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CAMbrella work package 5

CAM use – the providers’ perspective

This work package sought to identify the different models of CAM provided by registered physicians and CAM practitioners (including non-medical providers with no academic background) by country within European public health systems.

CAM provision in Europe comprises health care practitioners and physicians with different healing attitudes, medical background, training, certification, and practice. Data are only available if they are registered in any specific body open to the public, and are therefore scarce, scientific publications are almost lacking completely.

Both medical and non-medical practitioners play an important role in the provision of CAM within the healthcare system in Europe. CAM provision in the EU27+12 is maintained by more than 150,000 registered medical doctors (MDs) with additional CAM certification and more than 180,000 registered and certified non-medical CAM practitioners. This suggests up to 65 CAM providers (35 non-medical practitioners and 30 physicians) per 100,000 inhabitants, compared to the EU figures of 95 general medical practitioners per 100,000 inhabitants.

Acupuncture is the most frequently provided method (53% of all practitioners) with 80,000 physicians and 16,000 non-medical practitioners trained in the therapy, followed by homeopathy (27% of all practitioners – 45,000 physicians and 4,500 non-medical practitioners). These two disciplines are both dominated by physicians.

Herbal medicine and manual therapies are almost exclusively provided by non-medical practitioners.

Naturopathy, on the other hand, is dominated by 15,000 (mostly German) physicians, as is anthroposophic medicine (4,500) and neural therapy (1,500).

CAM provision in Europe has not yet gained governmental interest at large; state funded research based knowledge is mainly available for Denmark, Germany, Norway, Switzerland, and the UK. This calls for more research in this field throughout the EU and associated countries.

Teaching and certification are subject to inter-national, national or in some countries even regional regulations. There is a complete lack of coherence in training, education and provision of CAM.
CAM provision in Europe requires the:
• transparent harmonisation of CAM training, medical education and certification
• standards of the regulation and registration bodies for both therapists and products to be open to the public.

The complete work package report can be downloaded here.

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