What makes medicine "alternative"?

From Hua Shou's "Expression of the Fourteen Meridians".
Public domain image courtesy of Wikipedia.

A friend of mine recently sent me this quick email.

What makes a medicine conventional or alternative ?
Or maybe neither.

Thoughts ?

As I was packing for a trip to Cuba at the time, I had to be brief. Here was my reply:

"Conventional", "allopathic", and "Western" are all (generally derisive) labels that are applied to science-based medical practices. Conversely, "alternative" or "complementary" or "integrative" medical practices are generally those that are eschewed by the science-based crowd. The labels used are meant to present a false equivalence to the consumer, implying that "alternative" medicine is just as good as "conventional" medicine. Some completely reasonable, evidence-based practices (such as good diet, exercise, etc.) are presented as "alternative" health practices, even though they are commonly recommended by mainstream medical practitioners.

To quote John Maynard Keynes: "When the facts change, I change my mind."

Generally, "alternative" health practices are those that have not been shown to be effective in rigorous, well controlled, properly blinded scientific studies. Here's the key point: Once something has been shown to work, it becomes part of "conventional" medicine. On the other side of that coin, "alternative" medicines generally resist change, and refuse to admit defeat when the evidence shows them to be ineffective. Homeopathy is a prime example. Acupuncture is another (although acupuncture is tough, because there is some evidence to show that it does work; the problem is, almost all of the positive studies are for electro-acupuncture, which is actually not acupuncture at all but simply a TENS unit, an real medical treatment for pain).

To quote Tim Minchin, "By definition ... alternative medicine ... has either not been proved to work, or has been proved not to work. You know what they call alternative medicine that's been proved to work? Medicine."

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For more information, I highly recommend checking out the Science-Based Medicine blog at sciencebasedmedicine.org.

I hope that helps!