Complementary and Alternative Medicine and the Australian Medical Association:

An Exercise in Institutional Dogma, Not Scientific Stewardship

Complementary and Alternative Medicine and the Australian Medical Association:

An Exercise in Institutional Dogma, Not Scientific Stewardship

The Australian Medical Association’s ‘Complementary and Alternative Treatments Position Statement (Revised 2025)’ purports to offer a balanced, patient-centred, and evidence-based appraisal of complementary and alternative medicine (CAM). On closer examination, however, the document functions less as a neutral policy guide and more as a reaffirmation of biomedical orthodoxy, institutional self-protection, and epistemological exclusion. It reveals a profession struggling to reconcile its authority with a rapidly evolving healthcare landscape in which patients increasingly seek integrative, preventive, and non-pharmaceutical approaches.

The AMA’s position is undermined by internal contradictions, selective use of evidence standards, paternalistic assumptions about patients, and a failure to acknowledge the well-documented limitations and harms of conventional medical practice, which I have outlined clearly in prior Substacks

Definitional Framing and the Problem of Circular Authority

The AMA begins by defining complementary and alternative treatments as therapies “not currently considered part of conventional medicine”. This definition is not merely descriptive; it is epistemologically loaded. It presupposes that conventional medicine is the sole arbiter of legitimacy, rather than one historically contingent model of healthcare shaped by regulatory, commercial, and political forces.

Such circular reasoning—wherein medicine defines itself as the standard and all else as deviation—fails to acknowledge that many now-accepted medical practices were once considered alternative. The history of medicine repeatedly demonstrates that progress often emerges from outside dominant paradigms, not within them. To conflate “conventional” with “validated” is to confuse authority with truth.

Evidence-Based Medicine or Evidence Gatekeeping?

Central to the AMA’s critique of CAM is the claim that most complementary therapies lack adequate scientific evidence, with repeated calls for validation through randomised controlled trials (RCTs) . While rigorous evidence is essential in healthcare, the AMA’s invocation of RCTs as an exclusive gold standard is both selective and methodologically naive.

Many CAM interventions—particularly nutritional, lifestyle, and traditional medicine approaches—are complex, individualised, and not amenable to reductionist trial designs. Moreover, the financial realities of research funding mean that non-patentable interventions are structurally disadvantaged in the evidence hierarchy. The absence of large RCTs is therefore often a reflection of economic neglect, not therapeutic inefficacy.

Crucially, the AMA does not apply this same evidentiary scepticism to conventional medicine. Numerous widely prescribed pharmaceutical interventions lack robust long-term outcome data, rely on surrogate endpoints, or have been approved despite later revelations of harm. The Covid vaccines clearly demonstrated the lack of safety and efficacy and the fallacy of the general vaccine science in which no vaccine has undergone a RCT. The selective deployment of “evidence-based” rhetoric risks transforming a scientific principle into a gatekeeping mechanism.

Patient Autonomy and the Language of Vulnerability

The position statement repeatedly characterises CAM users—particularly children, older adults, and individuals with serious illnesses such as cancer—as “vulnerable” and susceptible to being “misled” . While protection from exploitation is a legitimate concern, the blanket portrayal of CAM consumers as cognitively or emotionally compromised is both reductive and dismissive.

This framing obscures a critical reality: many patients seek complementary therapies after experiencing inadequate outcomes, adverse effects, or dismissive care within the conventional system. The growth of CAM is not merely a marketing phenomenon; it is a response to unmet needs. To pathologise patient choice without interrogating the failures that drive it reflects institutional defensiveness rather than genuine patient advocacy.

Risk, Safety, and the Selective Silence on Iatrogenesis

The AMA emphasises the potential risks of CAM, including adverse reactions, interactions, and delayed access to conventional treatment . Absent from the document, however, is any acknowledgment of the extensive literature on iatrogenic harm associated with mainstream medicine.

Adverse drug reactions, polypharmacy, overdiagnosis, overtreatment, and medical error constitute a substantial burden of morbidity and mortality in Australia and internationally. The omission of this context creates a distorted risk narrative in which CAM is portrayed as inherently dangerous, while conventional medicine is implicitly assumed to be safe. Such asymmetry undermines the credibility of the AMA’s safety concerns.

Economic Arguments Without Systemic Context

The AMA raises concerns about the financial costs of CAM, particularly when patients defer conventional treatment . This argument is presented without reference to the broader economic failures of the current healthcare model, including the escalating costs of chronic disease management, pharmaceutical dependence, and hospital-centric care.

Many complementary approaches emphasise prevention, lifestyle modification, and early intervention—strategies that are consistently shown to reduce long-term healthcare expenditure. To single out CAM as a financial risk while ignoring the systemic inefficiencies of conventional care reflects a narrow and selective economic analysis.

Regulation, Scope, and the Policing of Dissent

The latter sections of the position statement focus heavily on regulation: restricting diagnostic language, enforcing scope-of-practice boundaries, controlling professional titles, and establishing public registers of banned practitioners . While regulation is essential to protect the public, the tone and breadth of these proposals suggest an intent not merely to ensure safety, but to constrain professional plurality.

Particularly concerning is the assertion that complementary therapists should not diagnose conditions that “the medical profession does not believe” exist. This stance risks enshrining biomedical consensus as legal orthodoxy, foreclosing legitimate debate and innovation. History cautions against granting any profession unilateral authority over the boundaries of knowledge.

Advertising Ethics and Asymmetrical Scrutiny

The AMA’s call for stringent advertising controls on CAM products and services is framed as consumer protection . Yet the document remains silent on the pervasive influence of pharmaceutical marketing, disease-mongering, and industry-funded education within conventional medicine. Ethical consistency demands that standards applied to one sector be applied equally to all.

Conclusion: A Missed Opportunity for Integrative Leadership

The AMA’s 2025 position statement represents a missed opportunity. Rather than fostering an evidence-informed, patient-centred, and integrative approach to healthcare, it reinforces disciplinary boundaries and epistemological hierarchies that no longer reflect patient expectations or contemporary health challenges.

True scientific leadership requires humility, openness to plural forms of evidence, and a willingness to confront one’s own limitations. Until the AMA applies the same critical scrutiny to conventional medicine that it demands of complementary approaches, its claims to protect patients and uphold science will remain unconvincing.

Ian Brighthope.