A significant issue when choosing a complementary or alternative approach to healing is whether to choose by a particular treatment or by a practitioner. One can choose a particular approach because of its technique, conceptual framework, or belief system. Alternately, one can focus on looking for a practitioner whom one can respect and trust, with the particular approach he or she uses being of secondary importance. For most people, the choice will probably involve a consideration of both these issues.

In the process of choosing a provider, it may be useful to refer to the information sheets What is Complementary and Alternative Medicine? and How Other Medical Systems View Cancer in order to have some perspective on different approaches to cancer treatment. This information sheet addresses issues involved in choosing a provider.

There is wide variation in practice among alternative practitioners, as there is among conventional practitioners, and it is often useful to get a second opinion. This is true even within a single complementary or alternative modality. There are different schools, or styles, of acupuncture, for example, each with its own techniques and belief systems. Credentials for alternative practitioners also vary widely, with different licensing practices and standards in every state.

There is, unfortunately, no fail-proof recipe for choosing the right practitioner for you. Here are some common-sense suggestions and some questions that might yield helpful information.

To choose a healthcare treatment

Consider the following points:

1. Why do you want to try "alternative medicine"?

• Are you sure that available Western treatments would not offer what you desire?
• Are you concerned with cost?
• Are you concerned with side effects?
• Are you dissatisfied with the rapport between you and your Western-trained physician?

Answering such questions may guide you towards the type of alternative treatment that would best address the particular shortcomings of the treatments currently offered you.

2. Try to understand what you will be using.

• Be acquainted with the general principles and ideas behind the systems available to you, and choose what appeals to you the most. There are several books and pamphlets now available that give a succinct overview of various therapies.

3. What will your investment be?

• How much time and money will you need to spend before you have an idea of whether the therapy will work for you?
• Is your insurance likely to reimburse you for the treatment, and for how many sessions, or will you be paying out of pocket?

4. Will it work for you?

• Testimonials about treatments that have worked for someone can be very powerful, and we are all likely to be influenced by them. However, it is important to remember that, for a number of conditions, including cancer, no treatment works for everyone, and that different people have different tolerances for side effects. What works for one person may not work for another. Conversely, because a treatment was not useful to someone else does not necessarily mean it will not be useful for you. Gather as much information about your choices as possible, including talking to people about what has and has not worked for them and why. Then weigh the possible risks and benefits for your particular situation. Please remember that individuals are not always accurate reporters of their own medical history.

• To find individuals who have used the therapy of interest, contact consumer organizations and self-help groups. They may have a list of what their members have been using and their reactions to them. Friends and relatives can also be a valuable source of information.

• Some information is available on what type of therapy can be used for specific conditions. While this information may have some value, it is important to realize that it is based mostly on clinicians' personal experience rather than on solid scientific research. This information may be obtained from various professional organizations. While these organizations do their best to provide objective information, be aware that their very purpose is to defend and promote the profession and practice that you are potentially interested in using.

5. Can I mix various therapies?

• If you plan to use both alternative and conventional therapies (in particular, drugs in combination with herbal remedies), be aware that there is a possibility they might interfere with each other. This interaction may be either positive (better when both therapies are combined) or negative (the combination may be toxic). Relatively little is known about this potential interaction. If you plan to combine several therapies, make sure that your various practitioners know what you are doing.

6. Should I tell my primary care physician

• It is always a good idea to discuss any and all treatment plans with your physician and to keep him or her informed of your progress.
• If the practitioners you are seeing attempt to discourage you from using another therapy, try to find out the reasons for it. Do not hesitate to obtain additional opinions or advice. If you are convinced that you need to stop one therapy to continue another one, find out what the consequences might be.

To choose a health care practitioner

Consider the following points:

1. How did you hear of the practitioner?

• Some practitioners have excellent reputations, and their patients may be good referral sources. However, in some areas of the country, alternative practitioners are not very common, and it may be difficult to locate patients who can recommend them. In such areas, there is little choice of practitioner and, therefore, little opportunity for comparison.
• Some complementary and alternative practitioners are associated with organizations and training programs, including allopathic (conventional Western) medical schools. These can be another source of referral.

2. Do not hesitate to contact the practitioner and attempt to talk to him or her directly.

• Visit the practitioner for an initial consultation. Take advantage of this first visit to ask any questions you still need to ask. In addition, observe the practitioner. What are his or her bedside manners? Do you feel reassured and trusting? Trust your intuition. Remember that in some practices, the initial visit is mostly for patient assessment, and little actual treatment is done. Do not be unduly disturbed if this is the case for you.
• Ask questions concerning his or her credentials. Do not forget that in some countries, becoming a health care practitioner does not entail obtaining a degree from a school but may be taught in an apprenticeship.
• Ask how long the practitioner has practiced, and where.
• Describe your problem and ask how familiar the practitioner is with it? Has he or she treated such a condition before? How often? What was his or her success rate? Would he or she consider it appropriate to suggest the names of some patients whom you could contact?
• How long will it take before seeing results? How much will it cost in time and money?

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