Complementary Therapies and Medical Education: Relevance for Clinical Recommendation and Their Integration into the Health Care System

1. Use of Complementary Therapies by Patients and Health Professionals’ Perceptions and Knowledge of These Practices

The use of complementary therapies among the general population has shown sustained growth worldwide, particularly among patients with chronic diseases, cancer, pain or stress-related conditions, as well as individuals who perceive complementary and alternative therapies as more consistent with their personal values, beliefs, and philosophical orientations toward health and life. International studies report rates of complementary and alternative therapy use of up to 70% of the general population, depending on the country and the type of practice evaluated. Among hospitalized and outpatient populations, a significant proportion of patients do not disclose the use of these therapies to their physicians, which may generate risks of interactions with conventional treatments or negatively affect therapeutic adherence (1, 6, 9, 10, 11).

At the national level, a study conducted at the “José de San Martín” Hospital de Clínicas showed that approximately 55% of surveyed patients used complementary therapies, often without informing the medical team. This situation reflects not only a widespread pattern of use but also a gap in clinical communication that may have consequences for treatment safety and effectiveness (1).

Studies examining health professionals’ knowledge and attitudes toward these therapies indicate that, although many physicians are aware of their existence, formal training in this field is scarce or nonexistent. This limitation restricts their ability to critically evaluate the benefits and risks associated with their use and to guide patients in a safe and responsible manner (8, 17).

Within the university context, research on medical school education suggests that the type of training provided influences attitudes toward complementary and alternative medicine. As students progress through conventional medical training, they tend to develop increased skepticism toward these therapeutic approaches (7).

Critical analysis of the literature indicates that complementary therapies are widely used by patients across different health care settings, while physicians generally lack the necessary training to understand their modes of action and associated risks. This highlights the need to equip future professionals with critical tools to identify, evaluate, and guide the safe and responsible use of these practices.

2. Identification of Educational Gaps in Undergraduate Medical Education

The increasing use of complementary therapies by patients poses a significant educational challenge for undergraduate medical training. Numerous studies agree that, although future physicians will routinely encounter consultations related to these practices, formal education on the topic remains limited, fragmented, or entirely absent. This educational gap directly affects professionals’ ability to understand the modes of action of complementary therapies, evaluate their benefits and limitations, recognize potential risks or interactions, and guide patients in an informed and safe manner—often leading to their outright dismissal.

In the Latin American context, Pacheco, Fritzsche, and Bedregal (2022) (12) assessed the attitudes and knowledge of faculty members in Psychiatry programs regarding complementary and alternative medicine. Their findings indicate that even in specialized academic settings, knowledge is heterogeneous and frequently insufficient, accompanied by ambivalent attitudes. The authors note that the lack of systematic training hinders a critical approach to these practices and limits their reflective incorporation into clinical discussion, despite their frequent use by patients. This finding is particularly relevant, as it demonstrates that the educational gap affects not only undergraduate students but also those actively involved in their training.

In Argentina, a study aimed at determining the level of knowledge, acceptance, and recommendation of complementary or alternative medicine among practicing physicians. The results revealed a marked lack of knowledge regarding these practices: approximately half of the surveyed professionals would not recommend them to patients or family members, and more than 40% considered that they lack sufficient scientific evidence to support their use. Nevertheless, a significant proportion reported having used them personally and expressed openness to their incorporation within health care institutions, contributing to their formal recognition as legitimate practices. Additionally, a high level of interest in receiving training, seeking information, and including these contents in undergraduate education was observed, and 37% of respondents considered coexistence between conventional medicine and complementary medicine to be necessary (14). These findings reveal an educational gap paradoxically accompanied by an explicit demand for training.

From an international perspective, the analysis conducted by Khamis and Ribeiro (2015) (13) on the inclusion of complementary and alternative medicine in undergraduate medical education highlights similar challenges. The authors describe that, despite widespread recognition of the use of these practices, teaching within medical curricula is inconsistent and lacks common guidelines. The absence of structured content limits the development of basic competencies, such as systematic inquiry into the use of complementary therapies during clinical encounters, critical appraisal of the available evidence, and informed dialogue with patients regarding benefits, risks, and interactions with conventional treatments. In this sense, the educational gap translates into communication difficulties and potential risks to patient safety.

Authoritative medical literature also acknowledges this scenario. Recent editions of Harrison’s Principles of Internal Medicine note that physicians routinely encounter patients who use complementary practices, often without disclosing their use. The text warns that lack of professional knowledge not only prevents the identification of potential benefits but may also contribute to harm, whether through pharmacological interactions, inappropriate expectations, or underestimation of adverse effects. In this context, the importance of physicians possessing sufficient knowledge to address these practices from a critical, person-centered perspective is emphasized, without implying uncritical validation or substitution of conventional medicine (28).

It is essential to emphasize that, although many complementary practices are presented as “natural,” they are not necessarily harmless. Complementary and alternative medicine holds significant potential to improve patients’ quality of life, but its application must be carefully evaluated and supervised to avoid dangerous interactions or adverse effects. Multiple studies have shown that indiscriminate or unsupervised use of these practices may pose risks, particularly when patients do not inform their physicians about their use (15, 29). Therefore, training health care teams in competencies related to integrative medicine becomes essential, focusing on the appropriate use of complementary therapies alongside conventional treatments.

Taken together, this evidence identifies a clear educational gap in undergraduate medical education: the absence of curricular spaces that address, in a critical and evidence-based manner, the modes of action, benefits, limitations, and risks of complementary therapies. This deficiency restricts future physicians’ ability to appropriately guide patients, discourages clinical dialogue about these practices, and may compromise the safety and quality of care. Addressing this gap does not entail training physicians as practitioners of complementary therapies, but rather equipping them with conceptual and critical tools to understand their real-world use within the population and to accompany patients in an ethical, informed, and safe manner.

3. Recent World Health Organization Strategies and Guidelines (2025–2034) on Traditional, Complementary and Integrative Medicine: Safe and Responsible Integration and the Role of Professional Education

The World Health Organization has renewed its global approach to traditional, complementary and integrative medicine through the WHO Global Traditional Medicine Strategy 2025–2034 (18), which updates and expands previous guidelines (2002–2005 and 2014–2023). This new strategic framework is grounded in the recognition of the widespread use of these practices across diverse cultural and health care contexts, as well as their potential contribution to primary health care and universal health coverage, provided that their incorporation is carried out in a safe, responsible, and evidence-based manner.

The 2025–2034 Strategy is structured around four interrelated objectives: strengthening the scientific evidence base to assess safety, efficacy, and potential mechanisms of action; developing regulatory frameworks to ensure practice quality and patient protection; promoting the progressive and context-specific integration of traditional, complementary and integrative medicine into health care systems in line with public health priorities; and optimizing its intersectoral value through coordination among the health, education, research, and community sectors. These objectives are supported by guiding principles such as person-centered care, health equity, respect for cultural diversity, protection of traditional knowledge, and the guarantee of the right to safe and high-quality care (18).

A central aspect of this strategy is the emphasis on ensuring that the integration of traditional, complementary and integrative medicine is not carried out in an uncritical or unregulated manner. The strategy underscores that incorporation into health care systems requires clear regulatory frameworks, appropriate oversight mechanisms, and effective coordination with conventional medicine in order to prevent risks, avoid unsafe practices, and protect patients’ rights.

Within this framework, the education of health professionals plays a strategic role. The 2025–2034 Strategy highlights the need for physicians and health care teams to possess basic competencies to recognize the use of complementary therapies, understand their general modes of action and the current state of evidence, identify potential risks or interactions with conventional treatments, and establish clear, ethical, and respectful communication with patients. This training is not intended to transform professionals into practitioners of complementary therapies, but rather to provide them with critical tools to enable informed and safe integration within clinical practice, in alignment with principles of quality of care, bioethics, equity, and person-centered care (19–22).

4. Clinical Implications of the Concurrent Use of Complementary Therapies and Conventional Medical Treatments

The concomitant use of complementary therapies alongside conventional medical treatments represents an increasingly common clinical reality across diverse health care settings. Numerous studies indicate that a significant proportion of patients resort to these practices as a complement to medical care, particularly in the management of chronic diseases, oncology, pain disorders, stress, and long-term conditions. However, this therapeutic coexistence does not always occur within a framework of open communication and adequate clinical supervision, raising important implications for patient safety and quality of care (23–25).

From a clinical perspective, one of the main challenges associated with the concurrent use of complementary therapies lies in the potential risks of interactions with pharmacological treatments or conventional medical procedures. Certain practices, natural products, or non-pharmacological interventions may interfere with medication efficacy, potentiate adverse effects, lead to delays in adherence to prescribed treatments, or introduce confusing symptomatology. These risks are amplified when the use of complementary therapies is not disclosed to the health care team, a situation well documented in the literature and often associated with patients’ fear of disapproval or dismissal by medical professionals.

The absence of specific training in complementary therapies may limit physicians’ ability to identify warning signs, critically assess potential benefits and risks, or distinguish between practices with some degree of scientific support and those lacking sufficient evidence or presenting potential harm. In this regard, lack of knowledge not only hinders adequate patient guidance but may also contribute to incomplete clinical decision-making or decisions based on fragmented information.

In this context, physician–patient communication emerges as a central element of clinical safety. Multiple studies show that patients are more willing to disclose the use of complementary therapies when they perceive an open, respectful, and non-judgmental attitude from health care professionals. Informed dialogue allows exploration of patients’ motivations, expectations, and beliefs, as well as joint evaluation of the appropriateness, potential risks, and limitations of the concurrent use of these practices within the overall therapeutic plan (26, 27).

From an ethical and person-centered perspective, omission of this dialogue may compromise fundamental principles of medical practice, such as those established in Argentina’s National Patient Rights Law No. 26,529, including patient autonomy, non-maleficence, and shared decision-making. Conversely, appropriate clinical communication helps strengthen the therapeutic alliance, improve adherence to conventional treatments, and reduce the risk of adverse events associated with unsupervised practices.

Within this framework, it is essential that physicians possess conceptual and communication tools that enable them to address the concurrent use of complementary therapies in a critical, informed, and safe manner. This does not imply uncritical validation of such practices nor their substitution for conventional treatments, but rather the ability to recognize their real-world use within the population, identify potential interactions or risks, and guide patients from an integral, ethical, and evidence-based approach (28).

Analysis of these clinical implications reinforces the need to incorporate content into undergraduate medical education that addresses the concurrent use of complementary therapies and conventional medicine, with emphasis on patient safety, critical evaluation of risks and benefits, and the strengthening of physician–patient communication as a cornerstone of responsible, person-centered health care.

5. Proposal of Conceptual and Educational Criteria for the Inclusion of Knowledge on Complementary Therapies in Medical Education

Based on the evidence analyzed in the previous objectives, it becomes necessary to propose conceptual and educational criteria to guide the inclusion of content related to complementary therapies in medical curricula. This proposal is grounded in the widespread use of these practices by the population, the educational gaps identified in undergraduate medical education, and the recommendations of international organizations—particularly the World Health Organization—regarding their safe and responsible integration into health care systems (18–20, 22).

From a conceptual perspective, the incorporation of such content should be based on a clear definition of complementary therapies as non-pharmacological practices that can be integrated with conventional medicine without seeking to replace it, and whose clinical value must be assessed in light of the current scientific evidence, patient safety, and the overall therapeutic context. This framework makes it possible to move beyond both uncritical dismissal and indiscriminate acceptance of these practices, promoting a reflective, informed, and scientifically and ethically grounded approach.

From an educational standpoint, international literature agrees that teaching content related to complementary therapies is more effective when oriented toward the development of professional competencies rather than the transmission of specific techniques. Accordingly, it is proposed that such content be integrated transversally within existing courses, such as internal medicine, pharmacology, public health, bioethics, or physician–patient communication, prioritizing critical analysis of the real-world use of these practices within the population and their impact on clinical care (12, 13).

Key educational axes include: recognition of the complementary therapies most frequently used by patients; general understanding of their possible mechanisms of action and the limitations of the current scientific evidence; identification of risks, adverse effects, and interactions with conventional treatments; and the ability to critically appraise the related scientific literature. These components are essential to reduce risks associated with uninformed or unsupervised use of these practices (12–14).

Additionally, several authors emphasize the importance of strengthening future physicians’ communication skills by promoting systematic and unbiased inquiry into the use of complementary therapies during clinical encounters. Training in this area should encourage open and respectful dialogue with patients, shared decision-making, and the development of a therapeutic relationship based on trust, thereby contributing to clinical safety and adherence to conventional treatments (12–14).

The current World Health Organization strategy reinforces this perspective by emphasizing that the responsible integration of traditional, complementary and integrative medicine requires health professionals who are able to understand these practices from a critical, contextualized, and person-centered approach, without necessarily engaging in their direct practice. Within this framework, medical education plays a strategic role in ensuring that the incorporation of such knowledge aligns with principles of quality, equity, bioethics, and the protection of patient rights (18).

Taken together, the proposed conceptual and educational criteria aim to guide the responsible inclusion of knowledge on complementary therapies in undergraduate medical education. Far from redefining the professional role of physicians, this inclusion seeks to strengthen their capacity to understand the real-world use of these practices, evaluate their clinical implications, and accompany patients in an ethical, informed, and safe manner, in line with the contemporary challenges faced by health care systems. In a context of limited formal regulation, this approach prioritizes patient safety and informed decision-making, while reinforcing physicians’ ability to support the responsible use of complementary therapies.