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A Comparative Conceptual Framework of Mainstream Health Providers' Views and Behaviours Regarding Complementary/Alternative Medicine
Unformatted Document Text:  4 (1995) in their review of 12 studies, for example, rate physicians’ perception of the effectiveness of CAM as 46 ± 18 on a scale of 0 to 100. Most studies, at minimum, express a need for more information and more reliable research on CAM’s efficacy. Kaczorowski et al (2002) report that 46.5% of their Canadian respondents identified the knowledge level of physicians as a concern. An even higher number, 84%, indicated a need to learn more about CAM in Winslow and Shapiro’s (2002) study of U.S. physicians. In a study comparing UK with German physicians, Schmidt et al (2002) report that the majority of both groups were concerned about lack of scientific evidence. Ernst et al (1995) contrast physicians’ more positive assessments of the effectiveness of CAM therapies with the available evidence at the time, concluding that data on efficacy is largely insufficient. Many physicians adopt an attitude of acceptance of patients’ choices and, as Astin et al (1998) report in their review of 25 surveys, roughly half of physicians believe in the value of at least one modality of CAM, most notably acupuncture, chiropractic and massage. Similarly, Ernst et al (1995) indicate that manipulative therapies, followed by acupuncture, are considered the most effective or useful by physicians, albeit categorizations of CAM modalities differ across national boundaries, making direct comparisons of studies problematic, as Astin et al (1998) note. Astin et al (1998) report that 43% of physicians refer for acupuncture, 40% for chiropractic and 21% for massage although fewer are actually practicing any form of CAM, with rates ranging from 9% for homeopathy to 19% for chiropractic and massage. Berman et al (1998) list, in contrast, psychotherapy and lifestyle therapies as the most accepted by their population of U.S. physicians, with use rates reported as 92.3% and 71.2%, respectively. Use of other therapies ranged between 9% for herbal medicine and 47.3% for behavioural medicine. Perry and Dowrick (2000) note that 18% of their respondents reported using CAM regularly with patients. Notably, Himmel et al’s (1993) survey of physicians in Germany suggests significantly more positive views than studies featuring other nations, with 95% CAM usage reported, albeit Schmidt et al’s (2002) subsequent comparison of German and UK physicians indicates that differences in

Authors: Hirschkorn, Kristine. and Bourgeault, Ivy.
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(1995) in their review of 12 studies, for example, rate physicians’ perception of the effectiveness
of CAM as 46 ± 18 on a scale of 0 to 100. Most studies, at minimum, express a need for more
information and more reliable research on CAM’s efficacy. Kaczorowski et al (2002) report that
46.5% of their Canadian respondents identified the knowledge level of physicians as a concern.
An even higher number, 84%, indicated a need to learn more about CAM in Winslow and
Shapiro’s (2002) study of U.S. physicians. In a study comparing UK with German physicians,
Schmidt et al (2002) report that the majority of both groups were concerned about lack of
scientific evidence. Ernst et al (1995) contrast physicians’ more positive assessments of the
effectiveness of CAM therapies with the available evidence at the time, concluding that data on
efficacy is largely insufficient.
Many physicians adopt an attitude of acceptance of patients’ choices and, as Astin et al
(1998) report in their review of 25 surveys, roughly half of physicians believe in the value of at
least one modality of CAM, most notably acupuncture, chiropractic and massage. Similarly,
Ernst et al (1995) indicate that manipulative therapies, followed by acupuncture, are considered
the most effective or useful by physicians, albeit categorizations of CAM modalities differ across
national boundaries, making direct comparisons of studies problematic, as Astin et al (1998) note.
Astin et al (1998) report that 43% of physicians refer for acupuncture, 40% for chiropractic and
21% for massage although fewer are actually practicing any form of CAM, with rates ranging
from 9% for homeopathy to 19% for chiropractic and massage. Berman et al (1998) list, in
contrast, psychotherapy and lifestyle therapies as the most accepted by their population of U.S.
physicians, with use rates reported as 92.3% and 71.2%, respectively. Use of other therapies
ranged between 9% for herbal medicine and 47.3% for behavioural medicine. Perry and Dowrick
(2000) note that 18% of their respondents reported using CAM regularly with patients. Notably,
Himmel et al’s (1993) survey of physicians in Germany suggests significantly more positive
views than studies featuring other nations, with 95% CAM usage reported, albeit Schmidt et al’s
(2002) subsequent comparison of German and UK physicians indicates that differences in


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