Alternative Practices

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Alternative practices or medicine is any therapeutic practice that generally lacks biological plausibility and repeatability and is lacking adequate evidence from properly done clinical trials that have appropriate control groups. They commonly rely on pseudoscience and logical fallacies to justify their use and existence. Some alternative medicine practices are based on implausible theories that contradict how the body works. Alternative medicine is not subjected to the same standard of regulatory oversight that traditional medicine is and is not required to meet the higher standards before claims can be made for interventions. They are more likely to rely on anecdotes and testimonials rather than the results of controlled clinical trials that traditional approaches are based on.

Alternative practices are widely used in society despite the general lack of their efficacy. It is a multi-billion dollar industry. The modern industry can trace its roots to the snake oil salesman of the past. Some are used in podiatric practice and some are used to treat foot and lower limb problems. Regulated and licensed health practitioners in most countries are required to practice in an evidence-based way.

The are various attempts to rebrand alternative medicine to gain more respectability and gain more legitimacy. These terms include complementary medicine (CM); complementary and alternative medicine (CAM); supplementary, complementary and alternative medicine (SCAM); integrative medicine (IM); holistic medicine (HM); and functional medicine (FM).

The problem with alternative medicine is that generally in adequately and properly controlled prospective studies have shown that it generally does no better than a placebo. Many of the claims that are made regarding the efficacy of alternative medicines are often based on research on them is usually of low quality with methodological flaws. The anecdotes and testimonials that it works are probably more likely based on responses that could be explained by the placebo effect, the natural history of the condition, regression to the mean, positive mood changes and the benefits of the therapeutic alliance rather than the efficacy of the alternative approach.

Some alternative approaches may have some benefits in palliation. For example, the massage-based approaches (eg reflexology) may just make people feel better for reasons other than the alleged pseudoscientific explanations.

The potential harms of alternative medicine are the financial cost paid for no health gains and the indirect cost of evidence-based treatments being delayed and the unreasonable expectations that are encouraged by alternative health practitioners. There is also the potential exposure to direct harm and the possible negative consequences of alternative medicines interacting with conventional medicines.

Alternative Practices:

AcupuntureAmino Neuro FrequencyApplied KinesiologyAyurvedaChinese Medicine
ChiropracticCraniosacral TherapyEnergy MedicineFish PedicureFoot Reading
Functional MedicineGroundingHomeopathyIntegrative MedicineNeurokinetic Therapy
OsteopathyOzone TherapyReflexologyReikiTai chi
Urine Therapy

Fontanarosa & Lundberg (1998)

There is no alternative medicine. There is only scientifically proven, evidence-based medicine supported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is “Eastern” or “Western,” is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest. We recognize that there are vastly different types of practitioners and proponents of the various forms of alternative medicine and conventional medicine, and that there are vast differences in the skills, capabilities, and beliefs of individuals within them and the nature of their actual practices. Moreover, the economic and political forces in these fields are large and increasingly complex and have the capability for being highly contentious. Nonetheless, as believers in science and evidence, we must focus on fundamental issues—namely, the patient, the target disease or condition, the proposed or practiced treatment, and the need for convincing data on safety and therapeutic efficacy.

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Alternative medicine is often the butt of jokes from comedians. eg:

Q: What do you call alternative medicine that works?
A: Medicine

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