In the European Union there are approximately 145,000 dual-trained doctors, i.e. trained in conventional medicine and a particular CAM modality. CAM is also increasingly practised by dentists and veterinarians. CAM modalities include acupuncture, anthroposophic medicine, ayurvedic medicine, herbal medicine/phytotherapy, homeopathy, naturopathy, osteopathy, chiropractic and traditional Chinese or Tibetan medicine among others. They all may be integrated into patient care within the context of general medical practice, conventional specialist practice or full-time CAM practice. CAM treatment is provided within a broad scope, which includes an awareness of the need for conventional medical diagnosis, prognosis and treatments.
In addition to the approximately 145,000 physicians practising CAM therapies, there are in the order of 160,000 non-doctor CAM practitioners practising CAM modalities such as those just mentioned, as well as other CAM therapies, such as aromatherapy, kinesiology, massage, reflexology, shiatsu, yoga, qigong, etc. CAM offers a whole person approach to health, each CAM therapy seeking to help the patient according to its distinct diagnostic and treatment methods. CAM treatments can be provided on a stand-alone basis and/or complementary to conventional medicine approaches. These modalities are delivered mostly in private practice. Increasingly CAM practitioners regularly collaborate with conventional medical practitioners.
Acupuncture (96,380) is the most provided method for both doctors (80,000) and non-medical practitioners (16,380), followed by homeopathy (45,000 doctors and 5,250 non-medical practitioners), with both disciplines being dominated by doctors. The use of herbal medicine/phytotherapy is difficult to assess as herbal medicinal products are in use by doctors in several EU Member States (e.g. Germany) and are also used by other CAM practitioners such as naturopaths and practitioners of traditional Chinese medicine and Ayurveda. According to a CAMbrella survey, herbal medicine is the most reported CAM therapy used by patients, variously categorised as medical herbalism, herbal medicine, herbs, herbal products, herbal therapies, herbal remedies, herbal teas and phytotherapy. Reflexology (24,600) is (by self-declaration) almost exclusively provided by non-medical practitioners. Naturopathy (22,300) is predominately practised by (15,000 mostly German) doctors. Anthroposophic medicine (4,500) and neural therapy (1,500) are the most provided methods practised exclusively by doctors.