WHAT ARE THE REASONS FOR PEOPLE TO USE SO-CALLED ALTERNATIVE MEDICINE?

This is by far the most frequently asked questions I get when giving lectures or joining discussions about so-called alternative medicine (SCAM). People usually hope for an easy answer with perhaps 2 or 3 reasons that stick out. Sadly, this is not possible: there are many reasons, and their importance varies depending on dozens of circumstances.

Here are 12 options for what I consider to be the main reasons. My list is based on both the published evidence and on my 30 + years of researching SCAM:

1. Dissatisfaction with Conventional Medicine

This is the reason that is often thought to be the most important one. I doubt that this is the case. True, many people turn to alternative medicine due to perceived limitations of conventional treatments, such as ineffective results, long wait times, risk of adverse effects, or high costs. Dissatisfaction with conventional medicine is relevant (and often justified) but it is not usually the main factor.

2. Misinformation

I have grown to be convinced that misinformation should be on top of this list. People are told copious amounts of utter nonsense about SCAM. Misinformation originates from practitioners, journalists, the Internet, social media, friends, relatives, VIPs, manufacturers, and sometimes even from politicians. If people had reliable information about SCAM, not many would use it, I am sure.

3. Holistic and Approach

SCAM practitioners and enthusiasts regularly emphasizes holistic care, addressing physical, emotional, and spiritual health. People seeking SCAM are often drawn to its emphasis on balance, well-being and whole person care. I have often pointed out that this is merely another form of misinformation: any good healthcare is about the whole person, and most of SCAM is far from holistic.

4. Fewer Side Effects

Some believe SCAMs, such as homeopathy or naturopathy, have fewer or less severe side effects compared to pharmaceutical drugs or invasive procedures. This is mostly true but, at the same time, it is based on misinformation. The value of a therapy does not depend on its risks; it depends on whether it generates more benefit than risks. And, as we have discussed ad nauseam on my blog, most SCAMs do not rank highly on this score.

5. Personal Empowerment

SCAM often involves active patient participation, such as lifestyle changes or self-administered interventions. This can make individuals feel more in control of their health. People who feel strongly about such issues should, I think, should be reminded that personal empowerment exists in conventional medicine too – only when it comes to it, for instance, when a physician asks a patient to change her lifestyle, it is often not accepted or even frowned upon.

6. Distrust of Pharmaceutical Industry

Distrust in the pharmaceutical industry or the medical/scientific establishment, often fueled by concerns about profit motives or overmedication, pushes some people towards SCAM. This argument is voiced regularly; it really belongs to the first-listed reason above. The sentiment is a powerful motivator, I am sure. Moreover, it seems to become more and more widespread. Personally, I think a certain level of distrust is healthy. What puzzles me, however, is that distrust is so often completely suspended by enthusiasts when if comes to the SCAM industry.

7. Personalized Care

SCAM practitioners often offer individualized remedies and attention. Many people feel that these are lacking in conventional settings. The argument sounds reasonable; yet, I would urge patients to consider that even a totally individualized nonsense must still result in nonsense and can hardly be preferable to a non-individualized but effective therapy.

9. Affluence

There is plenty of evidence to show that, in the West, it is predominantly wealthy people who try SCAM. This implies that many of us have enough cash in our pockets and therefore don’t mind investing some of it in this or that SCAM. The motto seems akin to ‘keeping up with the Joneses’: if so-and-so can afford to have SCAM sessions, I surely must do the same!

10. Education

Most of the surveys on SCAM use demonstrate that SCAM users tend to be well educated. After many years of looking into these issues, I suspect that they are well-educated alright – but not well enough. They often seem to have a superficial understanding of the issues involved. Yet, sadly their knowledge is not deep enough to realize when they are led up the garden path.

11. Time and empathy

In General, SCAM practitioners offer their patients more time than conventional healthcare providers. Many people therefore consult SCAM practitioners – sometimes even when they are aware that the SCAM therapy they are getting is ineffective. They crave empathy, sympathy, warmth, attention, etc. All of this needs time – time that is unavailable under the conventional healthcare systems. Here we have gone full circle: conventional medicine’s lack of time is one of the factors that contributes strongly to the dissatisfaction listed under No1.

12. Efficacy

You may have noticed that I left the most obvious reason to the last: SCAM is employed because it is effective! As we have seen over and over again on this blog, most SCAMs are not effective or not as effective as we are led to believe. Yet, some people are convinced otherwise. Who is correct, the individual experience or the scientific evidence? I have tried to explain many times why our experience can be seriously misleading. Those who still don’t get it may be well educated but, as I pointed out above, not well enough.

There are, of course, many further reasons why people use SCAM. The whole area, it turns out on closer inspection, is a veritable minefield. Many of the reasons are criticisms of conventional medicine in disguise, and conventional healthcare practitioners could, in my view, improve their clinical routine dramatically, if only they considered them carefully.