Preferred Models of Integrative Care

Abstract

The opinions of healthcare providers play a crucial role in the debate around integrating complementary and alternative medicine (CAM) into the current healthcare system. The aim of this study is to explore the issue of CAM integration from the provider viewpoint by determining (a) what working relationship CAM practitioners and general practitioners (GPs) prefer or find acceptable, (b) whether there is agreement in the responses of CAM practitioners and GPs and (c) whether expressed opinions differ by CAM modalities. A cross-sectional random sample of CAM practitioners (acupuncturists, chiropractors, massage therapists, naturopaths, homeopaths and herbalists; n = 1112) and GPs (n = 413) from Alberta and British Columbia, Canada, were mailed a questionnaire at three timepoints in 2003. In total, 457 questionnaires were returned from CAM practitioners (41% response rate) and 85 from GPs (21% response rate). Participants were asked to rate four models of integration (independent model, collaborative model, supervised model, assimilation model) for six CAM therapies (acupuncture, chiropractic, massage therapy, naturopathy, homeopathy and herbology). The collaborative model was rated as the most acceptable by all CAM practitioners and GPs, across all therapies. The least acceptable model, for both CAM practitioners and GPs, was the assimilation model. CAM practitioners and GPs disagreed on the acceptability of the independent model and the supervised model, and these differences were statistically significant. A collaborative working relationship is preferred by both CAM practitioners and GPs. An integrative healthcare system would need to faciliate such working relations.