MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

For some time now, I have been using the umbrella term ‘so-called alternative medicine’ (SCAM). As I explain below, I think it is relatively well-suited. But this is not to say that it is the only name for it. Many other umbrella terms have been used in the past.

Is there perhaps one that you prefer?

  • Fringe medicine is rarely used today. It denotes the fact that the treatments under this umbrella are not in the mainstream of healthcare. Some advocates seem to find the word derogatory, and therefore it is now all but abandoned.
  • Unorthodox medicine is a fairly neutral term describing the fact that medical orthodoxy tends to shun most of the treatments in question. Strictly speaking, the word is also incorrect; the correct term would be ‘heterodox medicine’.
  • Unconventional is also a neutral term but it is open to misunderstandings: any new innovation in medicine might initially be called unconventional. It is therefore less than ideal.
  • Traditional medicine describes the fact that most of the modalities in question have been around for centuries and thus have a long tradition of usage. However, as the term is sometimes also used for conventional medicine, it is confusing and far from ideal.
  • Alternative medicine is the term everyone seems to know and which is most commonly employed in non-scientific contexts. In the late 1980s, some experts pointed out that the word could give the wrong impression: most of the treatments in question are not used as a replacement but as an adjunct to conventional medicine.
  • Complementary medicine became subsequently popular based on the above consideration. It accounts for the fact that the treatments tend to be used by patients in parallel with conventional medicine.
  • Complementary and alternative medicine (CAM) describes the phenomenon that many of the treatments can be employed either as a replacement of or as an adjunct to conventional medicine.
  • Holistic medicine denotes the fact that practitioners often pride themselves to look after the whole patient – body, mind, and spirit. This could lead to the erroneous impression that conventional clinicians do not aim to practice holistically. As I have tried to explain repeatedly, any good healthcare always has been holistic. Therefore, the term is misleading, in my view.
  • Natural medicine describes the notion that many of the methods in question are natural. The term seems attractive and is therefore good for business. However, any critical analysis will show that many of the treatments in question are not truly natural. Therefore this term too is misleading.
  • Integrated medicine is currently popular and much used by Prince Charles and other enthusiasts. As we have discussed repeatedly on this blog, the term is nevertheless highly problematic.
  • Integrative medicine is the word used in the US for integrated medicine.
  • CAIM (complementary/alternative/integrative medicine) is a term that some US authors recently invented. I find this attempt to catch all the various terms in one just silly.
  • So-called alternative medicine (SCAM) is the term I tend to use. It accounts for two important facts: 1) if a treatment does not work, it cannot possibly serve as an adequate alternative; 2) if a therapy does work, it should be part of conventional medicine. Thus, there cannot be an ‘alternative medicine’, as much as there cannot be an alternative chemistry or an alternative physics.

Yet,some advocates find ‘SCAM’ derogatory. Intriguingly, my decision to use this term was inspired by Prince Charles, arguably the world’s greatest champion of this sector of healthcare. In his book ‘HARMONY’, he repeatedly speaks of ‘so-called alternative treatments’.

You don’t believe me?

Fair enough!

In this case – and in order to save you the expense of buying Charles’ book for checking – let me provide you with a direct quote: “Some so-called alternative treatments seek to work with these functions to aid recovery…” (page 225).

And who would argue that Charles is dismissive about alternative medicine?

 

 

 

17 Responses to What is the best umbrella term for an area of healthcare comprising modalities as diverse as homeopathy, acupuncture, iridology, dietary supplements and about 400 more?

  • It’s called NewAge – rhymes with “sewage”

  • Personally, I’d call it ‘contradictory medicine’, because the theory each of them directly contradicts most if not all of the others. They don’t get called out on that often enough, I feel! And of course they contradict medicine and basic human physiology.

    Then maybe have a different category for things like Tai Chi and Yoga, where the theory contradicts modern medical and physiological knowledge, but they can lead to positive effects and useful behavioural changes, which otherwise might not be achieved.

  • Words and names are indeed important – something that the denizens of the alternative universe realize all too well: just look at how in the past half-century or so they constantly came up with new names in attempts to attract the same credibility and respectability as real medicine (while ironically often denouncing that very same real medicine as ‘allopathy’).

    Generally, I try to avoid the word ‘medicine’ altogether, as that falsely suggests a level playing field with real medicine – most alternative practitioners have no medical education to speak of, no in-depth knowledge of sickness and health, and no diagnostic or healing skills to speak of.

    The term I use the most is ‘alternative treatments’ (alternatieve behandelwijzen in Dutch). People still understand what is meant (contrary to ‘SCAM’, which always needs explaining), without immediately engendering close associations with proper medicine. Importantly, it is less derogatory than ‘quackery’ (or SCAM) – a term that is better avoided when discussing the subject with someone other than a sceptic.

    • the problem with ALTERNATIVE TREATMENTS is that SCAM comprises numerous diagnostic techniques as well.

      • Hmm, yes, you have a point there. Still, I think that the more encompassing term ‘medicine’ is too much honour.

        However, one could simply consider diagnosis to be an integral part of the treatment. After all, in many alternative modalities, there is either no distinct diagnostic procedure at all(*), or there is no real difference between ‘diagnosis’ and ‘treatment'(**).
        And in a very real sense, many patients start feeling better already when receiving a practitioner’s attention during the diagnostic stage – which is not strange, as this attention is the actual (and often only) real treatment.

        There are of course exceptions, e.g. practitioners who take real blood samples and try to find anomalies (real or perceived), or herbalists who try to identify ailments that may be treated with herbs, achieving some degree of efficacy.

        Perhaps it is an interesting exercise to actually try and make an inventory of what constitutes a ‘diagnosis’ in several alternative modalities, both in terms of diagnostic procedures and conclusions drawn. I’ll make a note of it, perhaps it leads to new insights into the alternative universe.

        *: E.g. homeopathy does not involve any diagnostic process to establish what is actually wrong with someone and subsequently fix that problem, but merely collects as many ‘symptoms’ as possible in order to find the best match with a ‘remedy’ – a procedure that does not merit the qualification of diagnosis in my opinion.
        Of course this does not stop homeopaths and other alternative practitioners from inventing all sorts of diagnoses on the spot, such as ‘blocked energy’ or ‘toxins’ etcetera.

        **: In many forms of ‘energy medicine’, a practitioner’s diagnosis is fully congruent with the treatment – again often involving an ‘energy blockage’ or any other made-up cause that is at the same time ‘released’ through the practitioners intervention.

  • We distinguish “science” from “pseudoscience”, so we could so the same with “medicine” and “pseudomedicine”.

  • NOT ‘integrative ‘ or ‘integrated’.
    Those folks want to integrate whatever it is they are up to with conventional, progressive, evidence-based medicine.
    This blog piece is about the terminology for the un-evidenced rump.

    Prince Charles’ SCAT ain’t bad.
    Scat: In music/singing: ‘meaningless sounds are improvised’ – using emotive, onomatopoeic, and nonsense syllables.

    Cambridge Dictionary has scat = ‘waste’. As in scatology.
    Ancient Greek: skor, ‘excrement’.
    This seems apposite.

    These treatments are no so much ‘alternative’ themselves, but for the benefit of patients and therapists with alternative mindsets to the rational.

    In Real Secrets of Alternative Medicine , I coined ‘Condementary medicine’ – As in ‘condement’ – which adds to the taste and flavour of food but has no substantial effect on the substance. (And liked by Harriett Hall!)

    My preference: ‘Camistry’, practised by ‘camists’ on ‘camees’.

  • I like “faith based” … as in faith based medicine. I compare this with medicine that’s grounded in bioscience.

    ~TEO.

    • Fantasy based would be variant on this theme.

      I often use “Play Medicine” or “Make-believe medicine” when discussiing homeopathy and other “fantasy based health services”

      • Fantasy based would be variant on this theme.

        I often use “Play Medicine” or “Make-believe medicine” when discussiing homeopathy and other “fantasy based health services”

        Well, my comparison of faith-based medicine to medicine grounded in bioscience was made in “good faith,” if you will. It was an effort to answer EE’s search for an umbrella term that offers useful insight rather the judgement and pejoration I see here. While my description was aimed particularly at the Father, Son, and Holy Ghost of Alt-Med (TCM, “chiropractic,” and homeopathy, respectfully), any system of medicine that includes a diagnosis and treatment was meant to be included in my faith-based comparison. Notably, what characterizes faith-based medical efforts is that they all “work,” even when they don’t for any given person or complaint. They “WORK” is the _starting_ point of the faith-based practitioner and consumer whereas bioscience begins with the null hypothesis.

        Perhaps a story might illustrate what I’m talking about. When I was clinic faculty at a chiropractic college in the early 90’s, the clinic director asked me to treat him with acupuncture. When it didn’t help, he said, “Well, we KNOW it works, it just didn’t work for me.” Biomedicine doesn’t share this sort of unlimited faith in their interventions. Similarly, patients and advocates of faith-based medicine would respond to me when I told them I was a chiropractor and acupuncturist at a party, “Oh, I believe in chiropractic” or “I believe in acupuncture.” I learned quickly not to respond with, “Well, I don’t” unless I wanted to spend the rest of the evening trying to shake them from their unshakable faith in their practitioner.

        So, while you or I might think advocacy of a particular Alt-Medical intervention is a fantasy, make-believe … indeed delusional, because these efforts are unsupported by fact and science, these descriptors don’t cut to the chase as to what I think cleanly separates alternative medicines from those grounded in bioscience.

        ~TEO.

  • I suggest Complimentary and Related Alternative Pseudoscience or CRAP

  • According to Edzard in his new book 20 CAM therapies have some sound evidence.

    Therefore CAM doesnt appear to be as binary as some thought ie All bad or all good.
    These 20 therapies could be called Newly Integrated Complementary Healthcare Enlightenments (NICHE).
    Unfortunately this leaves 20 treatments according to Edzard with no evidence.
    Boo!
    Anyway sometimes Camees going to Camists for our Camistry should be Nichees going to Nichists for our Nichistry.

  • I like to use “non-science” medicine. If you say it quickly its meaning becomes even more clear 😉.

    Niall

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