What is alternative medicine? Alternative medicine can be defined as any health care remedy or system not generally accepted in modern biomedicine or therapies that are offered in place of or as substitutes for conventional therapies. Alternative therapies include, but are not limited to the following disciplines: folk medicine, herbal medicine, diet fads, homeopathy, faith healing, Ayurvedic medicine, chiropractic, acupuncture, naturopathy, massage, and music therapy. Allopathic medicine is the term used to refer to mainstream medical practice.

How common is the use of alternative medicine? Four out of 10 adults used alternative medicine therapies in 1997; total visits to alternative medicine practitioners increased by almost 50 percent from 1990 and exceeded the visits to all U.S. primary care physicians. The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. Americans spent $27 billion out-of-pocket for alternative therapies in 1997. The users of alternative medicine tend to be more educated, have poorer health status and have a more holistic orientation to health. They use alternative medicine not so much as a result of being dissatisfied with conventional medicine but largely because they find these health care alternatives to be more congruent with their own values and beliefs toward health and life. In 1994, 11% of parents in Quebec reported having used alternative medicine for their child. Chiropractic, homeopathy, naturopathy and acupuncture were the most frequently used. A systematic review of alternative medicine use in children showed that the prevalence of use is variable (9% - 70%) and the rates of use in certain subgroups ( e.g. children with arthritis, cancer and cystic fibrosis) are among the highest.

What do pediatricians feel about alternative medicine? Pediatricians are becoming more open to alternative medicine About 50% of pediatricians would consider referring a patient for complementary and alternative medicine treatments, such as acupuncture, massage therapy or biofeedback. The majority, 83.5% of the doctors surveyed, believed that some of their patients were using some form of complementary or alternative therapy, but discussions about complementary and alternative medicine were generally initiated by either parents or the children themselves, and not by the physicians. Most pediatricians surveyed also expressed an interest in learning more about alternative therapies through continuing medical education courses. And 37% of the pediatricians questioned reported using some form of alternative medicine themselves.

Where do patients find information about alternative medicine? Many will consult their own doctor or alternative medicine health care providers such as naturopaths, herbalists, chiropractors, homeopaths and practitioners of Chinese medicine or Ayurvedic medicine. Some will consult pharmacists or seek information in libraries, bookstores, and health food stores. Currently both patients and physicians search the Internet for help on issues concerning alternative medicine. Information may be found on web sites, e-mail lists, chat groups, and file archives. The web sites may include databases, publications, parent support groups, alternative medicine specialty interest groups, commercial sites and alternative medicine practices. The quality of information obtained at many of these sites is of concern to health professionals since there does not need to be any control over the accuracy of information nor to have an editorial board or peer review. Many of these sites turn out to be fronts for manufacturers or glorified online-order catalogues.

What are reliable sources on the Internet for information about alternative medicine? The following are resources on the Internet that attempt to provide objective information and satisfy the needs of both patients and health care workers and physicians. This list is by no means comprehensive but is a useful starting point and accessing these sites will lead to many other alternative medicine web sites.

These web sites offer hyperlinked listings of other alternative medicine web sites

A Resource Guide to Naturopathy and Alternative Medicine http://www.termlifeinsurance.org/additional-resources/naturopathy-and-alt-medicine/

Rosenthal Center for Alternative and Complementary Medicine- http://cpmcnet.columbia.edu/dept/rosenthal/CAM.html

This site is a professional research resource whose listings include research databases, academic centers, government sites, and electronic journals. Personal resources such as mailing lists, anecdotal information, and advice pages are clearly categorized. Sites have been selected either for their uniqueness as an information resource or because they provide links to many more resources. Promotional and commercial sites have generally been excluded unless they provide impartial information resources.

http://www.chiroappointment.com/articles/health-care-information.html

http://altmed.od.nih.gov/

The Office of Alternative Medicine (OAM) was established in 1992, as a part of the National Institutes of Health (NIH). The NCCAM was established in 1998, in order to "facilitate the evaluation of alternative medical treatment modalities" to determine their effectiveness. The NCCAM conducts and supports basic and applied research and training and disseminates information on complementary and alternative medicine to practitioners and the public. It provides technical assistance in research education, networks experts in complementary and alternative medicine and research methods, and brings together researchers to prepare for grant applications. The NCCAM holds regular meetings with the Food and Drug Administration (FDA) to enlist its cooperation in re-evaluating current rules and regulations governing research on and the use of devices, acupuncture needles, herbs, and homeopathic remedies. The NCCAM also corresponds with many alternative medical organizations, providing them with information about research support and development.

Complementary Health Studies – University of Exeter U.K. http://www.ex.ac.uk/~prmaggs/lib/sschs.html

This provides a list of several databases and specific subject areas are highlighted e.g. reflexology , homeopathy as well as directories and resources. It also provides access to

FACT-Focus on Alternative and Complementary Therapies (http://www.ex.ac.uk/FACT/), a review journal that aims to present the evidence on complementary medicine in an analytical and impartial manner. It is written by research staff within the Department of Complementary Medicine, Postgraduate Medical School, University of Exeter. Contents pages from past issues are accessible here.

http://www.altmedicine.com/

The visitor to this site is welcomed with the statement 'Be aware that alternative health and healing covers everything from pure hogwash to promising and proven therapies'. This is, followed by some handy hints to help the consumer evaluate alternative medical approaches ('Be skeptical, but open-minded' and "Although anecdotal evidence may be valid, look for scientific evidence that a procedure works"). As well as daily news updates, diverse online resources are collected under separate sections. For example, the Diet and Nutrition page links to a Consumer Reports review of the top ten herbs that can heal, and the big bad five that can harm.

These sites allow one to search for articles on specific topics about alternative medicine.

www.softlineweb.com/althealth

Alt-HealthWatch is a full-text database of periodicals, peer-reviewed journals, academic and professional publications, magazines, consumer newsletters and newspapers, research reports, and association newsletters focused on complementary, alternative and integrated approaches to health care and wellness. Alt-HealthWatch provides in-depth coverage on both professional and consumer levels across the full spectrum of more than two hundred therapies, modalities and perspectives addressed by integrated medicine. Free text searching and complete indexing make Alt-HealthWatch easy to use. A search on a topic will indicate the source of an article, e.g. a peer reviewed journal vs. a newsletter.

http://odp.od.nih.gov/ods/databases/ibids.html

This is a database of published, international, scientific literature on dietary supplements, including vitamins, minerals, and botanicals. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, health care providers, and researchers in locating credible, scientific literature on dietary supplements. IBIDS was developed and is maintained through an interagency partnership with the Food and Nutrition Information Center, National Agricultural Library, and U.S. Department of Agriculture.

The IBIDS database currently contains over 300,000 scientific citations and abstracts. Due to copyright laws, IBIDS cannot provide full-text articles on the World Wide Web. However, it provides a journal list of over 1,500 publications with links to their web sites where one may order the full journal article. If desired, one can search on peer-reviewed journals only.

Southwest School Of Botanical Medicine- Plant Abstracts http://chili.rt66.com/hrbmoore/Abstracts/Abstracts.html

These are generally abstracts of research articles from the last 10 years, that predominantly include European and Asian plants.

These include sites that attempt to combat health-related frauds, myths, fads and fallacies.

http://www.quackwatch.com/

This is a nonprofit corporation whose primary focus is on quackery-related information.. Founded by Dr. Stephen Barrett in 1969, its activities include investigating questionable claims, answering inquiries, distributing reliable publications, reporting illegal marketing, improving the quality of health information on the Internet and attacking misleading advertising on the Internet

http://www.healthwatcher.net/

http://www.chirowatch.com/

Health Care Reality Check

http://www.hcrc.org/index.html

This site provides access to The Scientific Review of Alternative Medicine (http://www.hcrc.org/sram/index.html), a peer-reviewed medical journal dedicated exclusively to evaluating alternative medicine. There is also a news section with announcements about health fraud and an online Encyclopedia of articles about alternative medicine. There is also a dictionary of almost 1200 metaphysical healthcare methods.

Many adults and children are using alternative medicine in addition to traditional therapies to treat various medical conditions. Family physicians and pediatricians need to keep up with information about these alternative therapies. The Internet provides unprecedented ease of access on information about alternative medicine. Sites that provide relevant and `reliable information about alternative medicine are reviewed in this article.