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To the Editor.—Among the questions addressed in the study by Dr Astin¹ on reasons patients use alternative medicine are matters relating to quality of care, trust and confidence in physicians, and expectations that physicians will do what is best. Conspicuously absent is any question along the lines of "Has conventional treatment worked for you?" I grant that Astin did not set out to test efficacy as one of his primary hypotheses, but as a patient I would say that the question of efficacy is the most important determinant of my satisfaction with any form of treatment. My initial presumption would be that patients in general would not part with good money unless they felt they were getting better results outside conventional health care. It would be interesting to know why the author rejected this obvious question in favor of a more roundabout approach. Any conclusions about patients' (dis)satisfaction surely . . . [Full Text of this Article]

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Why Patients Use Alternative Medicine: Results of a National Study
John A. Astin
JAMA. 1998;279(19):1548-1553.
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