The article was created within the H2020 EDUC-SHARE project framework (Working Package 8 "Dissemination and communication”, Task 8.2 “Internships for student journalists in genuinely scientific environment”).
The Revenge of the Joss Sticks
Why the practice of Complementary and Alternative Medicine is on the rise
Sitting on simply padded chairs, staring at the crème painted walls, colorful brochures and abstract paintings makes everyone doozy. Sitting there, waiting to be called in, and looking up every time someone walks by creates a dump feeling in every patient in the waiting room. This void ends abruptly when the doctor calls your name. In the next moment, the patient and doctor sit across one another. Looking at a single person with all the hope in his heart makes every grown person feel like a little child. Most of the time, problems and solutions are found. Medical professionals work hard every day trying to help every patient on the list. But there are some cases, in which one goes out of the doctor’s office and feels more misunderstood and left alone than when going in. Often, this has nothing to do with the overall resources in healthcare facilities.
Dissatisfaction with conventional medicine leads to the turn to alternatives.
The EUprimecare study of 2014 analyzed patient satisfaction with primary care services in seven different EU countries (Germany, Spain, Estonia, Finland, Hungary, Italy, and Lithuania). Interestingly, the varying resources of the countries did not have a distinct impact on the results: Germany, a country with great economic wealth showed the lowest level of overall patient satisfaction with only 59.6 percent. And the “highest level had a country which had many economic struggles in the last years – Italy. 87.4% of Italian responders were satisfied with primary care services. Some of those who are not satisfied do turn to Complementary and Alternative Medicine, short CAM. The term stands for a number of methods, for example, acupuncture, aromatherapy, chiropractic, herbal medicine, homeopathy, meditation, naturopathy, osteopathy, Pilates, and yoga. The dissatisfaction with conventional medicine is one of the three reasons why people turn to CAM. The other reasons are the expectation of benefits, and the perceived safety of the methods which was investigated by Mayuree Tangkiatkumjai, Helen Boardman and Dawn-Marie Walker in 2020. Their work paints a clear picture: “Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.” There are clear push and pull factors in place which have a strong influence on people long term. Numbers for this shift were provided by a group of experts for The Ochsner Journal in 2012 about the “Use and Acceptance of Complementary and Alternative Medicine Among the General Population and Medical Personnel”. According to the study the usage and practice of CAM methods did increase between 1990 and 2006 in all the countries that were examined.
Someone who is active in the research field right now is Audrey Bochaton. She is a geographer at the Université Paris Nanterre. Bochaton came to this research field when she worked with breast cancer patients and interviewed women in order to follow their paths of seeking care. This included for example comparing the paths of patients living in the city and those living outside of it. During her encounters with the patients, she became aware of differences in the therapeutic methods the women choose for themselves. Aside from conventional biomedical treatment, there is a lot of existing methods belonging to the field of complementary medicine. What she noticed was that not every woman got complementary treatment. This sparked her interest in further research.
In France, complementary medicine is mainly provided by the private health sector - so there could be financial restrictions in place for some patients. The unavailability in the public sector is not a coincidence as Bochaton makes clear: There is still resistance to the Complementary approach among French medical professionals.
Doctors who treat cancer patients are feeling helpless.
At this moment, she is interviewing these doctors about the trajectories of the implementation or nonimplementation of complementary medicines in their facilities in the last ten years. Her studies are still ongoing. One thing that is already standing out for her, is the feeling of helplessness of doctors who treat cancer to help patients manage side effects and better cope with the period of care. So, they see a need for an addition to the conventional treatment of cancer. Of course, this does not mean replacing it in any way. Something is on the move, according to Audrey Bochaton. More and more Complementary methods are being included despite the reluctance of many professionals.
The geographer is just at the beginning. In further studies, she wants to analyze regional differences when it comes to the practice of Complementary and Alternative Medicine. This means comparing different French regions with each other, and also different countries.
The practice of Complementary Methods is more prevalent in richer countries.
In some other European countries, for example, Denmark, Sweden, Finland, and Germany CAM is integrated into the public healthcare sector. In German-speaking countries, homeopathy is especially prevalent. This can be explained by the roots of this method field as the inventor of homeopathy, Samuel Hahnemann, was German and has a great fan community to this day. It is no wonder that 73% of Germans practiced CAM in 2002, according to a study by Stefanie Joos, Berthold Musselmann, Antje Miksch, Thomas Rosemann, and Joachim Szecsenyi in 2008. The culture is different than in other countries which is also recognized by the state. There are special statelicensed, non-medical CAM practitioners called “Heilpraktiker” who provide these special services. It is practically an Enigma that such rich, “advanced” and “secular” countries are especially supporting such methods. But it is proven that CAM is more prevalent in wealthier countries. Erlend L. Fjær and his colleagues analyzed the “use of complementary and alternative medicine (CAM) in Europe” in 2020. They found that “countries’ health expenditures were positively related to the prevalence of overall and physical CAM treatments.” This relationship seems as already mentioned grotesque at first. But on second thought: To get the conventional treatment plus Complementary treatment can be expensive. In developing countries, getting on a minimum level of primary care is the most important step. CAM seems in this light like a fashionable accessory. Maybe, that is actually the case with some of the methods. They are nice accessories for those who can afford it – and in that way a sign of privilege. It is no wonder that in the just mentioned study, the experts found that the use of CAM is more prevalent in higher socioeconomic groups. In the age of the internet, new alternative diets, supplements, and natural-based facemasks are being advertised. The most popular example of this was of course the face roller for youthful skin about of rose quartz which was all over social media in 2021.
There is something about all-natural, plant-based, biodynamic things with shiny stones and hemp that makes people feel good about themselves. According to the mentioned studies, middle-aged women are the target audience for CAM products and services. This could have multiple reasons. First of all, the unmet need for suitable healthcare is higher for women. The feeling of helplessness seems to be greater. This is connected to the second point: Mothers do want to treat their children with seemingly natural and soft methods which can be seen by the anti-vaccine tendency of some young parents. Also, and this is something conventional medicine will not be able to provide: CAM does feed the social need to take an active part in the own health and ones loved ones. Especially for parents, this could be a great factor. But also for those suffering from health problems who are also a key group of CAM users are interested in leaving the player’s bench and playing an active role in their life.
The discussion around CAM is emotional. Many beliefs and feelings are invested. The walls are up. Also, CAM use is higher among those with higher education which maybe brings some ego problems in the game. The lack of scientific evidence of any effect of some CAM methods is shocking – but also put in question. This needs to be fixed before any move of further implementation can be made. The point here is the importance of distinguishing between the different CAM Methods. Putting yoga in the same category as homeopathy creates injustice on both sides. There needs to be an answer for each method separately about the opportunities it gives to the great public which are actually tested and proven. Leaving the field of more natural and empathic medicine to anti-science groups and some companies with a 200-year-old receipt would be fatal. Giving patients more support and finding new ways to help them is the only way to stop doubts about conventional medicine and its professionals. There is only one way out and that is to go further.
Author: Katrin Engler
“The project EDUC-SHARE has received funding from the European Union´s Horizon 2020 research and innovation programme under grant agreement No 101017526.”