Bridging the Gap Between Alternative and Conventional Med

8/19/2019 Bridging the Gap Between Alternative and Conventional Med

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Confronting the c ommunication gap between conventional and

alternative medicine: a survey of physicians' attitudes.

CONTEXT: An e stimated 60 million Americans use some from of complementary and

alternative medicine, though approximately 7 0% do not tell their physicians a bout this u se.Open communication between conventional medical providers a nd patients i n this a rea istherefore lacking.

OBJECTIVE: To explore the dynamics that could potentially c ontribute to communicationbreakdown between physicians a nd patients o ver the use of alternative therapies.

DESIGN: Mail-in, self-administered questionnaire. PARTICIPANTS: 96 practitioners i n primarycare and medical subspecialties r epresenting the local county m edical society, Stark c ounty,Ohio.

MAIN OUTCOME MEASURES: Data were o btained on the following: (1) physicians' level offamiliarity w ith 23 different alternative therapies, (2) the question of whether physicians u sedthe therapies t hemselves, (3) physicians' assessment of the potential benets a nd harm ofeach therapy, and (4) physicians' response to the prospect of their patients u sing thesetherapies.

RESULTS: Respondents r eported the use of myriad alternative therapies. Only 2 8%, however,referred p atients f or alternative therapies. The physicians d emonstrated c lear preferences f orspecic therapies ( i.e., when asked about benets, familiarity, and reactions t o patient use,they resp onded differently d epending on the therapy). Indication that the doctor-patientrelationship m ight be t erminated a s a r esult of alternative t herapy u se was m ore c ommonamong su bspecialists t han among p rimary ca re p ractitioners.

CONCLUSIONS: Overall, physicians de monstrated an open attitude toward a lternativetherapies. This nding indicates that patients should disclose their use of alternative therapiesto their doctors. Increased referral to alternative healthcare providers m ay req uire bothongoing peer-reviewed studies of efficacy and increased physician access to informationconcerning therapies t hat have undergone denitive study.

There is no alternative medicine. There is only scientifically proven, evidence-based medicinesupported by solid data or unproven medicine, for which scientific evidence is lacking. Whether a therapeutic practice is "Eastern" or "Western," is unconventional or mainstream,or involves mind-body techniques or molecular genetics is largely irrelevant e cept forhistorical purposes and cultural interest. We recogni!e that there are vastly different types ofpractitioners and proponents of the various forms of alternative medicine and conventional

medicine, and that there are vast differences in the skills, capabilities, and beliefs ofindividuals within them and the nature of their actual practices. oreover, the economic and


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political forces in these fields are large and increasingly comple and have the capability for being highly contentious. #onetheless, as believers in science and evidence, we must focus onfundamental issues$namely, the patient, the target disease or condition, the proposed orpracticed treatment, and the need for convincing data on safety and therapeutic efficacy.

Context.— %esearch both in the &nited 'tates and abroad suggests that significantnumbers of people are involved with various forms of alternative medicine. (owever, thereasons for such use are, at present, poorly understood.

Objective.— To investigate possible predictors of alternative health care use.

Methods.— Three primary hypotheses were tested. )eople seek out these alternatives because *+ they are dissatisfied in some way with conventional treatment * they seealternative treatments as offering more personal autonomy and control over health caredecisions and */ the alternatives are seen as more compatible with the patients0 values, worldview, or beliefs regarding the nature and meaning of health and illness. 1dditionalpredictor variables e plored included demographics and health status.

Design.— 1 written survey e amining use of alternative health care, health status, values,and attitudes toward conventional medicine. ultiple logistic regression analyses were used

in an effort to identify predictors of alternative health care use.

Setting and Participants.— 1 total of +2/3 individuals randomly selected from apanel who had agreed to participate in mail surveys and who live throughout the &nited'tates.

Main Outcome Measure.— &se of alternative medicine within the previous year.

Results.— The response rate was 456.The following variables emerged as predictors ofalternative health care use7 more education *odds ratio 89%:, +. 536 confidence interval8;


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alternatives to be more congruent with their own values, beliefs, and philosophicalorientations toward health and life.

Subjects were two groups of patients, one whose members were visiting a GP and the other whosemembers were seeing a variety of Alternative Practitioners (AP), who were not significantly different interms of sex, age, level of education, marital status, occupational status, political views, newspaperreadership, ethnic grouping, religion, and income !he major difference between the two groups werethe fact that the AP group were more critical and s"eptical about the efficacy of modern medicine# theybelieved their health could be improved# they stayed loyal to their chosen practitioner# they had triedmore alternative therapies and have more self$ and ecologically aware lifestyles# and they believed thattreatment should concentrate on the whole person and greater "nowledge of the physiology of the body

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Bridging the Gap Between Alternative and Conventional Med