5 European Countries With Different Views on Alternative Medicine, and What Can We Learn From Them

What is alternative medicine, and how is it used in Europe?

Complementary and alternative medicine, or CAM, is a popular term in Europe to describe a wide range of medical services that are less reliant on modern medication, such as acupuncture, reflexology, herbology, chiropractic, osteopathy, massage therapy, homeopathy, and naturopathy. People frequently report that their CAM services are individualized and not rushed, giving them a sense of personal care they can’t find in other treatments. CAM continues to grow in acceptance across Europe with 100 million EU citizens using an alternative treatment. At least a third of the population in nine countries uses CAM regularly. The EU is expecting demand to continue to grow and is working to streamline regulation and research on CAM as EU citizens press to have CAM covered in their normal healthcare.

1. Norway: how alternative medicine found a home in hospitals

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Healthcare in Norway is showing how CAM can infiltrate and even be embraced in the most hostile medical arena: hospitals. Physicians and administration in hospitals across all nations are typically far more skeptical of CAM than general practitioners or other health providers. Yet, even with recent controversy, the number of Norwegian hospitals offering CAM (and especially acupuncture) rose dramatically since 2000.

Two things happened: First, the Norwegian Research Council developed a CAM research group in 2000 at the University of Tromso. This became the National Research Center in Complementary and Alternative Medicine (NAFKAM), bringing CAM more evidence-based credibility that doctors are seeking. Second, hospital administrations began to take note of the growing demand from patients and providers to move away from medication reliance and use natural-based therapies. As a result, 50 percent of the hospitals in Norway offered at least acupuncture in 2008, doubling the number from seven years earlier. Patient satisfaction and demand were now a part of administrative decisions.

Then came 2012. A popular series in Norwegian public television ran a piece criticizing the lack of documented effect in acupuncture. A heavy debate fired off in the media with detractors claiming acupuncture as a “theatrical placebo.” Several Norwegian CAM providers at the time noted a decrease in acupuncture services, and hospitals in 2013 reported a drop in offered acupuncture. The debate rages on both in and out of Norway.

Yet Norway is nowhere near done with alternative treatments. Despite the drop in acupuncture in hospitals in 2013, overall hospitals were offering more total CAM services, moving from 50 percent to 65 percent in five years. Usage of CAM in psychiatric hospitals staggeringly jumped from 29 percent to 76 percent. By 2016, CAM usage was on the rise again in Norway, outpacing inflation and medical costs. And acupuncture remains the most widely used and requested CAM treatment in Norway, in and out of hospitals. Norwegian hospitals are proving that even with some bumps, traditional and CAM medicine can coexist, blending research and patient satisfaction, even in the most intensive medical settings.

2. Denmark: reducing sick leave and building trust with reflexology

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Denmark’s open attitude to modern CAM started over 25 years ago with reflexology and some field-shifting research. In 1992, reflexology was the most popular alternative treatment in Denmark (and remained the lead CAM for Danes until recently). With the demand came the money for research, and the research Denmark put out in the ‘90s is still widely touted by reflexologists across the world.

Three studies showed not only high patient satisfaction but also that reflexology for employees lowered sick leave. In three different work settings, and across longer and longer research spans, at least 75% of participants consistently reported partial to full pain relief. In total, the studies showed thousands of saved hours in sick leave and a decrease in leave loss of over $100,000 in just one sitting. The result of this research: Two-and-a-half times more Danes used reflexology in 2003 compared to 1987.

These days Denmark is seventh in CAM usage in the EU with at least one-third of its citizens using at least one alternative treatment a year. Over 60 percent would like to see insurance cover the vast array of alternative healing, and 73 percent of Danish doctors are positive about CAM research. Danes still use reflexology but are also seeking acupuncture, homeopathy, and chiropractic treatment. The increasing demand and the spreading interest appear directly related to optimism around past and future research. Denmark’s research push decades ago demonstrated that CAM methods could show results and helped legitimize funding for research around the continent and globe.

3. Lithuania: modernizing herbalism and sharing it worldwide

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Lithuania is a growing medical tourism destination that is holding onto its traditional healing roots. Lithuanian folk medicine, including herbalism, started with rich and complex belief systems. This type of medicine was practiced within families or by local healers and involved herbal rituals with symbolic charms to treat the physical and spiritual health of the person. As the medical field advanced, herbalism remained accessible, affordable, and trusted by Lithuanians.

Today, Lithuania commandingly leads other EU countries when it comes to alternative medicine use and exports both supply and demand with herbal medicine. Lithuanian immigrants still desire herbal medication and search their local stores to find an equivalent. Most declare that herbal medication from Lithuania is still superior and either bring their own Lithuanian medication back after visits or have others bring orders. Lithuanian naturopathy and herbal stores have found success in larger cities across the US and Europe, keeping the tradition and business thriving.

In response to the national and global demand, Lithuanian university pharmacies and private pharmacies are active manufacturers on the global medicinal herbs scene. Modern herbalism is now in the field of endobiogenics, where herbs meet pharmacies. Eight percent of registered Lithuanian pharmacies prepare herbal medications with over 100 registered medicinal plants in Lithuania. Search through the resumes of leading global endobiogenists and you will find most had a fellowship at the Lithuania University of Health Sciences in Kaunas. Modern medicine processes are keeping Lithuanian herbalism alive and well.

4. Austria: alternative medicine as part of medical training

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Over and over patients say they want alternative medical treatments incorporated with their current medical services, not as a replacement. As the battles rage in the global medical field over who does what service and which services are covered, Austria is moving towards integration. More and more Austrian general practitioners (GPs) are receiving special training in CAM so that they can directly offer their patients multiple types of treatment.

The data on Austrian GPs receiving specialized CAM training is the definition of exponential growth. In 1996, nine percent of GPs were trained in at least one CAM service. In two years, that number doubled. There was another substantial jump by 2000 and then another 66 percent jump to 2007. Around 6,000 GPs now have special training in CAM. As the number of doctors seeking training grows so does the number of Austrian programs offering training, currently 29 across the country. The more programs that are offered through the Austrian Medical Association, the more the confidence of both patients and physicians increases. It’s no surprise then that Austria is in the top three users of CAM in the EU (along with Germany and Switzerland).

Integrative health care is the wave of the future across western medicine, bringing multiple types of health-care providers together under one roof in one center. Austria, with CAM, is taking this one step further by providing a single provider that can offer one assessment and multiple services.

5. Germany: leaders in evolving alternative medicine practices

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From being the birthplace of homeopathy to being first in CAM usage in Europe to leading regulation and coverage movements, Germany is at the forefront of alternative medicine. Now it’s time to see where the next stage of change happens in CAM. Doctors and politicians in Germany are currently moving to strike the incredibly popular homeopathy from insurance coverage, and how Germany proceeds from here may set the tone for CAM coverage across the EU.

Homeopathy is the only surviving alternative medicine that was born in Europe. Dr. Samuel Hahnemann from Meissen, Germany, discovered that cinchona bark, or quinine, produced mild symptoms of malaria. He came up with the concept that “like treats like” and that what would make a healthy person ill can make an ill person well. Holistic assessment and heavily diluted natural substances make up the core of homeopathic treatment. Modern German homeopathic remedies come as globuli, or little white balls, and are available from both GPs and Heilpraktikers (state-recognized natural health practitioners). Germany is one of the top two users of all complementary medicine in Europe, but its usage of homeopathy sets it apart and remains much higher than in other countries, especially in children and among wealthier Germans.

But the evidence for homeopathy is frequently called into question. France has moved to phase out insurance payments for homeopathy by 2021, and now German medical organizations are pushing to introduce a law to ban insurance reimbursement, as well. But the possible subtraction of homeopathy from coverage is not signaling a step back from Germans using CAM. On the contrary, the German medical system is multi-tasking; also on the agenda for CAM policies is regulation for Heilpraktikers, broad insurance coverage for all evidenced-based CAMs, and integrative training for German GPs. Germany has been innovative in healthcare and healthcare coverage, and the next steps they take in CAM regulation will likely lead trends.