Integrating CAM Therapies in Healthcare: A Non-biased Survey

Patients all over the world go to various medical practitioners to get their conditions treated. Some of those patients choose General Medical Practitioners (GPs), while others choose Complementary and Alternative Medicine (CAM) therapy.

Both medical approaches can eventually lead to favorable results. However, CAM therapy isn’t considered a standard medical care approach and often isn’t included in the national funding system.

In this post, we’ll discuss a 2003 survey involving CAM practitioners and GPs in two Canadian cities, British Columbia, and Alberta.

What Are CAM Therapies?

CAM is an approach to medicine that aims to treat patients using alternative methods than your usual GP.

Such an approach includes herbal medicine, chiropractic medicine, naturopathic medicine, homeopathic medicine, acupuncture, and massage therapy.

Why Aren’t CAM Therapies Officially Included in the Current Healthcare System?

All of the mentioned practices, while still managing to achieve good results with various patients, don’t follow the standard medical approach.

They don’t have biological plausibility or repeatability as well, which translates into mixed and inconsistent results. Also, the results aren’t evidence-based.

Because of that, they’re not globally recognized as standard medicine or fully integrated into the national funding system.

What Is the Purpose of This Survey?

This survey targets the debate of why such practices aren’t integrated into standard medicine by viewing the opinions of both GPs and CAM therapists.

The purpose is to understand the medical providers’ point of view to determine three points:

• What kind of work relationship do GPs and CAM practitioners find acceptable
• Are there agreements in the responses of both involved parties
• Are the expressed opinions differ by CAM modalities

What Are the Parameters of This Survey?

The survey was conducted in Alberta and British Columbia, Canada. It targeted a total of 1,525 practitioners; 1,112 of which were CAM therapists and 413 were GPs.

However, there was only a 41% response rate from CAM practitioners, as only 457 questionnaires were returned. The GPs scored an even lower response rate, as 85 GPs (21%) responded to the questionnaire.

Both parties were asked to rate six types of CAM therapies which are:

• Herbal medicine
• Chiropractic medicine
• Homeopathic medicine
• Acupuncture
• Massage therapy
• Naturopathic medicine

The rating was to be done through four models:

The Collaborative Model

The collaborative model involves full cooperation between the GP and the CAM therapist. That doesn’t necessarily mean that both parties will work in the same location, as they can freely work in separate clinics.

However, what makes this a collaborative approach is how both practitioners will work together in full communication to manage the patient’s condition.

The Independent Model

In this model, both GPs and CAM practitioners would work independently from each other to treat the patients.

There shall be no collaboration or supervision between both practitioners of any kind. However, GPs may choose to refer their patients to CAM therapists.

The Supervised Model

The supervised model still involves both practitioners working together. However, CAM practitioners are only allowed to provide therapy under supervision from GPs.

In this model, regardless of the outcome of the treatment, the final result is the GP’s responsibility.

The Assimilation Model

The assimilation model theoretically cancels the contribution of CAM practitioners, as it allows only GPs to assume CAM therapies.

In other words, CAM practitioners will no longer perform their medical services.

Survey Procedures

The questionnaire packages were mailed to the medical practitioners in 2003 between September and November. All letters had their introduction and confidentiality consents. The numbers were as follows:

‍

‍

Survey Results

Here are the final results per model:

The Collaborative Model

The survey found that both GPs and CAM practitioners gave the collaborative model, where both practitioners work in conjunction, the highest ratings. Across all CAM modalities, 76-90% supported the collaborative approach.

GPs, while still favoring the collaborative method, had a bit more variety regarding the CAM modalities they were willing to collaborate with.

GPs were willing to work the most with acupuncturists (79%) followed by massage therapists (78%). Chiropractors followed closely at 67%.

However, GPs were considerably less willing to work with the following CAM modalities:

• Herbalists (48%)
• Naturopaths (36.5%)
• Homeopaths (32%)

The Independent Model

This model was the second most acceptable one following the collaborative model across all modalities by CAM practitioners (57-81%) and GPs (23-71%).

Once again, GPs gave the lowest acceptance rate to herbalists (29%), naturopaths (29%), and homeopaths (24%).

Homeopaths and herbalists were also given relatively low acceptance rates by CAM practitioners to work independently, scoring 59% and 57% respectively.

The Supervised Model

Results were a bit mixed regarding the supervised model. It’s natural to expect that CAM practitioners wouldn’t want to be supervised by GPs and the results prove that expectation.

Only 3-10% of CAM practitioners found the supervised model acceptable, compared to 21-46% of GPs.

Massage therapy had the highest acceptance score among all modalities, receiving a 10% acceptance rate from CAM practitioners and 46% from GPs.

The Assimilation Model

For a model that takes one of the practitioners out of the picture, it’s expected to have the assimilation model receiving the lowest acceptance rates.

Depending on the modalities, only 1-3% of CAM practitioners found this model acceptable, compared to a 7-19% acceptance rate from GPs.

Have a look at this chart for an overview of the results:

Final Conclusion

The survey concluded that the collaborative approach is the most favored one by both CAM therapists and GPs across all treatment modalities.

The Independent approach follows closely across all modalities, giving slightly less but fairly consistent acceptance rate by both practitioner types.

The supervised and assimilated approaches were the least acceptable by both GPs and CAM therapists, scoring as low as 1%.

For more information and an in-depth look into the survey, check out the study here.

‍