Patients Want Healing Options in Primary Care

Patients and clinicians would like to see more healing options, including complementary and alternative medicine (CAM), incorporated into primary care, according to a new study in Annals of Family Medicine. These findings suggest that integrating open discussion and referrals to additional healing options into primary care may be both feasible and desirable, especially for patients whose conditions are not responding to standard medical treatments (eg, chronic pain, irritable bowel disorder, chronic fatigue).

The findings are based on comments made by participants in 7 focus groups conducted by a large, integrated healthcare system in Washington State in October and November 2008. The patients all had had at least 1 primary care visit within the 12 months before participating in the focus group. The Institute of Medicine has identified the integration of CAM into conventional medicine as an area worthy of more research, and physicians and patients alike have expressed interest in learning more about it. Yet large healthcare organizations have been slow to include CAM into their primary care practices. Many patients use CAM but do not tell their physicians because they fear a negative reaction.

All 7 groups mentioned exercise, massage, nutrition, recreational activities and lifestyle change, spirituality and religion, and therapeutic activities. Other options endorsed by patients and clinicians alike, though not in all 7 groups, included acupuncture, meditation, support groups, and yoga.

Patients reported that their physicians' negative reactions or lack of openness to the idea were important barriers to their trying other healing options. Clinicians cited a lack of knowledge about the options and about practitioners to whom they could confidently refer patients as the major obstacles to incorporating these recommendations into their practices.