Complementary and Alternative Medicines (CAM) encompass many different types of practitioners. They take a non-Western approach to healing. Chiropractic is often thought to be a part of these forms of treatment.
CAM and Western Medicine
Complementary and Alternative Medicine is a broad field of many diverse systems, operating differently than the (Western) medicine model; however, some medical practices have come to integrate this approach to healing into their treatment plans. CAM, when it is used at that same time as Western medicine, is called “complementary medicine” (i.e., using acupuncture to reduce pain during treatment). When CAM is used instead of Western medicine, it is called “alternative medicine”. Sometimes CAM and Western medicine are combined together in “integrated medicine”.1 Even some hospitals, such as the University of Colorado Hospital, have CAM and integrative medicine programs.2
Types of CAM
Complementary and Alternative Medicine can include mind/body therapies (the holistic model), as well as natural products and body manipulation practices. CAM practitioners may use herbal remedies, minerals, vitamins, and other supplements, such as probiotics and digestive enzymes. Mind/body therapies include yoga, meditation, and acupuncture. There are other mind/body practices as well, such as tai chi, deep-breathing, and hypnotherapy. Many of these treatments are over 2,000 years old. Body-based practices include spinal manipulation and massage therapy. In fact, many traditional medical offices now include these latter practices. Other types of CAM can include “movement therapies”, such as Pilates and Rolfing. Traditional and indigenous “healers” are also considered part of Complementary and Alternative Medicine (i.e., Native American medicine man). Magnet and light therapy, Reiki, and qi gong, which manipulate energy, are also CAM practices. There are older medical systems that are now considered CAM, including Ayurvedic and Chinese medicines. Homeopathy and naturopathy are more modern CAM systems.3
Is Chiropractic CAM?
There is some disagreement over whether or not chiropractic should be considered part of Complementary and Alternative Medicine. According to Dr. Lon Morgan, DC, DABCO, the effectiveness of the various CAM treatments is “controversial”. Some chiropractors wish to be part of Complementary and Alternative Medicine, even though Morgan feels “CAM approaches conflict with chiropractic ‘philosophy’”. If chiropractors are considered the same as naturopaths and energy healers, or if the treatment methods and “notions of the causes of disease” are so diverse and conflicting, it may not always benefit chiropractic, per Morgan. The chiropractors who wish to be considered CAM share the “Us vs. Them” commonality with the other practices (i.e., “CAM vs. medicine”). Morgan feels that the “schizophrenic approach to a chiropractic identity serves no one” since some alternative practices do not have the same rigorous standards that it takes to become a chiropractor.4 The American Chiropractic Association acknowledges that it can be positive that chiropractic is considered alternative healthcare because it is “one of the top two providers of choice”, which helps insurers respond to “public demand for alternative care”. With regard to insurance, however, the ACA recognizes that it may not be beneficial for chiropractic to be considered just alternative care. If chiropractic is part of mainstream insurance, patients will have better coverage for their chiropractic care. If insurers choose the “affinity product”, treating chiropractic the same as any other alternative provider, then the patient is left to pay a discounted, but cash, rate. The ACA opposes excluding chiropractors and does not support the affinity product. “Chiropractic care should be a benefit within all third party payer plans or programs”.5 The Affordable Care Act (healthcare reform law or “Obamacare”), which was upheld by the Supreme Court, contains a “provider non-discrimination provision”. ACA President Keith Overland, DC stated, “That makes it illegal for insurance companies to discriminate against doctors of chiropractic… the non-discrimination provision, when it is fully implemented, will extend the availability of chiropractic services”.6