J Altern Complement Med 2008 (Dec); 14 (10): 1255-1261 ~ FULL TEXT
Rainer Stange, M.D., Ph.D., Robert Amhof, M.A., and Susanne Moebus, Ph.D., M.P.H.
Objective: To generate valid data on attitudes about complementary and alternative medicine (CAM) as well as patterns of use in a large stochastic sample of general practitioner physicians and specialists.
Design: Cross-sectional survey in a large random sample of 516 German outpatient care physicians with qualifications in 13 medical fields representative of a basic population of 118,085 statutory health insurance physicians.
Materials and methods: Telephone interviews with 36 wide-ranging questions about CAM attitudes and preferred techniques were conducted in November and December 2005 as part of a national healthcare survey.
Results: In our sample, 51% were in favor of CAM use (26% were very much in favor, 25% were in favor).
Three single CAM techniques and three CAM treatment systems (integrating several techniques and/or covering a wide range of indications) were to be scored on their seriousness,
with 4 answers possible: rather credible, rather questionable, undecided, don’t know (Fig. 3).
Acupuncture was judged rather credible by 394 (76.4%), chiropractic by 373 (73.3%), homeopathy by 257 (49.8%), anthroposophical medicine by 101 (19.6%), electroacupuncture by 183 (35.5%),and autologous blood therapy by 144 (27.9%). The two latter techniques were chosen because of their widespread use in Germany in spite of explicit nonrecommendations given by the Federal Joint Committee, a national board of physicians and insurance providers.
The methods most frequently prescribed (combining answers for “very often” and “at times”) were physical therapy (71%), phytomedicine (67%), exercise (63%), nutrition and dieting (62%), massage (61%), relaxation techniques (55%), followed by more typical CAM interventions such as homeopathy (38%), acupuncture (37%), and traditional Chinese medicine (18%). Primary care physicians were significantly more inclined to use CAM than were specialists. No striking differences were observed with respect to gender or age.
Conclusions: This survey demonstrates a broader acceptance and practice of CAM by physicians than hitherto believed. Methods traditionally known as “natural medicine” were more frequently used than more typical CAM procedures. Further research should focus on physicians’ differing motivations and observed results.