Friday, March 06, 2009

CAM Paper Part IX: Conclusion and References

Although some physicians may be skeptical about the benefits of CAM, they should still educate themselves about CAM for several reasons. First, a significant proportion of patients seen in a primary care setting would like to try CAM or are already using it. These patients may ask their physicians for advice about CAM therapies they have seen on the internet or heard about from friends. One survey study found that patients who use CAM expect their physicians to be knowledgeable about CAM and to make referrals for CAM treatments as appropriate.(4)

Second, patients are often misinformed about CAM modalities, and they are at significant risk of making misguided decisions based upon unreliable information.(2) Informed physicians are in a better position to empower their patients to make informed decisions about the pros and cons of CAM. Physicians can also play a significant role in guiding patients away from harmful CAM therapies, as well as steering them toward alternative CAM therapies that do not interact with conventional drugs that patients may also be taking.

Finally, a physician who is indifferent or openly negative about CAM may undermine the trust between patient and physician by making it difficult for the patient to initiate a discussion about CAM. There is evidence that younger physicians tend to regard CAM more positively compared to older physicians, which may facilitate discussion of CAM by younger physicians.(3) However, all physicians should be prepared to objectively discuss CAM with patients, even physicians who are skeptical about the benefits of CAM. Approaching patients who inquire about CAM with a nonjudgmental attitude provides the physician with an opportunity to improve the therapeutic relationship while educating the patient.

1. Barnes PM, Powell-Griner E, McFann K, Nahin RL: Complementary and alternative medicine use among adults: United States, 2002. Seminars in Integrative Medicine 2004; 2: 54-71

2. Ernst E: How the public is being misled about complementary/alternative medicine. J R Soc Med 2008; 101: 528-530

3. Sewitch MJ, Cepoiu M, Rigillo N, Sproule D: A Literature Review of Health Care Professional Attitudes Toward Complementary and Alternative Medicine. Complementary Health Practice Review 2008; 13: 139-154

4. Ben-Arye E, Frenkel M, Klein A, Scharf M: Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients, physicians and complementary practitioners. Patient Education and Counseling 2008; 70: 395-402

5. Riccard C, Skelton M: Comparative analysis of 1st, 2nd, and 4th year MD students' attitudes toward Complementary Alternative Medicine (CAM). BMC Research Notes 2008; 1: 84

6. Moyer CA, Rounds J, Hannum JW: A meta-analysis of massage therapy research. Psychol Bull 2004; 130: 3-18

7. Ernst E: Chiropractic: A Critical Evaluation. Journal of Pain and Symptom Management 2008; 35: 544-562

8. Keating JCC, K. H.; Grod, J. P.; Perle, S. M.; Sikorski, D.; Winterstein, J. F.: Subluxation: dogma or science? Chiropractic & Osteopathy 2005; 13: 17-26

9. Miller K: The evolution of professional identity: the case of osteopathic medicine. Social Science & Medicine 1998; 47: 1739-1748

10. Gevitz N: Center or Periphery? The Future of Osteopathic Principles and Practices. J Am Osteopath Assoc 2006; 106: 121-129

11. Ernst E: Acupuncture รข€“ a critical analysis, Journal of Internal Medicine, Blackwell Publishing Limited, 2006, pp 125-137

12. Martin DP, Sletten CD, Williams BA, Berger IH: Improvement in Fibromyalgia Symptoms With Acupuncture: Results of a Randomized Controlled Trial. Mayo Clinic Proceedings 2006; 81: 749-757

13. Shapiro K: Natural Products: A Case-Based Approach for Health Care Professionals. Washington, D.C., American Pharmacists Association, 2006

14. Clark K: Nutrition Strategies for Managing Joint Pain, The Professionals’ Guide to Diet, Nutrition and Healthy Eating IDEA Health & Fitness Association, 2004, pp 62-65

15. Wheatley D: Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. J Psychopharmacol 2005; 19: 414-421

16. Westfall RE: Use of anti-emetic herbs in pregnancy: women's choices, and the question of safety and efficacy. Complementary Therapies in Nursing and Midwifery 2004; 10: 30-36

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