title: Complementary and alternative medicine provision in Europe--first results approaching reality in an unclear field of practices.
abstract: BACKGROUND
  The demand for complementary and alternative medicine (CAM) treatment in the European Union (EU) has led to an increase in the various CAM interventions available to the public. Our aim was to describe the CAM services available from both registered medical practitioners and registered non-medical practitioners.
  
  
  METHODS
  Our literature search comprised a PubMed search of any scientific publications, secondary references and so-called grey literature, a search of government websites and websites of CAM organisations to collect data in a systematic manner, and personal communications, e.g., via e-mail contact. Due to the different reliability of data sources, a classification was developed and implemented. This weighted database was condensed into tables and maps to display the provision of CAM disciplines by country, showing the distribution of CAM providers across countries.
  
  
  RESULTS
  Approximately 305,000 registered CAM providers can be identified in the EU (~160,000 non-medical and ~145,000 medical practitioners). Acupuncture (n = 96,380) is the most available therapeutic method for both medical (80,000) and non-medical (16,380) practitioners, followed by homeopathy (45,000 medical and 5,800 non-medical practitioners). Herbal medicine (29,000 practitioners) and reflexology (24,600 practitioners) are mainly provided by non-medical practitioners. Naturopathy (22,300) is dominated by 15,000 (mostly German) doctors. Anthroposophic medicine (4,500) and neural therapy (1,500) are practised by doctors only.
  
  
  CONCLUSIONS
  CAM provision in the EU is maintained by approximately 305,000 registered medical doctors and non-medical practitioners, with a huge variability in its national regulatory management, which makes any direct comparison across the EU almost impossible. Harmonisation of legal status, teaching and certification of expertise for therapists would be of enormous value and should be developed.
authors.affiliation: Institute of Complementary Medicine KIKOM, University of Bern, Switzerland.
authors.forename: Klaus
authors.initials: K
authors.lastname: von Ammon
authors.forename: Martin
authors.initials: M
authors.lastname: Frei-Erb
authors.forename: Francesco
authors.initials: F
authors.lastname: Cardini
authors.forename: Ute
authors.initials: U
authors.lastname: Daig
authors.forename: Simona
authors.initials: S
authors.lastname: Dragan
authors.forename: Gabriella
authors.initials: G
authors.lastname: Hegyi
authors.forename: Paolo
authors.initials: P
authors.lastname: Roberti di Sarsina
authors.forename: Jan
authors.initials: J
authors.lastname: Sörensen
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D000529:Complementary Therapies / Q000193:education / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005060:Europe; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008004:Licensure / Q000706:statistics & numerical data; D008007:Licensure, Medical / Q000706:statistics & numerical data; D009313:National Health Programs / Q000706:statistics & numerical data*