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Policy Perspectives
November 11, 1998

Factors That Shape Alternative Medicine

Author Affiliations

From the Rosenthal Center for Complementary and Alternative Medicine, Columbia University College of Physicians and Surgeons, New York, NY.

JAMA. 1998;280(18):1621-1623. doi:10.1001/jama.280.18.1621

THE LACK OF relevant high-quality scientific research has often been given as a reason1,2 to explain why a large number of health care practices are termed alternative. However, the fact that it required congressional intervention3,4 for the National Institutes of Health (NIH) to earmark 0.02% ($2 million) of its $10.7 billion 1992 budget to evaluate practices used by more than 35% of the US population suggests that issues beyond the scientific were involved. Nonscientific factors have played a major role in limiting scientific exploration of these areas, have discouraged potential investigators, and have dictated greater profitability elsewhere. This article examines current definitions of alternative medicine and proposes a new one, outlining those factors, sociological (academic), political, regulatory, and economic, that must be considered when exploring this field.

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