An Approach to Teaching Dermatologists About Complementary Medicine

Referring to complementary and alternative medicine--a possible tool for implementation

BACKGROUND

Patients' extensive use of complementary and alternative medicine (CAM) can affect doctor-patient communication. Substantial numbers of patients expect their primary care physician to be able to refer them to CAM practitioners. However, a simple and practical referral CAM process is lacking.

RESEARCH DESIGN AND METHODS

We developed an 11-item questionnaire that addresses issues a physician should consider in determining whether to refer a patient for CAM treatment, including biopsychosocial and communication concerns and the safety and effectiveness of modalities. The tool was administered via questionnaires posted and e-mailed to primary care physicians and CAM practitioners.

RESULTS

Our CAM referral tool was found to be considerably useful in a primary care setting. High reliability and validity of the tool were found among the primary care physicians (Cronbach's alpha score of 0.867, spearman rho correlation 0.2-0.67) and moderate reliability among CAM practitioners (0.745).

CONCLUSIONS

We hope that our CAM referral tool will help advance the integration of CAM and conventional medicine.

Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients' experiences and perceptions

OBJECTIVES

The aim of this study was to explore the use of complementary and alternative medicine (CAM) therapies in patients with acne, psoriasis, or atopic eczema and the attitudes about CAM of these patients.

DESIGN

This was a qualitative study, utilizing semistructured interviews and thematic analysis.

SETTING

Patients were recruited from the practices of dermatologists and general practitioners in a noncapital Australian city.

RESULTS

Twenty-six (26) interviews were conducted with patients with acne, 29 with psoriasis, and 7 with atopic eczema. Use of CAM therapies was common. Participants tended to value CAM over orthodox therapies because of their preference for natural approaches to their skin diseases and the perceived lesser potential for adverse effects of CAM therapies. Respondents with acne were more confident about the efficacy of CAM than were those with psoriasis or eczema. The resulting sense of control attenuated psychologic sequelae of acne. This was not apparent in psoriasis or eczema.

CONCLUSIONS

Practitioners should be cognizant of the likely use of CAM and its implications (including the potential for attenuation of psychologic morbidity) in their patients who have skin diseases.

An approach to teaching primary care physicians how to integrate complementary medicine into their daily practices: a pilot study

This paper describes a pilot educational approach to integration of complementary and alternative medicine (CAM) into the daily routine of primary care practice. Twelve (12) family practice residents and specialists were assigned to develop an integrative treatment program geared to address the needs of their own patients. In the process, participants were asked to formulate treatment plans by searching resources to find appropriate CAM modalities and consult with CAM practitioners. The effectiveness of the educational process was assessed by questionnaires. The researchers found that providing a short course in advanced integrative medicine improves physician ability to better formulate an individualized treatment plan. This approach of teaching has long-standing results, as noted with a 2-year follow-up evaluation.