A Canadian "CAM" researcher associated with Marja Verhoef, PhD’s highly respected shop at the University of Calgary sent me an email to see if leaders in the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) might be interested in participating in a little research survey project.
The researcher, Isabelle Gaboury, PhD, was using a Delphi Method (1) process to understand how established leaders in “complementary and alternative medicine,” a.k.a. CAM, feel about this term. Is it time to let “CAM” go? Did anyone ever like it in the first place? What would we suggest in its place?
Gaboury had previously secured participation in the survey from the mainly MD leaders of the 45 medical programs that make up the Consortium of Academic Health Centers for Integrative Medicine. This group might be expected to have some shared perspectives. Through ACCAHC, Gaboury hoped to reach a different set of experienced educators and researchers, those associated with the licensed CAM disciplines of chiropractic, acupuncture and Oriental medicine, naturopathic medicine, massage therapy, homebirth midwifery and a couple of related fields.
This subject has been lively since the CAM term was first invented in the early-1990s. Back then, CAM was an ameliorative move from the oppositional U.S. term, “alternative medicine,” used in the U.S. The British term, “complementary” was incorporated. CAM became a drag net to scoop up everything off medicine’s ocean floor that was not conventionally accepted. A huge bolus was created of individual therapies, providers, modalities, cultural practices, licensed disciplines, out-and-out hocus pocus, traditional world medicines and emerging professions.
No wonder the discontent with the term! And yet how strong is the case that we have not yet advanced far enough in our mutual respect to let it go.
Debate over terms at the IOM Summit
Strong opinion over what to call ourselves was front and center in the March 28, 2008 announcement on the Charlie Rose Show that a Summit on Integrative Medicine and the Health of the Public was to take place. A spokesperson for the Bravewell Collaborative that sponsored the historic Institute of Medicine (IOM) gathering quickly set up a barrier at the top of the show. She declared: “This is not about CAM.” (2) This summit would instead be about “integrative medicine,” an MD-led movement to transform conventional medicine and conventional medical education. Indeed, from the looks of the initial planning committee, this term would not have seemed to include any of the “CAM” disciplines. It was only after education of the IOM staff that an ACCAHC representative from the licensed fields was appointed.
The experience leaves a mixed taste. A battle line exists over the extent to which promoters of “integrative medicine” believe that its leadership should include the licensed CAM disciplines. (Many of the MD leaders do, including notably Victor Sierpina, MD, chair, and other leaders of the conventional medical Consortium.)
The subject didn’t go away at the actual IOM Summit, 11 months later, or at the Congressional hearings arranged by US Senators Barbara Mikulski (D-MD) and Tom Harkin (D-Iowa) in that very active February 23-27, 2009 week. Many Summit attendees suggested the field should be called “integrative health care” or “integrative health,” rather than “integrative medicine.” The argument is that these terms are more inclusive and speak to a health-creating, rather than reactive, approach to patients. Others believe that if “medicine” is left on the cutting room floor, integrative practice will never be respected by the leaders of medicine who we need to transform.