Modern medicine can take credit for tremendous achievements and advances in the understanding of human health and the prevention and treatment of disease. Antibiotics, vaccination, hygiene improvements, and modern pain control and anesthesia are just some examples of developments that have changed the world and, in some ways, have eclipsed the accomplishments of the first several thousand years of recorded medicine. But if modern medicine is so great, why are people so interested in alternatives? In reviewing studies and talking to many patients over the years, three major reasons seem to surface: when diseases are not curable, when our explanations are unsatisfying, and when our treatments are thought to be unsafe, questionable, and/or only “symptomatic.” An unspoken reason also seems to be that the experience of seeing a modern doctor can often feel rushed, overly-focused, and impersonal, where many alternative practitioners pride themselves on having a slower pace, listening carefully to the patient, and generally being more “holistic” in considering the patient and his or her health issues.

A provocative study approached this from a slightly oblique angle, but nicely demonstrates some of these principles in action. A very common form of “alternative thinking” in patients with atopic dermatitis is that foods are causative of, or at least significant contributors to their skin disease. Indeed, in one study some 75% of patients had made significant dietary modifications in an attempt to control the disease (Johnston et al. 2004). While certainly not unreasonable at face value given the high prevalence of actual food allergies in patients with atopic dermatitis, it can be an area of rumination and persistent worry, even after food allergens are identified and avoided, that there is something in the diet that is being missed. At times, severe dietary restrictions that may be actually unsafe are instituted without much rationale (Webber et al. 1989). Thompson and Hanifin found that families who felt strongly that certain foods were driving atopic dermatitis (in the absence of true allergy, of course), significantly de-emphasized these concerns once the eczema was under good control (Thompson and Hanifin 2005). That is to say, when conventional medicine is working well, and doing so safely, there seems to be less desire for alternatives, with the converse equally true.