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Efforts to build a complementary and alternative medicine (CAM) education and research infrastructure have been productive. Development has focused largely on graduate, postgraduate, and professional level training. This paper examines baccalaureate programs, looking at the prevalence and characteristics of CAM and holistic health training in the United States.A comprehensive literature and web site search was conducted to find educational institutions offering baccalaureate programs in CAM or holistic health. Search criteria included accredited undergraduate programs terminating in a minor, an AA, or a BA/BS degree.A search of health and education databases produced marginal results. Internet searches, by contrast, were very productive in locating CAM or holistic health-related programs generally and baccalaureateprograms specifically. The most effective search strings included terms such as 'holistic health,' 'minor,' 'certificate,'and 'undergraduate.' Using these terms, 5 programs were found in the United States that met the inclusioncriteria: Arizona State University East, Bastyr University, San Francisco State University, MetropolitanState College of Denver, and Georgian Court College.Preparing tomorrow's scholars and clinicians to contribute meaningfully to this emerging healthcare paradigm will require a plan that integrates all elements of higher education. The creation of a trulyeffective workforce of CAM-competent M.D.s, nurses, health educators, pharmacists, and other allied healthprofessionals will increasingly necessitate baccalaureate preparation. Curriculum discussions at the campus,state, and national levels are needed. [ABSTRACT FROM AUTHOR]

In attempts to improve their health and/or combat illness, approximately 4 in 10 Americans will use a complementary and alternative medicine (CAM) therapy this year. CAM therapies vary widely, with acupuncture, chiropractic, herbal medicine, and homeopathy among the more prominent modalities. CAM therapies are used in addition to and/or instead of the more conventional forms of medical care available in U.S. hospitals or licensed physicians' offices. A rapidly increasing interest in CAM has led to a nascent movement aimed at integrating various CAM therapies with the conventional health care system. In Washington State, for example, health insurance coverage for CAM therapies has been mandated, and a number of "integrated" delivery systems have been born. Although the political and economic forces leading to adoption and integration of CAM therapies vary widely by geographic locale, it is likely that some degree of integration will occur throughout much of the United States. Similar processes are occurring in Canada, Europe, and Australia, and indeed within middle and upper level socioeconomic strata worldwide. This paper identifies potential barriers and facilitators to potential integration, of medical disciplines and argues for an accessible, multidisciplinary and evidence-based, yet humanistic and patient oriented approach. [ABSTRACT FROM AUTHOR]

Traditionally in medicine, nearly all prescribing decisions were made by the treating physician. The patient had relatively little input and hardly any access to alternative sources of information bearing on that decision; the cost of the prescription was covered by the patient or by an insurer, and neither was likely to provide any feedback to the physician to shape his or her decision. Now, all that has changed. Beginning with the consumerist movement of recent decades and culminating in the explosion of health-related information on the Internet, patients are increasingly vocal participants in the prescribing decision, on both clinical and economic grounds. Payers have become participants as well, and increasingly seek to influence prescribing decisions in the light of their own economic imperatives. Added to all these cross-currents is an additional wild card: the proliferation of ‘alternative medicines,’ ‘nutraceuticals’ and other nostrums that society has placed beyond the reach of the evidence-based discourse and regulations that govern conventional drug therapy. In a country where patients struggle to cover the cost of prescription therapies proven both safe and effective in rigorous clinical trials, billions of dollars per year are spent on alternative treatments in the US, unencumbered by concerns about whether they actually work or that they might be toxic. While these patterns of communication, education, disinformation and economic influence are much more chaotic than those that prevailed in the ‘good old days,’ this very ferment may also present opportunities for improvement of rational pharmacotherapy and public health. This paper briefly outlines the above changes in patterns of communication and influence as they relate to medication use in today's industrialised world (particularly the US), and suggests both hopeful and terrifying scenarios describing where these trends might lead in the coming decade. [ABSTRACT FROM AUTHOR]

This article briefly discusses various articles contained within the issue that focus on various issues related to complementary and alternative medicine. According to Stephen Groft, first Acting Director of the Office of Alternative Medicine of the U.S. National Institute of Health, worldwide literature searches were used to determine the major fields of practice, which were verified and refined via discussions with practitioners. The six sections, reportedly, were: mind-body interventions; bioelectromagnetics applications; alternative systems of medical practice; manual healing methods; herbal medicine; and diet and nutrition. Currently, U.S. National Center for Complementary and Alternative Medicine (NCCAM) now uses five categories, including herbal medicine. In this issue, Curtis H. Jones points out, in his paper, that the category NCCAM now calls Whole Medical Systems overlaps the other four, creating confusion.