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Policy Perspectives
November 11, 1998

Factors That Shape Alternative Medicine

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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