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THE BEST ALTERNATIVE?

December 1998 
Alternative Medicine More than four out of ten people in the United States visited alternative medicine practitioners last year. Dr. George Lundberg of the Journal of the American Medical Association and Dr. Marcia Angell of the New England Journal of Medicine answer your questions.

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Melissa Stock of San Diego, CA, asks:

As alternative medicine goes under the scrutiny of scientific testing, would positive results mean it would no longer be considered alternative? What is the definition of alternative medicine?

Dr. George Lundberg responds:

There is no "alternative medicine." There is only medicine that has been scientifically tested and shown to be safe and effective-that should be used and paid for; medicine that has been scientifically tested and shown not to be safe and effective-that should not be used or paid for; and medicine which has some plausible reason why it might work but has not yet been tested-it should be tested-and for the most part, not used and not paid for until tested and shown to be safe and effective.

Dr. Marcia Angell responds:

That is an excellent question. Yes, once an alternative remedy has been scientifically tested and found to be safe and effective, it would be immediately accepted by the scientific community and become standard practice. Thus, the best definition of "alternative medicine" is that it consists of treatments that have not been scientifically tested. That is not to say that all treatments in mainstream medicine have been tested. Some older treatments have not been, and they should be. Appeals to "tradition" or "experience" are not enough. In fact, they can be very misleading.

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