Can doctors respond to patients' increasing interest in complementary and alternative medicine?

Editorial by Berman

Patients are increasingly using complementary and alternative medicine, 1 2 and doctors are responding to this in several ways, from being enthusiastic and interested to mystified and critical.3^–5 Complementary and alternative medicine incorporates several different approaches and methodologies,6 with techniques ranging from spiritual “healing” in cancer to nutritional interventions for premenstrual tension, acupuncture for pain relief, and manipulation for backache. In this article we encourage you to reflect on your understanding of complementary and alternative medicine in relation to your clinical practice, share some of the current initiatives in undergraduate and postgraduate familiarisation and training in this type of medicine, and explore the implications of education, support, and development.

The BMA's attitude to complementary and alternative medicine became much more positive between its first and second reports on the subject in 1986 and 1993.7 Around 39.5% of general practice partnerships in England provide access to some form of complementary therapy for their NHS patients,8 but this raises questions about how the provision of such treatment can be integrated into conventional practice. If the care is provided on a delegated or referred basis, how much does a doctor need to know to make appropriate referrals and supervise delegated treatment? If doctors are to treat patients with complementary and alternative medicine what training do they require?