Intended for healthcare professionals

Clinical Review ABC of complementary medicine

Complementary medicine and the doctor

BMJ 1999; 319 doi: (Published 11 December 1999) Cite this as: BMJ 1999;319:1558
  1. Catherine Zollman,
  2. Andrew Vickers

    Doctors deal with complementary medicine in a variety of professional situations. Patients may ask for advice about whether to pursue complementary therapies or which therapist to consult; they may request referral or delegation, either privately or on the NHS; or they may want to discuss treatment or advice given by complementary practitioners. Doctors prescribing drugs to patients taking complementary treatments may have concerns about possible interactions. Doctors should therefore consider strategies for minimising risk and facilitating sensible and appropriate discussions with patients and complementary practitioners.

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    Most patients do not tell their general practitioner if they are using complementary medicine. This may place some at unnecessary risk

    Medical attitudes

    Surveys of doctors' attitudes to complementary medicine show that, overall, physicians believe it is moderately effective, but low response rates make some studies unreliable. Although hospital doctors and older general practitioners tend to be more sceptical than younger doctors and medical students, most respondents believe that some of the more established forms are of benefit and should be available on the NHS. Younger doctors and medical students are more likely to perceive their knowledge of complementary medicine as inadequate and to want more tuition in the subject.

    Common concerns of doctors about complementary medicine

    • Patients may see unqualified complementary practitioners

    • Patients may risk missed or delayed diagnosis

    • Patients may stop or refuse effective conventional treatment

    • Patients may waste money on ineffective treatments

    • Patients may experience dangerous adverse effects from treatment

    • The mechanism of some complementary treatments is so implausible they cannot possibly work

    Qualitative research shows that many doctors want to be supportive of patients' choices and would welcome further information, although they generally regard complementary therapies as scientifically unproved. Doctors' concerns about such therapies include whether they are used as an adjunct or an alternative to conventional care, how effective conventional treatments are in the given condition, and the possibility …

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