Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients, physicians and complementary practitioners

Abstract Objective Our study explored the attitudes of patients toward complementary and alternative medicine (CAM) use, their family physicians’ role regarding CAM, and models for CAM referral and treatment. We compared patients’ perspectives regarding integration of CAM into primary care with atti...

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Bibliographic Details
Published in:Patient education and counseling 2008-03, Vol.70 (3), p.395-402
Main Authors: Ben-Arye, Eran, Frenkel, Moshe, Klein, Anat, Scharf, Moshe
Format: Article
Language:English
Subjects:
Adult
Alternative medicine
Analysis of Variance
Attitude of Health Personnel
Attitude to Health
Attitudes
Chi-Square Distribution
Clinical Competence - standards
Complementary Therapies - organization & administration
Complementary Therapies - psychology
Doctor-Patient communication
Female
Focus Groups
Humans
Internal Medicine
Israel
Male
Middle Aged
Nursing
Physician's Role - psychology
Physicians, Family - organization & administration
Physicians, Family - psychology
Primary health care
Primary Health Care - organization & administration
Referral and Consultation - organization & administration
Referrals
Safety
Surveys and Questionnaires
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Summary:Abstract Objective Our study explored the attitudes of patients toward complementary and alternative medicine (CAM) use, their family physicians’ role regarding CAM, and models for CAM referral and treatment. We compared patients’ perspectives regarding integration of CAM into primary care with attitudes of primary care physicians (PCPs) and CAM practitioners. Methods We conducted a comprehensive literature review and focus group discussions to develop a questionnaire, which we gave to three groups: a random sample of patients receiving care at an academic family medicine clinic and PCPs and CAM practitioners employed in the largest health maintenance organization in Israel. Results A total of 1150 patients, 333 PCPs, and 241 CAM practitioners responded to our questionnaire. Compared with PCPs, patients expected their family physician to refer them to CAM, to have updated knowledge about CAM, and to offer CAM treatment in the clinic based on appropriate training. When asked about CAM integration into medical care, more patients expected to receive CAM in a primary care setting compared to PCPs’ expectations of prescribing CAM (62% vs. 30%; p = 0.0001). Patients, CAM practitioners, and PCPs expected family practitioners to generate CAM referrals in an integrative primary care setting (85.6% vs. 82.4% vs. 62.6%; p < 0.0001). Patients supported CAM practitioners providing CAM treatments in the primary care setting, regardless of whether the practitioner held a medical degree (MD). Also, more patients than PCPs or CAM practitioners expected their family physician to provide CAM (28.2% vs. 14.5% vs. 3.8%; p < 0.0001). Conclusion Patients, PCPs, and CAM practitioners suggested that family physicians play a central role in CAM referral and, to a lesser extent, that they actually provide CAM treatment themselves. Practice implications PCPs need to be aware of their present and future role in informed referral to CAM and, to a lesser degree, in providing CAM in integrative primary care clinics. With the increasing use of CAM, patients may expect their family physician to be more knowledgeable, skillful, and have a balanced approach regarding CAM use. In addition, practitioners should learn how to communicate effectively and better collaborate with CAM practitioners to the benefit of their patients.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2007.11.019