitioners who use products like herbs, homeopathic preparations, and vitamins.
Complementary and alternative medicine is big business in Canada, and is estimated to cost about $2.35 billion per year. Mainstream medicine is scientifically based and focused on evidence, often using randomized controlled trials to demonstrate the benefits and harms of a treatment or procedure. However, the amount of research generating evidence about complementary and alternative medicine is growing. In 2004, Health Canada created the Natural Health Products Directorate, which has been tasked with regulating natural health products and is supposed to ensure that Canadians have access to safe and high quality products.
In cancer, this is particularly problematic because herbs and vitamins have been found to interact with chemotherapy for about 25% of patients, who are using chemotheraphy in conjunction with herbs and vitamins. For example, the College of Physicians and Surgeons of Ontario is undertaking public consultation to update their policy that outlines how doctors should assess and treat patients using complementary and alternative medicines.
However, at the same time they are also skeptical about some of the claims of mainstream medicine. Many patients, however, are unconcerned about the lack of scientific evidence, and instead focus on historical experience. I do recall hearing of studies that found there to be surprising variability in what can actually be found within bottles with the same label. So, naturally (pun-intended) many patients strongly believe that there are some healing properties to these treatments. The Board of Directors of Drugless Therapy – Naturopathy (BDDT-N), appointed by the Lieutenant Governor in council, has been responsible for public protection in Ontario with respect to the practice of Naturopathic Medicine since 1925. And what is their scope of practice that they have the right to practice free from prejudice? Disease occurs when this energy flow is blocked and TCM practitioners utilize both acupuncture and herbal therapies and sometimes body work such as shiatsu, to help patients get back to a place of balance. In the event of disease, their tools include: nutritional therapy, botanical extracts, acupuncture, homeopathy and occasionally prescription medication to treat patients. There are some controversial elements to Ayurvedic practices, such as detoxification through the purging of bowels or blood-letting. However, critics point out that many treatments in mainstream medicine have not been rigorously evaluated. For example, the National Institutes of Health, the primary government research funding agency in the United States, has a center focused on improving the amount and quality of evidence in complementary and alternative medicine.
Similarly, in Ontario, legislation was passed in 2007 to regulate practitioners of traditional Chinese medicine and acupuncture, naturopathic medicine and homeopathy.


The skepticism is partly driven by well-publicized examples of unexpected harms of treatments like Vioxx and hormone replacement therapy, as well as the continued burden of diseases like multiple sclerosis and some cancers, which have established treatments, none of which work for all patients, and many of which come with a myriad of undesirable side effects. In order to practice Naturopathic Medicine in Ontario Naturopathic Doctors must be registered with the BDDT-N.
In some countries many of the things currently on our shelves are only available by prescription from a trained professional. And that patients have the right to utilize different approaches to their care without discrimination, bad treatment or disrespect? We are a collection of volunteers and starting a new project in a community in the same niche.
The University of Arizona, through Dr Andrew Weil, offers several Integrative Medicine Residencies and Fellowship training for physicians and other health care providers looking to formalize their training in the integrative approach, University of Arizona Integrative Medicine Training.
Homeopathic treatments dilute substances (usually plant-based or minerals) to extremely low levels in the thought that these may stimulate the body to heal itself. Currently, there are no certifying organizations or licensing requirements in the United States for someone to practice Ayurvedic medicine. Faculty are appointed to the Center and to their discipline-specific departments and institutions. If you couple those two points, it becomes clear that the widespread acceptance of CAM has more to do with the psychological impact it has on patients than anything else. The impact on the public and on the profession of transitioning to the RHPA has been thoroughly researched by a team of health care policy professionals. How are TRADITIONAL CHINESE MEDICINE (TCM) providers different than LICENSED ACUPUNCTURISTs (LAc)?
Osteopaths take extra courses in the musculoskeletal system in their fundamental belief that the alignment and function of our bones, muscles and connective tissue strongly influence the whole body’s health. Currently, only 43 states in the US require this certification to obtain a license to practice Chinese Medicine. All 50 states in the US require licensing of Chiropractors through national board examinations after completion of training, Chiropractic Training. All homeopathic remedies sold in the US have been regulated by the government since 1938 and considered generally safe because of this.
Caution must be exercised when ordering Ayurvedic botanicals online as 20% were found to be contaminated with heavy metals such as mercury, lead and arsenic in a 2008 study, NIH Study Ayurvedic Contamination 2008. CAM treatments give more hope to patients, and as we have seen from the last US presidential election, hope is powerful – more powerful of a force than we consider it to be. It can be quite confusing for patients trying to find the right fit when seeking the best health care experience out there. They learn how to do manipulations (Osteopathic Manipulative Technique, OMT) similar to chiropractic medicine. New in 2015, there is now a way for eligible providers to take a national examination to become Board Certified in the area of Integrative Medicine. However, a CAc is not required to pass the National Certification Commission for Acupuncture and Oriental Medicine’s exam. Skeptics of homeopathy state that the level of dilution used removes most or all of the active ingredients and that if patients improve, it’s through the belief that they will improve, or the placebo effect. I do not discourage my patients from using CAM but I do try to ensure they approach such treatments with appropriate vigilance. I’ve outlined here some of the differences, which may help you to decide what type of provider you may benefit the most from seeing. Both Allopaths and Osteopaths then do 3-8 yrs post-graduate training in residencies and fellowships in order to specialize in an area of medicine such as Pediatrics, Family Medicine, General Surgery, Neurology, Dermatology, etc.



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