On the definition of complementary, alternative, and integrative medicine: Societal mega-stereotypes vs. the patients' perspectives

Much confusion exists regarding the definitions of complementary, alternative, and integrative medicine. Whereas 'complementary and alternative medicine' (CAM) is used to describe a variable set of diagnostic and therapeutic modalities considered as non-conventional, 'integrative medicine' is commonly used to describe the combination of allopathy and CAM. CAM, however, is nothing more than a categorical label that subsumes numerous therapeutic modalities generally sharing few commonalities. Creating a unique category out of such diversity has lead to misunderstanding and skepticism. From the physician's stand-point, this can generate numerous stereotypes, prejudices, and misconceptions that may compromise the therapeutic relationship, impede compliance, and lead to treatment failure. To help avoid this dangerous pitfall, we propose a distinctly new operational definition for CAM; one that shifts the focus from the traditional, population-based approach to a definition that focuses on the individual. This paper outlines various definitions of CAM and discusses their relative strengths and weaknesses for the 21st century practice of medicine. It is our conclusion that individual patients, rather than society, should be the frame of reference and defining source for what constitutes integrative medicine and CAM.