Provider Support for CAM: Usefulness,Ethics,and Dilemma

Dear Editor:

I read the recent publication by Bann et al. with a great interest. ¹ Bann et al. concluded that “CAM treatment effects can arise in part from sources related to the therapeutic relationship, as well as the philosophy of healing and specific techniques designed to reduce symptoms.” Provider support is mentioned as an important key for success in this report. Indeed, I agree that provider support can result in psychosomatic treatment of the patients. However, I would like to share some ideas on this aspect. In developing countries, such as in Thailand, there is no good regulation and control on complementary and alternative medicine (CAM) provided. Some providers in real life in these countries are nonmedical personnel. The aim of support can be unethically misused by these personnel. Often, some providers provide incorrect information or disguise some information to the patients aiming at sale of their unproven CAM products. In lay journals, recommendation for ingesting herbs that have the potential for adverse interactions and are contraindicated for certain groups is very common. ² Certainly, provider support can be a tool for their unethical practice. However, the same accusations can of course be leveled at the traditional biomolecular fraternity. Similar malpractices on traditional drugs can be seen and not completely controlled. This is an actual dilemma for our view on both CAM and traditional biomolecular practice in the developing world at present. ³