Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—I agree with Lord Baldwin that pragmatic concerns (ie, conventional medicine has not been effective) often may be an important determinant of alternative medicine use. Baldwin also suggests that the finding that alternative medicine is more "philosophically congruent" with patients' beliefs could be interpreted as a kind of dissatisfaction with conventional medicine. However, users of alternative therapies did not report higher levels of dissatisfaction with their conventional care. One possible explanation for this seemingly contradictory finding is that satisfaction may be closely tied to the patient's level of expectation. For example, a person who treats a cold with an herbal remedy like Echinacea may at the same time be quite satisfied with his or her conventional practitioner, in part because the person does not expect that conventional medicine will be able to offer much in the way of preventing or treating such ailments.
Astin JA. Why Patients Use Alternative Medicine—Reply. JAMA. 1998;280(19):1659-1661. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-19-jbk1118