CAMLAW: Complementary and Alternative Medicine Law Blog

Holistic dog online reports on CAM treatments

Care for your holistic dog, and learn whether CAM is a treat or treatment.

Holistic Dog Online reports that JAAIMOnline Offers AAIM Members an Opportunity:

The American Association of Integrative Medicine. multidisciplinary approach to medicine provides the maximum therapeutic benefit. AAIMs advocacy for broader treatment options facilitates bond between integrative and Western medicine.

AAIMs advocacy for broader treatment options facilitates bond between integrative and Western medicine. The end result is gathering place for healers, educators and researchers from all specialties to compare notes and combine forces, benefiting both the patient and the health care provider. Latest issues of JAAIMOnline available! The issue of JAAIMOnline is available to readers with six new articles on integrative medicine related issues. multidisciplinary approach to medicine provides the maximum therapeutic benefit. Articles The American Association of Integrative Medicine AAIM recognizes that health is more than the absence of disease.

JAAIMOnline Offers AAIM Members an Opportunity to Share With and Educate Their Peers About Their Field of Expertise Read the article submission guidelines for JAAIMOnline, The Online Journal of the American Association of Integrative Medicine Adds OnLine Newsletter to Growing List ofMember Benefits. Hear what our members have to say about AAIM.... Visit the Redcross Site for local chapter and donations.

AAIMs advocacy for broader treatment options facilitates bond between integrative and Western medicine. Visit the Redcross Site for local chapter and donations.

Articles The American Association of Integrative Medicine. Approvals and Accreditations cosponsored by the American College of Forensic Examiners International American Psychological Association APA California Board of Registered Nurses CABRN National Association of State Boards of Accounting NASBA Accreditation Council of Continuing Medical Education ACCME Association of Social Work Boards ASWB National Board of Certified Counselors NBCC AAIM seeks to advance the goals of the Integrative Medical Professional on variety of levels...

An energy medicine website reports on An analysis of news media coverage of complementary and alternative medicine. (medicine side effects):

An analysis of news media coverage of complementary and alternative medicine.

PLoS ONE. 2008;3(6):e2406

Authors: Bonevski B, Wilson A, Henry DA

BACKGROUND: To examine the accuracy and adequacy of lay media news stories about complementary and alternative medicines and therapies. METHODOLOGY/PRINCIPAL FINDINGS: A descriptive analysis of news stories about complementary and alternative medicine (CAM) in the Australian media using a national medical news monitoring website, mediadoctor.org.au. Each story was rated against 10 criteria by two individuals. Consensus scores of 222 news articles reporting therapeutic claims about complementary medicines posted on mediadoctor.org.au between 1 January 2004 and 1 September 2007 were calculated. The overall rating score for 222 CAM articles was 50% (95% CI 47% to 53%). There was a statistically significant (F = 3.68, p = 0.006) difference in cumulative mean scores according to type of therapy: biologically based practices (54%, 95% CI 50% to 58%); manipulative body based practices (46%, 95% CI 39% to 54%), whole medical systems (45%, 95% CI 32% to 58%), mind body medicine (41%, 95% CI 31% to 50%) and energy medicine (33%, 95% CI 11% to 55%). There was a statistically significant difference in cumulative mean scores (F = 3.72, p = 0.0001) according to the clinical outcome of interest with stories about cancer treatments (62%, 95% CI 54% to 70%) scoring highest and stories about treatments for children's behavioural and mental health concerns scoring lowest (31%, 95% CI 19% to 43%). Significant differences were also found in scores between media outlets. CONCLUSIONS/SIGNIFICANCE: There is substantial variability in news reporting practices about CAM. Overall, although they may be improving, the scores remain generally low. It appears that much of the information the public receives about CAM is inaccurate or incomplete.

PMID: 18545688 PubMed - indexed for MEDLINE


Energy Medicine

reiki healing

In North Carolina, an insurance dispute closes a clinic that offered alternative therapies:

A popular Chapel Hill alternative medicine clinic has closed after insurer Blue Cross and Blue Shield of North Carolina decided to stop reimbursing patients for many of the clinic's services. Plum Spring Clinic, which was located in Southern Village, officially shut down Aug. 1, though some staff members continued to see patients at the clinic's offices through the end of the month.

The majority of the clinic's patients were Blue Cross policy holders, and as a result the clinic could not continue to operate following the company's decision, said medical director Michael Sharp.

Sharp declined to comment further on the specifics of the Blue Cross decision. He referred questions to a statement on the clinic's Web site noting that the insurer's decision was based on the opinion that the clinic's services - which included acupuncture, psychotherapy and nutritional testing - are alternative and holistic treatments that aren't medically necessary.

"The dispute with Blue Cross Blue Shield is still active," Sharp said, adding that his lawyer advised him to keep additional details of the dispute private.

A spokesman for Blue Cross said the company also would not comment on the case because Sharp has retained legal counsel.

Sharp said 27 people lost their jobs when the clinic closed, but many of the medical professionals from the clinic will continue to practice in the Chapel Hill area.

"I think most of the people have found another place to practice," he said. "Some people are deciding to take a break."

Many of the clinic's patients were upset about the closing and the Blue Cross decision, Sharp said. The clinic saw 6,000 patients in its more than seven years of operation.

"There were a lot of people that felt that they had the rug pulled out from under them," he said. While the services and treatments offered by the clinic are available elsewhere, patients might not be able to receive insurance coverage.

Isabelle Geffner, spokeswoman for Duke Integrative Medicine, which specializes in alternative treatments, said she was unaware of any other insurance-related closings. She added that insurance companies' failure to cover alternative medicine is a major problem facing the field.

"We recognize that ultimately we need to reform the health care system so the kind of care we are modeling is available to every patient," Geffner said.

Lew Borman, program manager for Blue Cross's corporate communications, said the company's policies regarding alternative medicine have not changed.

"Anything that's considered investigational we don't cover," Borman said, noting that the company classifies most alternative and complementary medicine as investigational, meaning the benefits haven't been scientifically proven.

This is an unfortunate situation. One of the legal services our law firm offers is a focus on helping maximize insurance reimbursement through proper billing and coding of CAM therapies.

Morristown Memorial Hospital schedules Community Health Day:

Community Health Day at Morristown Memorial Hospital is scheduled for 9 a.m. to 1 p.m. on Saturday, Sept. 6, at Headquarters Plaza in Morristown. With the day of free health-related services, the hospital reaches out to the underserved. Now in its 13th year, the event attracts hundreds from the community each year. Its exhibitors offer free health screenings, information and counseling and other health-related services. Community Health Day screenings are for cholesterol, hearing, vision, foot, bone density, diabetes, blood pressure, respiratory, body mass index and prostate cancer. The Atlantic Mind Body Center for integrative medicine will have representatives at the event to promote the center's chi gong, art therapy and massage.

The Partnership for Prescription Assistance will have its Help Is Here Express bus, traveling enrollment center on site so patients can find out they are eligible for help paying for their medicines. The bus comes equipped with computer terminals and mobile phones.
To accommodate the area's growing Latino population, every exhibitor will have a Spanish-speaking representative and educational materials in Spanish. Health screening information, consent forms and brochures will be available in English and Spanish.

Representatives will attend from community services: Jersey Battered Women's Services, Morris County Office of Health Management, and OSHA. Registration for NJ Family Care will be available.
This day of wellness was initiated in 1996, through a partnership between Pastor Robert Rogers at The Church of God in Christ and Morristown Memorial to bring health screenings and education into the community. It now includes the support of Calvary Baptist Church, Union Baptist Church, Tabernacle of Faith Church, St. Margaret's Catholic Church, Bethel AME Church, and the County College of Morris. The event is funded by a grant from the Morristown Memorial Health Foundation.

Morristown Memorial Hospital is at 100 Madison Ave. in Morristown. It is part of Atlantic Health.

Atlantic Health also includes Overlook Hospital in Summit. Atlantic Health is the primary academic and clinical affiliate in New Jersey of Mount Sinai School of Medicine and The Mount Sinai Hospital. The hospital is accredited by The Joint Commission.

A Health, Wellness Festival is Slated for good medicine:

The Good Medicine Health and Wellness Festival will be held Sept. 14, 11 a.m. to 8 p.m., at The Music Box @ Fonda, (Henry Fonda Theater), 6126 Hollywood Blvd., in Hollywood, Calif. More than 100 licensed and accredited practitioners will be in attendance to administer more than a dozen natural healing modalities. There will be educational sessions in integrative medicine led by experts in the field, sound healing and merchandise from dozens of natural products and services vendors.

Health and wellness therapies represented at Good Medicine include acupuncture, yoga, massage, Reiki, Qigong, Tai-Chi, sound healing, nutrition, Ayurveda, Chinese medicine, guided meditation, hypnotherapy, and holistic health. Good Medicine attendees will receive hands-on treatments from licensed/certified and insured practitioners as part of their admission to the event.

Tickets range from $35-$65; children under 12 are free and group discounts are available. L.A. Watts Times readers receive a discount on event tickets. The code 312 is good for 10 percent off tickets purchased online at www.thegoodmedicine. com. Also, a tree will be planted for each ticket sold online. Ticket prices are 100 percent tax deductible and sales benefit New Earth's community-based services.

Information: (310) 455-2847 or www.thegoodmedicine.org.

Online nursing education features CAM:

The Healthcare Medicine Institute (HealthCMI) launches nursing continuing education online courses using open source solutions for the web at www.healthcmi.com . "Open source solutions allow our learning management systems to operate on any type of server and all browsers including those for Mac OSX, Windows, and Linux thereby bringing the online classroom to all nurses with access to the internet," notes Adam White, President of the Healthcare Medicine Institute. At HealthCMI, nurses simply download course materials, take an online quiz, and automatically receive a certificate of completion for nursing continuing education credit. "HealthCMI provides California Board of Registered Nursing approved online courses. In addition, HealthCMI is adding Florida Board of Nursing certification as well as certification for Washington D.C. and national certification through the American Nurses Credentialing Center," notes Adam White.

It seems that integrative medicine may be the future but HealthCMI's integrated technology is in wide-scale use today. HealthCMI uses the Joomla! open source content management system to implement learning management systems for end users such as acupuncturists, nurses, and dentists. Joomla! gets financial support for code development projects from Google and open source organizations. Joomla! is considered one of the largest and most powerful open source content management systems in use today. It is employed worldwide for everything from small-scale websites to large-scale corporate applications. The advantage for HealthCMI is that multitudes of plug-ins are produced by the open source community for Joomla! . This facilitates the secure, powerful, and ergonomic implementation of systems for operating an online classroom.

Known for its acupuncture continuing education online division, HealthCMI launches the nursing continuing education online division with three important courses on the treatment of high cholesterol and triglycerides. "The hyperlipidemia series of nursing continuing education online courses addresses the acute need for education concerning this serious medical condition affecting millions of people worldwide. Part one of this series provides the western medical understanding of high cholesterol and high triglycerides. Part two provides dietary remedies for high cholesterol and triglycerides while part three provides herbal remedies from the Chinese medical tradition," notes Adam White. Mr. White explains that open source learning management systems used by HealthCMI allow authors in China and the U.S.A. to seamlessly collaborate on research and educational documents. This allows for the sharing of information between the acupuncture and nursing continuing education divisions of the institute. The result is a comprehensive approach to addressing high cholesterol and high triglycerides with the best of western and Chinese medicine combined. "The future of medicine is integrative medicine -- East meets West. People want solutions and a combined effort raises the bar of educational standards," notes Mr. White.

"Nursing continuing education online has never been easier and it now joins our acupuncture continuing education online classroom presence on the internet," notes Mr. White. Next, HealthCMI plans to complement its medical education offerings by implementing an online classroom learning environment for its dental continuing education division. "At HealthCMI, we are dedicated to quality educational materials for medical professionals. We strive to improve the quality of information available for the acupuncture, nursing, and dental communities," notes Mr. White. In addition to its educational offerings, the Joomla! open source system employed by HealthCMI allows for the distribution of HealthCMI's medical news and information systems. The RSS feeds are generated by the content management system for the acupuncture continuing education, nursing continuing education, and dental continuing education divisions of the company.

About HealthCMI:
HealthCMI is the online division of the Healthcare Medicine Institute. HealthCMI provides online continuing education courses to medical professionals for acupuncture, dental, and nursing applications. The Healthcare Medicine Institute is dedicated to supporting a consortium of authors and presenters in providing valuable, useful, and interesting medical works in an effort to raise medical standards of education worldwide.

Contact:
Adam White, President
Healthcare Medicine Institute
Call 831-359-9129
https://www.healthcmi.com

An autism conference explores environmental factors:

The Autism Center of Pittsburgh and AutismLink, the largest autism advocacy organization in the State of Pennsylvania will be holding the 2008 Pittsburgh Autism Expo on Friday, October 24 and Saturday, October 25, 2008 at the Crowne Plaza Hotel in Pittsburgh, PA. Details on the conference and registration can be found at http://www.pghautismexpo.com. This two day conference is only $70 for parents and $140 for professionals. Certificates will be provided for continuing education credits. (Attendees must submit their own certificates for credit.) The conference will focus on the relationship between vaccines, the environment and autism spectrum disorders and feature some of the country's top experts on the subjects of nutrition, environmental toxins, and the relationship between autism and vaccines. "Recent findings in several cases at the CDC indicate that there may be a link between vaccines, autism, environmental toxins and mitochondrial disease," said Cindy Waeltermann, President of the Autism Center of Pittsburgh. "Parents are very concerned and hungry for information on these topics." David Kirby, the New York-based investigative journalist and author of the NY Times Bestseller, "Evidence of Harm, Mercury in Vaccines and the Autism Epidemic - A Medical Controversy," the keynote speaker, will discuss recent developments in what has become perhaps the most contentious medical debate of a generation. Presenters include Dr. Russell Blaylock, M.D., board certified neurosurgeon, author and lecturer; Dr. Philip DeMio, M.D., DAN Physician and father of a child with autism; Dr. Cheryl Leuthauser, D.O., Integrative medicine specialist; Kelly Dorfman, MS, LN, Nutritionist; Drs. Len Brancewicz and Joe DiMatteo, Board Certified Nutritionists and Homeopaths; Dr. Charles Simkovich, DC, Chiropractor & Cranio Sacral Therapy; Dr. Scott Faber, M.D., Developmental Pediatrician For more information, call (412) 364-1886 or visit www.pghautismexpo.com. Seating is limited. SOURCE AutismLink http://www.pghautismexpo.com

Here is a study of CAM as treat or treatment:

Treat or Treatment: A Qualitative Study Analyzing Patients' Use of Complementary and Alternative Medicine Posted on: Sunday, 7 September 2008, 03:00 CDT

By Bishop, Felicity L Yardley, Lucy; Lewith, George T

Objectives. We analyzed how patients use complementary and alternative medicine (CAM) and examined how patients' perspectives relate to existing, expertled taxonomies. Methods. We conducted semistructured interviews with 46 people who used CAM in southern England, then performed a qualitative thematic analysis of the interviews.

Results. CAM appeared to be used in 4 different ways: as treats, and as alternative, complementary, or conventional treatments. Treats were portrayed as personal luxuries, not directed at an identified health need. Systematic differences in the context, anticipated benefits, and implications for financial justification were revealed when nonmedical therapies were viewed and used as alternative, complementary, or conventional treatments. Specific CAM practices were viewed and used in different ways by different participants.

Conclusions. Some participants used CAM practices as a personal luxury, not as a health care technology. This is incongruent with existing expert-led taxonomies. Physicians and researchers need to be aware that patients' views of what constitutes CAM can differ radically from their own. They should choose their terminology carefully to initiate meaningful dialogue with their patients and research participants. (Am J Public Health. 2008;98:1700-1705. doi:10.2105/AJPH. 2007.110072)

Substantial numbers of patients use practices of complementary and alternative medicine (CAM) such as acupuncture, aromatherapy, and homeopathy in the United Kingdom,1 Europe,2,3 North America,4,5 and Australia.6 In the United Kingdom, 10% of the population used a practitioner-based CAM therapy in 2000,1 and CAM practices in general are increasing in popularity and accessibility.4,7,8 Physicians have a legitimate interest in their patients' use of these therapies, particularly when there are known potential interactions with conventional medicine. 9 However, up to 77% of patients do not disclose their use of CAM therapies to medical practitioners.10 We present a patient-centered analysis of CAM therapies that offers fresh insight into and explanation for this important phenomenon.

CAM therapies are typically defined in the literature by what they are not: they are "not taught widely at US medical schools or generally available at US hospitals."11 They are commonly grouped together under the umbrella term CAM, a term that indicates the ways in which these therapies are provided, either alongside or instead of conventional (bio)medicine.12 We use this terminology here not in an attempt to prejudge patients' conceptualizations but as a convenient, common, and widely accepted means of referring to this collection of therapies.

Various expert-led taxonomies for CAM have been suggested.13-15 A House of Lords report classified them into 3 main categories: professionally organized alternative therapies (e.g., homeopathy), complementary therapies (e.g., aromatherapy), and alternative disciplines (e.g., traditional Chinese medicine).13 By contrast, the National Centre for Complementary and Alternative Medicine classifies nonmedical therapies into 5 categories: alternative medical systems (e.g., homeopathy), mind-body interventions (e.g., meditation), biologically based therapies (e.g., herbal medicine), manipulative and body-based methods (e.g., chiropractic care), and energy therapies (e.g., crystal and gem therapy).14

These categorizations provide a useful organizational framework for understanding differences and similarities between individual therapies. But the extent to which patients' views might overlap with these taxonomies is unclear. Conceptual incongruence between patients' perspectives and those of researchers, providers, and policymakers has been observed. 16 Aspects of patients' conceptualizations and classifications of CAM therapies have been investigated previously, including the concepts of complementary and alternative,17, 18 the perceived differences between CAM therapies and conventional medicine,19 perceived similarities and differences between individual CAM therapies,20 the different psychosocial predictors of primary reliance and adjunctive CAM use,21 and the conceptual similarities between CAM and physical fitness.22 However, during an ethnographic study23 it became apparent that lay people were using and thinking about CAM therapies in ways that have not yet been described or examined. We report on a qualitative analysis based on that study, which systematically examined 4 major ways in which patients use, think about, and conceptualize 5 different CAM therapies.

METHODS

Data Collection

In the context of an ethnographic study, we conducted semistructured interviews with people who used CAM therapies at 2 high street (i.e., main street) clinics located within shops owned by a national pharmacy company that sells a range of health, beauty, and hygiene products. Thus, we were able to investigate the use of these therapies in a setting that was both accessible and provided affordable treatments; understanding CAM use in such settings is likely to become increasingly important for both researchers and providers if the demand for private CAM therapies continues. Interviews were conducted with 46 people (42 women and 4 men) who were attending the clinics for aromatherapy massage (12 people), herbal medicine (3), homeopathy (8), osteopathy (13), or reflexology (12). Two individuals experienced 2 different therapies and were interviewed twice. Even though we recruited relatively small numbers of people receiving homeopathy and herbal medicine, we reached saturation for our analysis with respect to these therapies; that is, we interviewed sufficient numbers to be able to analyze how patients used them.

Therapists informed their patients about the research (timing was left to the therapists' discretion), and F. L. B. invited them to participate in the study following their appointments. Sampling was purposive, in that we tried to interview CAM users who were likely to have a wide range of different experiences and views. To achieve this diversity, we invited people to take part who were using the therapies in diverse ways (e.g., a single visit or long-term follow- up), on different days (weekdays and weekends), and at different times (from morning through evening). Interviews were audiotaped whenever possible, or if participants preferred, notes were made during and immediately after interviews.

Open-ended questions and prompts were used to explore participants' experiences of CAM therapies. Topics included the participants' choice of therapy, choice of therapist, experiences at the clinic, and perceptions of their therapy. The issue of how participants categorized and defined therapies emerged as important in early interviews, as did the terms alternative, complementary, and conventional. This issue was explicitly probed in later interviews, in which the following questions were asked: (1) Do you see it [the specific therapy being used by the participant] as a form of health care? (2) What kind of health care do you think it is? (3) Do you think of it as alternative or complementary or conventional, or can you think of a better way to describe it?

Audiotapes were transcribed verbatim and imported with field notes into Atlas.ti version 4.1 (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), which facilitated data organization, management, and analysis. Pseudonyms were used to protect participants' anonymity.

The interviews were carried out between October 2002 and March 2003 in 2 cities in southern England.

Data Analysis

After data review and immersion in the data by the researchers (i.e., extensive reading and re-reading of the transcripts and repeated listening to recorded interviews), all sections of the interview that explicitly or implicitly described or defined the therapy used by the participant were analyzed at a detailed level, using descriptive, open coding. These codes were then grouped to form themes. Similarities and differences between the themes were examined across participants and therapies.24 The resulting insights were integrated to develop a conceptual model that summarizes participants' ways of using CAM therapies into 4 categories. Two researchers independently classified half of the coded segments of text into these categories; classifications were consistent for 87% of text segments, and inconsistencies were resolved through negotiation. This process provided a check on the analysis by requiring the researchers to engage in explicit definition, explanation, and discussion of analytic categories and their decisionmaking.

RESULTS

Two major categories of CAM use emerged from the analysis: (1) CAM therapy as a treat, and (2) CAM therapy as a treatment. A treat is defined as an enjoyable luxury, not directed at an identified health need, whereas a treatment is a means of preventing, alleviating, or curing specific health problems. Participants' accounts of using therapies as treatments were grouped into 3 subcategories, conceptualizing therapies as complementary, alternative, or conventional medical treatments (Table 1). Participants did not always talk about a therapy in the same way throughout their interviews; neither was there a simple relation between therapy modality and how a therapy was used. Although homeopathy and herbalism were used exclusively as alternative treatments, there was variation in how people used aromatherapy massage and reflexology, and only osteopathy was viewed as a conventional treatment (Table 2).

Therapies as Treats

Reflexology or aromatherapy massage were categorized as treats when they were described as pleasant experiences used for personal enjoyment rather than any specific problem: "I chose reflexology [because] I'd heard how good it is"; "I personally wouldn't use aromatherapy as a health treatment; no, I use it for being pampered." Margaret came for aromatherapy "just to treat myself really . . . just because I felt like having something to cheer me up today," although she added, "I guess in terms of my all-over health I do feel better for having it because it's a nice experience."

It could be argued that depicting therapy as a treat is consistent with a biomedical view of health. If holistic outcomes, such as relaxation, are seen as important for health, then a therapy that provides relaxation is more likely to be seen as a treatment than a treat. People with a biomedical view of health, however, do not always see therapies as treats. Betty changed from considering reflexology as a treat to regarding it as a potential treatment after realizing that it might offer her physical benefits beyond enjoyment: "I didn't appreciate the treatment basis of it, not until I actually had it. I thought it would just be quite nice and relaxing. I was amazed at how much it helped my feet. . . I'm still going to stay a bit skeptic though." Before she had tried reflexology, she thought it would offer her relaxation, which she suggested is "nice" but does not explicitly relate to her health. It was only when Betty experienced the physical effect of reflexology on her feet, which were a source of discomfort for her, that she considered it might be a treatment.

Carol had regular aromatherapy massages and viewed them as "my luxury," linking her enjoyment and their financial cost: "I enjoy them, they make me feel good . . . I don't smoke. I'd rather spend my money on aromatherapy." Like Betty, Carol explicitly associated what might (by others) be considered to be a holistic health outcome ("feeling good") with enjoyment rather than health per se. The link between paying for a therapy and viewing it as a luxury suggests that therapies might be used as treats when they are seen as nonessential, expensive, and exclusive. The study clinics provided beauty therapies (e.g., manicures) alongside CAM therapies and it was possible to purchase gift vouchers for aromatherapy massage and reflexology, thus encouraging both healthy and sick people to view these therapies as treats. Furthermore, our participants willingly accepted personally meeting the financial (i.e., uninsured out- ofpocket) cost of therapies as treats.

Therapies as Treatments

The key difference between recipients seeing and using a therapy as a treatment rather than a treat is that treatments were used to prevent, relieve, or cure a specific, health-related need. Participants were categorized as using therapies as treatments when they described health problems (symptoms or diagnoses) requiring treatment (prevention, relief, or cure) for which they believed the CAM therapy could be effective.

Alternative treatments. Participants were categorized as using therapies as alternative treatments when they described using them for conventionally diagnosed chronic benign illnesses (arthritis, eczema, asthma, headache) that had not been satisfactorily managed by conventional medicine. Alternative treatments were also used for situations perceived as incompatible with conventional medicine. Kay said, "This time, I've got more of a feeling that my body is not functioning properly. You can't go to your [general practitioner] for this. . . . When you have general malaise, homeopathy is better, it is a general, holistic approach."

Participants believed alternative treatments were able to go "further than" simple symptomatic relief, providing them with an understanding of the treatment and the causes of their illness. Michelle saw the herbalist about her migraines because, she said, "maybe I have an allergy or intolerance or something" and hoped that "if I become a bit more healthy then I won't need to take them [herbal remedies] as much" and that the remedies will "readjust the balance." Isabel was using homeopathy for high blood pressure and hoped for both biomedical ("to be cured") and holistic ("to feel better, to be healed") outcomes.

Participants also saw the processes involved in alternative treatments as different from those of conventional medicine, perceiving in alternative treatments a more personal approach with focus on the individual rather than symptoms; a focus on identifying causes or "the root" of a problem; more participatory, involving, and enjoyable consultations; more "natural" or restorative approaches; and a comparative lack of unpleasant side effects.

Some participants contrasted alternative treatments with beauty therapies to emphasize that alternative treatments were indeed treatments. Vicky said, "I've had facials here with the beauty therapists and they're a bit detached, and that's fine, 'cause it's like buying a product from them. But health is different. It's expertise. It's a trust thing." ....

What an intriguing idea--trick or treatment.

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