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Complementary and alternative medicine: challenges and opportunities for American medicine.

Both as an art and as a science, medicine is ever-evolving. Before the emergence of the empirical and experimental sciences, physicians relied heavily on the art of medicine. But in the past century, progressively detailed investigations of individual organs, cells, and molecules led to the emergence of biomedicine, with its heavy reliance on science, as the now-dominant and conventional basis for medicine. In the past century, advances in the biomedical sciences, coupled with improvements in sanitation and public health, resulted in dramatic improvements in health and a neardoubling of life expectancy. With these stunning successes, however, have come new challenges for conventional medicine, which has now to manage chronic diseases prevalent in an aging population. In this context, physicians are sometimes unable to cure their patients or offer them adequate relief from their symptoms, despite the current abundance of new treatments and technologies. Moreover, the reliance on technology and the economic imperatives of managed care have affected the privileged physician–patient relationship, depriving it of the rich dialogue that characterizes the art of medicine and can extend the healing process beyond that afforded by drugs and other treatments alone.