Transparency in Dutch CAM practices: a comparison between CAM and GP physicians.

Heiligers, P., Dulmen, S. van. Transparency in Dutch CAM practices: a comparison between CAM and GP physicians. Abstract. 11th European Conference ENOP 'On Organizational Psychology and Human Services Work', Lissabon, 22-24 oktober 2009. 29-30
Introduction: CAM (Complementary and Alternative Medicine) is increasing worldwide because the demand is growing. Transparency is needed to provide more objective information about CAM services, to date largely unknown by a majority of care users and mainstream care providers. Despite the fact that CAM physicians in the Netherlands are conventionally trained physicians there are mainstream colleagues criticizing them. Objectives: In this study we offer basic insight in CAM services by comparison with mainstream care. A higher transparency of CAM services will probably lead to better understanding and a more acknowledged position of CAM services. Questions:
What are the characteristics of CAM practices and what differences with GP practices can be traced?
What are the differences in patient profiles between CAM and GP practices? Method: Physicians within three CAM specialties were included. 16 homeopathic, 13 acupuncture and 11 naturopathic specialists. Within 6 month CAM physicians included patients: 502 in homeopathy, 808 in acupuncture and 529 in naturopathy. Data were collected with written questionnaires for physicians and patients and physicians? Registrations of consultations. Data were compared with data of the National Study on GP practices (154 GPs). Multilevel analyses were used to control for patient characteristics in comparisons of practices. Results: In CAM practices fatigue, psychic problems and problems with the nervous system are noted more compared to GP practices. Additionally, the comparison gives an idea about specific expertise of CAM specialists. Acupuncturists seem to be experts on problems with the motion system, homeopathic physicians on skin problems and in naturopathic practices problems with the gastrointestinal system are found significantly more.Further on, CAM physicians spend twice to four times more time in consultations compared to GPs. CAM patients are more often female and highly educated than GP patients. Patients expect CAM physicians to be more person-centered, take more time, listen more carefully and explain more than mainstream GPs. The main reasons to visit a CAM physician is that patients had positive information and they wanted additional advice. Conclusions: CAM practices seem to offer an additional and specialized type of care and their patients seem to expect the extra attention and advice.(aut. ref.)