The Complementary and Alternative Medicine (CAM) and Integrative Medicine (IM) special interest group of the Society for Medical Anthropology (SMA) was organized to encourage the anthropological study of CAM and IM as emergent socio-medical phenomena having global ramifications in the 21st century. Members of this special interest group recognize that CAM/IM is a contemporary example of medical pluralism, influenced by processes of globalization and hybridization, scientization and commodification. CAM/IM is a global phenomenon and needs to be studied as such.
CAM and IM are forms of “Cosmopolitan Medicine” (Leslie 1976, 1980) that demand examination in relation to social, cultural, political economic and biotechnological forces as well as intensified flows of people, information and products that characterize globalization. In addressing this special interest groups’ scope of interest, it is useful to contextualize the study of CAM and IM within more general ethnomedical inquiry.
Ethnomedicine broadly encompasses the study of medical pluralism and healing traditions (“systems”) as conceptualized and practiced at distinct points in history and in particular geographical, social, cultural, and political economic contexts (Nichter 1992). The broad study of ethnomedicine encompasses the study of comparative medical systems, popular health culture, and folk illnesses (and so on) and is of longstanding interest to medical anthropologists, and the focus of such professional working groups as Curae and IASTAM.
The frequent focal point of studies of CAM and IM is its development as an area of clinical practice in conjunction with biomedicine. Social science studies of CAM and IM capitalize on aspects of complex medical systems in the U.S. and elsewhere, namely that we have within one cosmopolitan culture, the opportunity to comparatively study competing “systems” of medicine treating the same populations and thus learn more about how healing works, and how medical systems work in general.
Eisenberg, D. 2003. “Complementary and Integrative Medical Therapies: Current Status and Future Trends”. In Exploring Complementary and Alternative Medicine, pp 1-15. National Academies Press.
Complementary and alternative medical (CAM) therapies encompass a broad spectrum of practices and beliefs (1). From an historical standpoint, they may be defined “… as practices that are not accepted as correct, proper, or appropriate or are not in conformity with the beliefs or standards of the dominant group of medical practitioners in a society” (2). From a functional standpoint, complementary (a.k.a.”alternative”) therapies may be defined as interventions neither taught widely in medical schools nor generally available in hospitals (3). Ernst et al. contend that “complementary” medical techniques “[complement] mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine” (4). The terminology currently in use to describe these practices remains controversial. Many commonly used labels (e.g., “alternative,” “unconventional,” “unproven”) are judgmental and may inhibit the collaborative inquiry and discourse necessary to distinguish useful from useless techniques (5). “Complementary and Alternative Medicine” (CAM) is the language currently used by the NIH and U.S. federal agencies to describe this field of inquiry. The NIH National Center for Complementary and Alternative Medicine (NCCAM) defines CAM as, “Healthcare practices outside the realm of conventional medicine, which are yet to be validated using scientific methods.” Two recent articles by Kaptchuk et al, explore the taxonomy of CAM therapies in the context of medical pluralism(6;7).
refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies while emphasizing the primacy of the patient-provider relationship and the importance of patient participation in health promotion, disease prevention and medical management. “It (integrative medicine) views patients as whole people with minds and spirits as well as bodies and includes these dimensions into diagnosis and treatment” (8). In the January 2001 British Medical Journal edition devoted entirely to Integrated Medicine, the Journal’s editor, Richard Smith, wrote: “It mightn’t be too pretentious (although it might) to say that such a growth (of integrative medicine) might restore the soul to medicine – the soul being that part of us that is the most important but the least easy to delineate” (9). A variety of articles and editorials have wrestled with the challenges of properly labeling and describing this field of inquiry (8;10-22).
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(5) Eisenberg DM, Delbanco TL, Kessler RC. Letter to the editor. N Engl J Med. 1993;329:1203.
(6) Kaptchuk, TJ and Eisenberg, DM. Varieties of healing: 1. Medical pluralism in the United States. Ann Intern Med 135(3), 189-195. 2001.
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(7) Kaptchuk, TJ and Eisenberg DM. Varieties of healing: 2: A taxonomy of unconventional healing practices. Ann Intern Med 135(3), 196-204. 2001.
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(8) Weil A, et al. Integrated medicine. BMJ. 2001;322:119-20.
(9) Smith R. Editor’s choice: Restoring the soul of medicine. BMJ. 2001;322:117.
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(12) Fontanarosa PB, Lundberg GD. Alternative medicine meets science. JAMA. 1998;280:1618-19.
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(14) Angell M, Kassirer JP. Alternative medicine–the risks of untested and unregulated remedies [editorial; comment]. N Engl J Med. 1998;339:839-41.
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(18) Gaudet TW, Snyderman R. Integrative Medicine and the Search for the Best Practice of Medicine. Academic Medicine. 2002;77:861-63.
(19) Astin J. Complementary and Alternative Medicine and the Need for Evidence-based Criticism. Academic Medicine. 2002;77:864-68.
(20) Brokaw JJ, Tunnicliff G, Raess BU, Saxon DW. The Teaching of Complementary and Alternative Medicine in U.S. Medical Schools: A Survey of Course Directors. Academic Medicine. 2002;77:876-81.
(21) Kemper KJ, Amata-Kynvi A, Sanghavi D, Whelan JS, Dvorkin L, Woolf A et al. Randomized Trial of an Internet Curriculum on Herbs and Other Dietary Supplements for Health Care Professionals. Academic Medicine. 2002;77:882-89.
(22) Konefal J. The Challenge of Educating Physicians about Complementary and Alternative Medicine. Academic Medicine. 2002;77:847-50.
Opher Caspi, Lee Sechrest, Iris Bell, Carter Marshall, Howard Pitluk, and Mark Nichter On The Definition of Complementary, Alternative, and Integrative Medicine: Societal Mega-Stereotypes vs. The Patients’ Perspectives” Alternative Therapies in Health and Medicine 9(6):58–62. 2003.