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]

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.

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.