Complementary and alternative medicine. Considering the alternatives.

Therapies variously described as alternative, complementary, or unconventional because they lie outside the realm of scientific medicine practiced by graduates of orthodox U.S. medical schools are gaining mainstream respectability despite many questions about their efficacy and safety. Depending on definitions, surveys indicate that fewer than 10 percent to nearly 40 percent of Americans supplement or substitute for conventional health care with alternative systems of medical practice. Spending for complementary and alternative medicine (CAM) nationwide has been estimated at up to $14 billion a year. Establishment of an Office of Alternative Medicine in the National Institutes of Health in 1992 has heartened advocates of CAM, increased interest and government funding for research into unorthodox therapies, and lent credibility to CAM modalities. Embracing marginal therapies may represent an opportunity for physicians and health systems to reduce inappropriate consumption, offer a wider range of choices to patients, and profit from a lucrative market.