The current definitions of complementary and alternative medicine (CAM) and orthodoxy are culturally and politically determined. They obscure the debate about holism and integrative care and they give therapies and therapists precedence over patients in the design of health care systems. This paper considers three current models of delivery of CAM and biomedical care in the world. These models are the market model, the regulated model, and the assimilated model. Each of these models is described and consideration is given to likely futures for each of them. A fourth model, the patient centered model is proposed, which shifts the power from therapists to patients and regulates products and services irrespective of CAM or biomedical definitions. Only this latter model is presented as the one likely to support the development of truly integrated medicine, explicitly for the benefit of patients rather than therapists or industries.