In recent years, an increasing number of individuals in the United States have turned to complementary and alternative medicine (CAM) to address their healthcare needs. Over the past two decades, patients have demonstrated a greater interest in understanding their medical care and actively engaging with their physicians. There is a growing emphasis on the doctor-patient relationship, wherein patients seek a more collaborative role in their healthcare. Many individuals now prefer to exert greater control over their health and are less inclined to rely exclusively on conventional medical professionals.
The widespread availability of healthcare information on the internet has contributed to this shift, as patients frequently bring printed materials or online research to medical appointments. This trend reflects broader dissatisfaction with the impersonal nature of mainstream healthcare, including managed-care systems and reduced face-to-face time with physicians. As a result, many individuals explore alternative approaches that offer a more personalized experience.
Traditional medicine encompasses a vast body of knowledge, skills, and practices rooted in cultural beliefs and historical experiences. It is utilized for the maintenance of health as well as the prevention, diagnosis, and treatment of physical and mental illnesses. In contrast, conventional Western medicine relies primarily on scientific research and standardized treatments that are widely accepted in clinical practice. However, a significant limitation of many complementary health approaches is the lack of extensive scientific research supporting their efficacy.
CAM practitioners cater to the growing demand for alternative therapies. Data from the 2012 National Health Interview Survey indicate that approximately 33 percent of adults and nearly 12 percent of children in the U.S. use some form of complementary health approach. Among these, the most commonly utilized therapies involve natural products such as dietary supplements (excluding vitamins and minerals), with fish oil being one of the most frequently used supplements. Notably, patients are often willing to pay out-of-pocket for CAM services. In fact, annual out-of-pocket expenditures on complementary health approaches among Americans aged four and older are estimated at $30.2 billion. Nearly half of these expenditures are directed toward visits to CAM practitioners, including chiropractors, acupuncturists, and massage therapists, while another significant portion is allocated to the purchase of natural products. A smaller fraction—approximately $2.7 billion—is spent on self-care resources, such as books and CDs on complementary health topics. This spending accounts for roughly 9 percent of all out-of-pocket healthcare expenditures in the United States and 1.1 percent of total national healthcare spending.
Complementary medicine includes a variety of treatments that can be used alongside conventional Western medicine, forming what is known as an integrative approach. Common CAM modalities include massage therapy, meditation, biofeedback, tai chi, Reiki, music therapy, guided imagery, and dietary supplements. These approaches are often used in conjunction with conventional treatments such as pharmaceuticals, immunotherapy, chemotherapy, radiation, and surgical interventions. Many CAM practices offer therapeutic benefits, including pain relief, stress and anxiety reduction, alleviation of nausea, enhanced wound healing, improved circulation and flexibility, and increased overall well-being.
CAM therapies can be categorized into several distinct groups. Manipulative and body-based practices include massage therapy, reflexology, chiropractic manipulation, and cupping. Mind-body interventions encompass meditation, deep breathing exercises, yoga, guided imagery, music therapy, animal-assisted therapy, biofeedback, hypnotherapy, and prayer therapy. Energy-based therapies involve practices such as tai chi, Qi Gong, therapeutic touch, Reiki, acupuncture, and the use of magnets. Expressive therapies include journaling, art therapy, and participation in support groups. Additionally, herbal medicine, dietary supplements, and aromatherapy are commonly used as natural health interventions.
Herbal medicine, a significant component of CAM, involves the use of plants for their medicinal and therapeutic properties. Herbal remedies are often considered cost-effective and widely accessible. However, consumers must ensure that they use high-quality herbs in controlled dosages and seek recommendations from qualified naturopathic practitioners. A primary reference for herbal medicine is the German Commission E Monographs, a comprehensive therapeutic guide that evaluates the safety and efficacy of various herbs. It was initially developed in the 1970s, when the German government conducted extensive research on herbal remedies, publishing official monographs detailing approved uses, contraindications, side effects, dosages, drug interactions, and other essential therapeutic information.
While CAM is widely utilized in the United States, access to these treatments is often influenced by health insurance coverage. Research on acupuncture, chiropractic care, and massage therapy suggests that utilization rates for these approaches tend to be higher among individuals without health insurance. Even when insurance does provide coverage for CAM therapies, it is often partial rather than comprehensive. Patients seeking information on insurance coverage for CAM treatments may contact their state insurance department for guidance. Resources such as USA.gov offer contact information for state and local consumer agencies, including insurance regulators.
Despite the growing popularity of CAM, a critical limitation remains the lack of rigorous scientific research supporting many alternative therapies. Before adopting any healthcare approach, it is essential for consumers to assess the associated risks, benefits, and available evidence. The National Center for Complementary and Integrative Health (NCCIH) actively funds research to evaluate the safety and efficacy of CAM modalities, providing a valuable resource for individuals seeking evidence-based guidance.
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