Complementary And Alternative Medicine Professions Research Articles

The regulation of complementary and alternative medicine professions in Ontario, Canada

BackgroundThis paper explains the regulation of complementary and alternative medicine (CAM) health professions, through the comparison of four distinct examples in Ontario, Canada including: chiropractors, naturopaths, homeopaths, and traditional Chinese medicine (TCM) practitioners. MethodsThis study analyzes the agenda setting and formulation stage of the policy process. In other words, it explores what happened between stakeholders before each of these CAM professions achieved regulation. Alford’s model of dominant, challenging and repressed structured interests (DSIs, CSIs, and RSIs respectively) is used to describe the competition between various players within the healthcare system and their position in the health policy process. ResultsAll four CAM professions have existed as a RSI at some point in their history, however, over the last century has sought to align themselves with various (or even become) challenging structural interests (CSIs) in order to be recognized as a regulated health profession. Dominant structural interests (DSIs), particularly the medical profession, initially largely ignored these professions’ practices, unless sufficient public support of CAM practitioners’ therapies warranted them to consider the need to regulate them. ConclusionUnregulated CAM professions may increase their likelihood of becoming regulated if they: (1) gain popularity/strong support from patients or the general public, (2) organize themselves sufficiently that they pose a direct threat to one or more scopes of practice desirable by the DSIs and/or (3) are willing to adopt standards in education, training, and ethics that may [initially] reduce their scope of practice or profession’s membership or slow their profession’s growth.

The association between the use of biomedical services and the holistic use of traditional East Asian medicine: a national survey of outpatients in South Korea

ObjectivesThe holistic use of a system of complementary and alternative medicine (CAM) is potentially linked to its treatment outcomes. This paper examines how the use of biomedicine is associated with...

Barriers to the conduct and application of research in complementary and alternative medicine: a systematic review

BackgroundThe popularity of Complementary and alternative medicine (CAM) has grown considerably over the past few decades. This has been accompanied by increasing public pressure for CAM to be evidence-based. Notwithstanding, the conduct and application of research in CAM faces a number of obstacles. No systematic review has mapped these barriers to date. Therefore, this systematic literature review aimed to explore, identify and map the barriers to the conduct and application of research in CAM.MethodsSystematic searching of MEDLINE, Embase, AMED, CINAHL, The Cochrane library, Google scholar and Google was conducted between February and June 2016 for pertinent publications. Pearling (secondary searching) of retrieved publications was also undertaken. Literature published only in English were included; however, no year limit was placed for searching. Two critical appraisal tools were used to critically appraise descriptive studies and opinion publications.ResultsA total of 21 eligible publications were included in this review; this comprised of eight primary research articles and thirteen opinion publications. A critical appraisal process found two categories of good quality publications while recognising their limitations in terms of descriptive and opinion publications. The synthesised data from the selected publications about the barriers to the conduct and application of research within CAM were captured within two broad components, namely capacity and culture. Capacity encompassed elements such as access, competency, bias, incentives and time. Encompassed within culture were elements relating to the values and complex system of CAM.ConclusionsMultiple barriers exist for the conduct and application of research in CAM. Given the growing popularity of these therapies, it is essential that the evidence base underpinning CAM also continues to expand. Without overt recognition of these barriers, enabling strategies cannot be applied. By addressing these barriers, CAM professions will be able to develop a critical mass and a well-coordinated research effort to assist the integration of evidence – based practice in CAM.

Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis

ObjectivesThe purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope. MethodsThis study used a 2-stage exploratory grounded approach. In stage 1, we identified how CAM is represented (if considered as professions vs modalities) across a purposely sampled diverse set of policy topic domains using exemplars to describe and summarize each. In stage 2 we convened 2 stakeholder panels (12 CAM practitioners and 9 health policymaker representatives), and using the results of stage 1 as a starting point and framing mechanism, we engaged panelists in a discussion of how they each see the dichotomy and its impacts. Our discussion focused on 4 licensed CAM professions: acupuncture and Oriental medicine, chiropractic, naturopathic medicine, and massage. ResultsWorkforce policies affected where and how members of CAM professions could practice. Licensure affected whether a CAM profession was recognized in a state and which modalities were allowed. Complementary and alternative medicine research examined the effectiveness of procedures and modalities and only rarely the effectiveness of care from a particular profession. Treatment guidelines are based on research and also focus on procedures and modalities. Health plan reimbursement policies address which professions are covered and for which procedures/modalities and conditions. ConclusionsThe policy landscape related to CAM professions and modalities is broad, complex, and interrelated. Although health plan reimbursement tends to receive the majority of attention when CAM health care policy is discussed, it is clear, given the results of our study, that coverage policies cannot be addressed in isolation and that a wide range of stakeholders and social institutions will need to be involved.

‘Quackery’ in the Academy? Professional Knowledge, Autonomy and the Debate over Complementary Medicine Degrees

In 2012, the group ‘Friends of Science in Medicine’, mostly comprising academic doctors and scientists, lobbied to remove teaching in complementary and alternative medicine (CAM) from Australian universities. Seemingly inspired by an earlier UK-based campaign, the group approached vice-chancellors and the media, arguing that CAM degrees promoted ‘pseudo-science’ and ‘quackery’. Although epistemological disputes between biomedicine and CAM are well documented, their emergence in a higher education context is less familiar. This article explores the position-taking of those on each side of the debate, via a thematic analysis of stakeholders’ views as reported in news articles and other outlets. Bourdieu’s concepts of capital and autonomy are used to sketch out the stakes of the struggle. It is argued that the debate is significant not only for what it reveals about the current status of CAM professions in Australia, but for what it suggests more broadly about legitimate knowledge in the university.

The Role of CAM in Public Health, Disease Prevention, and Health Promotion.

As the worldwide burden of chronic disease continues to rise, disease prevention and health promotion become increasingly important components of public health. Although many complementary and alternative medicine (CAM) practices have emphasized health promotion and the area of CAM health care holds much opportunity and challenge for issues of public health, CAM research to date has been dominated by more clinically restrictive issues [1, 2]. However, CAM practitioners can constitute a public health resource to increase the population's access to certain clinical preventive services if integrated into mainstream public health practice. As part of this integration of CAM practices, it is important to investigate methods of effective interprofessional collaboration involving both CAM and mainstream professions. It is also essential to identify issues that might be challenging to integration from the perspective of both mainstream and CAM providers such as professional biases on both sides, differences in perception of health and disease, common language, and adherence to evidence-based principles. This special issue includes original research papers and systematic reviews investigating the issues related to CAM practices in the public health arena as well as outcomes of CAM treatment for chronic disease prevention and/or management (tertiary prevention). There are 14 articles in this issue, from six countries and on a wide variety of topics. The topics addressed are almost equally divided between treatment of specific conditions of public health importance and disease prevention through risk factor reduction. A smaller number of articles address issues related to traditional medicine use among the general public. Articles on treatment of conditions include a large clinical study by J.-F. Tang et al. on safety and evaluation of Danhong injection; a basic science study on Brucea javanica oil by Y. Liu et al.; a systematic review and meta-analysis of the efficacy of compound kushen on cancer pain by X. Ma et al.; an analysis of Qigong's effect on chronic fatigue syndrome by L. P. Yuen et al.; a systematic review of acupuncture for allergic rhinitis and asthma by L. Zhou et al.; and an analysis of the effects of guided imagery on patients on mechanical ventilation by B. Brakovich et al. Articles on prevention and risk factor reduction were a randomized controlled trial of Tai Chi on weight loss, metabolic syndrome, and bone mineral density by T. C.-Y. Kwok et al.; an analysis of body constitution through Traditional Chinese Medicine by C.-H. Lee et al.; a survey of apitherapy use for disease prevention by S. Trumbeckaite et al.; an exploration of the possible effect of CAM on antibiotic resistance by W. B. V. Leeuwen et al.; and a survey of the effect of Traditional Chinese Medicine on decreasing stroke risk among users of corticosteroids for dermatitis by J.-L. Shen et al. Finally, F. Xu et al. described the validation of a questionnaire based on Traditional Chinese Medicine to assess health status; S. H. Ng et al. described use of the Theory of Planned Behaviour related to Traditional Chinese Medicine use; and G. D. Hughes et al. characterized the use of herbal medicines for noncommunicable disease. These articles tended to focus more on single herbal or other traditional preparations or procedures for both treatment and prevention, with very little emphasis on health behaviour, which is typically a cornerstone of public health programs. Behaviours related to diet, physical activity, and stress reduction are known to be increasingly important factors in determining the health of the public and are also areas of importance and emphasis for many CAM practitioners. It is necessary for CAM professions to become visible in this arena and for CAM research to extend into this direction rather than focusing narrowly on specific therapies if these efforts are to be recognized and utilized for the benefit of populations. Cheryl Hawk Jon Adams Jan Hartvigsen

Educating for collaboration: The outcomes of an interprofessional education workshop for complementary and alternative maternity care providers

ObjectivesDespite high community use of complementary and alternative medicine (CAM) poor collaboration between conventional and CAM practitioners have been identified in many health sectors including maternity care. This is in part associated with a deficit in the formal training of CAM practitioners which overlooks collaborative practice skills and guidelines. This study evaluates the outcomes of an interprofessional education workshop which endeavours to improve the collaborative practice of CAM practitioners providing care to pregnant women. MethodsA pre-workshop and post-workshop questionnaire which evaluated the participants’ perception of self-proficiency and their interprofessional practice behaviours when providing maternity care. Descriptive and inferential statistical analysis of the data was undertaken. ResultsCAM practitioners (n=30) providing care to pregnant women participated in the project. Prior to taking part in the workshop a low level of confidence in pregnancy-specific physiology and psychology knowledge more broadly but also poor confidence in engaging with conventional maternity care providers and understanding conventional models of maternity care was identified amongst participants. Participants who felt more positive about their knowledge of pregnancy and birth physiology were more likely to enquire about women's conventional care and discuss safety issues with women in their care. Following workshop involvement the participant's awareness of the models of maternity care available to Australian women improved alongside participants’ knowledge of the scope and role of obstetricians and midwives. There was a reduced need by participants to have their role acknowledged by conventional care providers as important to enable effective collaboration after workshop completion. ConclusionsInterprofessional education is argued to be a valuable tool to promote interprofessional collaboration and communication. It may be employed as a useful tool to encourage stronger links and improved integration between CAM and conventional health professionals.

Referral to Massage Therapy in Primary Health Care: A Survey of Medical General Practitioners in Rural and Regional New South Wales, Australia

ObjectivesMassage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. MethodsA 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. ResultsA total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as “no longer at this address” (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. ConclusionsThere appears to be substantial interface between massage therapy and GPs in rural and regional Australia. There are high levels of support for massage therapies among Australian GPs, relative to other CAM professions, with low levels of opposition to the incorporation of these therapies in patient care.

What is the Academic Consortium for Complementary and Alternative Health Care (ACCAHC)?

The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) is a multidisciplinary, collaborative not-for-profit charitable organization created to improve patient care. This mission is accomplished through fostering mutual respect and understanding between various disciplines and emerging fields, mainly through interprofessional education, engagement in key policy initiatives, and the promotion of whole-person research. There are five core disciplines involved in ACCAHC (acupuncture and Oriental medicine, chiropractic, direct-entry midwifery, naturopathic medicine, and massage therapy), and three emerging fields (Ayurveda, homeopathy, and Yoga therapy). Membership seats are held by the council of colleges, plus the accrediting and certifying agencies of these disciplines. Other members are emerging CAM professions who are striving to meet regulatory standards in the United States. Why Is ACCAHC Necessary? The structure of health care in the United States is changing. Based on recent statistics, four out of ten Americans utilized some form of complementary and alternative medicine (CAM) within the past 12 months(1). According to the Bravewell Collaborative(2), “Over the past two decades, there has been documented growth in the number of clinical centers providing integrative medicine, the number of medical schools teaching integrative strategies, the number of researchers studying integrative interventions, and the number of patients seeking integrative care.” With such extensive growth, integration of CAM and conventional health care is imperative. ACCAHC is an organization dedicated to the optimal integration of CAM practitioners and professions into mainstream medicine. Such collaboration among the CAM disciplines and emerging fields strengthens and unifies this effort.

P03.17. A fellowship program for CAM providers in evidence informed geriatrics

Purpose Elderly residents in long term care (LTC) settings experience a myriad of health complaints that may be amenable to complementary and alternative medicine (CAM) therapies. However, specialized training addressing the unique features of geriatric health care, particularly in LTC settings, will be required if CAM professionals are to play a meaningful role. The purpose of this presentation is to describe an evidence informed geriatric fellowship program at a CAM institution which educates acupuncture, chiropractic and massage therapy practitioners.

P04.81. Mapping the natural health landscape: New Zealand-based CAM professionals survey

Purpose Complementary and Alternative Medicine (CAM) is increasing in New Zealand (NZ). As public interest in the use of CAM grows, political recognition has become increasingly topical. However, no NZ-based, empirical study of CAM professionals has been performed. The survey reported here provides a direct response to this important research gap. It examines key aspects of practice, demographics, attitudes and beliefs held about integrative medicine, CAM regulation and research attempting to quantify CAM contribution towards public health in NZ.

Notes on the Relations between CAM and the Social Sciences

Hans Baer and colleagues (this issue) argue that critical medical anthropology (CMA) can help naturopathy to develop a more holistic concept of health that includes the role of environmental and social structural factors. On the basis of the reactions of three naturopaths who were his students in Australia and the reception to talks that he gave at naturopathic colleges in the United States, he suggests that naturopaths and other practitioners of complementary and alternative medicine (CAM) may be open to the proposition of a CMA–CAM synthesis. Although I am sympathetic to the general proposition that much is to be gained from a dialogue between social scientists and CAM researchers and professionals, I suggest three cautions about the specific proposition that a CMA–CAM synthesis has long-term potential. The first caution comes from personal experience that draws attention to some of the divisions within CAM fields. I was once invited by a prominent member of the chiropractic research community to present my research at a leading conference on chiropractic research, which included reports by the top researchers on their clinical trials research and other forms of evidencebased research. My work on the history of intellectual suppression for medical researchers who operated outside the mainstream of cancer research and therapy was invited to be part of a plenary session on bias in medicine. The session also included discussions of chiropractic researchers who had experienced hostile reviews and a broader discussion of the industrial connections of researchers and editors at leading medical journals. Notwithstanding the prominence of my host in the chiropractic research community and the importance of bias against chiropractic research in mainstream medical journals, the topic of our session became controversial. Some of the chiropractic researchers who were gaining a position in the clinical trials research funding system and winning acceptance for their work as a complementary modality were concerned with the potential negative implications that a critical analysis of bias in clinical trials research and journal publications would have on their inroads into mainstream medical research. They also were concerned that discussions of publication bias and intellectual suppression would fuel antiresearch sentiment among rank-and-file practitioners. As a result, the session was pushed off the program and offered as a rump session for those who wished to stay after the conference ended. The example suggests that when discussing issues of the integration of social science research into CAM fields, attention must be paid to divisions within the CAM fields. As medical integration proceeds, the

Advancing Integration Through Evidence Informed Practice: Northwestern Health Sciences University's Integrated Educational Model

A consistent theme running through the healthcare debate is the need for new care models that include collaborative, team-based care. There is also growing recognition that interprofessional education is critical to achieving collaborative, patient-centered care. Not unlike conventional, biomedical professions, CAM (complementary and alternative medicine) professions have also educated students in silos with little interaction between various disciplines. Northwestern Health Sciences University, under their NIH NCCAM-funded R-25 grant, is breaking new ground in requiring that their students in chiropractic, massage, and OAM complete a common course in evidence informed practice. A previous Explore column described the core competencies that the students are required to achieve. This column focuses on the practicalities and challenges of offering a course to students enrolled in three different degree programs. Perhaps it will stimulate readers to consider how we might achieve interprofessional education that brings together all health professional students, biomedical and CAM.

Complementary and alternative medicine (CAM) professional practice and safety: A consensus building workshop

The use and practice of complementary and alternative medicine (CAM) may have potential safety issues. These may relate to practitioner competence, product quality, interactions with medication and non-compliance with conventional medicine. Safety is central to all healthcare practitioners and is an area where CAM groups should work together to achieve consensus.With many CAM professions in the UK moving towards regulation, the Research Council for Complementary Medicine (RCCM) recognised the need for consensus between professions on the best way forward for collecting and using safety data. A 3hour consensus workshop of UK CAM professional body representatives was convened. Results highlighted the importance of, and challenges inherent in, collecting CAM safety data. The definition of safety was discussed, in particular variation in adverse effects between therapies and recognition of both practitioner and product safety issues. A range of methods of collecting safety data were suggested, with triangulation of many approaches felt to be most useful. The main problem in recording adverse event data within practice was identified as the barrier of distrust. However, three examples of safety data collection projects were cited, which were all well received by practitioners, suggesting that developing such a scheme across CAM professions is a valuable endeavour. It is important to demonstrate the benefits or ‘rewards’ of collecting such data to practitioners, rather than ‘punish’ non-collection.We suggest that new schemes are piloted with a small, local groups of practitioners, and supported by their professional organisations. Feedback from the professional bodies represented at the workshop was very positive and suggests that in the UK they are keen to move forward with the safety agenda. We would welcome comments from other countries on the safe practice of CAM.

A Train the Trainer Model for Integrating Evidence-Based Medicine into a Complementary and Alternative Medicine Training Program

Public interest in complementary and alternative medicine (CAM) has grown over the past decade, accompanied by increased demand for evidence-based approaches to CAM practice. In order to define the role evidence-based decision making has in CAM practice, CAM professionals must have a full understanding of evidence-based medicine (EBM) concepts. This paper describes the design, implementation, and evaluation of a week-long intensive EBM short course for CAM faculty at a naturopathic and classical Chinese medicine institution. This 20-hour course, entitled Principles of EBM for CAM Professionals, teaches participants how to access and appraise biomedical literature, apply it to their work, and teach these concepts to their students. Results from precourse and postcourse evaluations suggest that, in a small group of participants, there were significant changes in EBM practice attitudes, self-appraised skills, and objectively assessed skills as a result of this course. Participants indicated they were committed to increasing their use of EBM in practice, enhancing EBM skills, using EBM in teaching, and working to change the culture at their institution to support use of EBM. At six months, 80% of participants had fully or partially followed through on their commitment to change plans.

Values in complementary and alternative medicine

In recent years so-called Complementary and Alternative Medicine (CAM) practices have made significant political and professional advances particularly in the United Kingdom (UK): osteopathy and chiropractic were granted statutory self-regulation in the 1990s effectively giving them more professional autonomy and independence than health care professions supplementary to medicine; the practice of acupuncture is widespread within the National Health Service (NHS) for pain control; and homoeopathy is offered to patients by a few General Practitioners alongside conventional treatments. These developments have had a number of consequences: one is that both CAM and Conventional and Orthodox Medical (COM) professions have had to reappraise their professional identity. In manual therapy for example, questions have been asked about the differences between physiotherapy, osteopathy and chiropractic, and what the justification is for having separate professions. A wider question concerns the relationship between CAM and COM; are CAM distinct professions or should they, as has happened to a limited extent in the UK, be absorbed into the broader field of 'Medicine' or 'Health Care' as adjunctive therapies. CAM professions have also had to develop, implement and enforce codes of practice for practitioners and clarify the scope of practice within a profession. At the heart of these issues lies the need to identify and clarify professional values. A key claim of CAM professions is that their practice is distinct and the outcome of treatment at least as effective and in many cases more effective than with conventional therapies. In addition, what counts as effective outcome is often different from conventional medical understanding, involving more subtle humanitarian considerations, for example. Three values are identified as being commonly held across CAM professions. These are: offering 'natural' treatment; being patient rather than disease focussed; and being holistic. However, these may not be as distinctive of CAM as is claimed either because the meaning is unclear or because COM professions claim similar values. The paper argues that the values that inform 'good practice' and 'effective outcome' should be seen as distinct components of professional competence. This has implications for establishing professional identity and codes of practice.

Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey

BackgroundComplementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate.Methods218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey©®.ResultsA total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator ®, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon.ConclusionsThis mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic, CAM professionals, and pediatric healthcare providers. The pediatric diplomate certificate was established in 1993 and provides didactic education over a 2 to 3 year span. The results of this study can be used for historical information as this specialty continues to grow.

An overview of 45 published database resources for complementary and alternative medicine

Complementary and alternative medicine (CAM) has succeeded to implement itself in the academic context of universities. In order to get information on CAM, clinicians, researchers and healthcare professionals as well as the lay public are increasingly turning to online portals and databases, which disseminate relevant resources. One specific type of online information retrieval systems, namely the database, is being reviewed in this article. This overview aims at systematically retrieving and describing all databases covering the field of CAM. One of the requirements for inclusion was that the database would also have to be published in a medical journal. The databases AMED, CAMbase, EMBASE, and MEDLINE/PubMed were searched between December 2008 and December 2009 for publications relevant to CAM databases. The authors' specialist library was also searched for grey literature to be included. All included databases were then visited online and information on the context, structure and volume of the database was extracted. Forty-five databases were included in this overview. Databases covered herbal therapies (n = 11), traditional Chinese medicine (n = 9) and some dealt with a vast number of CAM modalities (n = 9), amongst others. The amount of time the databases had been in existence ranged from 4 to 53 years. Countries of origin included the USA (n = 14), UK (n = 7) and Germany (n = 6), amongst others. The main language in 42 of 45 databases was English. Although this overview is quite comprehensive with respect to the field of CAM, certain CAM practices such as chiropractic, massage, reflexology, meditation or yoga may not have been covered adequately. A more detailed assessment of the quality of the included databases might give additional insights into the listed resources. The creation of a personalised meta-search engine is suggested, towards which this overview could be seen as a first step.

A Culture of Dissent: Australian Naturopaths’ Perspectives on Practitioner Regulation

Despite the recommendations in 2006 that naturopaths and Western herbal medicine practitioners be more closely regulated, there have been no moves toward state-mandated (statutory) registration or licensure of naturopaths in any Australian state or territory. Debate within the naturopathic profession on the appropriateness of statutory practitioner regulation has historically contributed to dissent and the creation of organizational factions. In turn, the opposing factions and resulting disunity are disincentives for government endorsement of statutory registration. This article provides an overview of the naturopathic profession in Australia and the regulatory quest, highlighting how professional marginalization and the pursuit of state protection have fueled the push for statutory registration. Considering the extent of public support for complementary and alternative medicine (CAM) practices, the unification of the dissenting factions within the naturopathic profession could create a powerful group, one in which current self-regulatory mechanisms might be more effective, so negating some of the perceived needs for statutory regulation. However, with the increasing use of CAM and most health professions regulated via registration Acts, there are significant arguments to support statutory registration for naturopaths in a manner similar to other health care professionals.

Medicine by the patient’s definition

Medicine by the patient’s definition