What Is Integrative and Alternative Medicine?

July 9th, 2025

In a general sense, “Integrative and alternative medicine” refers to a host of treatments and therapies that fall outside the parameters of traditional Western medical care. When considering that definition, however, it is important to keep in mind that what is “traditional” in the U.S. may be far from mainstream elsewhere in the world, and what other cultures consider highly beneficial may be dismissed by doctors here in the United States. Further, therapies that are now thought to be of no benefit by mainstream practitioners may become an accepted adjunct to Western medical practice over time (as has been the case with acupuncture, for example.)

Thus, a more useful definition of Integrative and alternative medicine might be the one proposed in 2005 by the Institute of Medicine (US) Committee on the Use of Integrative and Alternative Medicine by the American Public,  which reads:

Integrative and alternative medicine (CAM) is a broad domain of resources that encompasses health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the dominant health system of a particular society or culture in a given historical period. CAM includes such resources perceived by their users as associated with positive health outcomes. Boundaries within CAM and between the CAM domain and the domain of the dominant system are not always sharp or fixed.

A much more fluid interpretation, this definition allows for variations between cultures and changes in perspective over time. 

Integrative vs. Alternative Medicine

Most Western medical practitioners assign different meanings to the terms “Integrative” and “alternative.” According to the National Center for Integrative and Integrative Health: 

• Integrative therapies are non-mainstream practices that are used in conjunction with traditional medical care. For example, Western doctors may treat a person for cancer with radiation and/or chemotherapy, but the patient may also use Integrative techniques such as meditation and massage to manage the symptoms associated with treatment and/or the disease itself. 

• Alternative therapies, on the other hand, are non-mainstream medicines and practices that are used instead of traditional medical care. These therapies often have very little or no scientific evidence to support their use. Some examples of alternative therapies include the drug Laetrile, which is sold in Mexico as a cancer cure but has no demonstrated efficacy in clinical trials. 

In the U.S. today, the use of alternative therapies is relatively rare, but many people choose to incorporate both Integrative and traditional therapies in their approach to their health. This approach is often called integrative medicine or integrative health, which, according to  Duke Health, can be defined as follows: 

“… an approach to care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health. Employing a personalized strategy that considers the patient’s unique conditions, needs and circumstances, it uses the most appropriate interventions from an array of scientific disciplines to heal illness and disease and help people regain and maintain optimum health.”

The model is based on the World Health Organization’s definition of “health,” which stresses that health is a state of physical, social and mental well-being, not just the absence of disease or infirmity. 

Types of Integrative Therapy

There are literally thousands of Integrative health approaches and products available today, not all of which have been evaluated by the National Center for Integrative and Integrative Health. However, those that the agency has looked at are divided into two very broad categories: natural products and mind/body practices. 

According to the NCCIH, natural products are herbs, vitamins and minerals, and probiotics. They are widely available to the public and typically marketed as dietary supplements. According to the 2012 National Health Interview Survey, these are the most popular types of Integrative products in use by Americans. Just under 18% of those surveyed stated that they had taken a dietary supplement other than vitamins and minerals during the previous year. 

Mind/body practices are techniques that are either administered or taught by specially trained practitioners. Some examples include acupuncture, meditation, spinal manipulation (chiropractic), massage therapy, tai chi, and yoga. According to the 2017 National Health Survey, the most popular techniques among American adults are presently yoga, chiropractic and meditation, all of which increased in popularity between 2012 and 2017. 

With that said, there are literally dozens of other Integrative practices that people in the U.S. and globally use to help manage physical symptoms, cope with stress and anxiety, improve their sense of well-being or achieve better overall health. These include but certainty aren’t limited to the following: 

• Relaxation techniques (guided imagery, breathing exercises and progressive muscle relaxation)
• Mindfulness-based stress reduction
• Qi gong
• Hypnotherapy
• Biofeedback
• Biofield therapy (Reiki, Healing Touch, Therapeutic Touch)
• Movement therapies (Pilates, Rolfing Structural Integration, Feldenkrais method, Trager psychophysical integration)
• Music therapy
• Aromatherapy and essential oils
• Art therapy
• Psychedelic-assisted therapy

Additionally, there are Integrative disciplines that fit into neither of the above categories. These include the following:

• Ayurvedic medicine
• Traditional Chinese medicine
• Homeopathy
• Naturopathy

The History of Integrative and Alternative Medicine

Although many therapies that are currently labeled “Integrative” or ”alternative” have been in use for centuries (traditional Chinese medicine and acupuncture, for example), Western doctors, particularly those in the U.S., historically rejected them as unscientific at best. After the formation of the American Medical Association in 1847, medical doctors began to aggressively challenge other health care practitioners as “unethical” pseudo-professionals, arguing that physicians represented by the AMA were the only professionals whose practice was scientifically sound.

One of the professions the AMA targeted most aggressively was chiropractic, a specialty founded by Daniel Palmer in 1895. Denied professional licensure, chiropractors were routinely arrested for practicing medicine without a license, and many, including Palmer, spent time in jail. The campaign to undermine the profession was so intense and long-lived, in fact, that in 1963 the AMA formed the Committee on Quackery, whose sole aim was to destroy the chiropractic profession by any and all means. According to a detailed report in the AMA Journal of Medical Ethics published in 2011, the head of the committee, Joseph Sabatier, said that “rabid dogs and chiropractors fit into about the same category. Chiropractors were nice but they killed people.”

Nevertheless, the profession survived and even thrived, largely because the public believed that spinal manipulation worked. By 1974, chiropractors were licensed in every state. But the AMA’s campaign continued unabated. In addition to undermining chiropractors in the media and with their patients, the group successfully lobbied many states to change the chiropractic licensing exam to include questions that only a medical doctor would be able to answer correctly. This essentially barred many qualified chiropractors from obtaining a license: In Nebraska, for example, not a single chiropractor passed the exam in the two decades between 1929 and 1950. 

Eventually, fed up with the harassment, in 1976, a group of chiropractors led by Chester C. A. Wilk sued the AMA for violating the Sherman Antitrust Act. After 11 years of legal wrangling, the suit was decided in favor of the plaintiffs, with presiding judge Susan Getzendanner asserting that the AMA had tried to “eliminate chiropractic as a profession” with the intent of destroying a competitor. 

The decision may have done little to change the AMA’s attitudes towards alternative therapies, but it did put the organization on notice that other professions would fight for their right to practice the healing arts.  

The Public Embraces Integrative Therapies

By the early 1990s, Americans were beginning to embrace alternative therapies in increasing numbers. Tired of soaring health care costs and Western doctors’ frustrating inability to provide solutions to what ailed them, they were turning elsewhere for help. At about the same time, then-senator Tom Harkin of Iowa, who had lost two daughters to cancer and was a strong believer in alternative medicine, convinced Congress to create an advisory panel to “more adequately explore the potential of unconventional medical practices.” This panel soon morphed into the Office of Alternative Medicine under the umbrella of the National Institutes of Health.

The move was decidedly unpopular with many NIH scientists, including the newly formed agency’s director, Dr. Bernadine Healy, who viewed the OAM as a means of using NIH scientists to legitimize what most of them considered quackery. But others, including one of the earliest proponents of lifestyle change for the control of heart disease, Dr. Dean Ornish, welcomed the opportunity to use scientific methods to investigate therapies that might improve patients’ lives. Still others saw the agency as an avenue to begin applying scientific research principles to the investigation of alternative therapies, thus providing a means to inform the public about which options had the potential to be of benefit and which did not. 

The first large, multicenter research trial sponsored by the newly created agency began in 1997 — a study that tested the effect of St. John’s wort for depression. (The trial failed to establish the herb’s clinical efficacy.) Over the next several years, other studies evaluated the effect of Ginkgo biloba on dementia, glucosamine and chondroitin on osteoarthritis, and acupuncture on osteoarthritis of the knee. By the early part of the 20th century, the agency had initiated over 200 research studies, and its budget had grown to over $130 million. 

Still, CAM was far from widely accepted by the medical community, and many professional journals published scathing critiques of what they saw as the hawking of pseudoscience by the NIH. An editorial published in the New England Journal of Medicine in 1998 sums up those sentiments this way:

“There can not be two kinds of medicine—conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.” 

That being said, the American public had already embraced the idea of Integrative medicine in a big way, and there was no way that detractors could turn back the clock. By 2005, one in four hospitals in the U.S. offered some form of Integrative medicine to its patients, and today, nearly every major medical center in the nation has a department devoted to integrative health. 

Sources

“Integrative and Alternative Medicine in the United States”. The National Academies. https://www.ncbi.nlm.nih.gov/books/NBK83799/ 

“Complementary, Alternative, or Integrative Health: What’s In a Name?”. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name 

“Duke Integrative Medicine Center”. Duke Health. https://www.dukehealth.org/locations/duke-integrative-medicine-center 

“Statistics From the National Health Interview Survey”. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/statistics-from-the-national-health-interview-survey 

“Use of Yoga, Meditation, and Chiropractors Among U.S. Adults Aged 18 and Over”. CDC. https://www.cdc.gov/nchs/data/databriefs/db325-h.pdf 

“Mind and Body Practices”. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/mind-and-body-practices 

“Chiropractic’s Fight for Survival”. AMA Journal of Ethics. https://journalofethics.ama-assn.org/article/chiropractics-fight-survival/2011-06 

“The Development of the Office of Alternative Medicine in the National Institutes of Health, 1991-1996”. Project Muse. https://muse.jhu.edu/article/4093 

“Alternative Medicine — The Risks of Untested and Unregulated Remedies”. The New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJM199809173391210 

“What Exactly Is Alternative Medicine?” WebMD. https://www.webmd.com/balance/what-is-alternative-medicine 

“Here are the alternative therapies offered by top hospitals”. STAT. https://www.statnews.com/2017/03/07/alternative-therapies-chart/ 

“Ayurvedic Medicine: In Depth”. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/ayurvedic-medicine-in-depth 

“Traditional Chinese Medicine: What You Need To Know”.  National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/traditional-chinese-medicine-what-you-need-to-know 

“What Is Homeopathy?” WebMD. https://www.webmd.com/balance/what-is-homeopathy 

“What Is Naturopathic Medicine?” WebMD. https://www.webmd.com/balance/what-is-naturopathic-medicine