Schweiz Med Wochenschr. 1999 Oct; 129(42): 1535-44.

[Complementary and conventional medicine: prejudices against and demands placed on natural care and conventional doctors]

Messerli-Rohrbach V, Schr A.

QUESTION: In Switzerland some 40% of the population use complementary healing methods, whereby 28% also make use of the services of alternative therapists. Are different demands made upon these alternative therapists in terms of their time, the respective perception of authority, understanding and trust, from those made upon conventional medical practitioners? METHOD: Within the framework of the Swiss National Research Programme 34: Complementary Medicine, qualitative interviews were initially conducted with 38 patients of natural-care doctors or traditionally-oriented family doctors. In a second stage, 3077 Swiss residents were interviewed by telephone in a longitudinal survey in 1995 and 2276 in 1996. RESULTS: The demand for doctors with partnership qualities decreases in favour of doctors more inclined to be directive, particularly in complementary medicine users in poor health. It took courage for about half of all those questioned to express an opinion at variance with that of their doctors. Both natural-care doctors and academically-trained family doctors clearly allocate sufficient time for consultation. Higher expectations were placed upon general practitioners in terms of accessibility, while natural-care doctors tended to be providers of advice in difficult situations. The level of compliance in terms of medication regime adherence is higher in the case of natural-care doctors. While users and non-users of complementary medicine alike expressed the expected attitudes and prejudices towards the other medical system, once again certain attitudes expressed by complementary medicine users depended upon their particular state of health. Natural-care doctors enjoy a relatively high legitimacy. DISCUSSION: The demands placed in terms of communication skills are high for both conventional and alternative medical practitioners, and call for a situation-sensitive approach to changing patient needs. General practitioners must accept that their traditional performance is as appreciated as ever but that in certain situations there are more significant explanation patterns concerning health and illness for patients than conventional medicine can offer. The (poor) level of compliance in the case of conventional medication should also be viewed in terms of the cost factor. In general, questions raised during consultations concerning medication should be seen as significant, as both users and non-users of complementary medicine pay close critical attention to them.