Extrapolation to the U.S. population suggests that in 1990, Americans made an estimated 425 million visits to providers of unconventional therapy. This number exceeds the number of visits to all U.S. primary care physicians (388 million).
Expenditures associated with use of unconventional therapy in 1990 amounted to approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out-of-pocket.
Dr. Eisenberg's follow-up study, published in 1998,2 showed that the public's use of "alternative medicine" was still on the upswing. In Dr. Eisenberg's second survey, he updated his terms, dropping the use of "unconventional medicine" in lieu of "alternative medicine."
Use of at least one of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997.
Extrapolations to the U.S. population suggest a 47.3% increase in total visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997, thereby exceeding total visits to all U.S. primary care physicians (386 million).
Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket.
Now comes a new nationally representative survey3 via the web from Intersurvey, Inc., that specifies what most everyone knew in a general way. Published May 12, 2000, the survey found that "two-thirds of Americans have tried at least one form of alternative therapy." If you take the InterSurvey results and those of Dr. Eisenberg, the growth in the use of alternative care went from one-third of the population in 1990 to over 42 percent in 1997, to two-thirds in 2000.
InterSurvey defined which forms of "alternative" care were tried most often. The two professions heading the list are chiropractic and massage therapy. This suggests that alliances between the two professions would benefit both.
The reasons people tried alternative care proved equally interesting:
This information should be considered the basis for a marketing plan. It clearly lays out how patients are moved to try alternative care, including chiropractic.
The survey also looked at perceived effectiveness.
When two thirds of the adult population is engaged in an activity, the terms "alternative" and "complementary" hardly seem appropriate. Society needs a new term that encompasses all of the nonmedical health care.
According to these findings, chiropractic is the second (by only one percentage point) most tried form of alternative care and rated "extremely effective" by the greatest number of users. With an extrapolated 37 percent of the population having experienced chiropractic at least once, it is conceivable that this number could grow to over 50 percent if the current trend continues.
And while chiropractic has yet to be experienced by half the people in the U.S., it's leading the pack with herbal medicine and massage to be the first form of "alternative care" to break that mark. These findings should further encourage the chiropractic profession to take the steps needed to take advantage of the growing interest in alternative care.
Editor's note: For additional thoughts on the opportunities for chiropractic based on this survey, please see "CAM No Mo'" on page 3 of this issue.
- Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States. N Engl J Med 1993;328:246-52.
- Eisenberg DM, Davis RB, Ettnes SL, Appel S, Wilkey S, Van Rompay MV, Kessler RC. Trends in alternative medicine use in the United States, 1990-1997. JAMA 1998;280:1569-1575.
- The InterSurvey study was conducted on the web between April 19 and May 3, 2000. The survey is based on a nationally representative sample of 1,148 adults. The margin of error has a 95 percent certainty of being +/- 2.9 percentage points. InterSurvey (www.intersurvey.com ) was founded by two Stanford University professors to "combine first-class science with the power of the internet to revolutionize the collection of information on public attitudes and behavior."