CAM un United States

Ivo Kwon, M.D.Gachon Medical School

Public Perceptions of the CAM

42% of US adults used CAM 71% thoughts the demand for CAM

will increase in the future $27 billion used for CAM therapy in

1998 $68 million governmental fund

allocated for CAM research in 2000

Common Cures by CAM(herbal therapy)

Common cold(59%) Burns(45%) Headaches(22%) Allergies(21%) Rashes(18%) Insomnia(18%) Pms(17%)

Public Perception of the CAM

Money allocation for the CAM

Governmental Fund

Common CAM modalities in the U.S.

Chiropractic Massage TCM/acupuncture Homeopathy Naturopathy Others – 태극권 , 기공 , herbal therapy 자기요법 , meditation

National policy for the CAM(1)

Different from state to state Licensed physician can practice

acupuncture or other CAM modalities.

No professional associations in the orthodox medical area.

No professional education for CAM only practitioner as GME in the orthodox medicine.

National policy for the CAM(2)

In some states(ex. California), Certain CAM modalities are covered by the health insurance but not common.

Federal Governmental support to CAM is though NIH(NCCAM) research.

National policy for the CAM(3)

REGULATIONS Dietary Supplement Health and

Education Act(1994) : 식품첨가물에 대해서 FDA 승인을 면제 -> DHEA 와 같은 첨가물 제조회사 매출이 140 억 달러로 증가 (1998)

Federal Trade Commission(FTC) : 1998년 식품첨가물 제조업체에 대해 그 광고의 유효성을 증명할 것을 요구

CAM research-History 1991 : NIH 내 연구기관 설립을 위한 2 만달러 기금

의회 통과 1993 : NIH Revitalization Act-OAM(Office of Alternative

Medicine) 설치 1993 : the Alternative Medicine Program Advisory Cou

ncil 설립 1997 : 최초의 III 상 임상시험 시작 1998 : NCCAM 설립 (Public Law 105-227) 1999 : National Advisory Council on CAM 2001 : International Conference 개최 , CAM on PubM

ed 등장

CAM research- 성격 Scientific Analysis Case-Control Study

CAM research- 목적 Stimulate the su

CAM research-main domain Alternative medicine system Mind-body interaction Biologically based therapy Manipulative and body based

methods Energy therapy

CAM research- 질병 영역 Arthritis/muskuloskeletal disorder Cancer Cardio-vascular disease Digestive disorder Neurological-mental disorder Women’s health

CAM research- 연구 대상 Botanical drug effect/drug interaction Clinical trials Acupuncture Homeotherapy others

CAM research

CAM research 2

CAM education AMSA(Amerian Medical Students Associ

ation) 에서 CAM 교육을 위한 기금 지원 (2000 년 부터 )

CAM education-2002 년 projects

Educational Initiative in CAM (Georgetown Univ) Integrative Medicine Curriculum for Health Profession

als(University of California San Francisco) Center for Pediatric Integrative Medical Education(Chil

dren's Hospital ) Integrating CAM into Health-Professions Education (U

niversity of North Carolina) CAM Curriculum Project(University of Minnesota ) CAM Education Program for Nursing (Rush-Presbyteria

n-St Luke's Medical Ctr)

CAM education-2002 년 projects

Evidence-Based Curriculum in Alternative Therapies (University of Texas Medical Branch)

Integrating CAM into a Family Medicine Residency Program (Maine Medical Center)

Interdisciplinary CAM Curriculum Model(University of Kentucky )

The Tufts Program in Evidence Based CAM (Tufts University) Integrative Curriculum for Medicine and Allied Health

(University of Michigan) CAM Curriculum at the University of Washington

(University of Washington) Oregon CAM Course(Oregon Health & Science University) Integrating CAM: Nursing Emphasis(University of

Washington)

CAM education in U.S : goal Introduction General understanding Integrated to orthodox medical

science Integrated to various education

tools

Example of CAM education : UCI resident education

대상 : 가정의학과 , 내과 레지던트 방법 : EBM practice/on line education 목적 : general understanding and helpfu

l to clinical decision making

Med.Students’ Use of CAM(Dr.Lie survey)

CAM modality Used %Meditation 40

Massage 43

Spirituality 35

Herbals 33

Chiropractic 19

TCM 13

Homeopathy 10

Biofeedback 8

hypnosis 6

The end

감사합니다 .