Complementary Therapies; Have They Become Mainstream in General Practice?

Complementary Therapies; Have They Become Mainstream in General Practice?

Pirotta, M. Cohen M., Kotsirilos, K. Farrish, S. Complementary Therapies; Have They Become Mainstream in General Practice? Medical Journal of Australia, 172: 105 -109, 2000.

Abstract

 

OBJECTIVES:
To describe Victorian general practitioners’ attitudes towards and use of a range of complementary therapies.
DESIGN:
A self-administered postal survey sent to a random sample of 800 general practitioners (GPs) in Victoria in July 1997.
PARTICIPANTS:
488 GPs (response rate, 64%).
MAIN OUTCOME MEASURES:
GPs’ knowledge; opinions about harmfulness and effectiveness; appropriateness for GPs to practise; perceived patient demand; need for undergraduate education; referral rates to complementary practitioners; and training in and practice of each therapy.
RESULTS:
Acupuncture, hypnosis and meditation are well accepted by the surveyed GPs, as over 80% have referred patients patients to practitioners of these therapies and nearly half have considered using them. General practitioners have trained in various therapies–meditation (34%), acupuncture (23%), vitamin and mineral therapy (23%), hypnosis (20%), herbal medicine (12%), chiropractic (8%), naturopathy (6%), homoeopathy (5%), spiritual healing (5%), osteopathy (4%), aroma-therapy (4%), and reflexology (2%). A quarter to a third were interested in training in chiropractic, herbal medicine, naturopathy and vitamin and mineral therapy. General practitioners appear to underestimate their patients’ use of complementary therapies.
CONCLUSIONS:
There is evidence in Australia of widespread acceptance of acupuncture, meditation, hypnosis and chiropractic by GPs and lesser acceptance of the other therapies. These findings generate an urgent need for evidence of these therapies’ effectiveness.
Comment in
Complementary and alternative medicine: an educational, attitudinal and research challenge. [Med J Aust. 2000]

Characteristics of Victorian general practitioners who practise complementary therapies

Characteristics of Victorian general practitioners who practise complementary therapies

Pirotta, M. Farish, S. Kotsirilos, V. Cohen M. Characteristics of Victorian general practitioners who practise complementary therapies. Australian Family Physician 31 (12) 1133-1138, 2002

Abstract

 

BACKGROUND:
To compare the characteristics of Victorian general practitioners who practise and do not practise complementary therapies.
METHOD:
A self administered postal survey sent to 800 Victorian GPs.
RESULTS:
The response rate was 64%. There were no statistically significant differences between complementary therapy practitioners and nonpractitioners in the number of patients seen per week, urban versus rural location, solo versus group practice or Fellowship of the Royal Australian College of General Practitioners. In some complementary therapies, practising GPs tended to be male, full time and older.
DISCUSSION:
Victorian GPs who practise complementary therapies are on the whole not from the fringes of the medical community. The reasons why GPs include complementary therapies in their practice cannot be answered by this study.
Comment in
The practise of complementary therapies. [Aust Fam Physician. 2003]
Complementary therapies in general practice. [Aust Fam Physician. 2003]

CAM practitioners and “regular” doctors: is integration possible?

CAM practitioners and “regular” doctors: is integration possible?

Cohen, M. CAM practitioners and “regular” doctors: is integration possible? Medical Journal of Australia 2004; 180 (12): 645-646

Abstract

 

Integrated clinics have already been established in response to community demand. The growing evidence base for complementary and alternative medicine (CAM) and its widespread community use compels doctors to understand complementary therapies and to refer patients to CAM practitioners where appropriate. Most general practitioners have patients with chronic illness who could benefit from the services of CAM practitioners, and virtually all CAM practitioners have patients who require access to mainstream diagnosis and therapy. Collaboration requires shared respect and trust, and education. Dangers of not integrating care include delaying or depriving patients of safe and effective management, and the potential for harmful interactions. Integration is currently being supported by government initiatives such as the new MedicarePlus package, as well as by initiatives from organisations such as the Australian Medical Association, the Royal Australian College of General Practitioners and the Australasian Integrative Medicine Association.

The integration of complementary therapies in Australian general practice: results of a national survey.

The integration of complementary therapies in Australian general practice: results of a national survey.

Cohen, M. Penman, S., Pirotta, M., Da Costa, C. The Integration of Complementary Therapies in Australian General Practice: Results of a National Survey. Journal of Alternative and Complementary Medicine. 2005 11(6), 995-1004 

Abstract

 

METHODS:
Australian general practitioners’ (GPs) attitudes toward and use of a range of complementary therapies (CTs) were determined through a self-administered postal survey sent to a random sample of 2000 Australian GPs. The survey canvassed GPs’ opinions as to the harmfulness and effectiveness of CTs; current levels of training and interest in further training; personal use of, and use in practice of, CTs; referrals to CT; practitioners; appropriateness for GPs to practice and for government regulation; perceived patient demand and the need for undergraduate education.
RESULTS:
The response rate was 33.2%. Based on GPs’ responses, complementary therapies could be classified into: nonmedicinal and nonmanipulative therapies, such as acupuncture, massage, meditation, yoga, and hypnosis, that were seen to be highly effective and safe; medicinal and manipulative therapies, including chiropractic, Chinese herbal medicine, osteopathy, herbal medicine, vitamin and mineral therapy, naturopathy, and homeopathy, which more GPs considered potentially harmful than potentially effective; and esoteric therapies, such as spiritual healing, aromatherapy, and reflexology, which were seen to be relatively safe yet also relatively ineffective. The risks of CTs were seen to mainly arise from incorrect, inadequate, or delayed diagnoses and interactions between complementary medications and pharmaceuticals, rather than the specific risks of the therapies themselves.
CONCLUSIONS:
Nonmedicinal therapies along with chiropractic are widely accepted in Australia and can be considered mainstream. GPs are open to training in complementary therapies, and better communication between patients and GPs about use of CTs is required to minimize the risk of adverse events. There is also a need to prioritize and provide funding for further research into the potential adverse events from these therapies and other therapies currently lacking an evidence base.

The legitimacy of academic complementary medicine

The legitimacy of academic complementary medicine

Myers, SP., Xue, CC., Cohen, M.M., Phelps, KL., Lewith, GT. (2012) The legitimacy of academic complementary medicine Medical Journal of Australia 197(2): 69-70

Abstract

Science sets out to rigorously eliminate bias, not to assert it. The arguments mounted for the closure of complementary medicine courses in Australian universities by the Friends of Science in Medicine in a recent editorial in the Journal1 are highly emotive and, while having a gloss of superficial reasonableness, they do not stand up to critical review. In a letter sent to Australian vice-chancellors, the Friends of Science in Medicine do not provide an evidence-based curriculum review but selective and outdated anecdotes about chiropractic in a polemic with references to six websites (Peter Lee, Vice Chancellor, Southern Cross University, personal communication).

Complementary medicine is a broad field in which generalisations have little value. The major professional and university-based disciplines of traditional Chinese medicine, chiropractic, osteopathy and naturopathy need to be differentiated from fringe practices, and the actions of rogue or unqualified practitioners should be viewed separately from the competence of the wider profession.