Barrett Bruce
Department of Family Medicine, University of Wisconsin Medical School, Madison, WI 53715, USA.
J Altern Complement Med. 2003 Jun;9(3):417-27. doi: 10.1089/107555303765551642.
In attempts to improve their health and/or combat illness, approximately 4 in 10 Americans will use a complementary and alternative medicine (CAM) therapy this year. CAM therapies vary widely, with acupuncture, chiropractic, herbal medicine, and homeopathy among the more prominent modalities. CAM therapies are used in addition to and/or instead of the more conventional forms of medical care available in U.S. hospitals or licensed physicians' offices. A rapidly increasing interest in CAM has led to a nascent movement aimed at integrating various CAM therapies with the conventional health care system. In Washington State, for example, health insurance coverage for CAM therapies has been mandated, and a number of "integrated" delivery systems have been born. Although the political and economic forces leading to adoption and integration of CAM therapies vary widely by geographic locale, it is likely that some degree of integration will occur throughout much of the United States. Similar processes are occurring in Canada, Europe, and Australia, and indeed within middle and upper level socioeconomic strata worldwide. This paper identifies potential barriers and facilitators to potential integration, of medical disciplines and argues for an accessible, multidisciplinary and evidence-based, yet humanistic and patient-oriented approach.
为了改善健康状况和/或对抗疾病，今年约十分之四的美国人会使用补充和替代医学（CAM）疗法。CAM疗法种类繁多，针灸、整脊疗法、草药医学和顺势疗法是其中较突出的方式。CAM疗法是在美国医院或有执照医生办公室提供的更传统医疗形式之外和/或取而代之使用的。对CAM疗法的兴趣迅速增长，引发了一场旨在将各种CAM疗法与传统医疗系统相结合的新生运动。例如，在华盛顿州，已强制要求医疗保险覆盖CAM疗法，并且出现了一些“综合”医疗服务体系。尽管促使采用和整合CAM疗法的政治和经济力量因地理位置不同而有很大差异，但在美国大部分地区很可能会发生某种程度的整合。加拿大、欧洲和澳大利亚也在发生类似的过程，实际上在全球中高社会经济阶层中也是如此。本文确定了医学学科潜在整合的潜在障碍和促进因素，并主张采用一种可及、多学科、基于证据且以人为本、以患者为导向的方法。
