Does Biomedical Training Predict Higher Coordination of Care by Licensed Acupuncturists?

Coordination of care is a critical contributor to the delivery of quality health services, especially among patients who selectively integrate complementary and alternative medicine (CAM) with biomedicine. Previous research documents that one of the primary reasons that physicians are reluctant to refer patients to CAM providers is their concern that these non-conventional practitioners have limited biomedical training. This common opinion, however, is not supported by research. To address this scientific gap, we investigated if CAM providers with advanced biomedical training achieved higher levels of care coordination, compared with colleagues who have less training in biomedicine. We focused on acupuncture because this profession is more highly regarded among physicians and considered more scientifically grounded. Exploratory factor analysis and multivariate regression analysis were conducted on a representative random sample of California acupuncturists (n = 400). Findings suggest that compared to those with limited training, acupuncturists with more advanced biomedical training did not achieve higher levels of care coordination as measured by the percent of patients who viewed them as primary care providers and the frequency of concurrent care management by physicians. Paradoxically, acupuncturists with more advanced biomedical training were less likely to have patients who concurrently seek care from their physicians and more likely to be viewed as primary care providers. This trend in CAM use as an alternative, rather than a complement, to the physician visit prompts us to reassess the potential consequences of current public policy initiatives to increase biomedical training for acupuncturists and other CAM providers.