Alternative medicine
Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability or evidence of effectiveness. Unlike modern medicine, which employs the scientific method to test plausible therapies by way of responsible and ethical clinical trials, producing repeatable evidence of either effect or of no effect, alternative therapies reside outside of mainstream medicine[n 1][n 2] and do not originate from using the scientific method, but instead rely on testimonials, anecdotes, religion, tradition, superstition, belief in supernatural "energies", pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources. Frequently used terms for relevant practices are New Age medicine, pseudo-medicine, unorthodox medicine, holistic medicine, fringe medicine, and unconventional medicine, with little distinction from quackery.
Alternative medicine
Alternatives to science-based medicine
Some alternative practices are based on theories that contradict the established science of how the human body works; others appeal to the supernatural or superstitious to explain their effect or lack thereof. In others, the practice has plausibility but lacks a positive risk–benefit outcome probability. Research into alternative therapies often fails to follow proper research protocols (such as placebo-controlled trials, blind experiments and calculation of prior probability), providing invalid results. History has shown that if a method is proven to work, it eventually ceases to be alternative and becomes mainstream medicine.
Much of the perceived effect of an alternative practice arises from a belief that it will be effective, the placebo effect, or from the treated condition resolving on its own (the natural course of disease). This is further exacerbated by the tendency to turn to alternative therapies upon the failure of medicine, at which point the condition will be at its worst and most likely to spontaneously improve. In the absence of this bias, especially for diseases that are not expected to get better by themselves such as cancer or HIV infection, multiple studies have shown significantly worse outcomes if patients turn to alternative therapies. While this may be because these patients avoid effective treatment, some alternative therapies are actively harmful (e.g. cyanide poisoning from amygdalin, or the intentional ingestion of hydrogen peroxide) or actively interfere with effective treatments.
The alternative medicine sector is a highly profitable industry with a strong lobby,[1] and faces far less regulation over the use and marketing of unproven treatments. Complementary medicine (CM), complementary and alternative medicine (CAM), integrated medicine or integrative medicine (IM), and holistic medicine attempt to combine alternative practices with those of mainstream medicine. Traditional medicine practices become "alternative" when used outside their original settings and without proper scientific explanation and evidence. Alternative methods are often marketed as more "natural" or "holistic" than methods offered by medical science, that is sometimes derogatorily called "Big Pharma" by supporters of alternative medicine. Billions of dollars have been spent studying alternative medicine, with few or no positive results and many methods thoroughly disproven.
Use and regulation
Appeal
Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.[138]
In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth, notably psychological effects, such as the will to believe,[139] cognitive biases that help maintain self-esteem and promote harmonious social functioning,[139] and the post hoc, ergo propter hoc fallacy.[139]
In a 2018 interview with The BMJ, Edzard Ernst stated: "The present popularity of complementary and alternative medicine is also inviting criticism of what we are doing in mainstream medicine. It shows that we aren't fulfilling a certain need-we are not giving patients enough time, compassion, or empathy. These are things that complementary practitioners are very good at. Mainstream medicine could learn something from complementary medicine."[140]