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Career Profile: complementary medicine

 

Use of complementary medicine in the NHS is increasing. For example, a survey of GPs by Sheffield University found that 49% of practices offered access to some form of complementary medicine in 2001, compared with 39% in 1995. A number of NHS hospitals also use various complementary medicine therapies. For instance, acupuncture is sometimes used to assist in childbirth, and for other purposes in a number of pain clinics.  However, most employment opportunities in complementary medicine still lie in the private sector, rather than the NHS, and even where available in the NHS tend to be part time rather than full time.

 

Choosing a branch of complementary medicine with proven clinical value

 

The Oxford Handbook of Complementary Medicine (OHCM) evaluates the evidence for a wide range of complementary therapies. Each is rated on a six point scale for each relevant medical condition. These range from Beneficial (effectiveness has been demonstrated by clear evidence from RCTs, and expectation of harms is small compared with the benefits) to Likely to be ineffective or harmful (for which ineffectiveness or harmfulness has been demonstrated by clear evidence).

Acupuncture, Biofeedback, Hypnotherapy, Massage, Music Therapy and Relaxation Therapy are among the types of complementary medicine for which there appears to be the most positive evidence.

Further information follows on each, with the OHCM assessment, followed by information on each as an alternative or complementary career option. To practice in each area professional indemnity insurance is, of course, needed.

 

Acupuncture

Beneficial for nausea and vomiting after chemotherapy, surgery or pregnancy related; neck pain; and osteoarthritis of the knee.

Likely to be beneficial for seven other conditions, from anxiety to back pain.

Doctors can train and become members of the British Medical Acupuncture Society (BMAS). To achieve the Diploma in Medical Acupuncture (Dip Med Ac) requires a minimum of 100 Training Hours, with clinical experience assessed by a log book of at least 100 case histories and by a clinical assessment.

http://www.medical-acupuncture.co.uk/

 


Biofeedback

The use of instrumentation to monitor, amplify and feed back information on physiological responses so that a patient can learn to regulate these responses. (OHCM)

Beneficial for faecal incontinence: bowel control; headache, hypertension, migraine, and urinary stress incontinence: bladder control.

Likely to be beneficial for six other conditions, from asthma to Raynauds phenomenon.

For further information see the Association for Applied Psycho-physiology and Biofeedback (a US organisation) http://www.aapb.org/ ; the  Biofeedback Foundation of Europe http://www.bfe.org/; http://www.york-biofeedback.co.uk/.


Hypnotherapy

Beneficial for labour

Likely to be beneficial for six other conditions, from insomnia to irritable bowel syndrome

Doctors may be trained through the British Society of Clinical and Academic Hypnosis. Accreditation qualifies the member for admission to the referral list for practitioners. To remain accredited you are expected to attend at least one advanced course every three years.

http://www.bscah.com/

The Royal Society of Medicine has a Hypnosis and Psychosomatic Medicine section.

 

Massage

Beneficial for anxiety

Likely to be beneficial for seven other conditions, from depression to back pain.

Massage was one of the first disciplines to be registered with the Complementary and Natural Healthcare Council (CNHC) http://www.cnhc.org.uk/

The British Massage Therapy Council is an umbrella organisation http://www.bmtc.co.uk/


Music Therapy

Beneficial for anxiety, stress and psychopathology

Likely to be beneficial for three conditions (mood, pain and schizophrenia)

A career in music therapy requires a high standard of musicianship and a postgraduate qualification at one of the seven institutions recognised by the Association of Professional Music Therapists (http://www.apmt.org/) which provide eligibility for registration with the Health Professions Council. This is normally for people who have studied at a College of Music or done Music as their degree at University. Occasionally an alternative background (education and psychology are mentioned) plus a high level of musicianship will be accepted for entry to the postgraduate courses. The requirements for Assistant Therapists are not quite so demanding.

 

Relaxation Therapy

Beneficial for anxiety, insomnia and nausea/vomiting (chemotherapy induced).

Likely to be beneficial for nine conditions, from depression to rheumatoid arthritis.

A Physiotherapy or Occupational Therapy qualification is likely to be useful.

 

Regulation of Complementary Medicine

There is a General Chiropractic Council (http://www.gcc-uk.org/) and a General Osteopathic Council (http://www.osteopathy.org.uk/) which provide statutory regulation.

The Complementary and Natural Healthcare Council (http://www.cnhc.org/) covers Alexander technique, Bowen, Massage Therapy, Nutritional Therapy, Aromatherapy, Reflexology, Shiatsu, Sports, Rememdial and Yoga Therapy; with further areas being included from 2010 onwards.

Arts therapists are covered by the separate Health Professions Council (http://www.hpc-uk.org/), which focuses on more traditional allied health professions, such as Dieticians, Occupational therapists, Physiotherapists, Radiographers and Speech and language therapists.

 

Further Information

Oxford Handbook of Complementary Medicine; Edzard Ernst, Max H Pittler, Barbara Wider, Kate Boddy    ISBN 978-0-19-920677-3   (Oxford University Press 2008)

http://www.naturalstandard.com/ a complementary medicine specific database

www.library.nhs.uk/cam - a database whose primary aim is to provide relevant information to clinicians

http://www.nhsdirectory.org/ The NHS Directory of Complementary and Alternative Practitioners, for use by NHS professionals

Evidence - based Complementary and Alternative Medicine, an international peer reviewed journal  http://ecam.oxfordjournals.org/

 

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