Elevation Of Alternative Medicine's Standards.

Much of this chapter has been given to discussion of the first century of unconventional medicine precisely because attitudes set during that period continue to shape interprofessional relations as the second century of alternative medicine draws to a close. But concomitant with this historical constancy, there have been profound changes over the course of the twentieth century, too. In 1900, alternative systems of practice were still bound to crude and speculative theoretical rationales; they still claimed panacea-like potency for their therapies; they operated schools with minimal requirements that admitted students of dubious qualifications; they were tainted, some more than others, with hucksterism (chiropractic schools, a 1930s survey observed, “fairly reek of commercialism”); and they unrealistically aimed to overthrow rather than complement allopathic medicine.

By midcentury, however, a vigorous bootstrapping effort was underway, which had already raised the level of education and ethics in all systems of practice. Theoretical foundations were being strengthened and therapeutic claims modified. Conventional medicine was being acknowledged as highly effective in its sphere, and alternative practitioners' longstanding competitive attitude toward allopathic physicians was giving way to a goal of cooperation.

For their part, mainstream physicians steadily assumed a more flexible stance too, first, as has been noted, toward osteopathic medicine. During the 1950s and early 1960s, the AMA gradually recognized that the quality of osteopathic academic training was comparable to that of allopathic. Then, in the mid-1960s, osteopaths were admitted into orthodox residency programs, even to membership in the American Medical Association. During that same decade, DOs in California and Washington were actually encouraged by those states' medical societies to convert their degrees to MD and join the allopathic ranks.

The medical establishment's sudden willingness to merge with osteopathy was, of course, assailed by some as an attempt to suppress competition by assimilating it. Ever since, alternative medical systems have been riven with angst that the culmination of their struggle for professional respectability might turn out to be absorption into the mainstream and loss of their identity and independence.Therefore, although the trend of professional improvement in alternative medicine has taken an even sharper upward turn since the middle of this century, a gulf of distrust and misunderstanding remains between the sides. The aura of sectarianism cast by alternative systems for so long lingers in the memory of many mainstream practitioners, distorting their view of complementary medicine and inhibiting them from appreciating the remarkable transformation that has occurred.

This blaming of complementary healers for the sins of their fathers, moreover, is as ironic as it is unjust, since allopaths' fathers committed all the same sins. Prior to this century, orthodox medicine was littered with naive theories, ineffective (sometimes dangerous) therapies, and inferior educational institutions. Whatever skeletons there are hidden in alternative medicine's closet are to be found in the allopathic closet as well, and one might reasonably think of the professional evolution of the major systems of complementary medicine as a repetition of the pattern of development of the allopathic profession, with a time lag of half a century or so. For the analogy to be fully accurate, however, more extensive and concrete evidence of the efficacy of complementary therapies is required. It was for the purpose of filling that need that the National Institute of Health's Office of Alternative Medicine was established in 1992.