Most people have heard of, or tried, a form of Complementary and Alternative Medicine (CAM). This is a complex topic, not only because there are so many different types of CAM, but also because there are diversified opinions provided by media, healthcare workers and other individuals. At APA, we neither promote nor discourage the use of CAM, but seek to provide information and resources to help you make an informed decision about what is best for your health.

What is CAM?

Complementary and Alternative Medicine (CAM) is an alternative method of treatment which can include medicinal products, practices or methods of treatment which can be used in place of standard or conventional treatment or in conjunction with standard treatment. Complementary therapies are intended to be used in conjunction with standard medical practice, while alternative therapies are used instead of conventional treatment. When complementary therapies are used alongside conventional medicine this will sometimes be called “integrative medicine”.

CAM is often based on traditional or cultural practices which may have been used for centuries while conventional medicine is mostly based on medicines, practices or methods which are the subject of continuous scientific testing and modification. Specific medicines or therapies classified as CAM may have been trialled in scientific studies and reported in conventional medical journals for several diseases and conditions, however they are often not deemed to be medicine that must be practiced by registered medical practitioners (General Practitioner or specialist). However, many GPs and specialists may recommend CAM to their patients if there is sufficient evidence to include them as part of the standard protocol for care.

Although CAM can be regulated by Professional Associations and/or the Therapeutic Goods Administration, there are several modalities which are practiced without sufficient regulation or supervision and there have been instances where the irresponsible treatment by well meaning CAM practitioners has led to unsatisfactory outcomes in patients.

For example, the Pain Management Network provides some further detail here.

Different types

Here is a list of some of the therapies which fall into the category of CAM:

Acupuncture

Alexander technique

Aromatherapy

Art, music and dance therapy

Ayurveda

Biofeedback

Biofield therapies

Chiropractic

Dietary/vitamin supplements

Electromagnetic therapy

Herbalism

Homeopathy

Hypnosis

Massage

Meditation

Naturopathy

Nutrition therapy/diet

Osteopathy

Pilates

Qi Gong

Reflexology

Reiki

Spiritual healing

Therapeutic touch

Traditional Chinese Medicine

Yoga

 Why do some people use CAM?

  • A desire to explore all available options
  • Seeking holistic or natural therapies
  • Dissatisfaction and mistrust with conventional medicine, particularly for conditions without a cure, or when the treatment has unpleasant side-effects
  • Either they, or someone they know has had a good experience with CAM

Why doesn’t everyone use CAM?

  • Not all are based on scientific evidence
  • Effectiveness and safety may have been brought into question
  • They can be expensive if they are not covered by Medicare or health insurance
  • GPs or specialists might not discuss or recommend CAM

Questions to ask:

There are three main points to ask any CAM therapist about;

  1. Effectiveness
    1. What is the evidence for the effectiveness?
    2. In what way should I expect this to benefit me?
    3. Do the benefits outweigh the side effects?
  2. Safety
    1. What are your qualifications?
    2. What is the evidence for the safety? Keep in mind that natural does not always mean safe.
    3. What are the risks and what side effects I should look out for?
    4. Could this interfere with medications or treatments I’m currently using? (Please note that it is more important to ask your GP or specialist this question)
  3. Cost
    1. What are the costs involved?
    2. How often will I need to come back before I can expect to notice a benefit?

Why isn’t it covered by Medicare?

Under some circumstances CAM are contributed to by Medicare;

  • Osteopathy and chiropractic can be accessed on the MBS if you are on a GP Management Plan (also referred to as Team Care Arrangement, Chronic Care Plan, Extended Care Plan) – see our article on Chronic Care Plans, Extended Care Plans Care Plans
  • Some GPs are trained in Medical Acupuncture which can be subsidised by Medicare

In general, Medicare only funds treatments that are evidence-based. Evidence-based means that there are enough high quality scientific studies that prove a treatment is effective and safe. The inclusion of acupuncture on the MBS is somewhat controversial because it can be argued that there is no high quality evidence to suggest that it works – this article from the Australian Medical Association (AMA) is an interesting read.

Information on what is covered by Medicare can be found on the Medicare Benefits Schedule website click here.

What about blood tests and other scans that are part of my CAM therapy?

  • Some CAM practitioners may suggest that you ask your GP to order specific blood tests or scans so that they will be covered by Medicare
  • The Royal Australian College of General Practitioners (RACGP) holds the stance that doctors should only order tests that are medically necessary
  • So your GP will likely decline these requests if they do not believe they are necessary based on the evidence available
  • If a GP orders a test that is found to be unnecessary, the GP will have to pay the cost of the test back to the government, so don’t take it personally if they deny your request
  • If you still want to have these tests performed you will need to pay for them out of pocket
  • See Appropriate Diagnostic Testing from the RACGP

Some Complementary and Alternative therapies are covered by Private Health Insurance Funds. APA recommends patients contact their health fund to find out if the CAM is covered by Private Health Insurance.

Should I tell my doctor about it?

You should always discuss any CAM you use (or are considering) with your treating doctors. This is because they may interfere with medications or treatments you have been prescribed.

An article from the Australian Family Physician states that less than half of CAM users actually discuss it with their doctor. If you are worried that your doctor won’t agree with the CAM you are using, it is still important for your safety to discuss it openly and honestly.

Even if you take natural-only products or supplements, it is important that your doctors know about it, as natural does not always mean safe.

Things to be cautious of:

AHPRA is the board that regulates health care workers including some of the CAM therapies (chiropractors, osteopaths and Chinese Medicine providers). CAM providers registered with AHPRA are not allowed to (although some still do) advertise claims that are misleading, such as;

  • Curing cancer
  • Cures that are unsubstantiated (look out for anything that seems too good to be true)
    • Chiropractors are allowed to say they may help with back and neck pain, but are not allowed to advertise for preventing infections, checkups for babies and children, and other conditions where there is a lack of evidence;
    • Osteopaths can say they may help with back and neck pain, but not conditions that are non-musculoskeletal such as behaviour problems and checkups for babies and children;
    • Chinese medicine providers may say they can help with fatigue, stress, nausea and pain, but are not allowed to make claims about being totally safe and effective or other specific claims where the evidence is lacking.
  • That they are “specialists” rather than “having a particular interest in”
    • The word “specialist” can only be lawfully used within medicine, dentistry and podiatry (for podiatric surgeons).
  • Testimonials from patients about the treatment, for example “After seeing this chiropractor I was cured”.
  • Advertising regular check-ups to prevent conditions that you do not already suffer from where there is not enough evidence to support it.
    • An example of this is claiming a newborn checkup by a chiropractor or osteopath is essential
  • This is outlined in more detail on the AHPRA website

 “Any suggestion of allergy, food intolerance, genuine nutrient deficiency or serious illness should be verified by a medical specialist or allied health professional. If you have a real health problem, visit a qualified doctor for a correct diagnosis.” – CHOICE

“Be very cautious about any practitioner who advises you to abandon your conventional medical treatment.” and “During the first visit with your practitioner, ask about their training and qualifications.” – The Better Health Channel

“Avoid chiropractors who advise you not to have your children immunised.” and “Avoid chiropractors who claim to prevent or treat diseases, infections and health conditions other than musculoskeletal ones. The same goes for those who claim to detect and treat subluxations, or who prescribe and sell dietary supplements or homeopathic remedies.” – CHOICE