Complementary medicine and general practice: an urban perspective

Author(s): Dowrick, C.

Abstract: Background: Complementary medicine appears to be an increasingly popular option amongst both doctors and patients. General practitioners in more affluent parts of Britain have showed considerable interest in its use. Objectives: To ascertain use of and attitudes towards complementary medicine, amongst general practitioners working in a socioeconomically deprived urban area. Methods: A postal questionnaire survey of all general practice principles in Liverpool, using freepost envelopes and one reminder after 3 weeks. With respect to eight common complementary therapies, respondents were asked whether they treat with, refer to or endorse each therapy; for their views an NHS funding, effectiveness, adverse reactions, training needs, and theoretical validity, for each therapy. Results: The response rate was 131/252 (52%), higher amongst women and doctors aged under 40. During the previous week 74 (56%) of respondents had been involved in complementary medical activity with their patients: I 3% had treated directly, 31 % had referred to and 38% had endorsed one or more complementary therapies. Acupuncture was most popular as an NHS option, and along with osteopathy and chiropractic was the therapy most highly regarded by respondents in terms of effectiveness. Homeopathy and hypnotherapy received a mixed reaction, while medical herbalism, aromatherapy and reflexology were viewed more sceptically. Sixty-two per cent of respondents reported successful outcomes of complementary treatments, compared with 21 % reporting adverse reactions. Knowledge and training desires were highest for homeopathy and acupuncture. Respondents were generally uncertain about the theoretical validity of these therapies: 50% though acupuncture had a valid basis, compared with only 23% for homeopathy and 8% for reflexology. Conclusions: The degree of support for complementary medicine therapies amongst general practitioners in this socioeconomically deprived urban area was similar to that found elsewhere in Britain. These general practitioners appeared to tolerate high levels of clinical uncertainty, endorsing a wide range of therapies, despite little knowledge of their content or conviction of their validity.

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