Des Moines, Iowa-The Journal of the American Medical Association has just published a new study entitled “Trends in Alternative Medicine Use in the United States, 1990-1997,” by David M. Eisenberg, M.D. Dr. Eisenberg's study is a welcome sequel to his publication five years ago,¹ which acted as a catalyst if not a benchmark to the rising public interest in alternative methods of health care delivery. What has followed has been a rapid succession of papers documenting the continued rising trend of both public and professional interests in alternative medicine.^2-11 The facts that (1) Eisenberg has shown that the number of visits to alternative practitioners has practically doubled within the past five years (particularly within the confines of a managed care environment), and (2) the institution within the NIH that is dedicated to research in alternative medicine has been promoted from an office to a National Center and has had its budget more than doubled within the past year, reflect a national trend that is unlikely to be reversed anytime soon.

These results are fully consistent with the trends forecast by the Institute for Alternative Futures in a study sponsored by the National Chiropractic Mutual Insurance Company and administered by the Foundation for Chiropractic Education and Research (FCER).¹² The results also might explain the outbreak of recent, poorly documented backlashes against alternative medicine and chiropractic that have appeared in recent editorials in both The New England Journal of Medicine¹³ and the British Medical Journal.¹⁴ Both of these appear rather fatuous to be raising issues concerning the lack of documentation when only 15% of all procedures in the medical profession have any published evidence of their own.¹⁵

With regards to chiropractic, the results clearly demonstrate an increasing utlilization rate among all age groups. The increase echoes the recent report that chiropractic utilization is twice that of estimates made 15 years ago.¹⁶ More importantly, it appears that chiropractic patients are well-distributed among all age groups and may in fact be adherents over the long term. This immediately raises the desirability of conducting further research in the areas of maintenance and prevention as two areas of health management that appear thus far to have been inadequately addressed by conventional medicine. I believe that chiropractic is ideally suited for such an undertaking, as maintenance and prevention are integral parts of chiropractic theory and practice.

REFERENCES:

Eisenberg DM, Kessler RC, Foster C, Norlac FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. Prevalence, costs, and patterns of use. New England Journal of Medicine 1993; 328(4): 246-252.

Spiegelblatt L, Laine-Ammara G, Pless IB, Guyver A. The use of alternative medicine by children. Pediatrics 1994; 94(6): 811-814.

Borkan J. Neher JO, Anson O, Smoker B. Referrals for alternative therapies. Journal of Family Practice 1994; 39(6): 545-550.

Kronenberg F, Mallory B, Downey JA. Rehabilitation medicine and alternative therapies: New words, old practices. Archives of Physical Medicine and Rehabilitation 1994; 75: 928-929.

Fisher P, Ward A. Complementary medicine in Europe. British Medical Journal 1994; 309: 107-111.

Blumberg DL, Grant Wd, Hendricks SR, Kamps CA, Dewan MJ. The physician and unconventional medicine. Alternative Therapies in Health and Medicine 1995; 1(3): 31-35.

Gordon JS. Alternative medicine and the family physician. American Family Physician 1996; 54(7): 2205-2211.

Chung MK. Why alternative medicine? American Family Physician 1996; 54(7): 2184-2187.

The Landmark Report on public perceptions of alternative care. Sacramento, CA: Landmark Healthcare, Inc., 1998.

Astin JA. Why patients use alternative medicine. Results of a national study. Journal of the American Medical Association 1998; 279(19): 1548-1553.

Cooper RA, Laud P, Dietrich CL. Current and projected workforce of nonphysician clinicians. Journal of the American Medical Association 1998; 280(9): 788-794.

Institute for Alternative Futures. The future of complementary and alternative approaches [CAAs] in U.S. Health Care. Alexandria, VA: Institute for Alternative Futures, 1998.

Angell M, Kassirer JP. Editorial: Alternative medicine--The risks of untested and unregulated remedies. New England Journal of Medicine 1998; 339(11): 839-841.

Ernst E, Assendelft W. Editorial: Chiropractic for low back pain: We don't know whether it does more good than harm. British Medical Journal 1998; 317: 160.

Smith R. Where is the wisdom: The poverty of medical evidence. British Medical Journal 1991; 303: 798-799.

Hurwitz EL, Coulter ID, Adams AH, Genovese BJ, Shekelle PG. Use of chiropractic services from 1985 through 1991 in the United States and Canada. American Journal of Public Health 1998; 88(5): 771-776.

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