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Considering Alternative Therapies? Introduction The decision to use complementary and alternative treatments is an important one. The following are topics to consider before selecting an alternative therapy—the safety and effectiveness of the therapy or treatment, the expertise and qualifications of the health care practitioner, and the quality of the service delivery. These topics should be considered when selecting any practitioner or therapy. What about Safety and Effectiveness of the Therapy? Generally, safety means that the benefits outweigh the risks of a treatment or therapy. A safe product or practice is one that does no harm when used under defined conditions and as intended. Effectiveness is the likelihood of benefit from a practice, treatment, or technology applied under typical conditions by the average practitioner for the typical patient. Many people find that specific information about an alternative and complementary therapy’s safety and effectiveness may be less readily available than information about conventional medical treatments. Research on these therapies is ongoing, and continues to grow. You may want to ask a health care practitioner, whether a physician or a practitioner of complementary and alternative health care, about the safety and effectiveness of the therapy or treatment he or she uses. Tell the practitioner about any alternative or conventional treatments or therapies you may already be receiving, as this information may be used to consider the safety and effectiveness of the entire treatment plan. The practitioner may have literature with information about the safety and effectiveness of the therapy. Credible information may be found in scientific research literature obtained through public libraries, university libraries, medical libraries, online computer services, and the U.S. National Library of Medicine (NLM) at the National Institutes of Health (NIH). For information about researching alternative medical therapies using the NLM, please contact the Office of Alternative Medicine (OAM) Clearinghouse and request the fact sheet, "Alternative Medicine Research Using MEDLINE." For general, nonscientific information, thousands of articles on health issues and complementary and alternative medicine are published in books, journals, and magazines every year. Articles that appear in popular magazines and journals may be located by using the Reader’s Guide to Periodical Literature available in most libraries. For articles published in more than 3,000 health science journals, consult the Index Medicus, found in medical and university libraries and some public libraries. Be an informed health consumer and continue gathering information even after a practitioner has been selected. Ask the practitioner about specific new research that may support or not support the safety and effectiveness of the treatment or therapy. Ask about the advantages and disadvantages, risks, side effects, expected results, and length of treatment that you can expect. Speak with people who have undergone the treatment, preferably both those who were treated recently and those treated in the past. Optimally, find people with the same health condition that you have and who have received the treatment. Remember that patient testimonials used alone do not adequately assess the safety and effectiveness of an alternative therapy, and should not be the exclusive criteria for selecting a therapy. Controlled scientific trials usually provide the best information about a therapy’s effectiveness and should be sought whenever possible.
What about the Practitioner's Expertise? Health consumers may want to take a close look into the background, qualifications, and competence of any potential health care practitioner, whether a physician or a practitioner of alternative and complementary health care. First, contact a state or local regulatory agency with authority over practitioners who practice the therapy or treatment you seek. The practice of complementary and alternative medicine usually is not as regulated as the practice of conventional medicine. Licensing, accreditation, and regulatory laws, however, are increasingly being implemented. Local and state medical boards, other health regulatory boards or agencies, and consumer affairs departments provide information about a specific practitioner’s license, education, and accreditation, and whether there are any complaints lodged against the practitioner. Check to see if the practitioner is licensed to deliver the services the practitioner says he or she delivers. Appropriate state licensing of education and practice is the only way to ensure that the practitioner is competent and provides quality services. Most types of complementary and alternative practices have national organizations of practitioners that are familiar with legislation, state licensing, certification, or registration laws. Some organizations will direct medical consumers to the appropriate regulatory agencies in their state. These organizations also may provide referrals and information about specific practitioners. The organizations usually do not function as regulatory authorities, but promote the services of their members. Second, talk with those who have had experience with this practitioner, both health practitioners and other patients. Find out about the confidence and competence of the practitioner in question, and whether there have ever been any complaints from patients. Third, talk with the practitioner in person. Ask about the practitioner’s education, additional training, licenses, and certifications, both unconventional and conventional. Ask about the practitioner’s approach to treatment and patients. Find out how open the practitioner is to communicating with patients about technical aspects of methods, possible side effects, and potential problems. When selecting a health care practitioner, many medical consumers seek someone knowledgeable in a wide variety of disciplines. Look for a practitioner who is easy to talk to: you should feel comfortable asking questions. After you select a practitioner, the education process and dialogue between you and your practitioner should become an ongoing aspect of complementary health care.
What about the Delivery of Service? The quality of the service delivery, or how the treatment or therapy is given and under what conditions, is an important issue. However, quality of service is not necessarily related to the effectiveness or safety of a treatment or practice. Visit the practitioner’s office, clinic, or hospital. Ask the practitioner how many patients he or she typically sees in a day or week, and how much time the practitioner spends with the patient. Look at the conditions of the office or clinic. Many issues surround quality of service delivery, and each one individually does not provide conclusive and complete information. For example, are the costs of the service excessive for what is delivered? Can the service be obtained only in one place, requiring travel to that place? These issues may serve as warning signs of poor service. The primary issue to consider is whether the service delivery adheres to regulated standards for medical safety and care. Contact regulatory boards or agencies described in the previous section to obtain objective information. You also may gather information by talking with people who have used the service, and through health care consumer organizations. What about the Costs? Costs are an important factor to consider as many complementary and alternative treatments are not currently reimbursed by health insurance. Many patients pay directly for these services. Ask your practitioner and your health insurer which treatments or therapies are reimbursable. Find out what several practitioners charge for the same treatment to better assess the appropriateness of costs. Regulatory agencies and professional associations also may provide cost information. Consult your Health Care Provider Most importantly, discuss all issues concerning treatments and therapies with your health care provider, whether a physician or practitioner of complementary and alternative medicine. Competent health care management requires knowledge of both conventional and alternative therapies for the practitioner to have a complete picture of your treatment plan.
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