Julie Buring is a professor of medicine and the Director of Clinical Research at the Division for Research and Education
in Complementary Medical Therapies at the Harvard Medical School.
Alternative medicine is a topic that has provoked a great deal of controversy and "has so much need for well-conducted
research," states Dr. Buring. Harvard Medical School is attempting to meet this need at the Osher Institute by conducting research on
Complementary and Alternative Medicine (CAM). The Osher Institute is a division of the Harvard Medical School with the mission of
researching, investigating, and delivering educational programs to the medical community.
Complementary medicines are defined as those used in conjunction with conventional medicines; alternative medicines are
used in place of conventional ones; and integrative medicine combines medical therapies and CAM therapies for which there is scientific
evidence of safety and efficacy. However, the safety and efficacy of many complementary and alternative medicines have not yet been
demonstrated. CAM therapies are divided into five domains, including biologically-based systems, body-based systems, mind-body
medicines, energy therapies, and alternative medical systems (such as homeopathy and naturopathy). The most commonly used CAM therapies
from within these domains are chiropractic therapy, massage therapy, herbal remedies, and relaxation techniques, and these are often used in
combination. Dr. Buring describes several studies conducted by Dr. Eisenberg (Director of the Osher Institute and expert on CAM
research) in the 1990s. In these studies, researchers were surprised to discover the dramatic increase in the use of CAM therapies and the greater
out-of-pocket expenditures for visits to CAM providers. The discovery that the disclosure rate of patients to their physicians concerning the
additional use of CAM therapies was only about forty percent in both 1990 and 1997 was equally surprising.
Dr. Buring discusses many of the "pull factors" attracting people to alternative medicines, such as the assumption that
what is natural is necessarily safe. Ephedra is a well-known example of why "just because it's natural doesn't mean it's safe." Dr.
Buring states that although research has shown that the use of Ephedra is cause for concern, due to insufficient studies there is not
yet enough evidence to prove its safety or harm. Studies must be the "cornerstone of recommendations of use" for CAM therapies, and the
Harvard Medical School is working to provide information that is essential to making educated and beneficial health care decisions about CAM.
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