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The search for health includes many beliefs and practices that are outside conventional medicine. Physicians are important sources for information and guidance about health matters, but our patients also rely on a wide range of other sources including family and friends, cultural traditions, alternative practitioners, and increasingly the Internet, popular media, and advertising. An important step in patient-centered care is understanding what patients are doing to manage their health. This understanding is important to harness potential benefits and to help patients avoid harm.


Complementary health approaches include a broad range of practices, interventions, and natural products, which are not typically part of conventional medical care, or which may have origins outside of usual Western practice. Complementary approaches are defined as those used together with conventional therapies, distinguishing them from alternative practices, those used as a substitute for standard care. Complementary practices can roughly be divided into two major groups—mind and body practices, and natural products. Mind and body practices and disciplines are usually administered by or taught to others by a clinician, trained practitioner, or teacher, and include acupuncture, massage, meditation, and hypnosis. Natural products include a diverse group of orally or topically administered substances such as botanical products, unconventional diets, dietary supplements, herbal medicines, homeopathic remedies, probiotics, and others. Brief definitions for some of the common complementary and alternative health practices are provided in Table 469-1. Although some complementary health practices are recommended or provided by a physician or a complementary health care provider such as a chiropractor, acupuncturist, or naturopathic practitioner, many of these practices are undertaken as “self-care.” Although some are reimbursed, most are paid for out of pocket.

TABLE 469-1Terminology of Complementary Health Approaches

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