In the North America, Europe, and other industrialized world regions, an increasing percentage of the population is using complementary, alternative, and integrative approaches to treat or selftreat medical and mental health problems. A large patient survey (N = 7,503) found that females, college graduates, and persons who believed that they received poor health care were more likely to use CAM, and only one-half of individuals who used CAM notified their health care providers. The majority of CAM users are well educated, committed to personal growth, satisfied with the conventional care provided by their physician or other health care provider, and use both prescription medications and CAM approaches for the same problem. An increasing number of medical schools, nursing schools, and psychology graduate programs offer courses on CAM. Symposia on CAM modalities are included in the annual meetings of the American Medical Association (AMA), the American Psychiatric Association (APA), and other professional medical associations. Approximately half of US physicians—and the majority of European physicians—believe that acupuncture, chiropractic, and homeopathy are valid therapeutic modalities and refer patients to practitioners of these therapies. Increasing numbers of primary care physicians are becoming certified to practice massage, acupuncture, herbal medicine, homeopathy, and other nonallopathic modalities.
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