Physician perceptions of health information from practitioners of complementary and alternative medicine: A survey of BC doctors

Patients are exposed to many sources of health information. While not all sources are of the same quality, patients will make important decisions based on information they feel to be credible. In the last 100 years, the medical profession has made a concerted effort to bring the best available scientific evidence to bear on health concerns. Yet this process is not necessarily mirrored by other groups offering health advice.

The use of complementary and alternative medicine (CAM) is reported to be common in BC as it is in Canada in general. With the assistance of the BCMA and the College of Physicians and Surgeons of BC, members of the BCMA Allied Health and Alternative Therapies Committee constructed a self-administered questionnaire enquiring about physicians’ impressions of the effect of patient reliance on alternative or complementary practitioners or practices. Surveys were sent to random samples of 1043 general practitioners and 1008 specialists.

Physicians were asked about their location, years in practice, where they trained, and other demographic questions. The response profile matched that of physicians in BC overall.

Doctors were asked about how often they enquired about their patients’ use of alternative medicine and were asked to pick from a list of 40 types of alternative medicine that they had used in their practice. The most frequently reported alternative modalities employed by respondents were lifestyle changes and diet modifications. Massage therapy, chiropractic, and acupuncture had each been used for at least some patients by roughly 20% of the doctors surveyed. Others from the list were used rarely or not at all.

Between one-quarter and one-third of doctors reported being aware of patients who had come to harm because they refused or delayed conventional treatment in favor of alternative remedies. Further, just over half of those surveyed were aware of their patients being directly harmed by alternative therapies. Thirty-seven percent reported that they knew of their patients using alternative medicine diagnostic techniques. Interestingly, although roughly 20% of physicians felt massage, chiropractic, and acupuncture had some clinical utility, fewer than 1% felt the attendant diagnostic techniques had any validity.

Respondents were asked whether they were aware of a patient incurring large or burdensome costs associated with the use of alternative medicine. Twenty-five percent answered yes. On the other hand, 88% of respondents reported being aware of cases where they felt the use of alternative medicine reduced the overall costs of treating a health problem. Fifty percent of respondents reported being aware of cases where they felt the concurrent use of conventional and unconventional therapies resulted in better treatment of the medical condition. Conversely, 50% also stated they knew of cases where the use of conventional plus unconventional therapies resulted in less than optimal treatment of a medical condition.

Doctors were asked to rate their overall impression of the quality of health information from alternative medicine practitioners. In response to the statement “Alternative therapists provide patients with accurate and reliable information about health,” 6% of respondents agreed and 84% did not.

Perhaps the most striking findings (already published in the Scientific Review of Alternative Medicine) were in the realm of information about vaccines. Doctors were asked whether they were aware of their patients receiving information on vaccines from alternative medicine practitioners. They were further asked their impression of how reliable that information was and what its effect had been. In particular, doctors were asked whether they felt vaccine information from alternative medicine providers had made patients more or less likely to immunize themselves or their children. Sixty percent of physicians were aware of their patients receiving information about vaccines from CAM practitioners. Of that 60%, 90% felt that the quality of information from CAM providers about vaccines was either poor or very poor, and 79% felt that the information had made their patients either less likely or much less likely to vaccinate their children.

Click here to read the full report of the survey’s findings.

—Lloyd Oppel, MD
—Richard Mathias, MD
—Morley Sutter, MD
Allied Health and Alternative Therapies Committee