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How Should Complementary Practitioners and Physicians Communicate? A Cross-Sectional Study from Israel

The Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Clalit Health Services, Haifa and Western Galilee District (EB-A, MF)
Clalit Mashlima –Complementary Clalit Health Services, Israel (MS)
Integrative Medicine Program, The University of Texas, M. D. Anderson Cancer Center, Houston (MF)

Correspondence: Corresponding author: Eran Ben-Arye, MD, The Complementary and Traditional Medicine Unit, Department of Family Medicine, Clalit Health Services, 6 Hashahaf Street, Haifa 35013, Israel (E-mail: eranben{at}netvision.net.il)

Objectives: The extensive use of complementary and alternative medicine for patients can complicate dialogue between physicians and complementary and alternative medicine practitioners, but not much data have been collected on the expectations and attitudes of physicians and complementary and alternative medicine practitioners concerning their communication and collaboration. In this study, we compared the results of a cross-sectional survey of both groups to elucidate the attitudes and expectations regarding communication and collaboration.

Methods: Questionnaires were mailed electronically or through the mail to 2532 primary care physicians and 450 complementary and alternative medicine practitioners employed by Clalit Health Services, the largest health maintenance organization in Israel.

Results: Questionnaires were returned by 333 physicians (response rate of 13%) and 241 practitioners (response rate of 54%). According to our results, the majority of both groups expressed an interest in clinical practice collaboration (69% and 77% of physicians and practitioners, respectively; P = .043); preferred using a medical letter to communicate with each other; and expected to consult with each other about mutual patients to formulate treatment plans. However, the practitioners were more interested than the physicians in collaborative scientific research (15% vs 42%, respectively; P < .0001) and collaborative medical education (2% vs 27%, respectively; P < .0001). The physicians also supported a physician-guided model of teamwork in clinical practice, whereas the practitioners supported a more collaborative model.

Conclusions: Educational programs for primary care physicians and complementary and alternative medicine practitioners should focus on aspects of communication between the groups and practical methods for writing referral or medical letters.