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Use of complementary medicine in the NHS is increasing. For example, a survey of GPs by Sheffield University found that 49% of practices offered access to some form of complementary medicine in 2001, compared with 39% in 1995. A number of NHS hospitals also use various complementary medicine therapies. For instance, acupuncture is sometimes used to assist in childbirth, and for other purposes in a number of pain clinics. However, most employment opportunities in complementary medicine still lie in the private sector, rather than the NHS, and even where available in the NHS tend to be part time rather than full time.

Choosing a branch of complementary medicine with proven clinical value

The Oxford Handbook of Complementary Medicine (OHCM) evaluates the evidence for a wide range of complementary therapies. Each is rated on a six point scale for each relevant medical condition. These range from Beneficial (effectiveness has been demonstrated by clear evidence from RCTs, and expectation of harms is small compared with the benefits) to Likely to be ineffective or harmful (for which ineffectiveness or harmfulness has been demonstrated by clear evidence).

Acupuncture, biofeedback, hypnotherapy, massage, music therapy and relaxation therapy are among the types of complementary medicine for which there appears to be the most positive evidence.

Further information follows on each, with the OHCM assessment, followed by information on each as an alternative or complementary career option. To practice in each area, you will of course need professional indemnity insurance.

Acupuncture

Beneficial for nausea and vomiting after chemotherapy, surgery or pregnancy related; neck pain; and osteoarthritis of the knee. Likely to be beneficial for seven other conditions, from anxiety to back pain.

Doctors can train and become members of the British Medical Acupuncture Society (BMAS). To achieve the Diploma in Medical Acupuncture (Dip Med Ac) requires a minimum of 100 training hours, with clinical experience assessed by a log book of at least 100 case histories and by a clinical assessment.

British Medical Acupuncture Society

Biofeedback

The use of instrumentation to monitor, amplify and feed back information on physiological responses so that a patient can learn to regulate these responses.

Beneficial for faecal incontinence: bowel control; headache, hypertension, migraine, and urinary stress incontinence: bladder control. Likely to be beneficial for six other conditions, from asthma to Raynauds phenomenon.

Association for Applied Psychophysiology and Biofeedback (US organisation)

Biofeedback Federation of Europe

Stress Management Training and Coaching with Biofeedback

Hypnotherapy

Beneficial for labour. Likely to be beneficial for six other conditions, from insomnia to irritable bowel syndrome.

Doctors may be trained through the British Society of Clinical and Academic Hypnosis. Accreditation qualifies the member for admission to the referral list for practitioners. To remain accredited you are expected to attend at least one advanced course every three years.

British Society of Clinical and Academic Hypnosis

Royal Society of Medicine: Hypnosis and Psychosomatic Medicine section

Massage

Beneficial for anxiety. Likely to be beneficial for seven other conditions, from depression to back pain.

Massage was one of the first disciplines to be registered with the Complementary and Natural Healthcare Council (CNHC)

Music Therapy

Beneficial for anxiety, stress and psychopathology. Likely to be beneficial for three conditions (mood, pain and schizophrenia).

A career in music therapy requires a high standard of musicianship and a postgraduate qualification at an institution recognised by the British Association for Music Therapy, which provide eligibility for registration with the Health and Care Professions Council. This is normally for people who have studied at a College of Music or studied music as their degree at university. Occasionally an alternative background (education and psychology are mentioned) plus a high level of musicianship will be accepted for entry to the postgraduate courses. The requirements for assistant therapists are not quite so demanding.

Relaxation therapy

Beneficial for anxiety, insomnia and nausea/vomiting (chemotherapy induced). Likely to be beneficial for nine conditions, from depression to rheumatoid arthritis.

A physiotherapy or occupational therapy qualification is likely to be useful.

Regulation of Complementary Medicine

There is a General Chiropractic Council and a General Osteopathic Council which provide statutory regulation.

The Complementary and Natural Healthcare Council covers Alexander technique, Bowen, massage therapy, nutritional therapy, aromatherapy, reflexology, shiatsu, sports, remedial and yoga therapy, among others.

Arts therapists are covered by the separate Health & Care Professions Council, which focuses on more traditional allied health professions, such as dietitians, occupational therapists, physiotherapists, radiographers, and speech and language therapists.

Further Information

Oxford Handbook of Complementary Medicine; Edzard Ernst, Max H Pittler, Barbara Wider, Kate Boddy ISBN 978-0-19-920677-3 (Oxford University Press 2008)

Natural Medicines, a complementary medicine specific database.

University College London Hospitals: Complementary and Alternative Medicine Library and Information Service (CAMLIS)

Evidence-based Complementary and Alternative Medicine, an international peer reviewed journal