Complementary and alternative medicine. (The Alert Collector).(Book Review)

Complementary and alternative medical therapies ranging from acupuncture to yoga are becoming mainstream. Evidence of this is the December 2, 2002, cover story in Newsweek magazine which explored the science of alternative medicine. According to this feature article, almost half of American adults seek treatment from outside the traditional medical system. An increasing number of physicians are integrating these therapies into conventional medicine. In addition, several leading medical schools have established centers for integrative medicine, and many more have established curricular offerings in complementary and alternative medicine. The federal government has also taken note of this important trend with the establishment of the National Center for Complementary and Alternative Medicine.

This guest columnist is uniquely qualified to write on this topic. In addition to holding a Ph.D. in Communication, Information and Library Studies from Rutgers University, he holds a Doctor of Naturopathy from Trinity College of Natural Health. He is also a Reiki practitioner. Since 1993, Crawford has been Head of Public Services at the Penn State Harrisburg Library. Previously he served as Reference and Public Services Librarian and Automation Project Director at Moravian College. He is a prolific author, having written on topics as diverse as the ownership of religious texts by academic libraries, bestsellers in academic libraries, professional standards for college libraries, and issues for digital libraries. His articles have appeared in Reference & User Services Quarterly, College & Research Libraries, the Journal of Academic Librarianship, the Journal of Government Information, Computers in Libraries, Internet Reference Services Quarterly, Health Care on the Inter net, the Journal of Higher Education, and other leading professional journals. Crawford is also a frequent reviewer of reference books and has presented at more than forty conferences and meetings. He has a long record of committee service within the Reference and User Services Association. In addition, he is active in his local community, currently serving as a member of the Hershey (Pennsylvania) Public Library Endowment Board.--Editor

When one thinks of complementary and alternative medicine, the first question is usually, "What is it? Generally abbreviated CAM, complementary and alternative medicine can conjure up a variety of meanings. To some, anyone practicing CAM is a "quack." To others, allopathic (Western) medicine itself is accused of being nothing more than a system that pushes toxic drugs onto compliant patients. The truth, of course, lies somewhere in the middle. As Andrew Weil says:

 
   Alternative medicine is now the 
   fastest-growing sector of American 
   health care. Despite continuing 
   objections from the rearguard 
   of the scientific establishment, 
   many forward-looking doctors 
   have begun to recognize the 
   virtues of complementary medicine. 
   As for the American consumer, 
   millions are voting with 
   their feet and their pocketbooks 
   for treatments other than those 
   conventional physicians are 
   trained to provide. Alternative 
   medicine is clearly moving into 
   the mainstream. (1) 

Weil teaches at the University of Arizona's Medical School in the Integrative Medicine Program, a program that introduces allopathic physicians to the world of CAM so that they can incorporate it into their medical practices. Many hospitals and medical schools have established similar programs, and some CAM therapies are a regularly accepted part of medical care.

One great driving force behind this trend is the number of people using CAM, often as an adjunct to traditional medical care. According to a 1998 article in the Journal of the American Medical Association that examined the trends in the use of alternative medicine in the United States, 42.1 percent of the respondents to the survey indicated they had used an alternative therapy during the previous year. (2) These therapies included herbal medicine, massage, megavitamins, energy healing, and homeopathy. In addition, most of these individuals paid the expenses out of their own pockets, although 36 percent had some of the expenses covered by insurance. The authors of the article estimated that there were 629 million visits to alternative medicine practitioners in 1997 versus 427 million in 1990. These are startling numbers when one considers that there were an estimated 386 million visits to all primary care physicians in 1997 and 388 million in 1990. They also conservatively estimated that $27 billion was spent on CAM services and products during 1997--a figure that rivals the estimated $29.3 billion spent in 1997 for out-of-pocket expenditures for all U.S. physician services, including out-of-pocket expenditures for hospitalizations.

According to Blumenthal, in 1997 a total of more than $441 million was spent solely on herbal supplements in food, drug, and mass-market retail outlets in the United States. (3) The leading sellers were ginkgo (more than $90 million in sales), ginseng ($86 million), and garlic ($71 million). Echinacea and St.-John's-wort each accounted for more than $45 million in sales. These figures, however, do not show the true scope of the market for herbs. It was estimated that the retail value of herbs sold in the United States for 1996 alone was actually approximately $3.24 billion, an average of $54 per person. (4) That year it was estimated that sixty million adult Americans, or one-third of the adult population, used herbal medicines.

CAM represents a significant and growing presence in the medical landscape of the United States. Libraries must be cognizant of this trend so that they can supply materials that treat these topics; but deciding what to collect can be difficult. A recent search of the Amazon.com book database for the terms "alternative health" yielded more than 3,500 hits while "alternative medicine" resulted in more than 2,500 results. These searches, however, did not find most of the books on topics related to CAM, especially those on specific therapies.

Defining the scope of complementary and alternative medical therapies is difficult. More difficult is choosing the materials to include in such an abbreviated listing of resources. For this review, the major types of CAM are covered, including non-Western medical systems, natural healing techniques, and energetic healing therapies. Thus, the items listed can be considered representative, although many are excellent sources in their own right.

General Resources

Bright, Mary Anne, ed. Holistic Health and Healing. Philadelphia: F. A. Davis Co., 2002. (ISBN 0-8036-0796-2).

This book focuses on sixteen commonly used alternative and complementary therapies that can be readily found in the United States today. The work, which is designed for use in college nursing and health courses or as a resource for practicing healthcare providers, is organized into four main sections: health as wholeness; holistic healing modalities; complementary healing practices; and traditional healing systems. The first section, health as wholeness, discusses the paradigm shifts currently happening within healthcare, the bioenergetic basis of health, the psychophysiology of mind-body healing, the relationship of culture and holistic healing, and global health issues. Within the holistic healing modalities section, chapters include meditation, imagery, nutrition, herbs, massage, and therapeutic touch. In the third section, the complementary health practices of naturopathy, homeopathy, anthroposophic medicine, osteopathy, chiropractic, and holistic dentistry are highlighted. Finally, Chinese medicine, Ayurveda, yoga, and t'ai chi are discussed in the last section. Under each modality, the chapter authors have included clinical examples and current research on efficacy, in addition to historical background, the philosophical and theoretical basis, a case example, and references.

Fontanarosa, Phil B., ed. Alternative Medicine: An Objective …