FOCUS: THE POWER OF BELIEVING

Ten years ago, the BMA dismissed alternative medicine as a 'passing fashion'. It has never been more popular

CYNICS WILL see it as the triumph of superstition over science, a victory for magic over medicine. Figures published last week show that alternative therapists now outnumber family doctors and their ranks are continuing to swell.

After centuries of medical advance in which spectacular successes have been scored against disease, the world is slipping back to a pre-scientific era. Fears about the side-effects of drugs and disappointment with orthodox medicine at the end of the 20th century have caused millions to turn to herbal potions and ancient remedies.

One person in four is estimated to have tried alternative medicine or visited its practitioners, and four out of five pronounce themselves satisfied with the results. Should we despair at the growth of what some describe as witchcraft or celebrate a new holistic approach to healing?

The latest survey, conducted for the Department of Health by the Centre for Complementary Health Studies at the University of Exeter, identified 39,800 complementary practitioners compared with 36,200 GPs. The biggest single grouping were healers, of whom there are now 14,000. They are followed by reflexologists, who treat ailments by manipulating the feet, of whom there are 5,300, osteopaths (2,300) and acupuncturists (1,700).

The findings confirm that the alternative medicine industry is riding on the crest of a decade-long boom. Since 1986, when the British Medical Association dismissed it in a report as "a passing fashion" - one of the association's most embarrassing gaffes - new adherents have flocked to the cause.

Consumption of alternative remedies has risen faster in Britain than in any other European country, although it still lags behind that in Germany, France and the Netherlands. Private medicine has extended cover to include the main therapies and the NHS is spending at least pounds 1m a year on complementary practitioners. Nearly 40 per cent of GPs offer access to alternative practitioners.

Last year, Prince Charles, already a supporter of alternative farming and alternative architecture, lent his support to the movement with the launch of the Foundation for Integrated Medicine which seeks to encourage closer co-operation between the orthodox and alternative traditions.

Edzard Ernst, Britain's only professor of complementary medicine - at the University of Exeter - views the boom with a sceptical eye. "In our surveys, what comes out as the number one reason [for the growth in alternative medicine] is that people want to try all the options. They have become more aware that alternative medicine is out there, they have enough money and are gullible enough to want to try it."

Professor Ernst's mission is to bring scientific rigour to the study of complementary therapies so that patients and doctors can distinguish what works from what does not. He argues that unless researchers adhere to scientific principles and publish well organised studies, they will remain on the periphery of medicine. But the growth of demand in the absence of this evidence shows that what matters to patients is results, not science. Magic is acceptable if it accomplishes what is promised.

Growing disaffection with the achievements of orthodox medicine is also fuelling the growth of alternatives to it. Although orthodox medicine has triumphed against major killers such as polio and diphtheria, it has failed to make an impact on the less severe chronic ailments such as back pain, allergies and stress that blight many people's lives. "People have got cheesed off with what is happening in medicine," said Professor Ernst. "The average consultation time of seven minutes is unsatisfactory and the GPs are just as unhappy with it as the patients."

Time is what alternative practitioners have in spades. The Exeter survey estimated that each practitioner had an average workload of only 80 patients a year who would be seen a number of times. Consultations lasting an hour or more are common.

The appeal of alternative medicine is linked to the amount of time available to patients, the use of touch, the magical qualities surrounding the practitioner and conviction in the method of healing.

It is backed by the belief that alternative remedies are harmless. But that is not necessarily true. A worldwide review of research into acupuncture found 300 cases of serious complications over the past 30 years, most caused by inadequate understanding of anatomy by the acupuncturist combined with aggressive needling. A study of children taken to faith healers in the US found 172 had died over a 20 year period, all but three of them suffering from conditions that would have been treatable had their parents allowed them to consult conventional doctors.

None of this deters its adherents, who argue that it should be seen as an adjunct to orthodox medicine, not a replacement for it. Nor are they concerned about the absence of scientific proof. They argue that there is a distinction between a therapy that cures and one that works by improving the response to disease.

A cure involves a measurable change in a disease process and this can be objectively confirmed. But a treatment may work, so the patient feels better, for all sorts of reasons: because someone gave them time, listened to their problems and responded to their concerns. Professor Ernst says there is "some truth" in the claim that alternative practitioners provide the medical equivalent of the soothing hand on the brow.

"If you look at who is using alternative medicine - and this comes out in virtually every survey conducted in Britain, the US and elsewhere - it is bored housewives with too much money who are in the middle of their lives and want to try something new."

He added: "There is a huge unfulfilled need out there. People are crying out for it. But it is tragic that the doctors supplying the medicine have to leave the empathy to be supplied by someone else. That is an important lesson for medicine."