The level of litigation against CAM therapists is currently very low, particularly compared with corresponding actions being brought against doctors and other health care professionals. This, in turn, is reflected by the low annual indemnity insurance paid by most CAM practitioners. CAM therapists tend to attribute this to CAM's safety profile compared with orthodox medicine, together with CAM practitioners’ ability to forge better therapeutic relationships with users. However, other commentators argue that the lack of litigation, as with the lack of formal complaints, is more indicative of shortcomings in the legal system (Stone and Matthews, 1996). As suggested above, psychological and institutional barriers may prohibit a patient from complaining. An additional reason that may currently make people disinclined to sue a practitioner is their unwillingness to litigate against a person with whom they have had a close relationship. Yet people seem to have fewer qualms about suing the NHS, which is a more remote bureaucracy. Paradoxically, litigation rates may increase if CAM is provided by conventionally trained practitioners or on the NHS.
Fear of litigation has already altered the nature of the therapeutic relationship in medicine. Two ways in which this happens is through ‘defensive medicine’ and a highly legalistic approach to information giving and obtaining informed consent. The nature of the CAM relationship could similarly change if litigation rates increased.