Why complementary medicine doesn’t stand up to conventional medicine (and why that’s a good thing).

One in ten people in the UK use complementary medicine each year and 50% of those are lifetime users, despite it receiving repeatedly bad press and coming under increasing pressure from European laws.

So why doesn’t it stand up?
When you look at the total effect of any intervention (treatment), be it conventional or complementary & alternative medicine (CAM), there are five aspects that contribute to recovery (the following model is based on research done on back pain over a period of six weeks).

1. Regression to mean. This is where the extreme cases, at either end of the pain scale, move towards the middle (mean) of the scale over time.  This accounts for around 10% of the intervention.
2. Natural history of the problem.  In the case of back pain, from your previous experience, if you give it a few weeks, it can get better regardless.  This counts as another 10% of the intervention.
3. Specific effects.  This is the actual treatment given, whether it be medication, remedial massage, ice etc.  It may surprise you to learn that this also counts for only 10% of the intervention.  Drug companies only have to prove 10% effectiveness of medication for it to be granted a license.   
4. Non-specific effects.  This includes your rapport with the practitioner, the ritual of the treatment given, the surroundings, if you got stuck in traffic on the way and your blood pressure shot up as a result of all the miles of cones on the motorway and not a blooming workman in sight!  Together with the context/meaning/placebo effects (see below), up to 70% of the intervention efficacy relies on these two factors!
5. Context/meaning/placebo effects.  We all know of the placebo effect, but it is often dismissed.   Placebo is actually a good thing, as it still helps, and clearly demonstrates the power (and importance) of the mind in healing the body.

CAM doesn’t stand up to conventional medicine in the way in which the specific effect (which only accounts for 10% of the intervention) is researched.   Conventional medicine takes a ‘reductionist’ view, isolating the symptoms and looking objectively rather than subjectively.  This is how statistics are produced (or skewed – but that’s a whole other story) to show that X drug is more effective than no drug, and it’s what double blind, randomised controlled trials were designed for.   It’s hard to do these trials when CAM is based on holism, i.e. looking at the whole person - what they’ve had for breakfast in relation to the discomfort they’re in now.  By it’s very nature it’s subjective: I’m yet to meet a human being that isn’t affected by the fabric of life.

Why is CAM so popular?
Where CAM does outshine conventional medicine is in the non-specific effects.   CAM practitioners stand out against GPs, consultants and other conventional medical professionals as they have the time to talk to people, listen, reach out and look at the whole person.  Their treatment rooms are generally less clinical (avoiding white-coat syndrome), you don’t have to wait for months for an appointment and you’re more likely to find, and deal with, the root cause of the issue.

Conventional medicine has only been around for the last 100 years or so, yet it’s grip on the western world is all pervading and mighty powerful.   So what we need is a new (or perhaps recycled) paradigm.  One where the effectiveness of the treatment is measured not by statistics but by the patients themselves, by case histories, by generational, traditional, tried and trusted methods, built on holism and the inter-connectedness of humans, animals, plants, the planet, the universe…  You get my drift.