The status of complementary and alternative medicine (CAM) in biomedical education: towards a critical engagement

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Handbook of the Sociology of Medical Education, 2009, 1st, pp. 1 - 296
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Complementary and alternative medicine (CAM) has become increasingly prominent over the last three decades with more individuals using CAM in combination with, or as an alternative to, biomedical treatments. In addition to this resurgence in consumer interest in CAM modalities, health-insurance companies in the US, Britain, Australia and New Zealand now fund selected CAM therapies such as chiropractic, osteopathy, acupuncture, homoeopathy and healing-touch therapy for certain medical conditions (Cassileth 1999). While there is still only limited and sporadic provision of CAM in mainstream western medical contexts, consumer interest, health-insurance rebates and political impetus have provided some degree of momentum toward the development of 'integrative' approaches to patient care. Progress has been slow in terms of actual mainstream integration of CAM practices, yet doctors are increasingly faced with patients wanting to discuss CAM-related issues. In areas such as cancer care or the treatment of other chronic illness, CAM use is traditionally high (Thome et at. 2002) and discussions about non-biomedical options are frequent and are valued by patients (Tovey and Broom 2007). However, the skill and knowledge base of practising clinicians in relation to CAM is generally limited and paradigmatic divergences between CAM and biomedicine can complicate patient-doctor discussions regarding what constitutes 'effectiveness', 'evidence' and 'risk' (Broom and Tovey 2007b).
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