In USA

A 2002 report on public attitudes and understanding issued by the US National Science Foundation defines the term "alternative medicine" as treatments that had not been proven effective using scientific methods.^[1]

Criticisms have come from individuals such as Wallace Sampson in an article in Annals of the New York Academy of Sciences, June 1995.^[99] Sampson argued that proponents of alternative medicine often used terminology which was loose or ambiguous to create the appearance that a choice between "alternative" effective treatments existed when it did not, or that there was effectiveness or scientific validity when it did not exist, or to suggest that a dichotomy existed when it did not, or to suggest that consistency with science existed when it might not; that the term "alternative" was to suggest that a patient had a choice between effective treatments when there was not; that use of the word "conventional" or "mainstream" was to suggest that the difference between alternative medicine and science based medicine was the prevalence of use, rather than lack of a scientific basis of alternative medicine as compared to "conventional" or "mainstream" science based medicine; that use of the term "complementary" or "integrative" was to suggest that purported supernatural energies of alternative medicine could complement or be integrated into science based medicine. "Integrative medicine" or "integrated medicine" is used to refer to the belief that medicine based on science would be improved by "integration" with alternative medical treatments practices that are not, and is substantially similar in use to the term "complementary and alternative medicine".^[8] Sampson has also written that CAM is the "propagation of the absurd", and argues that alternative and complementary have been substituted for quackery, dubious, and implausible.^[131]

Another critic, with reference to government funding studies of integrating alternative medicine techniques into the mainstream, Steven Novella, a neurologist at Yale School of Medicine, wrote that it "is used to lend an appearance of legitimacy to treatments that are not legitimate." Another, Marcia Angell, argued that it was "a new name for snake oil."^[132] Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science based medicine will adopt it regardless of whether it was considered "alternative" to begin with.^[47] It was thus possible for a method to change categories proven vs. unproven, based on increased knowledge of its effectiveness or lack thereof. Prominent supporters of this position include George D. Lundberg, former editor of the Journal of the American Medical Association JAMA.^[43]

In an article first published in CA: A Cancer Journal for Clinicians in 1999, "Evaluating complementary and alternative therapies for cancer patients.", Barrie R. Cassileth mentioned that a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. This was supported by the National Institutes of Health NIH.^[133]

In March 2009 a Washington Post staff writer reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine, quoting one of them, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, saying "One of our concerns is that NIH is funding pseudoscience." They argued that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and have shown little or no effect.^[132] Stephen Barrett, founder and operator of Quackwatch, has argued that practices labeled "alternative" should be reclassified as either genuine, experimental, or questionable. Here he defines genuine as being methods that have sound evidence for safety and effectiveness, experimental as being unproven but with a plausible rationale for effectiveness, and questionable as groundless without a scientifically plausible rationale.^[134] Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment.^[131] Barrett has pointed out that there is a policy at the NIH of never saying something doesn't work only that a different version or dose might give different results.^[135] Barrett also expressed concern that, just because some "alternatives" have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.^[134]

Writers such as Carl Sagan 1934-1996, a noted astrophysicist, advocate of skeptical thinking Scientific skepticism and the author of The Demon–Haunted World: Science as a Candle in the Dark 1996, have described the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.^[136]

According to two writers, Wallace Sampson and K. Butler, marketing is part of the medical training required in chiropractic education, and propaganda methods in alternative medicine have been traced back to those used by Hitler and Goebels in their promotion of pseudoscience in medicine.^[99][137]

The NCCAM budget has been criticized^[132] because, despite the duration and intensity of studies to measure the efficacy of alternative medicine, there had been no effective CAM treatments supported by scientific evidence as of 2002, according to the QuackWatch website; the NCCAM budget has been on a sharp and sustained rise.^[138] Critics of the Center argue that the plausibility of interventions such as botanical remedies, diet, relaxation therapies and yoga should not be used to support research on implausible interventions based on superstition and belief in the supernatural, and that the plausible methods can be studied just as well in other parts of NIH, where they should be made to compete on an equal footing with other research projects.^[132]