Question:
Complementary and alternative medicine is no longer an obscure issue inmedicine. Our patients are using alternative therapies in addition toconventional care 1 2 and sometimes do not share this information with us. Buteven if they did would we know how best to advise them about safety issues orabout the effectiveness of a particular therapy for their problem? Surveysindicate that doctors and medical students are increasingly interested incomplementary and alternative therapy,3-5 yet lack of knowledge is one of thegreatest barriers to its appropriate use. Although many medical schools andtraining programmes now include teaching on complementary and alternativetherapies, the approaches are variable and often superficial.

In this issue Owen et al ask provocative questions about our attitudes andbehaviour towards complementary and alternative therapy (p 154),6 and point outthat few of us encountered such therapy as medical students or during latertraining. Nevertheless, there are signs of change, and Owen et al describeinitiatives to include complementary and alternative therapy in medicaleducation in the United Kingdom. Similar changes are occurring in the UnitedStates. In 1995 a national conference on complementary and alternative therapyeducation involving the National Institutes of Health recommended thatcomplementary and alternative therapy should be included in nursing and medicaleducation. Two years later a survey of all 125 US medical schools found that 75of them offered some form of education on complementary and alternativetherapy.7

Answer: yes, anything can be abused. i don't think that doctors are educating themselves simply tolearn about the negative aspects though. i believe that they understand the wave ofpreventative health self-reliance that is taking hold of the public and want to be kept in theloop when their patients ask questions. of course. and no legitimate herbalist or nutritionist would attempt to tell anyone otherwise. there are plenty of contraindications for ephedra. just like there are plenty of them forNSAIDS. it's not like it's some big secret that the alt health world is trying to pull over oneveryone. the information is widely and freely available from lots of reputable sources.