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Evolution of CAM Terminology
As interest in and use of non-mainstream health care practices has evolved in this country over the past several decades, the terminology used to describe CAM systems, practices, and products have had to evolve accordingly. Rather than focus on what these "other" health care systems are not (i.e., "unorthodox, "unconventional," or "unscientific"), more recent terminology has begun to focus on what these systems are and how they might be used.
For example, because many consumers appeared to be using unconventional health care practices as alternatives to conventional health care, the term "alternative medicine" was widely adopted in the United States and Europe in the later 1980s. This perception, however, was largely dispelled by surveys in the early 1990's, which found that people were using the two systems of health care mainstream and alternative-simultaneously. These surveys found that health care consumers were accessing a range of therapeutic and preventive options, both alternative and conventional, to essentially "complement" one another. As a result, the term "complementary medicine" was widely adopted not long afterwards to describe systems of health care and individual therapies that people used as adjuncts to their conventional health care.
A more recent and detailed survey conducted by Astin has found that, although many unconventional therapies were being used to complement mainstream medical care, some were being used instead of conventional medical care. These data suggested that the term "complementary" was only partially descriptive of what was occurring in the marketplace. To acknowledge this dichotomy, Congress adopted the phrase "complementary and alternative medicine" and applied it to the National Institutes of Health's National Center on Complementary and Alternative Medicine (NCCAM), when the Office of Alternative Medicine was elevated to the status of a coordinating research "Center" in 1999.
Even this terminology is unsatisfactory to many because it does not reflect emerging models of health care that have arisen in the overlapping areas between these various systems. Nor does it account for the fact that health care systems, practices, and products that are not widely accepted or readily available in one part of the United States may be fully accepted and easily available in another. Members of the Commission considered other terms, such as "integrative health care," " collaborative health care," "comprehensive health care," and ""holistic health care," but chose to use the term "complementary and alternative medicine" because it is used in the President's Executive Order and is widely recognized by the media and in the scientific literature.
To fully understand the complexities of CAM as well as its current relationship with conventional health care in this country, it is necessary to understand its recent history, its current status, and future prospects, including emerging models of integrative and collaborative care.