Americans who try alternative medicine generally use it to supplement - not replace - traditional care, researchers reported Wednesday.

The research from Yale University is the largest study ever on the use of unconventional remedies, using a population sample four times larger than any previous survey on the subject. The study looked at patient visits for such services as chiropractic care, herbal treatments, acupuncture and hypnosis.

The findings were published in Wednesday's edition of the Journal of the American Medical Association.

''These results show that alternative or unconventional medicine isn't really an alternative at all,'' said the study's lead author, Dr. Benjamin Druss.

Researchers considered the cases of just over 16,000 adults. The responses were drawn from a 1996 study called the Medical Expenditure Panel Survey.

During that year, an estimated 6.5% of the U.S. population sought both conventional and unconventional health care, the study found. A little less than 2% used only unconventional medicine, while close to 60% used only traditional medicine. About 32% reported using neither.

People who had used both types of health care had significantly more outpatient visits - eight vs. five - and used more preventative services.

But only 20% of patients who used both types of care told their primary care physicians about the alternative therapies, Druss said.

''Our findings reinforce the need for physicians to ask their patients about unconventional medical care so that these treatments are not at odds with conventional treatments,'' he said.

Dr. Stephen Barrett, a retired psychiatrist and consumer advocate, said he found the study noteworthy because it contradicts previous findings that alternative treatments are widely used.

''It's long been known that most people who use so-called alternatives are satisfied with their medical care and go into it as something extra,'' he said.